Jumat, 30 November 2007

WHAT FOOD IS GOOD FOR MY HEART INCLUDING HEART ASSOCIATION LIFESTYLE RECOMMENDATIONS OLIVE OIL TRANS FATS OMEGA 3

WHAT FOOD IS GOOD FOR MY HEART INCLUDING HEART ASSOCIATION LIFESTYLE RECOMMENDATIONS....Eating and Not Eating Certain Foods Can Impact Your Heart





Eating certain foods and avoiding others can impact your cardiovascular heart health. Does your doctor discuss with you what foods to eat and foods to avoid for heart health? Several nutrition specialists made recommendations for what to eat to help the heart and prevent cardiovascular (heart) disease.

  • Eat more omega 3 fatty acids











    Studies have suggested that omega 3 fatty acids can help the heart.
    For example,the Physician's Health Study found that increased fish intake reduced the risk of sudden cardiac death.
  • Fish Consumption and Risk of Sudden Cardiac Death. Recall that certain kinds of fish such as tuna and salmon are high in omega 3 fatty acids. For more about the benefits of omega 3 fatty acids
  • healty medical Blog: Fish Containing Omega 3 Fatty Acids Are on The Recommended List of the American Heart Association




  • A Video and Statistical Analysis of the Mediterranean Diet



  • Eat more plant proteins















    They recommend to eat more grains,nuts,legumes.
  • What Are Legumes

    Eat vegetables and cut down on saturated fat and trans fats which tend to be found in meat and processed foods.Trans fats are thought to increase cholesterol levels. Trans fat content of food is listed on the food labels.



  • AMERICAN HEART ASSOCIATION LIFESTYLE DIET RECOMMENDATIONS
  • UK FOOD STANDARDS AGENCY What we eat can make a big difference to the health of our hearts
  • What Trans Fat Labels Mean: Read Them and Get Healthy



  • Eat Less Salt and Sodium. High salt and sodium are related to high blood pressure. The FDA is thinking about how to rein in the massive amounts of sodium that appear in our diets in everything from processed foods to medicines.



  • Eat more healthy food oils such as olive oil.



  • FDA Allows Qualified Health Claim to Decrease Risk of Coronary Heart Disease and
  • Eating for Life: Protecting Your Heart What is the Mediterranean Diet and the Lyon Heart Study and Olive Oil's Heart Effect Located


  • Eat less trans fats and saturated fats
  • Increase consumption of whole grains and dietary fiber and decrease refined grains
  • modify alcohol intake and exercise regularly




  • Nutritional Assessment and Counseling for Prevention and Treatment of Cardiovascular Disease
  • Kamis, 29 November 2007

    SALT MAKES FOOD TASTE GOOD BUT HIGH SODIUM INCREASES BLOOD PRESSURE AND MAYBE CANCER THE FDA SAYS SALT IS PROBLEM LIST OF SODIUM CONTENT IN FOODS


    SALT AND SODIUM IN FOODS SALT MAKES FOOD TASTE GOOD BUT HIGH SODIUM INCREASES BLOOD PRESSURE AND MAYBE CANCER THE FDA SAYS SALT IS PROBLEM





    A LIST OF SODIUM CONTENT IN FOODS SALT IN COMMON FOODS YOU WILL BE SURPRISED





    Salt is a tasty but potentially dangerous food additive. Sodium is in breakfast food,medicines, bread, soup everywhere! Too much sodium, (as in sodium chloride which is salt) has been linked to high blood pressure,a risk factor for heart disease and stroke. The FDA has said salt is a problem in the American diet. A study from the American Institute of Cancer Research found that salt and salt-preserved foods probably increase the chance of developing stomach cancer.










    The FDA says salt is a problem and now the FDA is deciding whether and how to regulate salt in foods. The problem is salt and sodium are ubiquitous in our diets and darn it! salt makes things taste good!



    Sample sodium content of some favorite snacks (see sodium content list )

  • Sausage, Frankfurter 1,100
  • Sausage, Bologna 1,300
  • Crackers, Graham 670
  • Crackers, saltines 1,100
  • Salad dressing 700 to 1300
  • Tomato ketchup 1,042
  • Cereal, Rice flakes 987
  • Baking powder 11,000











  • FDA Contemplating Crackdown on Salt



    Studies published in the British Medical Journal have shown that those who reduced their salt intake did have a lower risk of heart disease and stroke. "“Our study provides unique evidence that sodium reduction might prevent cardiovascular disease and should dispel any residual concern that sodium reduction might be harmful,” it concludes".


    Most sodium is consumed in the form of sodium chloride which is table salt. Other forms of sodium are also found in food, so watch out for salt AND sodium.
  • Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)



  • healty medical Blog TEN RECOMMENDATIONS FOR PREVENTING CANCER: WORLD CANCER RESEARCH FUND SAYS THIS IS WHAT YOU CAN AVOID DOING AND EATING TO LOWER RISK OF CANCER


    Work by a US team led by Nancy Cook, of Harvard Medical School, and including Paul K Whelton of Loyola Medical Center in Illinois have followed up two trials originally conducted in the late 1980s and early 1990s. Both were designed to persuade people to cut their salt intake and to measure how far their blood pressure fell.






