Sunday, September 11, 2011

what is non-Hodgkin lymphoma?


'Spartacus' star Whitfield dies of lymphoma at 39

LOS ANGELES (AP) — Andy Whitfield, who played the title role in the hit cable series "Spartacus: Blood and Sand," has died at age 39, according to representatives and family.
Whitfield died Sunday in Sydney, Australia, 18 months after he was diagnosed with non-Hodgkin lymphoma, manager Sam Maydew told the Associated Press.
"On a beautiful sunny Sydney spring morning, surrounded by his family, in the arms of his loving wife, our beautiful young warrior Andy Whitfield lost his 18 month battle with lymphoma cancer," Whitfield's wife Vashti said in a statement. "He passed peacefully surrounded by love. Thank you to all his fans whose love and support have help carry him to this point. He will be remembered as the inspiring, courageous and gentle man, father and husband he was."
Andy Whitfield — who was born in Wales and moved to Australia in 1999 — was a virtual unknown when he was cast as the legendary Thracian slave in "Spartacus," a role made famous by Kirk Douglas in the 1960 Stanley Kubrick film.

The series proved a breakout hit for the Starz network and made waves with its graphic violence and sexuality.
While waiting for Whitfield's treatment and expected recovery, the network produced a six-part prequel, "Spartacus: Gods of the Arena," that aired earlier this year with only a brief voiceover from the actor.But in January after Whitfield's condition grew worse, the network announced that another Australian actor, Liam McIntyre, would take over the role.
Whitfield appeared in all 13 episodes of the first season that aired in 2010, and was preparing to shoot the second when he was diagnosed with cancer.

"We are deeply saddened by the loss of our dear friend and colleague, Andy Whitfield," Starz President and CEO Chris Albrecht said in a statement Sunday night. "We were fortunate to have worked with Andy in 'Spartacus' and came to know that the man who played a champion on-screen was also a champion in his own life."
Whitfield's previous credits included appearances on the Australian TV shows "Packed to the Rafters" and "McLeod's Daughters."

What is non-Hodgkin's lymphoma?

Non-Hodgkin's lymphoma is a type of cancer that originates in the lymphatic system. It is estimated to be the sixth most common cancer in the United States. The lymphatic system is part of the body's immune system and helps fight infections and other diseases. In addition, the lymphatic system filters out bacteria, viruses, and other unwanted substances.



The lymphatic system consists of the following:
Lymph vessels: These vessels branch out throughout the body similar to blood vessels.
Lymph: The lymph vessels carry a clear fluid called lymph. Lymph contains white blood cells, especially lymphocytes such as B cells and T cells.

  • Lymph nodes: Lymph vessels are interconnected to small masses of lymph tissue called lymph nodes. Lymph nodes are found throughout the body. Collections of lymph nodes are found in the neck, underarms, chest, abdomen, and groin. Lymph nodes store white blood cells. When you are ill and the lymph nodes are active, they will swell and be easily palpable (your doctor can feel them when she examines you).
  • Additional parts of the lymphatic system: The tonsils, thymus, and spleen are additional components of the lymphatic system. Lymphatic tissue is also found in other parts of the body, including the stomach, skin, and small intestine.
Because lymphatic tissue is found in many parts of the body, non-Hodgkin's lymphoma can start almost anywhere.

Monday, August 29, 2011

'Tawa-tawa' studied in fight against dengue

By Jocelyn R. Uy in Manila/Philippine Daily Inquirer | ANN 

Manila (Philippine Daily Inquirer/ANN) - Here's something to smile about: the tawa-tawa plant ( Euphorbia hirta L.) may contain a substance that could help prevent dehydration among dengue patients.
Health Secretary Enrique Ona said at a forum on Friday that, based on initial research work, the local plant "appears" to have "some effects" on rehydration.
But in the same breath, Ona stressed that this was "very preliminary" and that the Department of Health could not and was not making any official recommendation about the plant for its possible dengue-fighting properties.
The DOH has asked the Department of Science and Technology to look into plants, including "tawa-tawa," that may help in the treatment of the mosquito-borne disease, which has downed hundreds of children nationwide.
Ona said researchers at the DOST have begun trying to "isolate" the substance in the local plant that have potential in fighting dehydration.
The health agency earlier said that dehydration, aside from hemorrhage, is one of the common causes of death among dengue patients.
"Initial results in terms of isolation shows that there is an active component... however, very preliminary," said Ona. "So let's hope. Maybe there really is [and] we should be very happy with that."
But instead of experimenting with "tawa-tawa"-some dengue patients have brewed and drunk "tawa-tawa" tea-Ona stressed the importance of immediately seeing a doctor.
"Don't depend on tawa-tawa," warned the health chief. "As much as possible, consult your doctor."
Last year, the health department raised concerns about the growing interest in the local plant as an alternative remedy for dengue. The DOH warned the public against experimenting with the plant in the absence of an official study on its reputed anti-dengue properties.
Instead of drinking "tawa-tawa" tea, the health agency advised patients to drink oral rehydration solution (Oresol) to prevent dehydration.
The DOH has so far recorded 321 deaths nationwide from January 1 to August 20, lower than last year's count of 517 fatalities due to the disease.



"there is no contradict - tawa tawa is a herbal plant and is proven of time and many times"

Tuesday, August 23, 2011

9 Ways to flatten your belly in one week

by The Editors of Prevention,



Another reason to hate Mondays? Tight post-weekend waistbands. Unless you spent the past 2 days living like a monk, the cocktails, movie snacks, and dinners out can all add up to one thing: belly bloat.

“If you wake up bloated on Monday morning, your weekend food choices are likely to blame,” explains Keri Gans, RD, author of The Small Change Diet. “In fact, overindulging for two days straight can easily cause a gain of three pounds. Fortunately, this weight gain is usually temporary and easy to get rid of in less than a week.”

Feel flat again by Friday with these nine easy tips:



Reduce belly fat and lose inches by eating delicious foods!

Season Food Differently
You may be attracted to your saltshaker, but water is too. When you take in higher-than-usual amounts of the salty stuff, you’ll temporarily retain more fluid, contributing to that sluggish feeling, a puffy appearance, and extra water weight. Avoid salt, overprocessed foods, and salt-based seasonings. Gans suggests you also ditch the frozen microwaveable meals while you’re de-bloating—they’re packed with sodium. Instead, she recommends a simple turkey sandwich or a salad with chicken for lunch this week. And eat plenty of fruits and vegetables that are packed with water.

Add zest to your dinner recipes with fresh herbs and salt-free seasoning blends such as the Original and Italian Medley Mrs. Dash.

Trim Down Carbs
Stay away from heavy carbs such as bagels and pasta. When you decrease the carbs in your diet, you temporarily train your body to access stored carbohydrates called glycogen and burn them off, while also eliminating excess stored fluids.

Trim back on your daily carbs by having eggs for breakfast, making your sandwich open-faced with only one slice of bread, and packing protein-rich snacks such as turkey slices, low-fat string cheese, seeds, and nuts.

Switch Your Starch
If your belly bulges after a high-carb meal like pasta, complex carbohydrate-rich foods may be the cause of your bloat, says Jackie Wolf, MD, author of A Woman’s Guide to a Healthy Stomach. Most starches, including potatoes, corn, pasta, and wheat, produce gas as they are broken down in the large intestine. Rice is the only starch that doesn’t cause gas, so have a ½-cup serving of brown rice (which has more fiber) if you want carbs with dinners.

