Jumat, 30 Oktober 2009
European Society of anti-aging Medicine
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The wine glass looks half full
Not unexpectedly, the news media embraced and eagerly reported the latest revelation about the health benefits of red wine. The study, published in the online journal PLoS One this week, hinted that resveratrol, an antioxidant compound found in the skins and seeds of wine grapes, can boost cardiovascular health and slow aging in mice at lower doses than previously thought. Earlier studies have suggested that resveratrol helped mice run farther, stay slender, and stave off diabetes and cancer.
Any story about red wine or dark chocolate, especially one that gives people an excuse to indulge, is going to be well-received. As I write this, the New York Times article on the recent red wine study has been hovering near the top of the newspaper’s list of most popular online stories.
But as we swash down red wine and gobble bon bons, we may be inclined to forget that, along with all those antioxidants comes a good dose of alcohol and saturated fat. Excessive alcohol consumption (more than two daily drinks for men or more than one daily for women) can lead to liver disease, according to the Centers for Disease Control and Prevention (CDC). And recent studies suggest that one or two drinks a day may increase the risk of breast cancer.
And don’t forget the caveats associated with some of these studies. In most of the resveratrol studies (a notable exception being the recent PLoS study) mice were given massive quantities of compound. A human would have to guzzle at least several bottles of red wine a day to obtain a similar amount. And to reap the benefits of cocoa, you have to eat dark chocolate (preferably containing 70 percent cocoa), which tends to be bitter. With creamier chocolate the milk binds to the antioxidant compounds, making them unavailable to the body.
Finally, it is worth noting that the recent red wine study was partially financed by the Swiss DSM Nutritional Products, “the world's leading supplier of vitamins, carotenoids and other fine chemicals to the feed, food, pharmaceutical and personal care industries,” according to the company’s website. Similarly, several studies on cocoa flavanols have been funded by Mars Inc., the maker of chocolate products. So while it's tempting to toast to the promising results from these studies, the bottom line is more bittersweet.
By Coco Ballantyne
Photo by miss karen
Providing information or promoting drugs?
On 12 September, US Food and Drug Administration (FDA) officials released finalized recommendations for drug makers that wish to provide medical literature to doctors about unapproved uses of their products. It's no small matter, since over 20% of US prescriptions are written for ‘off-label uses’.
Earlier guidelines required companies to commit to submitting an application to the FDA for the unapproved use before sharing peer-reviewed journal articles or reference publications about it. However, the new recommendations permit sales representatives to share data about uses that companies don't plan to submit for FDA review.
Additionally, the finalized version of the new guidelines does not require that drug companies provide peer-reviewed materials that reach different conclusions about the unapproved use.
The revised policy recommends that that peer-reviewed materials given to doctors are not “marked, highlighted, summarized, or characterized by the [company] in any way”. Such actions could be considered ‘off-label promotion’ of drugs, which is what US pharmaceutical giant Eli Lilly did when it used catchy slogans to persuade doctors to prescribe the antipsychotic Zyprexa for unauthorized use in elderly patients (Lilly pleaded guilty to violating US law on 15 January). This practice is still illegal. However, I doubt the relaxed guidelines will help companies provide an unbiased view of their drug’s safety and clinical effectiveness—something that certain companies apparently need help with.
Photo by zimpenfish
Pediatric placebos
When I was a small child, I had an earache, so I asked my dad for a Band Aid. The source of my discomfort was an inner ear infection, so antibiotics would have been more on the mark—but a Band Aid seemed better than nothing. The placebo effect is powerful.
As reported in the New York Times this week, there is now a placebo pill designed for children that you can buy. The product is called Obecalp (placebo spelled backwards) and available online for $5.95 a bottle. Each cherry-flavored chewable Obecalp tablet is essentially a lump of sugar in a medicinal disguise. “Invented by a mommy,” says the website advertisement, featuring a headshot of the product’s inventor, a mother of three from Severna Park, Maryland. The implication is that, if a mom came up with the idea, then it must be okay to give fake meds to your children.
But how will mom (or dad) explain the situation when their children discover that the magical tablets they received for headaches, stomachaches and sore throats were always a hoax? The use of placebos sends an uncertain message to children. They will eventually know that their parents deceived them. Moreover, there is something unnerving about looking to pills for the answer to every ailment. There are other ways to comfort children. In some cases they simply need a dose of attention to feel better. Perceived physical ailments may also be a sign of emotional or mental distress that a sugar tablet cannot fix.
Doctors admit to prescribing placebos, according to a study published earlier this year in the Journal of General Internal Medicine. Researchers at the University of Chicago surveyed 466 physicians from three Chicago-area medical schools and found that nearly half of all respondents had used placebos in their clinical practice. One of their most common reasons for doing so: “to calm patients.” Something is wrong with a medical system in which patients need pills and injections to feel tranquil and reassured that they have received adequate care. It’s hard to imagine that adding more pills to the market, even if they are fakes, will help change this culture.