    You would be surprised at what contains sodium.A cup of soup can contain 1300 milligrams of sodium (see the quiz below). I was amazed when I happened to check Alka Seltzer, a long time favorite of mine. I figured it is a combo of sodium bicarb, citric acid and aspirin. Here is a list of Alka Seltzer's contents per the Alka Seltzer web site:



  • each tablet contains: sodium 567 mg
  • Aspirin 325 mg
  • Heat treated sodium bicarbonate 1916 mg
  • Citric acid 1000 mg
  • Alka-Seltzer® in water contains principally the antacid sodium citrate and the analgesic sodium acetylsalicylate.
  • Alka Seltzer Web Site



    Try this
  • Quiz on Finding Sodium in Your Diet



  • Here is A LIST OF THE SODIUM CONTENT OF COMMON FOODS


    "A key to healthy eating is choosing foods lower in salt and sodium. Most Americans consume more salt than they need. The current recommendation is to consume less than 2.4 grams (2,400 milligrams[mg] ) of sodium a day. That equals 6 grams (about 1 teaspoon) of table salt a day. The 6 grams include ALL salt and sodium consumed, including that used in cooking and at the table. For someone with high blood pressure, the doctor may advise eating less salt and sodium, as recent research has shown that people consuming diets of 1,500 mg of sodium had even better blood pressure lowering benefits. These lower-sodium diets also can keep blood pressure from rising and help blood pressure medicines work better".









  • The World Famous All Scrubbed Up: "What is THAT?" Competition #3 Part 2 - The Answer!

    Congratulations EmergencyEmm!

    Human Papilloma Virus is not rare. This guy had an immune deficiency which allowed a fairly common infection (warts) to get out of hand.


    An extract from the original article:

    After testing samples of the lesions and Dede's blood, Dr Anthony Gaspari of the University of Maryland concluded that his affliction is caused by the Human Papilloma Virus (HPV), a fairly common infection that usually causes small warts to develop on sufferers.

    Dede's problem is that he has a rare genetic fault that impedes his immune system, meaning his body is unable to contain the warts.

    The virus was therefore able to "hijack the cellular machinery of his skin cells", ordering them to produce massive amounts of the substance that caused the tree-like growths known as "cutaneous horns" on his hands and feet.

    Dede's counts of a key type of white blood cell are so low that Dr Gaspari initially suspected he may have the Aids virus.

    But tests showed he did not, and it became clear that Dede's immune condition was something far rarer and more mysterious.

    HPV is very common. It’s the virus that causes the warts on your fingers and knees as a kid – and yes, it’s the virus that causes genital warts (yech!). All doctors love those.

    As long as you all have good healthy immune systems, your wart virus will never get like this.

    Without getting overly medical - here's our favourite source - WikiDoc!

    Some HPV types may cause warts while others may cause a subclinical infection resulting in precancerous lesions. All HPVs are transmitted by skin-to-skin contact.

    A group of about 30-40 HPVs is typically transmitted through sexual contact and infect the anogenital region. Some sexually transmitted HPVs -- types 6, 11, may cause genital warts. However, other HPV types which may infect the genitals do not to cause any noticeable signs of infection.

    Persistent infection with a subset of about 13 so-called "high-risk" sexually transmitted HPVs, including types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68 — different from the ones that cause warts — may lead to the development of cervical intraepithelial neoplasia (CIN), vulvar intraepithelial neoplasia (VIN), penile intraepithelial neoplasia (PIN), and/or anal intraepithelial neoplasia (AIN). These are precancerous lesions and can progress to invasive cancer. HPV infection is a necessary factor in the development of nearly all cases of cervical cancer.[1]


    Another pic:


    So - 1 x guest post on offer to EmergencyEmm if he/she wants it!

    Senin, 26 November 2007

    SPIDER VEINS AND VARICOSE VEINS VIDEO OF LASER TREATMENT OF SPIDER VEINS and SCLEROTHERAPY OF VARICOSE VEINS HOW ARE VARICOSITIES SPIDER VEINS TREATED

    SPIDER VEINS AND VARICOSE VEINS VIDEO OF LASER TREATMENT OF SPIDER VEINS and SCLEROTHERAPY OF VARICOSE VEINS HOW ARE VARICOSITIES SPIDER VEINS TREATED







    About varicose veins and spider veins. If you're thinking of having vein treatments it helps to learn more about what varicose veins are and you can watch videos showing how varicose and spider veins are treated. This video shows a woman getting laser treatment for spider veins.I have also included below video of sclerotherapy performed on spider veins.