Stop Milking It
If you’ve ever felt gassy, crampy, or bloated after dairy, you may be one of 30 to 50 million Americans with lactose intolerance. This occurs in people whose bodies lacks the ability to break down and digest the sugar in milk, resulting in digestive issues like gas, bloating, cramping, and diarrhea. Try lower-lactose foods (such as hard cheese or yogurt) or lactose-free dairy products (such as rice milk and almond milk), or take a lactase enzyme to help break down lactose. Dr. Wolf recommends soy milk as a dairy alternative but warns that some people experience gas and bloating from soybeans as well.

Your Guide to Healthy, Happy Tummy

Make These Fruit Swaps
Wolf recommends you eat fruits that are kinder on your belly. Berries, grapes, and citrus contain a near-equal ratio of the sugars fructose and glucose, making them easier to digest than fruits with more fructose, such as honeydew, apples, and pears.

You can also eat canned fruits in natural juice or small portions of dried fruit, such as raisins and dried plums.

Hold The Hot Sauce
IF you love four-alarm food, lay off the Tabasco, barbecue sauce, and garlic for a few days while de-bloating. Spicy foods stimulate the release of stomach acid, causing irritation. Give dishes a flavor boost with in-season fresh or dried herbs such as dill, basil, mint, sage, tarragon, and rosemary. You can also use curry powder or lemon or lime juice—all perfect with fish or chicken. Also, steer clear of black pepper, nutmeg, cloves, chili powder, onions, mustard, horseradish, and acidic foods such as catsup, tomato sauce, and vinegar.

Use Prevention’s Recipe Finder Tool to Find Tasty Recipes Seasoned with Fresh Herbs

Ditch Diet Foods
Avoid low-calorie or low-carb products containing sugar alcohols, which go by the names xylitol or maltitol and cause gas, bloating, and worst—diarrhea. And don’t reach for a stick of gum when you’re trying to quell that sugar craving. Instead, satisfy your sweet tooth by using a little maple syrup on your morning oatmeal or yogurt snack.

Get On The Wagon
Steer clear of alcohol for the next few days to maximize your body’s belly-flattening capabilities. Alcohol causes dehydration and may slow your body’s ability to eliminate that excess weekend waste, so if you had a little too much to drink this weekend, start chugging the H20.

It’s best to eliminate that occasional glass of wine, beer, or hard alcohol this week while you’re on a skinny jeans crusade—all are high-acid beverages that can irritate your GI tract and cause swelling.

Do Some Activity Every Day
A study from Spain's Autonomous University of Barcelona suggests that mild physical activity clears gas and alleviates bloating. That's because increasing your heart rate and breathing stimulates the natural contractions of the intestinal muscles, helping to prevent constipation and gas buildup by expediting digestion. Take a short walk after meals or pedal lightly on a bike at the gym to help relieve bloat.

More Remedies For Belly Bloat
If you want extra belly-flattening aids, consider one of these products to soothe your belly problems.

•    Get gas relief with an over-the-counter product such as Gas-X.
•    Try peppermint capsules to kill bacteria that cause bloat and aid digestion.
•    Stay regular by increasing fiber with flaxseed or a fiber supplement such as Benefiber.
•    Take a daily probiotic capsule. Dr. Wolf likes Align, Digestive Advantage Intensive Bowel Support, and Pearls IC Intensive Care Probiotics.

A definite belly-flattening “don’t” is weighing yourself every day, says Gans. “Bloating is about how you feel. A lot of women will start weighing themselves daily—it’ll drive them crazy and could be discouraging. Go by how your clothes feel rather than letting the scale rule your week.”

Wednesday, August 17, 2011

Screening has little impact on breast cancer deaths









LONDON (Reuters) - Falling breast cancer death rates have little to do with breast screening but are down to better treatment and health systems, scientists said on Friday, in a study likely to fuel a long-running row over the merits of mammograms.Researchers analysed data from three pairs of countries in Europe and found that although breast cancer screening programmes had been introduced 10 to 15 years earlier in some areas than in others, declines in death rates were similar.The findings suggest that "improvements in treatment and in the efficiency of healthcare systems may be more plausible explanations" for falling deaths rates from breast cancer, they wrote in a study in the British Medical Journal.
World Health Organisation (WHO) data show that deaths from breast cancer are decreasing in the United States, Australia, and most Nordic and western European countries but breast screening is a hot topic among experts who disagree about whether nationwide mammogram programmes do more harm than good.
The fear among some is that over-diagnosis -- when screening picks up tumours that would never have presented a problem -- may mean many women are undergoing unnecessary radical treatment, suffering the physical and psychological impact of a breast cancer diagnosis that would otherwise not have come up.
But sweeping changes in U.S. guidelines two years ago that scaled back recommendations on breast screening caused an uproar among patient and doctors groups who said they put women at risk. That was swiftly followed by two conflicting European studies which further fuelled the row.

The first, by Danish scientists, found that breast cancer screening programmes of the type run by health services in Europe, the United States and other rich nations do nothing to reduce death rates from the disease, while the second, by a British team, found "substantial and significant reduction in breast cancer deaths" due to screening.  Then last month, researchers who conducted the longest ever breast cancer screening said it showed that regular mammograms prevent deaths from breast cancer, and that the number of lives saved increases over time.Every year, breast cancer kills around 500,000 people globally and is diagnosed in close to 1.3 million people.
For this study, researchers from Britain, France and Norway used WHO data to compare trends in breast cancer death rates within three pairs of countries - Northern Ireland versus Republic of Ireland, the Netherlands versus Belgium and Flanders, and Sweden versus Norway. Each pair had similar healthcare services and similar levels of risk factors for breast cancer mortality, but were different in that mammography screening was implemented about 10 to 15 years later in the second country of each pair.
The team, lead by Philippe Autier of the International Prevention Research Institute in Lyon, France, said they expected that reductions in breast cancer death rates would show up earlier in countries where screening was introduced sooner, but their analysis in fact showed little difference.The findings showed that from 1989 to 2006, deaths from breast cancer fell by 29 percent in Northern Ireland and 26 Percent in the Republic of Ireland; by 25 percent in the Netherlands, 20 percent in Belgium and 25 percent in Flanders; and by 16 percent in Sweden and 24 percent in Norway.
"Trends in breast cancer mortality rates varied little between countries where women had been screened by mammography for a considerable time compared with those where women were largely unscreened," Autier's team wrote.
"This is in sharp contrast with the temporal difference of 10 to 15 years in implementation of mammography screening and suggests that screening has not played a direct part in the reductions of breast cancer mortality."