Posted on behalf of Coco Ballantyne
Image by Fillmore Photography via Flickr
Kamis, 29 Oktober 2009
The Hypo Real Estate
Rabu, 28 Oktober 2009
OREA Guidelines for Access to Public Records
Selasa, 27 Oktober 2009
Heart Attack Risk Reduction: The Low-Hanging Fruit
Let's cut to the data. The investigators examined the fat composition of red blood cells in people who had suffered a heart attack, versus an equal number who had not. Participants who had heart attacks had less omega-3, more long-chain omega-6, and particularly higher trans fat in their red blood cells. In fact, 96% of the heart attack patients had elevated trans fat levels, compared to 34% of those without heart attacks. This is consistent with a number of other studies showing a strong association between blood levels of trans fat and heart attack risk (ref).
92% of heart attack patients were in the lowest category of EPA in their red blood cells, as opposed to 32% of those without heart attacks. EPA is an omega-3 fat that comes from fish, and is also made by the body if there's enough omega-3 alpha-linolenic acid (think flax and greens) around and not too much linoleic acid (industrial vegetable oil) to inhibit its production. 96% of heart attack patients were in the lowest category for alpha-linolenic acid, compared to 34% of the comparison group. 0% of the heart attack patients were in the highest category for alpha-linolenic acid.
62% of heart attack patients were in the highest category of arachidonic acid (AA), compared to 34% of the comparison group. AA is made from linoleic acid, and is also found in animal foods such as eggs and liver. Animal foods from pasture-raised animals are lower in AA than their conventionally-raised counterparts, and also contain more omega-3 fats to balance it.
The investigators found that low omega-3, high AA and high trans fats in red blood cells associate with heart attack risk far better than the Framingham risk score, a traditional and widely-used measure that incorporates age, sex, smoking status, total cholesterol, HDL, hypertension and diabetes.
If the associations in this study represent cause-and-effect, which I believe they do based on their consistency with other observational studies and controlled trials, they imply that we can have a very powerful effect on heart attack risk by taking a few simple steps:
- Avoid trans fat. It's found in margarine, shortening, refined soy and canola oils, many deep fried foods and processed foods in general.
- Avoid industrial vegetable oils and other sources of excess omega-6. Eating pastured or omega-3 eggs, rather than conventional eggs, can help reduce dietary AA as well.
- Ensure a regular intake of omega-3 fats from seafood, or small doses of high-vitamin cod liver oil or fish oil. Flax oil is also helpful, but it's an inferior substitute for fish oil.
In the future, I hope that most doctors will measure blood fatty acids to predict heart attack risk, with more success than current approaches. Instead of measuring cholesterol and prescribing a statin drug, doctors will prescribe fish oil and easy-to-follow diet advice**. Fortunately, some doctors are beginning to measure red blood cell fatty acid levels in their patients. The forward-thinking cardiologist Dr. William Davis has discussed this on his blog here. Take a good look at the graphs he posted if you get the chance.
*The title of the study is misleading because it implies a prospective design, in which blood fatty acids would be measured and volunteers followed to see who develops heart disease at a later time point. This study was cross-sectional (also called case-control), meaning they found people who had just had a heart attack and measured their blood fatty acids retrospectively. The other study I referenced above was prospective, which is a nice confirmation of the principle.
**"Eat butter on your toast. Ditch the margarine."
Board of Registration of Real Estate Brokers & Salespersons
Senin, 26 Oktober 2009
The Real Estate and Business Agents
Minggu, 25 Oktober 2009
Gene mutation may reveal clues for treating lung diseases
Oct. 15, 2009 -- A genetic mutation found in four children born with multiple abnormalities may provide insight into potential treatments for newborn lung distress and chronic obstructive pulmonary disease (COPD).
The children were born with abnormally developed lungs, gastrointestinal and urinary systems, skin, skull, bones and muscles. In addition, all had cutis laxa, an inherited connective tissue disorder that causes skin to hang loosely from the body. Three of the patients died from respiratory failure before age 2.
Details about the discovery of the mutation, found by researchers from Washington University School of Medicine in St. Louis, McGill University, New York University Langone Medical Center and collaborating institutions, are published in the Oct. 15 online edition of the American Journal of Human Genetics.
Elaine C. Davis, Ph.D., senior author and associate professor of anatomy and cell biology at McGill University in Montreal, Canada, compared various tissues from a mouse genetically engineered to be missing a form of the LTBP4 gene with skin tissue samples from one of the children. She found remarkable similarities. The mouse, provided by Daniel Rifkin, M.D., the Charles Aden Poindexter Professor of Medicine and professor of cell biology at NYU Langone Medical Center, showed similar connective tissue alterations by electron microscopy as the patient. The child had cutis laxa, lethal pulmonary complications and gastrointestinal and urinary disease.
Based on these observations, researchers in the laboratory of Zsolt Urban, Ph.D., a pediatric geneticist at Washington University School of Medicine, sequenced the LTBP4 gene in the four children and confirmed they had mutations. He determined that the patients were the first described to show severe symptoms of a novel syndrome, which the researchers have named Urban-Rifkin-Davis Syndrome.
The findings have potential implications for newborns with underdeveloped lungs as well as older patients with severe lung diseases, including COPD, says Urban, first author of the paper.