    Varicose veins and spider veins are those not so attractive veins that people develop on their legs. You see all sorts of confusing advertisements in the newspapers for how to treat varicose veins. "Spider veins are similar to varicose veins, but they are smaller. They are often red or blue and are closer to the surface of the skin than varicose veins. They can look like tree branches or spider webs with their short jagged lines. Spider veins can be found on the legs and face".



  • Click Here to Learn About RADIO FREQUENCY CATHETER A NEWER FASTER METHOD TO TREAT VARICOSE VEINS




    Veins have one-way valves composed of two leaflets that close together when filled with blood. The closed valve prevents blood from flowing back into the leg. If these valves become damaged and fail to function properly (become incompetent) blood can become static in the leg. If the valve is not closing properly blood falls back down and causes pressure sideways. Resulting in varicose veins.



  • Doctor Says Not Treating Varicose Veins Leading to Complications



    "Varicose veins are enlarged veins that can be flesh colored, dark purple or blue. They often look like cords and appear twisted and bulging. They are swollen and raised above the surface of the skin. Varicose veins are commonly found on the backs of the calves or on the inside of the leg. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus".



    A VIDEO ABOUT TREATMENT OF SPIDER VEINS AND VARICOSE VEINS USING LASER..CLICK THE ARROW TO BEGIN





    How are Varicose and Spider Veins Treated?




    "Besides a physical exam, your doctor can take x-rays or ultrasound pictures of the vein to find the cause and severity of the problem. You may want to speak with a doctor who specializes in vein diseases or phlebology. Talk to your doctor about what treatment options are best for your condition and lifestyle. Not all cases of varicose veins are the same".











    Some available treatments include:


  • Sclerotherapy


    "This is the most common treatment for both spider veins and varicose veins. The doctor injects a solution into the vein that causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood and the vein turns into scar tissue. In a few weeks, the vein should fade. The same vein may need to be treated more than once.



    HERE IS A VIDEO OF SCLEROTHERAPY FOR SPIDER AND VARICOSE VEINS..CLICK THE ARROW TO BEGIN







    This treatment is very effective if done the right way. Most patients can expect a 50% to 90% improvement. Microsclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia, and can be done in the doctor's office.



    Possible side effects include:


  • Temporary stinging or painful cramps where the injection was made
  • Temporary red raised patches of skin where the injection was made
  • Temporary small skin sores where the injection was made
  • Temporary bruises where the injection was made
  • Spots around the treated vein that usually disappear
  • Brown lines around the treated vein that usually disappear
  • Groups of fine red blood vessels around the treated vein that usually disappear













    "The treated vein can also become inflamed or develop lumps of clotted blood. Applying heat and taking aspirin or antibiotics can relieve inflammation. Lumps of coagulated blood can be drained".



  • Laser surgery

    "New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends very strong bursts of light onto the vein. This can makes the vein slowly fade and disappear. Lasers are very direct and accurate. So the proper laser controlled by a skilled doctor will usually only damage the area being treated. Most skin types and colors can be safely treated with lasers".



    Laser surgery is more appealing to some patients because it does not use needles or incisions. Still, when the laser hits the skin, the patient feels a heat sensation that can be quite painful. Cooling helps reduce the pain. Laser treatments last for 15 to 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity right after treatment, just as with sclerotherapy. For spider veins larger than 3 mm, laser therapy is not very practical.



    Possible side effects of laser surgery include:


  • Redness or swelling of the skin right after the treatment that disappears within a few days.
  • Discolored skin that will disappear within one to two months.
  • Rarely burns and scars result from poorly performed laser surgery.
  • Endovenous Techniques (radiofrequency and laser) – These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.



    The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal flow of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques".



    Possible side effect is slight bruising.


  • Endovenous Techniques (radiofrequency and laser)



    "These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.





    The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal f low of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.


    Possible side effects:
    Slight bruising.

  • Surgery

    Surgery is used mostly to treat very large varicose veins. Types of surgery for varicose veins include:



  • Surgical Ligation and Stripping
    With this treatment, problematic veins are tied shut and completely removed from the leg. Removing the veins does not affect the circulation of blood in the leg. Veins deeper in the leg take care of the larger volumes of blood. Most varicose veins removed by surgery are surface veins and collect blood only from the skin. This surgery requires either local or general anesthesia and must be done in an operating room on an outpatient basis.



    Possible side effects: Serious side effects or problems from this surgery are uncommon.


  • With general anesthesia, a risk of heart and breathing problems.
  • Bleeding and congestion of blood can be a problem. But the collected blood usually settles on its own and does not require any further treatment.
  • Wound infection, inflammation, swelling and redness.
  • Permanent scars.
  • Damage of nerve tissue around the treated vein. It is hard to avoid harming small nerve branches when veins are removed. This damage can cause numbness, burning, or a change in sensation around the surgical scar.
  • A deep vein blood clot. These clots can travel to the lungs and heart. Injections of heparin, a medicine that reduces blood clotting reduce the chance of these dangerous blood clots. But, heparin also can increase the normal amount of bleeding and bruising after surgery.
  • Significant pain in the leg and recovery time of one to four weeks depending on the extent of surgery is typical after surgery.