(Editing by Elizabeth Fullerton)





Coffee's anti-cancer link explained: study


Coffee has been shown to reduce the risk of skin cancer by helping kill off damaged cells that could otherwise turn into tumors, according to a US study published on Monday. The findings indicate that moderate caffeine drinking, or perhaps even applying coffee to the skin, could be useful in warding off non-melanoma cancer, the most commonly diagnosed of all skin cancers.Using mice that had been genetically altered to suppress a protein enzyme called ATR, researchers showed that the mice were able to fend off cancer even when exposed to ultraviolet light.Previous studies have suggested that drinking about a cup of caffeinated coffee per day has the effect of suppressing ATR and triggering the die-off of cells harmed by UV rays.The altered mice eventually did develop cancer, but three weeks later than normal mice, according to the study published in the Proceedings of the National Academy of Sciences.After 19 weeks of ultraviolet light exposure, the engineered mice showed 69 percent fewer tumors and four times fewer invasive tumors than the control group.However, the protective effects only went so far. After 34 weeks of UV exposure, all the mice developed tumors."Eventually, if you treat them long enough, the mice will develop cancer so it is not 100 percent protection forever," Allan Conney, one of the study's authors, told AFP."Really, with almost any carcinogen, eventually all the animals will develop tumors," added Conney, who is director of the Susan Lehman Cullman Laboratory for Cancer Research at Rutgers University in New Jersey.
Conney and his team were able to confirm their hypothesis that caffeine -- when consumed or applied to the skin -- works by inhibiting ATR. Now they say more studies are needed to see how it may work on humans.
"We want to see whether caffeine has an effect in people when you give it topically," he said.
"Caffeine might become a weapon in prevention because it inhibits ATR and also acts as a sunscreen and directly absorbs damaging UV light."  Skin cancer is the most prevalent cancer in the United States, with more than one million new cases each year, according to the National Cancer Institute.  Non-melanoma types of skin cancer, including basal cell and squamous cell types, are the most commonly diagnosed and are often treatable if detected early. Previous studies have shown coffee drinkers tend to have fewer incidences of breast, uterine, prostate and colon cancers, but the beneficial effects are not seen in people who drink decaffeinated coffee.

Wednesday, August 10, 2011

Anatomy and Physiology of the Heart



Anatomy of the Heart
The essential function of the heart is to pump blood to various parts of the body. The mammalian heart has four chambers: right and left atria and right and left ventricles. The two atria act as collecting reservoirs for blood returning to the heart while the two ventricles act as pumps to eject the blood to the body. As in any pumping system, the heart comes complete with valves to prevent the back flow of blood. Deoxygenated blood returns to the heart via the major veins (superior and inferior vena cava), enters the right atrium, passes into the right ventricle, and from there is ejected to the pulmonary artery on the way to the lungs. Oxygenated blood returning from the lungs enters the left atrium via the pulmonary veins, passes into the left ventricle, and is then ejected to the aorta. In the frontal view of the heart shown below, the right atrium is in blue, the left atrium in yellow, the right ventricle in purple, and the left ventricle in red. The chambers are semi-transparent so that the valves, drawn in white, can be seen.


Click image to play animation. Click again to stop.


The view below shows the detail of the valves in the right half of the heart seen from obliquely beneath. The large valve in the foreground is the tricuspid valve that prevents backflow from the right ventricle to the right atrium. The small round valve you see near the top is the pulmonary valve, where the pulmonary artery comes out of the right ventricle (you are looking at it almost straight up into the pulmonary artery).


Click image to play animation.
Click again to stop.

The view below shows the detail of the valves in the left half of the heart. You are looking obliquely at the top of the large mitral valve in the foreground through the semi-transparent atrial and ventricular walls. The mitral valve prevents the backflow of blood from the left ventricle to the left atrium. Behind the mitral valve, you can see a circular valve in an end-on view. That is the aortic valve, where the aorta comes out of the left ventricle. In the background, the tricuspid valve can be seen.


Click image to play animation.
Click again to stop.

Pumping Action of the Heart
The pumping action starts with the simultaneous contraction of the two atria. This contraction serves to give an added push to get the blood into the ventricles at the end of the slow-filling portion of the pumping cycle called "diastole." Shortly after that, the ventricles contract, marking the beginning of "systole." The aortic and pulmonary valves open and blood is forcibly ejected from the ventricles, while the mitral and tricuspid valves close to prevent backflow. At the same time, the atria start to fill with blood again. After a while, the ventricles relax, the aortic and pulmonary valves close, and the mitral and tricuspid valves open and the ventricles start to fill with blood again, marking the end of systole and the beginning of diastole. It should be noted that even though equal volumes are ejected from the right and the left heart, the left ventricle generates a much higher pressure than does the right ventricle. 

Electrical Activity of the Heart
When vertebrate muscles are excited, an electrical signal (called an "action potential") is produced and spreads to the rest of the muscle cell, causing an increase in the level of calcium ions inside the cell. The calcium ions bind and interact with molecules associated with the cell's contractile machinery, the end result being a mechanical contraction. Even though the heart is a specialized muscle, this fundamental principle still applies. 

One thing that distinguishes the heart from other muscles is that the heart muscle is a "syncytium," meaning a meshwork of muscle cells interconnected by contiguous cytoplasmic bridges. Thus, an electrical excitation occurring in one cell can spread to neighboring cells. Another defining characteristic is the presence of pacemaker cells. These are specialized muscle cells that can generate action potentials rhythmically. 

Under normal circumstances, a wave of electrical excitation originates in the pacemaker cells in the sinoatrial (S-A) node, located on top of the right atrium. Specialized muscle fibers transmit this excitation throughout the atria and initiate a coordinated contraction of the atrial walls. Meanwhile, some of these fibers excite a group of cells located at the border of the left atrium and ventricle known as the atrioventricular (A-V) node. The A-V node is responsible for spreading the excitation throughout the two ventricles and causing a coordinated ventricular contraction. 