"Many newborns commonly have breathing difficulties," Urban says. "Part of the problem is that the lung is not developed properly, especially the alveoli, the tiny sacs at the end of the smallest airways that serve as a place for oxygen uptake and gas exchange. This finding helped us identify a gene essential for the development of alveoli and potentially provide a target for intervention in premature babies."
Urban says potential treatments could include introducing the protein product of the LTBP4 gene to the newborn or using existing drugs that can moderate transforming growth factor beta (TGFß), which is overactivated in the tissues of these children. The drug losartan, now in trials for treating Marfan syndrome, another connective tissue disorder, has been shown to limit TGFß and merits further research as a possible treatment.
The researchers now are broadening their research into the new syndrome among other patients with cutis laxa. Urban, assistant professor of pediatrics, of medicine and of genetics at Washington University School of Medicine, heads the International Center for the Study of Cutis Laxa at St. Louis Children's Hospital.
"We are finding that about 70 percent of cutis laxa patients with pulmonary, gastrointestinal and urinary problems have Urban-Rifkin-Davis Syndrome," Urban says. "Now we will look at what percentage of cutis laxa patients with only pulmonary problems have the mutation."
Early developmental problems that are not detectable in childhood may predispose a person to age-related disease such as COPD, Urban says. Urban and colleagues are also testing samples collected from patients with COPD for LTBP4 mutations. When lungs are damaged with COPD, alveoli lose their elastic quality, and the walls between them are destroyed as they become thick and inflamed.
"Patients who may have a slightly reduced activity of LTBP4 might be more susceptible to chronic lung diseases later in life," Urban says. "Identifying genes that are central for the formation of alveoli may help us devise ways to regenerate alveoli in patients with COPD."
Urban Z, Hucthagowder V, Schürmann N, Todorovic V, Zilberberg L, Chio J, Sens C, Brown C, Clark R, Holland K, Marble M, Sakai L, Dabovic B, Rifkin D, Davis EC. Mutations in LTBP4 cause a syndrome of impaired pulmonary, gastrointestinal, genitourinary, musculoskeletal and dermal development. American Journal of Human Genetics. Advance online publication Oct. 15, 2009.
This study was funded in part by the National Institutes of Health, March of Dimes, Phillip Morris USA Inc. and the Canadian Institutes of Health Research.
Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation byU.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
Scientists identify roots of diabetic tissue damage
Oct. 21, 2009 -- Results from comprehensive assessments of diabetes' effects on cell metabolism may aid efforts to reduce diabetic damage to nerves, blood vessels and other tissues, according to researchers at Washington University School of Medicine in St. Louis and elsewhere.
The scientists found that by blocking the sorbitol pathway, one of several pathways cells employ to use the sugar glucose, they could prevent diabetic damage to nerves and blood vessels in a rat model. Prior clinical trials of blockers for this pathway have been disappointing, according to the researchers, but they and others now think that may be because the sorbitol pathway was inadequately blocked.
"What we've found should help fine-tune efforts to slow or prevent diabetes-associated complications such as hardening of the arteries, damage to vision and loss of nerve function," says senior author Joe Williamson, M.D., retired professor of pathology and immunology. "Evidence suggests that such complications are caused by increased levels of superoxide, and our results point to the sorbitol pathway as the main source of this chemically reactive compound."
The paper appeared online in the journal Antioxidants and Redox Signaling and will appear in print in the future.
Normally, cells use glucose mostly to make energy through a process called glycolysis. However, as glucose levels rise, cells begin to use glucose in a process called the sorbitol pathway. The high glucose levels associated with diabetes increase cells' use of glucose via glycolysis and the sorbitol pathway.
Both processes alter a molecule known as NAD (nicotinamide adenine dinucleotide), changing it to NADH, or NAD plus a hydrogen atom. To keep glycolysis possible, cells have to convert NADH back to NAD. If NADH levels increase relative to NAD, a metabolic imbalance occurs that can limit energy production essential for normal cell function and survival.
Pyruvate, an antioxidant produced by glycolysis, normally helps facilitate conversion of NADH into NAD. However, the sorbitol pathway does not produce pyruvate. Williamson and his colleagues theorized that when diabetes increases sorbitol pathway use, it places an increased burden on the cell by creating more NADH but leaving it with relatively less pyruvate to help change it back into NAD. They noted that a cell faced with too much NADH and too little pyruvate can turn to other enzymes to achieve the conversion, and that these enzymes produce superoxide as a product, making them an important source of diabetic tissue damage.
For the new paper, they tested the first component of this theory in a rat model of diabetes. Among other results, they found inhibiting either of two specific steps in the sorbitol pathway improved vascular function in the rats and reversed impaired motor nerve conduction velocity, or the speed at which nerves transmit electrical signals to stimulate muscles.
"It's already been established in other studies that pyruvate supplementation normalizes vascular dysfunction caused by high glucose levels and slows cataract formation in diabetic animals," Williamson says. "These results support our theories of why this happens, and others may be able to build upon this to create new and improved treatments for diabetes."