  • Ambulatory Phlebectomy – With this surgery, a special light source marks the location of the vein. Tiny cuts are made in the skin, and surgical hooks pull the vein out of the leg. This surgery requires local or regional anesthesia. The vein usually is removed in one treatment. Very large varicose veins can be removed with this treatment while leaving only very small scars. Patients can return to normal activity the day after treatment.


  • Possible Side Effects:

  • Slight bruising
  • Temporary numbness



  • Endoscopic vein surgery

    With this surgery, a small video camera is used to see inside the veins. Then varicose veins are removed through small cuts. People who have this surgery must have some kind of anesthesia including epidural, spinal, or general anesthesia. Patients can return to normal activity within a few weeks.

  • Varicose Veins and Spider Veins
  • The World Famous All Scrubbed Up: "What is THAT?" Competition #3 Part 1

    This one really got to me. I don't know what it is about us mere non-doctor mortals. SA Doc giggled and said "fascinating". I almost threw up.

    Anyhoo.

    Welcome to the WHAT IS THAT COMPETITION PART #3! Guess the medical thingy in the picture and you could win an AMAZING guest post on All Scrubbed Up valued at millions of emotional dollars!

    So... Here we go. What is THAT?!


    HINT:

    "I've never seen anything like this in my entire career."
    - Dr. Gaspari

    Minggu, 25 November 2007

    MOST COMPLETE AND COMPREHENSIVE MEDICAL STUDENT BLOGS LIST: LEARN ABOUT MEDICAL SCHOOL BY READING MEDICAL STUDENT BLOGS


    MOST COMPLETE AND COMPREHENSIVE MEDICAL STUDENT BLOGS LIST: LEARN ABOUT MEDICAL SCHOOL BY READING MEDICAL STUDENT BLOGS






    The most comprehensive list of medical student blogs probably on the Internet.Where medical school meets the Internet you find medical blogs. Medical students chronicling their thoughts and experiences about medicine and medical school. For someone interested(or just living vicariously) in attending medical school a great resource. I found a long and thorough list of medical student blogs.He doesn't write very often but when he does Mark Rabnett writes very well and at a high level.



    serve on the Executive Council of the Faculty Association. This is a working blog, where I record some of my professional hits and misses, with the occasional infusion of humour, while avoiding both ideological truculence and plodding nugacity".(I didn't know what nugacity is either, it means " trifling talk or behavior")(Reading his blog is good for your vocabulary too!)
  • Shelved in the W's








    Here is a partial list of medical student blogs. You van find the complete list at his blog.



    "This is a selected list of English-language med student blogs (and by that I mean I couldn't possibly find all the blogs out there, with new ones coming online every day it seems). I also ruled out blogs that did not have very recent posts; so some infrequent posters, or bloggers who must have got lost on their summer camping trip, are not included".






  • Agraphia - "Names are changed, stories are exaggerated, dates are made up, truths are bent. I’m a second year med student who has surprised himself with an ability to keep a blog running"


  • Anatomy on the Beach - "A medical student studying in the Caribbean."

  • The Angry Medic - "The Angry Medic is an idiot who got into Cambridge University by virtue of his unusually attractive eyelashes."


  • The Future Dr. House, D.O. - "Follow the life of an eager, wide-eyed, overly passionate premedical student as he slowly turns into the cynical, jaded and sarcastic, but brilliant, Dr. Gregory House, D.O."

  • The girl with the blue stethoscope - "I'm a medical student rapidly sliding towards the end of first year and I'm writing from the perspective of somebody who has had another career in health but wanted to be able to do so much more."

  • Half MD.com - "At the halfway point in medical education"

  • The Haversian Canal - "By Niels Olson, a Navy Lieutenant and third year medical student in New Orleans"

  • I Am Not A Drain On Society - "I'm destined to be a Drain on Society for at least another 5 years now - dodging tax and national insurance contributions while taking tax payers money to fund my education. Yeah right! By the time I finish (in 2011!) I will have been in full time education for 23 years (university for 9 alone). Depressing isn't it...."

  • I'm a medical student. Get me out of here! - "I'm a 5th year medical student at a Northern medical school in the UK. I like to moan and complain a lot and what better way to do so than with a blog. Follow my journey through medical school and life."


  • Island Med Student - "My name is Kendra and I am a second-year medical student attending Ross University School of Medicine on the Nature Island of Dominica."