Diabetic Complications


The Factors Behind Complications of Diabetes 
Authors: Janet Worsley Norwood and Charles B. Inlander
Excerpt from: Understanding Diabetes
Generally, you can't tell diabetic complications are developing, at least not without undergoing tests or medical procedures in a doctor's office. Diabetes proceeds unnoticed, silently ravaging the body. You might be without symptoms until some damage is already done.
There is, however, one surefire indication that problems are developing: persistently high blood-sugar levels. Diabetes experts believe that over the long haul levels above 240 mg/dl are unacceptable and dangerous. However, the ideal level for you is the target set by you and your physician. It will probably be in the 80 to 120 mg/dl range.
The length of time a person has diabetes also comes into play when looking at complications. Because people with type 1 diabetes usually get the disease earlier in life than those with type 2, they have the dubious distinction of running a greater risk of developing complications than those with type 2. For the most part, complications appear in people who have had diabetes for fifteen years or more, although certain short-term complications can appear (and disappear) at any time. Evidence of diabetes-related eye problems, for example, is present after five years in 1 percent of type 1 cases; by fourteen years, the percentage is close to 100.
The type of complications that develop also depends on diabetes type. Individuals with type 1 tend to develop different problems than those with type 2. For instance, type 1 diabetes tends to produce vision problems sooner than does type 2 diabetes, while type 2 diabetes appears to be linked to more heart attacks and strokes. The rates at which complications proceed also vary wildly.
Scientists don't really know why these differences exist. Nor do they know why complications sometimes develop in people who have blood-sugar levels firmly in hand while other people never develop complications, regardless of how well or how poorly they control their blood sugar. It may boil down to genetic differences or even to factors yet unknown.
The thing to remember is that everyone has different responses to high and low blood sugar, so you may want to know what their symptoms tend to be. Self-monitoring of blood glucose can track sugar patterns and guard against these short-term, but potentially deadly, complications.
Long-Term Complications
Long-term, chronic complications differ from short-term complications in that they take more time in developing, and once they arrive are less likely to disappear. Many long-term complications are tied to those structures that distribute blood throughout the body; the small and large blood vessels. Although scientists are not certain how it happens, they think that years of carrying blood with high sugar levels eventually damages or impairs blood vessels. The faulty metabolism of someone with diabetes may also create some chemical change that makes blood vessels more vulnerable to damage. Either way, many diabetic complications are vascular complications--complications pertaining to blood vessels, in other words.
Let's look now at some of the major long-term complications faced by people with diabetes.
EYE PROBLEMS
Eye problems that diabetes might cause include minor problems in focusing, premature development of cataracts, and various degrees of retinal damage (otherwise known as diabetic retinopathy).
If you have diabetes, it's very likely that you will experience at least one of these problems in the course of your lifetime. Most people who have had diabetes for five to ten years show some signs of eye damage, although it may be slight.
Cataracts
A cataract, a clouding of the lens in the eye, is a very common problem in older people, including folks who don't have diabetes. However, the evidence suggests that diabetes accelerates cataract development. The hastened development is thought to be a result of the intricate and still incompletely understood relationship between high blood-sugar levels and aging. One popular theory posits that when people have diabetes for an extended period of time, sugar by-products begin to build up in the lens of the eye, eventually leading to cataracts.
Mild cataracts are often left as they are--but an individual with diabetes is encouraged to work at keeping blood-sugar levels within the normal range, which seems to slow the accumulation of sugar by-products and, thus, slow the progression of complications. Once severe cataracts develop, however, many ophthalmologists believe that the best course of action is to remove the cataract and replace it with an artificial lens, also known as an intraocular lens. This surgical procedure can be done right in a doctor's office. Although cataracts certainly impede good vision, they are less troublesome than another long-term complication, diabetic retinopathy.
Diabetic Retinopathy
Diabetic retinopathy means damage to or disease of the retina, the delicate membrane that lines the inside wall of the eye. The retina responds to light and receives the image formed by the lens. When it becomes seriously damaged, blindness may result. In fact, retinopathy is the most frequent cause of vision loss in Americans 20 to 74 years old.
Diabetic retinopathy is caused by changes or abnormalities in the small blood vessels of the retina--changes that take years to occur. Experts estimate that 6,000 people a year develop retinopathy. Fortunately, early diagnosis and prompt treatment often can prevent blindness.
Almost everyone with diabetes develops this complication, but the first to feel its impact are people with type I diabetes, who frequently develop a mild form of this condition within five years of diagnosis of diabetes. In fact, there's a strong correlation between the amount of time someone has diabetes and the development of retinopathy. Quite simply, the longer you have diabetes, the greater your chance of developing retinopathy. Within ten years of diabetes diagnosis, half of all people with type 1 diabetes and a quarter with type 2 have some damage to their retinas. By twenty years after diagnosis of diabetes, nearly everyone with type 1 diabetes and over 60 percent with type 2 have some degree of retinopathy.
Retinopathy is not something to ignore. Among those with type 1 diabetes, retinopathy is responsible for four-fifths of all cases of blindness: among those with type 2, the number is one-third. Of course, not all cases of retinopathy result in blindness. The condition ranges in severity from mild to advanced.
The medical profession describes two forms of diabetic retinopathy: background retinopathy and proliferative retinopathy. Background retinopathy is a mild, early form of retinopathy that is characterized by gradual narrowing or weakening of the small blood vessels in the eye. Small bulges (called microaneurysms) develop on the vessels. Eventually a vessel may tear or break and then bleed (known in medical parlance as a hemorrhage).
Most folks with diabetes develop background retinopathy, but in the lion's share of the cases, the condition remains at a mild level. Vision is not affected unless blood vessels break and leak fluid into the macula, an area of the retina responsible for sharp, fine vision---the kind of vision needed to read this book. When fluid leaks into the macula, it swells and puts pressure on other areas of the eye. This situation is called a macular edema and it leads to blurred vision. The swelling is sometimes treated in people who appear to be at high risk for blindness with a high-tech procedure known as photocoagulation. In this, a precise laser beam is used to sear shut the leaking blood vessels. Photocoagulation doesn't cure retinopathy, but it can delay the loss of vision by a number of years or, in some cases, stop progression.
For the most part, however, because background retinopathy is mild, surgical treatment isn't  necessary.
Proliferative retinopathy, as its name suggests, is a severe form of retinopathy that develops when a network of new, fragile blood vessels proliferates in the retina at the site of previous breakages or hemorrhages. The new vessels are an attempt by the eye to repair the damaged, worn-out vessels caused by diabetes. Over time the new, fragile vessels may tear and leak blood into the vitreous humor, the clear, gelatinous material that fills the center of the eye. A small amount of blood won't dim vision, but the major hemorrhages associated with proliferative retinopathy may be large enough to affect sight, in which case they are known as vitreous hemorrhages.
As the eye tries to repair the damage caused by hemorrhages, scar tissue forms. The buildup of scar tissue may eventually damage the retina, resulting in partial loss of sight, or it may displace or cause the retina to become detached, resulting in total loss of vision.