Sorbitol pathway inhibitors similar to those used by the researchers have been tested previously with disappointing results in clinical trials, but Williamson says recent studies in animals suggest those inhibitors may not have blocked the sorbitol pathway sufficiently.
"We've assembled what appears to be the most coherent explanation to date on how high glucose levels affect several different aspects of cell metabolism, and all the indicators point to the sorbitol pathway as the primary source of increased superoxide," he says. "More effective inhibitors of the sorbitol pathway are still being explored and may be able to prevent diabetic complications in the future."
For now, though, Williamson emphasizes that the best way for diabetics to prevent complications is to keep glucose levels as close to normal as possible.
Williamson also suggests that pyruvate, as a treatment for patients with poorly controlled diabetes, merits further study, but cautions that the body metabolizes pyruvate very quickly. He suggests that pyruvate may be most immediately useful in preventing diabetic damage to the eye, where it can be applied directly as eye drops and quickly reach its targets, the retina and lens.
Yasuo I, Nyengaard J, Chang K, Tilton R, Kilo C, Mylari B, Oates P, Williamson J. Early neural and vascular dysfunction in diabetic rats are largely sequelae of increased sorbitol oxidation. Antioxidants and Redox Signaling, published online ahead of print.
Funding from the National Institutes of Health, Fonden til Laegevidenskabens Fremme (Copenhagen), the Lundbeck Foundation (Copenhagen) and the Kilo Research Foundation (St. Louis, MO) supported this research.
Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked third in the nation byU.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
Jumat, 23 Oktober 2009
Appraisers and Assessors of Real Estate
Kamis, 22 Oktober 2009
Choosing Real Estate-Related Services
Rabu, 21 Oktober 2009
Butter vs. Margarine Showdown
The really cool thing about this study is they also tracked butter consumption. So it's really a no-holds barred showdown between the two fats. Here's a graph of the overall results, by teaspoons of butter or margarine eaten per day:
Heart attack incidence increased with increasing margarine consumption (statistically significant) and decreased slightly with increasing butter consumption (not statistically significant). That must have been a bitter pill for Castelli to swallow! It gets better. Let's have a look at some of the participant characteristics, broken down by margarine consumption:
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People who ate the least margarine had the highest prevalence of glucose intolerance (pre-diabetes), smoked the most cigarettes, drank the most alcohol, and ate the most saturated fat and butter. These were the people who cared the least about their health. Yet they had the fewest heart attacks. Imagine that. The investigators corrected for the factors listed above in their assessment of the contribution of margarine to disease risk, however, the fact remains that the group eating the least margarine was the least health conscious. This affects disease risk in many ways, measurable or not. I've written about that before, here and here. Can this study get any better? Yes it can. The investigators broke down the data into two halves: the first ten years, and the second ten. In the first ten years, there was no significant association between margarine intake and heart attack incidence. In the second ten, the group eating the most margarine had 77% more heart attacks than the group eating none:
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So it appears that margarine takes a while to work its magic.They didn't publish a breakdown of heart attack incidence with butter consumption over the two periods. Perhaps they didn't like what they saw when they crunched the numbers. I find it really incredible that we're told to avoid dairy fat with data like these floating around. The Framingham study is first-rate epidemiology. It fits in perfectly with most other observational studies showing that full-fat dairy intake is not associated with heart attack and stroke risk. In fact, several studies have indicated that people who eat the most full-fat dairy have the lowest risk of heart attack and stroke.
It's worth mentioning that this study was conducted from the late 1960s until the late 1980s. Artificial trans fat labeling laws were still decades away in the U.S., and margarine contained more trans fat than it does today. Currently, margarine can contain up to 0.5 grams of trans fat per serving and still be labeled "0 g trans fat" in the U.S. The high trans fat content of the older margarines probably had something to do with the result of this study.
That does not make today's margarine healthy, however. Margarine remains an industrially processed pseudo-food. I'm just waiting for the next study showing that some ingredient in the new margarines (plant sterols? dihydro vitamin K1?) is the new trans fat.
Butter, Margarine and Heart Disease
The Coronary Heart Disease Epidemic
* More precisely, "coronary heart disease events", which includes infarction, sudden cardiac death, angina, and coronary insufficiency.
Real Property Issues
Selasa, 20 Oktober 2009
Senin, 19 Oktober 2009
Minggu, 18 Oktober 2009
A Little Hiatus
Sabtu, 17 Oktober 2009
Total Ankle Replacement with No Metal
Newswise — Patients suffering from severe arthritis now have an option for total ankle replacement that offers increased mobility and pain relief without permanent metal implants. Pioneered by Daniel K. Lee, D.P.M., F.A.C.F.A.S., at UC San Diego Medical Center, this technique is the first in the U.S to offer arthritis sufferers a non-metal, biological ankle replacement.
"Up until now, patients have had two options for replacing their ankle joints: metal implants or fusion of the joints," said Lee, director of foot and ankle surgery at UCSD Medical Center. "Now there is an option that actually restores the ankle with an FDA-approved biologic material that is similar to the collagen found in cartilage."