    A VIDEO about what medical school is really like (click the arrow to begin)


  • Sabtu, 24 November 2007

    SPIDER VEINS AND VARICOSE VEINS VIDEO OF LASER TREATMENT OF SPIDER VEINS and SCLEROTHERAPY OF VARICOSE VEINS HOW ARE VARICOSITIES SPIDER VEINS TREATED

    SPIDER VEINS AND VARICOSE VEINS VIDEO OF LASER TREATMENT OF SPIDER VEINS and SCLEROTHERAPY OF VARICOSE VEINS HOW ARE VARICOSITIES SPIDER VEINS TREATED








    About varicose veins and spider veins. If you're thinking of having vein treatments it helps to learn more about what varicose veins are and you can watch videos showing how varicose and spider veins are treated.









    This video shows a woman getting laser treatment for spider veins.I have also included below video of sclerotherapy performed on spider veins.







    Varicose veins and spider veins are those not so attractive veins that people develop on their legs. You see all sorts of confusing advertisements in the newspapers for how to treat varicose veins. "Spider veins are similar to varicose veins, but they are smaller. They are often red or blue and are closer to the surface of the skin than varicose veins. They can look like tree branches or spider webs with their short jagged lines. Spider veins can be found on the legs and face".








    Veins have one-way valves composed of two leaflets that close together when filled with blood. The closed valve prevents blood from flowing back into the leg. If these valves become damaged and fail to function properly (become incompetent) blood can become static in the leg. If the valve is not closing properly blood falls back down and causes pressure sideways. Resulting in varicose veins.





    "Varicose veins are enlarged veins that can be flesh colored, dark purple or blue. They often look like cords and appear twisted and bulging. They are swollen and raised above the surface of the skin. Varicose veins are commonly found on the backs of the calves or on the inside of the leg. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus".





    A VIDEO ABOUT TREATMENT OF SPIDER VEINS AND VARICOSE VEINS USING LASER..CLICK THE ARROW TO BEGIN





    How are Varicose and Spider Veins Treated?





    "Besides a physical exam, your doctor can take x-rays or ultrasound pictures of the vein to find the cause and severity of the problem. You may want to speak with a doctor who specializes in vein diseases or phlebology. Talk to your doctor about what treatment options are best for your condition and lifestyle. Not all cases of varicose veins are the same".

    Some available treatments include:


  • Sclerotherapy


    "This is the most common treatment for both spider veins and varicose veins. The doctor injects a solution into the vein that causes the vein walls to swell, stick together, and seal shut. This stops the flow of blood and the vein turns into scar tissue. In a few weeks, the vein should fade. The same vein may need to be treated more than once.



    HERE IS A VIDEO OF SCLEROTHERAPY FOR SPIDER AND VARICOSE VEINS..CLICK THE ARROW TO BEGIN







    This treatment is very effective if done the right way. Most patients can expect a 50% to 90% improvement. Microsclerotherapy uses special solutions and injection techniques that increase the success rate for removal of spider veins. Sclerotherapy does not require anesthesia, and can be done in the doctor's office.



    Possible side effects include:


  • Temporary stinging or painful cramps where the injection was made
  • Temporary red raised patches of skin where the injection was made
  • Temporary small skin sores where the injection was made
  • Temporary bruises where the injection was made
  • Spots around the treated vein that usually disappear
  • Brown lines around the treated vein that usually disappear
  • Groups of fine red blood vessels around the treated vein that usually disappear



    "The treated vein can also become inflamed or develop lumps of clotted blood. This is not dangerous. Applying heat and taking aspirin or antibiotics can relieve inflammation. Lumps of coagulated blood can be drained".



  • Laser surgery

    "New technology in laser treatments can effectively treat spider veins in the legs. Laser surgery sends very strong bursts of light onto the vein. This can makes the vein slowly fade and disappear. Lasers are very direct and accurate. So the proper laser controlled by a skilled doctor will usually only damage the area being treated. Most skin types and colors can be safely treated with lasers".



    Laser surgery is more appealing to some patients because it does not use needles or incisions. Still, when the laser hits the skin, the patient feels a heat sensation that can be quite painful. Cooling helps reduce the pain. Laser treatments last for 15 to 20 minutes. Depending on the severity of the veins, two to five treatments are generally needed to remove spider veins in the legs. Patients can return to normal activity right after treatment, just as with sclerotherapy. For spider veins larger than 3 mm, laser therapy is not very practical.



    Possible side effects of laser surgery include:


  • Redness or swelling of the skin right after the treatment that disappears within a few days.
  • Discolored skin that will disappear within one to two months.
  • Rarely burns and scars result from poorly performed laser surgery.
  • Endovenous Techniques (radiofrequency and laser) – These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.



    The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal flow of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques".



    Possible side effect is slight bruising.


  • Endovenous Techniques (radiofrequency and laser)



    "These methods for treating the deeper varicose veins of the legs (the saphenous veins) have been a huge breakthrough. They have replaced surgery for the vast majority of patients with severe varicose veins. This technique is not very invasive and can be done in a doctor’s office.