It may be difficult to tell if either form of retinopathy is developing. For the most part, people can have severe eye damage without knowing it, because the damage may not affect vision and may cause no pain. Of course, there are some obvious indications to the person with diabetes that something has happened to the eye. Partial loss of vision--even if very small--is an indication of a problem. "Floaters," "cobwebs," and "cotton wool balls" are terms that people have used to describe vision problems caused by tiny hemorrhages in the eye. A sudden, painful loss of vision may indicate a major hemorrhage.
Naturally, it's best to detect retinopathy before it reaches this stage. Eye examinations with a tool called a monocular direct ophthalmoscope are used to detect damage to the retina. A family physician can perform this test, although several studies indicate that physicians who are not ophthalmologists detect proliferative retinopathy in only 50 percent of the people who have the condition. That's not a particularly encouraging track record--"No better than random chance," in the words of one eye expert.
There are some treatment options for those people with advanced stages of either form of retinopathy: Photocoagulation--the use of laser beams---can seal leaking retinal blood vessels or reattach a detached retina. In some people, this is enough to stop the progression of diabetic retinopathy.
Vitrectomy is another, more intricate surgical procedure used in people with proliferative retinopathy. In this procedure, a physician removes the vitreous to clear out the light-blocking hemorrhage, uses microsurgery to repair the retina, if necessary, and then replaces the vitreous with a saline solution.
An article in the journal Annals of International Medicine explains that photocoagulation and vitrectomy prevent deterioration of vision in around 60 percent of patients. Laser therapy reportedly reduces the rate of vision loss by 50 percent in people with proliferative retinopathy and macular edema, conditions that often exhibit no symptoms. Vicrectomy reportedly improves visual acuity to 10/20 or better in 36 percent of treated eyes. That's the good news.
However, no surgery is free of potential complications. With vitrectomy, for example, the overall complication rate is about 25 percent, according to theAnnals of International Medicine article. Potential complications include infection, cataract development, bleeding, elevated pressure in the eye (which can lead to a condition called glaucoma), loss of vision, and retinal detachment or scarring.
Medical research is also looking at ways of slowing or even preventing the progression of retinopathy. One small Norwegian study found that people with type 1 diabetes who maintained near-normal levels of blood sugar over a long period of time--at least seven years--were significantly less likely to develop severe retinopathy. The patients in this study followed a tight-control regimen, using either continuous subcutaneous infusion pumps or multiple insulin injections.
The results of the Diabetes Control and Complications Trial show that tight blood-sugar control can prevent new cases of retinopathy. Tight control also helps retinopathy from growing worse, According to the study, the earlier tight control is instituted, the more beneficial it is at fending off complications.
Scientists are also hoping to discover why high levels of blood glucose damage the body's blood vessels. One theory is that an enzyme called aldose reductase, which converts glucose into a sugar alcohol called sorbitol, may play a role in triggering diabetic complications. For that reason researchers are looking into a class of drugs called aldose reductase inhibitors that block the actions of the enzyme. They hope these drugs can reduce the chance of developing retinopathy and other long-term complications. Studies are underway.
In November 1997, the Journal of the American Medical Association reported on a number of other agents that may potentially prevent retinopathy. These include aminoguanidine, a drug that inhibits the formation of certain proteins and lipids that are thought to contribute to blood vessel damage. Other possibilities include drugs that interfere with the growth of blood vessels in the retina; antioxidants such as vitamin E, thought to prevent damage to the endothelium (the innermost layer of the cornea, the clear covering of the eye); and agents that would interfere with the molecular and cellular reactions within the eye that cause cell death.
Although these new treatments sound promising, the key action in the here and now is getting prompt medical care for retinopathy, particularly if you have macular edema or proliferative retinopathy. Studies have found that there is a 16 percent risk for severe visual loss if proliferative retinopathy is left untreated for two years. That may sound like a small risk, but is it really one that's worth taking? You and your doctor must decide.
There are other ways diabetes can exacerbate retinopathy. Poor blood-sugar control, high blood pressure, and a history of smoking increase the risk of retinopathy and increase the chances that the condition will worsen. And as we mentioned before, people with type 1 diabetes are more likely to develop severe retinopathy.
A woman with type 1, type 2, or gestational diabetes who has no retinopathy before pregnancy is unlikely to develop retinopathy during pregnancy. However, the story is different for women with diabetes who already have some retinal damage when they become pregnant. About 5 to 12 percent of women with diabetes with mild retinopathy will see their retinopathy worsen. Women who already have moderate to severe diabetic retinopathy are at greater risk during pregnancy. In recent studies, about 47 percent of pregnant women with diabetes had an increase in severity in retinal damage, and 5 percent developed proliferative retinopathy.
These rapid changes may be due to the increased levels of hormones that accompany pregnancy. Pregnancy-induced or chronic high blood pressure is thought to play a role, too. In one study, 55 percent of pregnant women with diabetes who had high blood pressure in addition to retinopathy saw their retinopathy worsen, compared with 25 percent of the women who had normal blood pressure and retinopathy.
Experts say that pregnant women with signs of retinal damage can slow the progression of retinopathy by lowering blood-pressure levels. Doctors have also found that treating a woman's retinopathy with photocoagulation  can help reduce the risk of progression if the laser treatment is done before she becomes pregnant.
Like anyone with diabetic retinopathy, pregnant women should get regular eye examinations to monitor the course and development of this complication.
NEPHROPATHY
Officially known as diabetic nephropathy, nephropathy is a type of kidney disease that leads to kidney failure. Nephropathy tends to develop in people who have had diabetes for 20 years or more. It used to be that a third of all people with type 1 diabetes developed nephropathy, but today's treatment methods and the emphasis on better blood-sugar control are shrinking that percentage. People with type 2 diabetes develop nephropathy infrequently.
How It Happens
To see why nephropathy would be a problem, let's look first at what the kidneys do. The kidneys are organs located near the waist. Inside the kidneys are small blood vessels, called glomeruli, that act as filters, removing wastes from the blood and discharging them through the urine. Useful products, such as protein and glucose, are not eliminated but are sent back into the bloodstream.
Nephropathy is the condition in which small arteries in the kidneys become hardened and the glomeruli become damaged, in much the same way that the small vessels of the eye become damaged during retinopathy. The kidneys ultimately fail in their job of filtering out wastes. People with kidney failure must go on dialysis (the use of a machine to filter blood) or have a kidney transplant; otherwise, lethal levels of wastes and toxins build up in their bodies.
Nephropathy is caused by high blood-sugar levels. Also, high blood pressure, arteriosclerosis, smoking, and high cholesterol increase the likelihood of kidney complications. Frequent urinary tract infections add to the problem because an infection can easily spread to the kidneys and damage them.
Recognizing the Signs
Early warning signs of nephropathy include problems emptying the bladder, blood in the urine, and urinary tract infections. The disease can be confirmed through simple urine and blood tests. Just as the kidneys lose their ability to discharge wastes, they also lose their ability to keep protein and glucose in circulation. Sugar and protein begin to show up in the urine tests in larger and larger amounts. Blood tests also detect high levels of urea nitrogen and creatinine, another indication of kidney damage.
Handling the Problem
To halt kidney damage before kidney failure occurs, the wisest step is to take urinary tract infections seriously. Remember: Infections can back up further into the urinary system and spread to the kidneys, impairing their function.