During a two hour minimally-invasive surgical procedure, Lee, a podiatric foot and ankle surgeon, removes the damaged cartilage around the ankle joint through a four centimeter incision. The collagen material is then molded into the joint where it adapts to the contour of the patient's ankle.
"Unlike a metal device, the advantage to this material is that the implant can be customized in size and contour for every patient's individual need," said Lee. "No matter how the patient's ankle is shaped, the collagen is a perfect fit."
The biologic material, processed from either human or animal collagen sources, has been used for more than 10 years in plastic and abdominal surgery and heart valve replacement. Since it is non-allergenic and sterile in nature, there is no risk of rejection or need for the patient to take immunosupressors.
To allow the material to integrate fully with the ankle joint, a temporary external device is used to stabilize the joint area while keeping it "distracted" or open for a period of 4-6 weeks. Attached by small pins, the cylinder-shaped device serves as a shock system to keep the joint free from friction and movement until healing is complete. The device is then removed entirely, which keeps the patient's ankle free from any metal parts.
"Within 3 weeks after surgery, we see an incorporation of tissue onto the damaged cartilage," said Lee. "The idea here is to avoid fusion of the ankle and to add longevity to the joint. We want to give patients as much mobility as possible so they can get back to the activities they love the most."
Lee's patient's range in age from 30-85. Robert Adams, 82, a retired professor, received the ankle replacement after repeated attempts at physical therapy.
"My ankle collapsed on me," said Adams. "I didn't like the idea of a fusion with no motion or opening up my ankle for a metal device. Following this surgery, I no longer have sharp or stabbing pains. I am continuing to improve and can get around better."
For years, patients have had the option of total joint replacement in the hips, knees, and ankle with titanium and other metal devices. While the implants are well suited for hips and knees, metal replacements for the ankle show a high level of failure and unwanted complications such as metal collapse and breakage. Once an ankle is replaced with metal, options for revision surgery are little to none.
According to the Centers for Disease Control, an estimated 46 million U.S. adults, approximately 1 in 5, report doctor-diagnosed arthritis. As the U.S. population ages, these numbers are likely to increase sharply. The number of adults with arthritis is projected to increase to 67 million by 2030, and a good proportion of U.S. adults will have limited activity as a result. Nearly two-thirds of people with arthritis are younger than 65.
Description
Patients suffering from severe arthritis now have an option for total ankle replacement that offers increased mobility and pain relief without permanent metal implants. Pioneered by Daniel K. Lee, D.P.M., F.A.C.F.A.S., at UC San Diego Medical Center, this technique is the first in the U.S to offer arthritis sufferers a non-metal, biological ankle replacement.
Kamis, 15 Oktober 2009
Real Estate Licensee information and potential for misuse
Rabu, 14 Oktober 2009
Malocclusion: Disease of Civilization, Part IV
1: Prenatal Period
The major structures of the human face and jaws develop during the first trimester of pregnancy. The maxilla (upper jaw) takes form between the 7th and 10th week after conception. The mandible (lower jaw) begins two weeks earlier. The nasal septum, which is the piece of cartilage that forms the structure of the nose and divides the nostrils, appears at week seven and grows most rapidly from weeks 8 to 11. Any disturbance of this developmental window can have major consequences for later occlusion.
2: Early Postnatal Period
The largest postnatal increment in face and jaw growth occurs from birth until age 4. During this period, the deciduous (baby) teeth erupt, and the activity patterns of the jaw and tongue influence the size and shape of the maxilla and the mandible as they grow. The relationship of the jaws to one another is mostly determined during this period, although it can still change later in development.
During this period, the dental arch widens from its center, called the midpalatal suture. This ensures that the jaws are the correct size and shape to eventually accept the permanent teeth without crowding them.
3: Adolescence
The third major developmental period occurs between ages 11 and 16, depending on the gender and individual, and happens roughly at the same time as the growth spurt in height. The dental arch continues to widen, reaching its final size and shape. Under ideal circumstances, at the end of this period the arch should be large enough to accommodate all teeth, including the third molars (wisdom teeth), without crowding. Narrow dental arches cause malocclusion and third molar crowding.
Growth of the Dental Arch Over Time
The following graph shows the widening of the dental arch over time*. The dotted line represents arch growth while the solid line represents growth in body height. You can see that arch development slows down after 6 years old, resumes around 11, and finally ends at about 18 years. This graph represents the average of many children, so not all children will see these changes at the age indicated. The numbers are in millimeters per year, but keep in mind that the difference between a narrow arch and a broad one is only a few millimeters.
In the next few posts, I'll describe the factors that I believe influence jaw and face structure during the three critical periods of development.* These data represent many years of measurements collected by Dr. Arne Bjork, who used metallic implants in the maxilla to make precise measurements of arch growth over time in Danish youths. The graph is reproduced from the book A Synopsis of Craniofacial Growth, by Dr. Don M. Ranly. Data come from Dr. Bjork's findings published in the book Postnatal Growth and Development of the Maxillary Complex. You can see some of Dr. Bjork's data in the paper "Sutural Growth of the Upper Face Studied by the Implant Method" (free full text).