    The doctor puts a very small tube called a catheter into the vein. Once inside, the catheter sends out radiofrequency or laser energy that shrinks and seals the vein wall. Healthy veins around the closed vein restore the normal f low of blood. As this happens, symptoms from the varicose vein improve. Veins on the surface of the skin that are connected to the treated varicose vein will also usually shrink after treatment. When needed, these connected varicose veins can be treated with sclerotherapy or other techniques.


    Possible side effects:
    Slight bruising.

  • Surgery

    Surgery is used mostly to treat very large varicose veins. Types of surgery for varicose veins include:



  • Surgical Ligation and Stripping
    With this treatment, problematic veins are tied shut and completely removed from the leg. Removing the veins does not affect the circulation of blood in the leg. Veins deeper in the leg take care of the larger volumes of blood. Most varicose veins removed by surgery are surface veins and collect blood only from the skin. This surgery requires either local or general anesthesia and must be done in an operating room on an outpatient basis.



    Possible side effects: Serious side effects or problems from this surgery are uncommon.


  • With general anesthesia, a risk of heart and breathing problems.
  • Bleeding and congestion of blood can be a problem. But the collected blood usually settles on its own and does not require any further treatment.
  • Wound infection, inflammation, swelling and redness.
  • Permanent scars.
  • Damage of nerve tissue around the treated vein. It is hard to avoid harming small nerve branches when veins are removed. This damage can cause numbness, burning, or a change in sensation around the surgical scar.
  • A deep vein blood clot. These clots can travel to the lungs and heart. Injections of heparin, a medicine that reduces blood clotting reduce the chance of these dangerous blood clots. But, heparin also can increase the normal amount of bleeding and bruising after surgery.
  • Significant pain in the leg and recovery time of one to four weeks depending on the extent of surgery is typical after surgery.



  • Ambulatory Phlebectomy – With this surgery, a special light source marks the location of the vein. Tiny cuts are made in the skin, and surgical hooks pull the vein out of the leg. This surgery requires local or regional anesthesia. The vein usually is removed in one treatment. Very large varicose veins can be removed with this treatment while leaving only very small scars. Patients can return to normal activity the day after treatment.


  • Possible Side Effects:

  • Slight bruising
  • Temporary numbness



  • Endoscopic vein surgery

    With this surgery, a small video camera is used to see inside the veins. Then varicose veins are removed through small cuts. People who have this surgery must have some kind of anesthesia including epidural, spinal, or general anesthesia. Patients can return to normal activity within a few weeks.

  • Varicose Veins and Spider Veins










  • FDA ISSUES PUBLIC HEALTH ADVISORY ON CHANTIX: STOP SMOKING MEDICINE POSSIBLE ERRATIC BEHAVIOR


    FDA ISSUES PUBLIC HEALTH ADVISORY ON CHANTIX: STOP SMOKING MEDICINE POSSIBLE ERRATIC BEHAVIOR






    The stop smoking medicine Chantix that works by a different more novel mechanism than other smoking cessation drugs has run into some problems. The FDA has updated it's warning about possible side effects from the stop smoking drug Chantix. "As the agency's review of the adverse event reports proceeds, it appears increasingly likely that there may be an association between Chantix and serious neuropsychiatric symptoms. As a result, FDA has requested that Pfizer, the manufacturer of Chantix, elevate the prominence of this safety information to the warnings and precautions section of the Chantix prescribing information, or labeling".




    Health care professionals, patients, patients' families, and caregivers should be alert to and monitor for changes in mood and behavior in patients treated with Chantix. Symptoms may include anxiety, nervousness, tension, depressed mood, unusual behaviors and thinking about or attempting suicide. In most cases, neuropsychiatric symptoms developed during Chantix treatment, but in others, symptoms developed following withdrawal of varenicline therapy.

    "Patients should immediately report changes in mood and behavior to their doctor.
    Vivid, unusual, or strange dreams may occur while taking Chantix. Patients taking Chantix may experience impairment of the ability to drive or operate heavy machinery".The FDA had previously written an "early communication" about reported problems with behavior of people taking Chantix.








    "The manufacturer of Chantix, Pfizer, Inc., recently submitted to FDA postmarketing cases describing suicidal ideation and occasional suicidal behavior. FDA currently is reviewing these cases, along with a number of recent reports in the popular press and internet sites. A preliminary assessment reveals that many of the cases reflect new-onset of depressed mood, suicidal ideation, and changes in emotion and behavior within days to weeks of initiating Chantix treatment."







    "The role of Chantix in these cases is not clear
    because smoking cessation, with or without treatment, is associated with nicotine withdrawal symptoms and has also been associated with the exacerbation of underlying psychiatric illness. However, not all patients described in these cases had pre-existing psychiatric illness and not all had discontinued smoking".