If signs of developing kidney problems are detected, doctors often recommend a regimen of tight blood-sugar control and a low-protein diet to ease stress on the kidneys. Recent clinical studies suggest that use of the blood-pressure drug enalapril (Vasotec) may preserve kidney function, but more research is needed to confirm this.

CARDIOVASCULAR DISEASE
The word cardiovascular means "of the heart and blood vessels." Cardiovascular complications include problems such as angina, heart attack, stroke, and others related to poor circulation. Cardiovascular disease is the most common complication of type 2 diabetes. In fact, people with diabetes have a risk of cardiovascular disease that is two to five times that of people without the condition.
How It Happens
Just as diabetes changes the shape of the small blood vessels (known as microvascular changes), it also appears to thicken and obstruct the walls of the large blood vessels, thus restricting blood flow. These are called macrovascular changes. Macrovascular changes (such as arteriosclerosis, or hardening of the arteries) have been called the "underlying event" behind most cardiovascular disease. There's no doubt about it: Cardiovascular complications are very debilitating side effects of diabetes. However, the risk for such complications can be decreased by tight blood-sugar control.
Recognizing Risk Factors
Many factors can put a person with diabetes at risk of having a stroke or heart attack. Just having diabetes increases a person's risk of experiencing a stroke, according to the American Journal of Epidemiology, regardless of whether or nor the person has another risk factor--for example, if he follows a sedentary lifestyle, eats a high-fat diet, has high blood pressure, or smokes cigarettes. High blood pressure alone is a major cause of strokes.
Heart attacks and strokes are more common in people with type 2 diabetes than in those with type 1 diabetes, yet medical science is not sure exactly why this is. Experts believe it could be because people with type 2 diabetes tend to be overweight. (Obesity is a known risk factor for heart attack and stroke.)
Cardiovascular complications are, in the general population, more common in men than in women: Women experience strokes and heart attacks less frequently than men. Among people with diabetes, however, the men and women (especially those with type 2 diabetes) have an equal chance of suffering poor outcomes after heart attacks; they have a much higher cardiovascular death rate than their nondiabetic peers.
Overall, women seem to have a biological advantage when it comes to cardiovascular disease--most likely because of the effects of estrogen in women's systems. However, diabetes appears to be the great equalizer of the sexes, at least where heart attacks are concerned. Compared with men without diabetes, men with diabetes have about two times the average risk of developing cardiovascular disease; women with diabetes have three to five times the average risk of developing cardiovascular disease compared with women without the disease.
Handling the Problem
Because the rates of cardiovascular disease are so high in those with diabetes, the American Diabetes Association recommends and screening tests and intervention for heart disease for everyone with diabetes over age thirty.
Traditional screening tests include having your blood pressure taken with a blood pressure cuff and having your cholesterol evaluated with a blood test. An electrocardiogram (EKG) is also recommended. In this test, electrical leads are placed on the body to measure the electrical currents of the heart. The currents are then transcribed into a pattern along a continuous strip of graph paper, which is then read for any abnormalities.
To prevent heart disease in the first place, you can look to the obvious tactics of losing weight and lowering blood sugar in addition to some other methods. For example, if you've paid any attention to medical news in the past decade, then you should know that lowering levels of cholesterol and triglycerides is good for your heart. Cholesterol, a fatlike substance that comes from meat and diary products and is also produced by the body, is found in all the body's cells and in. the bloodstream. High levels of cholesterol in the blood, or hypercholesterolemia, have been implicated in the development of heart disease in general and arteriosclerosis (hardening of the arteries) in particular. What you may not know is that people with diabetes tend to have higher blood-cholesterol levels than other people. They also tend to have higher levels of low-density lipoprotein (LDL), what some call the "bad cholesterol" because it aids in the deposit of fats on artery and cell walls. As if that weren't bad enough, people with diabetes tend to have lower levels of the "good cholesterol," or high-density lipoprotein (HDL), the substance that escorts excess cholesterol from the body. All of this is unpleasant news for the cardiovascular system.
Triglycerides (sometimes known is VLDL, or very-low-density lipoprotein) are another form of fat in the body. High levels of triglycerides in the blood (hypertriglyceridemia) may not directly cause arteriosclerosis but may accompany other abnormalities that speed its development. People with diabetes tend to have high levels of triglycerides, too. Combine high triglyceride levels of 200 to 500 mg/dl with cholesterol levels between 200 and 300 mg/dl, and you have what the American Heart Journal calls combined hyperlipidemia, meaning too much fat. Triglycerides more than 500 mg/dl and/or cholesterol levels over 300 mg/dl are called massive hyperlipidemia. Combined and massive hyperlipidemia are found in over 30 percent of all people with diabetes--approximately two to three times more often than in people without diabetes.
We talk more about cholesterol and triglycerides in the next chapter when we examine diet. For now, it's enough to say that any person with diabetes who improves his cholesterol picture can help protect against developing cardiovascular problems. Evidence suggests that for every 1 percent reduction in blood-cholesterol level, there is a 2 percent reduction in coronary-artery disease for all people, regardless of whether they have diabetes.
Another thing that people with diabetes can do to reduce their risk of cardiovascular disease is to pop a simple pill, an aspirin. The remedy was discovered because a curious thing happened during the course of a clinical study known as the Early Treatment Diabetic Retinopathy Study.
Designed to gauge the effects of aspirin on diabetic retinopathy, the study included 3,700 people with type 1 and type 2 diabetes. Half took two aspirins a day (totaling 650 milligrams); the other half took a placebo. It turned out the aspirin had no effect, positive or negative, on retinopathy. But something positive did take place: People taking aspirin were 17 percent less likely to have had a heart attack during the five years of the study.
Aspirin can't solve all the cardiovascular woes of someone with diabetes, nor is aspirin useful for everyone. But it would be worth a trip to the doctor to discuss what aspirin can do for you.
Your doctor may also suggest treatment with drugs such as beta blockers or ACE (angiotensin-converting enzyme) inhibitors--which help reduce the risk of heart attack in people who already have cardiovascular disease-or simvastatin, a drug that helps lower cholesterol levels and reduces the risk of death from heart attack.
NEUROPATHY
Neuropathy is nerve damage. The word "damage" suggests something irrevocable and permanent, but actually, this is one long-term complication of diabetes with symptoms that can appear and disappear in a short period of time. It also varies in intensity, ranging from mild discomfort to severe, disabling pain.
How It Happens
As is true about many diabetic complications, neuropathy has stumped medical science when it comes to its causes. It's thought that something interferes with the body's nerve pathways so that nerve impulses are no longer transmitted properly. The culprit may be uncontrolled blood-sugar levels (although many people with good control develop this complication), or it may be that the nerves are somehow damaged during the metabolic changes associated with diabetes.
Neuropathy is relatively common. It's estimated that some form of nerve damage affects 60 to 70 percent of people with diabetes at some point in their lives. Some physicians claim that it's often the first noticeable sign of diabetes, particularly type 2. Unfortunately, neuropathy mimics many other medical conditions (as you'll see in a moment), so it's often initially diagnosed as something else.
Recognizing the Signs
In general, there are two main forms of neuropathy: peripheral and autonomic. The most common form of nerve damage, peripheral neuropathy, is sometimes called sensory neuropathy because it affects nerves that control sensations in the body. It also affects muscles controlled by sensory nerves. Sensory neuropathy can weaken muscles in the thighs, eyes, chest, and abdomen, sometimes causing painful muscle wasting, double vision and chest pain, More commonly, sensory neuropathy creates odd sensations (or, in some cases, loss of sensation) in the legs, feet, and hands. The sensations include numbness, tingling, muscle weakness and sporadic shooting pains. These sensations can be mild or they can be annoying. Some people experience double vision for short periods of time; others have great difficulty walking because of pain or because they lose some control of leg movements. Neuropathy has been known to interfere with sleep or rest.
In general, peripheral neuropathy is a temporary condition--one that disappears as mysteriously as it appears. However, it can lead to injury in cases where the person with diabetes feels no sensations of pain. This often happens on the bottoms of the feet, resulting in some of the foot problems that we discuss shortly.
Autonomic neuropathy is a less common complication, perhaps experienced by 20 percent of people with diabetes. Autonomic neuropathy is damage to the nerves that control various bodily functions, such as the digestive system, urinary tract, and cardiovascular system.
Autonomic neuropathy leads to many inconvenient problems: When it affects the nerves around the stomach, bladder, and bowels, it can cause vomiting, constipation, and feelings of bloatedness. When it affects the nerves that control the contraction of blood vessels, a condition called orthostatic hypotension may develop. This is a sudden drop in blood pressure when a person gets up after reclining, which may result in dizziness or fainting, Impotence, the loss of the ability to have an erection, is also related to (although not entirely caused by) neuropathic damage.
Handling the Problem
The symptoms of neuropathy of both types can be treated. Doctors often prescribe drugs to treat the symptoms of these different problems----for example, to relax muscles if the problem is constipation. Exercise helps some people; others benefit from bed rest. Because neuropathy varies tremendously from person to person, treating it is often a matter of trial and error.
But though symptoms can be treated, neuropathy itself cannot be reversed. Medications to treat or prevent nerve damage do not yet exist, although researchers are conducting studies using aldose reductase inhibitors-experimental drugs we discussed earlier in relation to retinopathy.
FOOT PROBLEMS
Cardiovascular complications damage blood vessels and diminish blood flow to the legs and feet. Add damage to the nerves of the legs and feet through neuropathy, and you've just laid the groundwork for serious foot ailments.
How They Happen
Foot ailments show up in about half of people who have had diabetes for 20 years or more. The scenario then proceeds like this: When people with diabetes lose sensation in their lower legs and feet, they are less likely to notice damage to the skin and tissues. Such seemingly minor injuries as cuts, bruises, blisters, bunions, corns, calluses, ingrown toenails, or even athlete's foot can develop into areas of infected tissue known as neuropathic ulcers.
It may seem impossible that a blister turns into an ulcer, yet the process is fairly simple. Let's say you have a new pair of shoes that has chafed and rubbed one foot raw. The area is red and inflamed. Once an inflammation or infection begins, its swelling compresses the blood vessels, which are already damaged or narrowed by diabetes itself. These factors diminish the flow of blood to the irritated area, meaning fresh oxygen and infection-fighting blood cells have a more difficult time getting to the problem site. All of this sets the stage for a serious infection. Once infection sets in, it's difficult to treat. Antibiotics, which are carried in the blood, can't reach the infected area efficiently. About 80 percent of foot ulcers occur on the bottom of insensate feet, or feet without feeling.
The real danger with the combination of infection and reduced blood flow is gangrene. If blood flow were to be completely blocked, the cells served by the obstructed blood vessels would die. Once gangrene sets in, the only way to stop its spread is by amputation of the dead tissue.
According to an article in Archives of Internal Medicine, "It has been estimated that the lifetime risk of a lower-extremity amputation is 5 to 15 percent among diabetic individuals, a risk fifteen times that of the nondiabetic population."
More than half of all lower-limb amputations in the United States are performed on people with diabetes. Each year, reports the American Podiatric Medical Association, the number of lower-limb amputations due to diabetic complications in the United States exceeds the number of limbs lost worldwide to land mines. Almost half of these 67,000 amputations could have been prevented through early detection and treatment.
Recognizing Risk Factors
As is true with all diabetic complications, certain factors increase risk of foot problems. The greatest of these is smoking. According to the American Diabetes Association, of the people with diabetes who need amputations, almost all are smokers. Other high-risk factors include being male and being African-American or Native American. Risk increases with age, too.
A 1998 study published in the Archives of Internal Medicine listed a number of criteria doctors can use to determine a patient's risk of foot ulcers. These include a history of amputation, diabetes for more than ten years, existing foot deformities, neuropathy, and difficulty feeling vibrations with the feet. The study authors encouraged practitioners to survey for these criteria in order to prevent such complications.
Handling the Problem
The trick to treating and preventing foot problems lies in finding out ifs a blood vessel is about to become blocked. It used to be that doctors could locate blockages in large vessels, such as those of the legs, only by ordering an x-ray called an angiogram. Then they might perform bypass surgery to detour blood around the blockage. In this surgery, a piece of healthy vein is "harvested" from an area of the body (possibly the thigh) and is attached at either end of the obstruction. The new vein directs blood to cells that had been receiving an inadequate supply. It's one method of preventing gangrene-albeit an invasive and expensive one.
Like many other diabetic complications we have discussed, amputation doesn't have to happen. With proper foot care, many, if not most, amputations may well be avoided.