Laws & Regulations For Real Estate Activities
Selasa, 13 Oktober 2009
Skin problems
Skin problems are very common. Some stem from the natural processes that occur in your body as you develop into an adult. Others are caused by germs, injury, or environmental conditions. Some problems can be avoided and cared for through simple first aid. For more serious problems, you should see a dermatologist. A dermatologist is a doctor who treats skin disorders.
ACNE
Acne is a skin problem very common in teenagers. It is related to the natural change in the body during development, which cause an excess of sebum to be produced. The extra sebum causes blackheads, whiteheads, and pimples which are referred to as acne. A blackhead is plug of hardened sebum in a pore. The blackhead is darkened not by dirt but by exposure to air. A whitehead is plugged pore that is not exposed to air because the sebum has collected under the epidermis. Sometimes bacteria grow in trapped sebum. This causes pimples to form. A pimple is a blocked pore that is inflamed and infected. It may be filled with pus.
For many years, scientists thought that greasy foods or chocolate caused pimples. Recent research, however, has shown that foods rarely cause acne. Acne may become worse through eating some foods, though. The iodine in fish is one example. If you find that eating certain foods seems to increase your skin problems, avoid them.
Mild cases of acne can be treated by keeping the skin clean. Some dermatologists recommend washing the face with only a face cloth and warm water. Others suggest using only very mild soaps. You should also avoid picking or squeezing pimples and blackheads. Squeezing is likely to increase rather than relieve your problem, because it causes infection to spread.
If the acne is severe, you should consult your doctor. Serious cases of acne may result in scars. A doctor may prescribe various treatments, including the use of medicines. Overuse of some skin lotions may worsen the problems because they contribute to clogged pores. Use a cream or lotion only when suggested by your doctor. Fortunately, most people eventually outgrow their acne problems.
DERMATITIS
The word used to describe redness and swelling of the skin is dermatitis. Dermatitis is not a disease but a skin condition that may result from many different causes.
An allergy is a reaction of the body to an irritating substance. Pollen, dust, plants, and animals are common causes of various allergies. You may eat, breath in, or brush against the allergy causing substance. Some substances can affect your breathing or heart beat. At other times, your skin may be affected.
Eczema is a swelling and redness of the skin, including blisters and itching, usually caused by an allergic reaction. Sometimes it results from food, such as chocolate or tomatoes. Hives are bumps on the surface of the skin, usually caused by an allergic reaction to food or medicine. They may also be caused by emotional stress. The bumps may be small or cover large areas of the skin. Hives usually itch badly and burn. Your doctor may prescribe medicines to relieve the intense itching. If your think your have and allergic reaction, try to identify the cause so you can avoid it.
Dermatitis may be caused when a harsh or irritating substance touches the skin. Contact dermatitis, as it is called, can be caused by detergents, clothing, soaps, perfumes, hair dyes, and makeup.
One of the most common forms of contact dermatitis is a poison ivy rash. An oil in the sap of this plant causes the skin to turn red and blister, usually within 48 hours. Itching and burning usually occur. Some people even have headaches and fevers. With or without treatment, a poison ivy rash normally disappears within three weeks.
The oil in this sap is extremely potent. A single ounce of it can cause a rash on 28 million people. Even during the winter, the sap from a leafless broken vine can cause a reaction. The best way to avoid getting poison ivy is to avoid touching the plant.
SKIN INFECTIONS
Skin infections are problems caused by germs. They can generally be prevented by avoiding contact with an infected person or object. Different germs cause a variety of skin problems.
One of the skin infections caused by bacteria is an outbreak of boils. A boil is a hard, red lump that is tender to the touch and is caused by an infected hair follicle. Most boils will burst in about two weeks if left alone. Wet, hot compresses applied to the boil every few hours will relieve pain and encourage bursting. Do not pinch or mash a boil because this will spread the infection.
Another common bacterial infection is impetigo. Impetigo is a skin infection caused by bacteria and characterized by small blisters that form yellow crusts. The infection spreads easily and enters the body through breaks in the skin, such as insect bites, cuts, and scrapes. The infected areas should be washed several times a day, enough to soak off any crusts. If it is more than a mild case, a doctor should be seen. Medicines are used to fight the bacteria both internally and at the site of the infection.
A wart is skin growth caused by virus. Warts are common in teenagers. Usually warts will disappear without treatment after several months. Warts that occur on the face, soles of the feet, or in the genital area should be examined and treated by a doctor.
Fungal infections are infections caused by a group of organisms, including yeasts and molds, that cause redness, itching, and flaking of the skin. The two most common types of fungal skin infections are ringworm and athlete’s foot. Ringworm gets its name from the way it looks; it is not caused by a worm.Ringworm is a fungus that causes red, scaly, round patches. Ringworm can be transferred from person to person or from a pet to person. It is not serious and is easily treated.
Athlete’s foot is an irritating and sometimes painful fungal infection of the moist skin under and between the toes. The fungus causes the skin to become red, flaky, and itchy. Drying the feet well, using an antifungal cream or ointment, and wearing absorbent cotton socks will help to end the infection and prevent its return.