  • FDA Issues Public Health Advisory on Chantix







    Chantix is a relatively new medicine to stop smoking. Chantix works by a different mechanism than the previous smoking cessation drugs. "The active ingredient in Chantix, varenicline tartrate, is a new molecular entity that received a priority FDA review because of its significant potential benefit to public health. Chantix acts at sites in the brain affected by nicotineand may help those who wish to give up smoking in two ways: by providing some nicotine effects to ease the withdrawal symptoms and by blocking the effects of nicotine from cigarettes if they resume smoking. FDA Approves Novel Medication for Smoking Cessation




    The hodge podge of previous remedies to stop smoking include everything from acupunture and hypnosis, which by the way, do work for some people, to nicotine patches and an anti depressant. Zyban is actually the anti depressant Wellbutrin.
    The single most important factor in successfully stopping smoking is a very strong desire and reason to stop smoking.






    "Cigarette smoking is a very difficult habit to break due in large part to nicotine dependence or addiction" said Dr. Steven Galson, Director of FDA's Center for Drug Evaluation and Research. "Chantix therapy has proven to be effective in smokers motivated to quit and will provide another tool for physicians to use for the millions of smokers who want to quit."




    Take a look at the American Lung Association's Free Online Smoking Cessation Program




    Here is a
  • screen saver with a stop smoking theme from Massachusetts Health Dept.



    The effectiveness of Chantix in smoking cessation was demonstrated in six clinical trials, which included a total of 3659 chronic cigarette smokers who were treated with varenicline. Five of the six studies were randomized, controlled clinical trials in which Chantix was shown to be superior to placebo in helping people quit smoking. These smokers had previously averaged 21 cigarettes a day for approximately 25 years. In two of the five placebo-controlled studies, Chantix-treated patients were also more successful in giving up smoking than patients treated with Zyban (bupropion).



    The approved course of Chantix treatment is 12 weeks. Patients who successfully quit smoking during Chantix treatment may continue with an additional 12 weeks of Chantix treatment to further increase the likelihood of long-term smoking cessation. In clinical trials, the most common adverse effects of Chantix were nausea, headache, vomiting, flatulence (gas), insomnia, abnormal dreams, and dysgeusia (change in taste perception)."



  • Chantix was Molecule of the Month









  • Kamis, 22 November 2007

    GUEST POST: Tough Surgeon (by Bongi)

    Second post (in an initial public offering - har har - of 3) by our man with the plan - BONGI!

    Enjoy... I didn't. This one was particularly gross for us "mere mortals". Read more of Bongi's stuff here.


    - - - - -


    A story that i thought quite funny at the time, illustrating us macho surgeons...

    sigmoid volvulus. a wonderful condition which is very common in africa. not the type the textbooks talk about found in institutionalised old folk, but the type found in young black adult males. prevalence highest in uganda, decreasing as one moves south, but still pretty common in south africa. so in my registrarship, i became quite good at detorting the volvulus which is the emergency treatment in casualties. if this doesn't work or on sigmoidoscopy (siggy as we called it) if you see any questionable bowel, immediate laparotomy is performed.

    anyway the patient came in and had a clear sigmoid volvulus on examination and x-rays. i got the siggy ready to detort and place a flatus tube. now, for the lay person, in this area of blocked colon, the feces has been rotting. yes rotten feces, the only thing to top regular or garden variety feces. the feces is also under extreme pressure, so as you insert the siggy, it deflates with vigor (explosively). many of my friends got showered with this rotten projectile fecal matter and often in their face when they detorted sigmoid volvulus on more than one occasion. i had evolved a way of doing it that decreased my chances of being the proverbial fan that was just about to get hit. yes, i think i was pretty good at it. in fact the picture above is me with my trusty siggy ready to detort a volvulus.

    so, getting back to the story; i called the students to see the procedure, because this could be their only chance to see it. i set everything up and started the siggy, with an enterage of students, a house doctor and a rotating medical officer standing to observe. i got to the twist, observed to make sure there was no necrosis and started gently inserting the flatus tube. it slipped easily in. and as usual there was a sudden and massive release through the tube of rotten feces and particularly rancid flatus. i stood there trying to control my gag reflex. it would be considered an acute loss of cool if the tough surgeon was seen to be gaging at anything by his awe struck juniors (tongue in cheek for those who wonder). i just couldn't. i gagged over and over again. now i was struggeling to prevent myself from vomiting. despite this, my prominent thought was that the students would think i was a wimp.

    then i looked up. every last one of them had bolted. not one had mannaged to overcome the stench to stay and watch. i laughed. all my ego driven worries about what they would think of me were in vain. obviously if a surgeon nearly gagged then mere mortals (tongue in cheek, flamers) like medical students and doctors would obviously not be able to be in the near vicinity of such a thing.

    the patient did well, got his elective colectomy the next week and went on his merry way.