Monday, August 1, 2011

7 Foods That Help You Shed Pounds

Water works

Ever hear that water can help you lose a few extra pounds? It can—if you eat foods that contain a lot of water, like fruits and veggies. In a University of Tokyo study, women who ate high-water-content foods had lower body mass indexes and smaller waistlines. Researchers speculate that the water in these foods may fill you up so you eat less. Make the strategy work for you by adding more of these in-season fruits and veggies—each is at least 90% water—to your meals.
Broccoli
Did you know broccoli is a great source of fiber and calcium? Try this delicious recipe for Broccoli Salad With Sesame Dressing and Cashews.

Cabbage

Rich in antioxidants like vitamin C, cabbage is a great immune-booster. Enjoy it lightly sautéed in a stir-fry or paired with sweet-tart apples. Or, try this recipe for red cabbage and apple salad with ginger vinaigrette.

Cauliflower

Like other cruciferous veggies, cauliflower is full of cancer-fighting phytonutrients and is a great source of vitamin C and folate. Nibble on raw or lightly steamed florets to maximize cauliflower's antioxidant power, or try this potassium-rich recipe forCauliflower and Yukon Gold Soup.

Grapefruit

A powerhouse for heart health, grapefruit contains vitamin C, folic acid, and potassium, along with pectin, a soluble fiber that may be a strong ally against atherosclerosis. Pink and red varieties also have vitamin A and lycopene, a phytochemical that protects arterial walls from oxidative damage. To get the juiciest specimens, select fruits heavy for their size and make sure to try them in this refreshing .

Lettuce

With a mere 60–70 calories per pound, lettuce is high on the list of diet-friendly foods. Romaine lettuce alone is a great source of B vitamins, folic acid, and manganese, which helps regulate blood sugar and is essential for proper immune system function. Choose other dark green or purple varieties such as green or red leaf for the most nutrients, and toss with a zesty homemade vinaigrette, or use in this hearty Layered Cobb Salad.

Radishes

These brightly colored vegetables are packed with potassium, folic acid, antioxidants, and sulfur compounds that aid in digestion. Don't forget the leafy green tops, which contain six times the vitamin C and more calcium than the roots. Thinly slice and toss in a fresh green salad or julienne for coleslaw. Try this recipe for grilled chicken with sweet-and-sour cucumber-radish salad.

Spinach

Tender and flavorful, this leafy green is rich in iron, folic acid, and vitamin K. It also contains disease-fighting antioxidants beta-carotene and vitamin C, as well as the phytochemical lutein, which protects eyes against age-related macular degeneration. Use as a substitute for lettuce in salad, lightly sauté with shredded carrot, sliced mushrooms, and garlic for a savory omelet filling, or try this simple Seasoned Spinachrecipe for a quick and nutritious side dish.

Friday, July 29, 2011

Yoga can reduce chronic pain, study finds

A small Canadian study announced July 27 found that practicing yoga twice weekly for eight weeks reduced the symptoms of chronic pain and mental stress in women with fibromyalgia.
The study is the first to look at the effects of yoga on levels of the hormone cortisol in women suffering with fibromyalgia. The condition, which predominantly affects women, is associated with chronic pain and fatigue, and symptoms such as muscle stiffness, sleep disturbances, and depression.
Previous research has found that women with fibromyalgia have lower-than-average cortisol levels, which can contribute to pain, fatigue, and stress sensitivity, according to the researchers. In the new study, participants' saliva revealed enhanced cortisol levels following a program of 75 minutes of hatha yoga twice weekly over the course of eight weeks. Also patients reported significant reductions in their pain levels, as well as a mental boost from the yoga practice.

"Ideally, our cortisol levels peak about 30-40 minutes after we get up in the morning and decline throughout the day until we're ready to go to sleep," said the study's lead author, Kathryn Curtis, a PhD student at York University in Canada. "The secretion of the hormone, cortisol, is dysregulated in women with fibromyalgia."
The study, published in the Journal of Pain Research, and follows another published earlier this year that found that patients with rheumatoid arthritis who practiced yoga showed significant improvements in their symptoms.
Earlier this year, a study was published in the Journal of Neuroscience that found that meditation also delivered powerful pain-relieving effects to the brain with even just 80 minutes' training for a beginner in an exercise called focused attention. In the study, the subjects each took four 20-minute sessions to learn how to control their breathing and put aside their emotions and thoughts.

Thursday, July 28, 2011

Getting A Good Night's Sleep

A good night's sleep is something we all value. Scientists tell us, and we know from experience, that it refreshes us, helps us perform better, and contributes significantly to health and happiness, especially in children. And yet, there are millions of us suffering from ongoing shortage of sleep.

According to the World Association of Sleep Medicine (WASM), sleep problems add up to a global epidemic that affects 45% of the world's population.

"Insomnia, obstructive sleep apnea (OSA), restless legs syndrome (RLS), and sleep deprivation significantly impact physical, mental and emotional health, in addition to affecting work performance and personal relationships," they said, on the fourth annual World Sleep Day on Friday 18th March 2011, when health professionals from WASM and other organizations worldwide came together to deliver the message that sleep is a "human privilege that is often compromised by the habits of modern life".

Dr R Michael Seyffert of the New Jersey Neuroscience Institute at JFK Medical Center in Edison, sees two or three teenagers a month with severe night-time cell phone problems, which he defines as spending two or more hours of texting and phoning each night. He says he has seen more of this in the last five years than ever before, and predicts it is only going to get worse.