SCALP PROBLEMS
Small flakes of dead skin from the scalp are called dandruff. These flakes appear when the skin cells on the scalp grow very fast. Dandruff may be caused by mild forms of skin diseases, such as eczema or psoriasis, but it is usually not a serious problem. If regular shampooing and careful rinsing do not control the flaking, antidandruff shampoos may help. If the shampoo does not work after a few weeks of application, you may wish to see a dermatologist.
When tiny animals called lice infest the hair, the condition is called pediculosis. Lice feed on the scalp, causing it to itch. They may also cause a rash on the neck. Lice lay their eggs on hair shafts. The eggs are called nits. Unlike dandruff, the nits cannot be shaken off. The spread of pediculosis can be reduced by not sharing clothing, combs, and brushes with others. If you discover lice in your hair, you can comb away the nits with a fine-toothed comb wet with vinegar. Then wash your hair with a special medicated shampoo.
BURNS
Burns are cause by being in contact with hot object, hot liquids or vapors, or with electricity or chemicals. Burns destroy the skin and affect the body’s ability to fight infection. Burns also upset blood circulation. Burns are divided into First-degree, second-degree and third-degree burns depending on the damage they cause. First-degree burns are burns that injure only the epidermis and heal without leaving scars. These might be caused by mild sunburn. Second-degree burns are burns that injure the epidermis and part of the dermis and may leave some scarring. Swelling and blistering are involved. Second-degree burns may be caused by such things as hot liquid, steam, or extreme sunburns. Third-degree burns are burns that go through all layers of the skin and affect the tissue underneath. The skin may look white, very red, or even black. Most third-degree burns do not heal themselves. The damaged skin usually has to be removed and new skin grafted on.
SKIN CANCER
There are several different types of skin cancer. Cancer is an uncontrolled growth of cells that invade and destroy neighboring healthy tissue. Some skin cancers are small pink growths that increase in size, damaging surrounding tissues, but do not spread to other parts of the body. Other cancers begin as a lump that turns into an ulcer and may spread to other parts of the body. One common type of skin cancer is called melanoma. Melanomas are enlarged moles that bleed. They may flat or raised and vary in size. This type of skin cancer usually spreads through the body.
Skin cancer can be cured if it is identified and treated early. It can also be avoided by not getting too much sun. Skin cancer is a long-term danger of being exposed to ultraviolet rays. The risk of developing skin cancer increases with age and the number of years of exposure.
PROTECTION FROM HARMFUL SUN RAYS
Brief exposure to sunlight stimulates your skin to produce vitamin D. Vitamin D is necessary for the healthy formation of bones and teeth. However, overexposure to the ultraviolet rays from the sun can damaged your skin. Sunlamps at home and in tanning studios give off harmful ultraviolet rays just as the sun does. Good hygiene includes knowing how much sun you can get without harming your skin.
There are different preparations that protect your skin from sunlight, depending on your skin. These preparations are graded by number. The higher the number, the greater the degree of protection. People with fair skin are wise to select a sunscreen with a value over 10. Darker-skin individuals may be safe with a somewhat lower grade. When applying sunscreen, be careful to apply enough lotion to the nose, lips, shoulders, and knees, which burn more readily than other parts of the body.
Kidney Stones
If I have a Kidney stone when should I call a doctor?
If you have a kidney stone, you may already know how painful it can be. Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not just go away. It may even get larger. Your doctor can help.
You should call a doctor when you have:
extreme pain in your back or side that will not go away
blood in your urine
fever and chills
vomiting
urine that smells bad or looks cloudy
a burning feeling when you urinate
These may be signs of a kidney stone that needs a doctor's care.
What is a kidney stone?
A kidney stone is a solid piece of material that forms in the kidney out of substances in the urine. A stone may stay in the kidney or break loose and travel down the urinary tract. A small stone may pass all the way out of the body without causing too much pain. A larger stone may get stuck in a ureter, the bladder, or the urethra. A problem stone can block the flow of urine and cause great pain.
Are all kidney stones the same ?
No. There are four major types of kidney stones.
The most common type of stone contains calcium (KAL-see-um). Calcium is a normal part of a healthy diet. The calcium that stays behind joins with other waste products to form a stone.
A struvite (STROO-vite) stone may form after an infection in the urinary system. These stones contain the mineral magnesium (mag-NEE-zee-um) and the waste product ammonia (uh-MOH-nyuh).
A uric (YOOR-ik) acid stone may form when there is too much acid in the urine. If you tend to form uric acid stones, you may need to cut back on the amount of meat you eat.
Cystine (SIS-teen) stones are rare. Cystine is one of the building blocks that make up muscles, nerves, and other parts of the body. Cystine can build up in the urine to form a stone. The disease that causes cystine stones runs in families.
What do kidney stones look like?
Kidney stones may be as small as a grain of sand or as large as a pearl. Some stones are even as big as golf balls. Stones may be smooth or jagged. They are usually yellow or brown.
What can my doctor do about kidney stones?