Few would disagree with him: as we drift on this tide of technology toward a total 24/7, globally connected society, with an increasing number of gadgets to inform, stimulate and entertain us, the traditional boundaries between activity and sleep are being eroded, and we are likely to see a rise in the number of people experiencing health problems from lack of sleep.

How Much Sleep Do We Need?

Expert opinion varies as to the exact number of hours of sleep we need for optimum health, and some suggest it also depends on individual needs and age. The American Academy of Sleep Medicine says most adults need about seven to eight hours of sleep a night to feel alert and well rested. The National Sleep Foundation also recommends between 7 and 9 hours.

One recent study suggests it could be as little as 6 hours, but more than 9 hours could be just as bad as not enough. Dr Charles Bae, a neurologist at the Cleveland Clinic Sleep Disorders Center in Ohio, and colleagues examined data on 10,654 patients who had competed questionnaires about quality of life, depression and average hours sleep per night.

They were surprised to find that sleeping more than 9 hours a night was linked to a similar reduction in quality of life and increase in symptoms of depression as sleeping less than 6, they said at the SLEEP 2011 conference in Minneapolis.

Children and teenagers need more sleep than adults. Teenagers need at least 9 hours, says the National Sleep Foundation in the US.

Many people do not realize that sleep is far from being a "passive" process where the brain just switches off at night. It is an "active" process involving the whole body and the brain.

Neurotransmitters, chemicals that brain cells use to signal to each other, control whether we are asleep or awake by action on different parts of the brain. In the brainstem, which joins the brain to the spinal cord, brain cells produce serotonin and norepinephrine that keep some parts of the brain active while we are awake, while other brain cells at the base of the brain control signals that lead to sleepiness and falling asleep by "switching off" the ones that keep us awake.

When we sleep we go through several stages of sleep from light to deep sleep, and then the cycle starts over. One of the stages is REM (rapid eye movement), which stimulates the brain regions used in learning. Infants spend much more time in REM sleep than adults. REM is also linked to increased production of proteins and learning of mental skills.

Research also suggests that a chemical called adenosine, which causes drowsiness, gradually accumulates in the bloodstream while we are awake and gradually breaks down during sleep.

Insufficient sleep is linked to diabetes, cardiovascular disease, obesity and depression, and other chronic diseases.

Lack of sleep is also responsible for accidents on roads and involving machinery, causing substantial injury and disability every year, according to the US Centers for Disease Control and Prevention (CDC), who warn that "drowsy driving can be as dangerous --and preventable -- as driving while intoxicated".

Top Tips for Getting a Good Night's Sleep

Against this backdrop of the encroaching 24/7 technological society eroding our sleep boundaries, we also have the usual stresses and strains of everyday life and work, the responsibilities of running a home, and taking care of family. Add to this financial worries, threat and reality of job loss, relationship problems, and coping with illness, it is no wonder that getting a good night's sleep is even more elusive. One thing we can do is to shift our perception of sleep as a luxury and treat it as necessity for good health, as important as keeping to a healthy weight, eating a healthy diet and taking plenty of exercise: we need to regard sleep as a "vital sign" of good health, say the CDC.

Here are some tips that might help:

Tip 1: Keep a Sleep Journal

A good place to start if you think you are not getting enough hours or quality of sleep at night, is to keep a sleep journal noting things like hours of sleep, ease or difficulty of falling asleep, when you exercise, when you drink alcohol and caffeine, how refreshed you feel, and then look for patterns between quality and length of sleep and what you do during the day and when you go to bed. This is often the first thing that a clinician will ask you to do.

For instance, after two weeks, you might find a pattern between exercise and sleep quality, or between caffeinated drink consumption late at night and the number of times you get up to go to the bathroom or difficulty falling asleep.

Tip 2: Stick to a Routine

Try to go to bed and get up at around the same time every day. Even at the weekend.

Keeping to a routine reinforces the body's sleep-wake cycle and helps you fall asleep more easily at night, say experts at the Mayo Clinic in the US.

If you need an alarm clock to wake you up on time, you should consider going to bed earlier.

Tip 3: Control Napping and Drowsiness

A cat-nap during the day can be a great refresher, especially for older people. But be careful about sleeping during the day: a refreshing nap may be useful occasionally for paying off your sleep debt, and is better than sleeping late because this disrupts your sleep-wake rhythm, but if you have insomnia and nap regularly, consider eliminating the daytime nap.

If you must have a nap, restrict it to 20 minutes and do it early afternoon and not later.

Drowsiness often happens after big meals. Avoid the temptation to let this drift into sleep. Get off the couch and get active: do the dishes, go for a walk, do some chores, or call a friend. The killer is the TV dinner: eat, fall asleep on the couch, wake up hours later, and then you can't get to sleep when you go to bed properly. We've all been there.

Tip 4: Avoid Lots of Drink and Food Before Bedtime

Keep in mind the saying: "breakfast like a king, lunch like a prince, and dine like a pauper". Eating or drinking large amounts before bedtime can result in indigestion, and night-time toilet visits to empty a bursting bladder. Try to eat a light meal at least two hours before bedtime, and if fatty or spicy foods give you heartburn, try to avoid them in your evening meal.

Be careful with coffee and tea, and other caffeinated drinks. Caffeine is a well-known stimulant that lingers in the body and if you drink it in the evening, it will not help you sleep. Try replacing that after-dinner coffee with chamomile tea, a traditional sleep inducing remedy that soothes.

Tip 5: Avoid Alcohol in the Evening

Although it is often thought of as a sedative, alcohol actually disrupts sleep. Even in small doses, it can impair quality of sleep, especially in the second half of the night.

Alcohol disrupts chemical messengers in the brain and the balance between REM sleep and non-REM sleep. The right balance in sleep patterns and brain waves, what scientists call "sleep architecture", helps us feel refreshed in the morning, as Jessica Alexander, of the UK's Sleep Council told the Times newspaper in an interview:

"Alcohol can mean that sleep is no longer refreshing, because the brain can't perform the normal restorative job it does during the night."

Tip 6: Make Your Bedroom Sleep-Friendly

Keep your bedroom dark, cool, quiet and comfortable. This is the ideal environment for sleeping. Consider carefully each item in your bedroom, especially gadgets. If you have to keep them there, then be strict about switching them off, or even put them away in a cupboard. Switch off the cell phone or turn it to silent mode.

Many people watch TV in bed and claim it helps them get to sleep. Try doing without it for two weeks, and see what effect it has on your quality of sleep. It could be that the light from the screen disturbs the natural sleep-wake rhythm, and stimulating content like violence, advertisements, sudden loudness, raises your adrenaline and has the opposite effect from that which eases your body into sleep.

If you can't lessen disturbing noises such as dogs barking, sirens, birds singing in the morning, then consider masking the sound with a fan or white noise generator, or wearing earplugs.

An eye mask that blocks out the light can also help if you wake up easily when a light goes on, or the early sun comes through the curtains.

Tip 7: Exercise in the Morning

Exercise is a great way to help us relax and consolidate sleep. However, when we exercise can affect our quality of sleep.

Researchers say that morning exercise is best, and that exercising too close to bedtime delays the time the body starts to unwind because it increases chemicals that are associated with wakefulness.

In a study published earlier this year, Dr Scott Collier, assistant professor at Appalachian State University, found that aerobic exercise at 7 am was linked to higher improvements in sleep quality than exercising at 1 pm and 7 pm.