If you have a stone that will not pass by itself, your doctor may need to take steps to get rid of it. In the past, the only way to remove a problem stone was through surgery.
Now, doctors have new ways to remove problem stones. The following sections describe a few of these methods.
Health is Your Greatest Asset
I once heard Dr. Dennis Kimbro http://www.denniskimbro.com say on a television interview that most millionaires fail a few times in business, and suffer some bankruptcies before they become successful. Another salient point he made is that most of people become millionaires around fifty years of age. Why this is the case I don't exactly know, unlike Dr. Kimbro I can only speculate on these matters.
My observation of many people makes me think perhaps the middle-age launch into business ventures has to do with people finding the confidence later in life. You have to have self-assurance to risk business ventures. Usually people don't have this type of business confidence until after they have run other peoples businesses.
Or at least they feel more confident once they have worked for other people.
Andrew Morrison, the owner of Small Business Camp, http://www.smallbusinesscamp.com once alluding to the book "Think and Grow Rich" said that many men become more successful in their middle years because they are less focused on sexual pursuits. I can relate to this because when I was in my twenties I would be too focused on dating, to have the focus to run a viable business.
However, what would be the point of having a successful business if we don't have the health to enjoy it?
Most people would agree business is a very competitive and challenging. It also stands to reason you should try to be at peak performance when undertaking a business venture. This is why you should seriously consider investing in your health to afford you the extra push -- to drive you to business success.
Some of the major reasons you may want to bolster your health and overall fitness are because:
- Studies show exercise helps relieve stress
- Exercise helps elevate your mood
- Exercise will help you think more clearly
- Resistance training will help increase your muscle and bone density which tend to decrease with age
- Stretching after exercise will to help keep you flexible which also tends to decrease with age
- Regular strenuous exercise can help you increase natural hormones in you body like testosterone which will increase muscle mass, sexual desire, and overall health
These are just some of the many well-known benefits you will achieve with a regular exercise program. It is no wonder that I find many people who are successful in business come from athletic or sports backgrounds. Many successful entrepreneurs have a regular fitness programs.
If you are a woman who has had children and find yourself with some undesired pounds good balanced workout programs could be considered from people like Denise Austin http://www.deniseaustin.com or Donna Richardson http://www.donnarichardson.com . For men you may like the workouts of people like Billy Blanks and his TaeBo system.
According to fitness trainers like Denise Austin, the focus of your workout should be on the balance of strength training, aerobics, and flexibility.
Most fitness experts like Jason Martin of the BODeStore.com http://www.BODeStore.com make the point that strength training as alluded to earlier "will increase bone density and muscle mass, aerobics will burn fat and give you more cardio fitness, and yoga or martial arts will help counter the inflexibility associated with age".
One thing you may experience as you age is you don't obviously have the natural energy you had when you were sixteen years old. Another problem you may experience is pain in your joints like your knees.
If you notice pain in your knees and elbows especially on damp or humid days you may be experiencing the on-set of arthritis. Arthritis can be demoralizing when you are trying to obtain optimal health. It is definitely something you didn't have to worry about or contend with when you were in your twenties. Don't let arthritis totally derail your pursuit of health in your most productive midlife years!
Seek the help of your doctor and perhaps explore some alternative remedies of relief. Personally I have found that some alternative treatments to be superior to pharmaceutical drugs. I hear good things about the supplement Phosoplex(tm) in helping with arthritis and other joint problems.
The most important thing is to remember when embarking upon a health and fitness program is to do so with moderation. Don't overdue it and risk injury. Make sure you invest in good fitness shoes with good heel and ankle support. In Denise Austin's words "avoid boredom by doing various physical activities that you enjoy with your family". If you are quite a bit over weight maybe start out with walking more.
In the end what does if profit you to become a millionaire, but you are totally unfit to enjoy your investment? Like the saying goes "your health is your greatest asset".
You can see more of this health insights at: http://www.HealthandFitnessVitality.com.
Swine Flu Symptoms
The swine flu patients is increasing enormously throughout the world, through electronic media every one came to know about this disease but unfortunately until today no country get success to prevent this disease.
First of all what is the swine flu (H1N1)? This disease started from US somewhere in April 2009 afterwards same disease found in Russia, England, Canada, India and other countries, this disease expanding through person to person same like if you have normal flu virus.
In the first place it is very difficult to understand this virus in the patients. Because this swine flu in people are same to the symptoms of normal human flu which is includes normal fever, headache, fatigue, body paining, pain in the throat etc.
If you want to recognize swine flu symptoms in children the breathing of the children is very fast or very difficult for breathing, the skin color will become bluish or gray, the kid will not drink enough fluids, persistent or severe vomiting, children will not wake up early or he will not interact quickly, normal flue like symptoms will improve then it will return with fever and worst cough.
In adults if you want to recognize and take precautionary measures when you feel very difficult while breathe or little shortness of breath, the person will feel pain in the chest, sudden dizziness, person will become confused manner, continue vomiting, normal flu like symptoms after sometime it will back with fever and worse cough these all symptoms to identify swine flu in adults.
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