    Rabu, 21 November 2007

    DIETING WEIGHT LOSS :LEARN FROM SUCCESS FIND OUT HOW PEOPLE LOST WEIGHT STORIES AND EXPERIENCES OF DIETING SUCCESS

    DIETING WEIGHT LOSS :LEARN FROM SUCCESS FIND OUT HOW PEOPLE LOST WEIGHT


    STORIES AND EXPERIENCES OF DIETING SUCCESS




    He was six foot two and 425 pounds. The Indiana University undergraduate says it was painful just to walk. And then he had an epiphany.
























    There was a Subway sandwich shop in his apartment building. "He used to eat there frequently but one day when he was at his heaviest, he noticed the sign advertising sandwiches with "7 under 6" grams of fat. He ate a 6-inch turkey (no oil, mayo or condiments or cheese) for lunch and a 12-inch veggie (no condiments or cheese) for dinner. He ate the same sandwiches every day. This is what made it so easy." The rest of course is history. Today he is 190 pounds and Jared Fogle travels the country espousing the benefits of dieting and Subway.




    Easier to Stay Focused and Succeed at Diet When You Have a Plan and Real Life Examples and Stories to Guide You


    When you have a diet plan, especially one that you know has worked for others it makes it that much easier to adhere to your plan. In a moment of temptation you can visualize the picture of the person who has succeeded and the story of their success.





    Great Stories,Resources and Pictures of People Who Succeeded at Dieting


    You can find great stories and pictures of people dieting successfully at USA Today Weight Loss Challenge and read about more about Jared Fogle at Jared Fogle and His Weight Loss. Another great resource is the Lean Plate Club by Sally Squires at the Washington Post.

    Senin, 19 November 2007

    DISSECTING AORTIC ANEURYSM: WHAT TEST FOR ANEURYSM ANEURYSMS WHILE DANGEROUS MAY HAVE NO SYMPTOMS

    DISSECTING AORTIC ANEURYSM: WHAT TESTS FOR ANEURYSM WHILE DANGEROUS MAY HAVE NO SYMPTOMS





    Risk Factors for Aneurysms include High Blood Pressure, Atherosclerosis, Cigarette Smoking


    Some Medical Conditions Such As Marfan's Syndrome May Also Increase Risk of Dissection



    He started to complain of not feeling well and then suddenly, John Ritter, the great star of Three's Company and many other hits had suffered a dissecting aneurysm. The layers of the arteries can weaken and start to bulge. That bulge is called an aneurysm. A sudden tear in a layer is called a dissection. Needless to say a sudden tear in an artery as important as the aorta can have very serious consequences.
















    The aorta is the large artery that carries the freshly pumped blood away from the heart's left ventricle and distributes it to the body. The aorta is the biggest of all the arteries and like the other arteries is composed of layers which makes sense when you consider that arteries carry blood under pressure versus veins which usually carry blood returning to the heart.





    A big problem is that most abdominal aortic aneurysms don't have symptoms, are not detectable on physical examination, and are discovered during radiologic testing for other reasons. Tobacco use, hypertension, a family history of aneurysms, and male sex are risk factors for an aneurysm. Most people have no symptoms. When an aneurysm leaks or tears you might feel



  • Sudden pain in your abdomen, groin, back, legs or buttocks
  • Nausea and vomiting
  • Abnormal stiffness in your abdominal muscles
  • Swelling or bulging in one area of your abdomen
  • Clammy skin







    Special Tests Required for Aneurysm Diagnosis



  • How Aneurysms are Detected and New Ideas About How to See Them with CT scans, Ultrasound and MRI











    Classically, a dissecting aneurysm presents with a sharp pain from the front radiating into the back but an aneurysm could present in other ways too.
    A problem with aneurysms is that a person can have one and not know it. People can function well with small aneurysms and routine testing may fail to pick them up. X rays are generally not sufficient to detect aneurysms and imaging like ultrasounds, CT scans and MRI are usually indicated.Sometimes aneurysms are detected on physical exam as a pulsatile mass in the abdomen.It is important to determine how big the aneurysm is and obviously where it is.
  • Abdominal Aortic Aneurysm



    "A new study says that women over 65 with a history of smoking or heart disease are also at high risk for an abdominal aortic aneurysm supporting the notion that they should also receive ultrasound screening to help spot and correct the dangerous condition. The findings, reported in the Journal of Vascular Surgery, challenge current recommendations on AAA screening issued by the United States Preventive Services Task Force".



  • Screening for Abdominal Aortic Aneurysms in Women May Save Lives



  • A Possible Blood Test for Aneurysms



    For an explanation of aneurysms with illustrations see
  • the Merck Manual section on aneurysms
  • Aneurysms and Aortic Dissection
  • FAST FOOD HIGH BLOOD PRESSURE SIX LIFESTYLE STEPS TO CONTROL BLOOD PRESSURE

    SIX LIFESTYLE STEPS TO CONTROL HIGH BLOOD PRESSURE HOW CAN I LOWER HIGH BLOOD PRESSURE BESIDES TAKING BLOOD PRESSURE MEDICINES


    What is Blood Pressure


    If you make it(and dump lots of salt and fat on it)they will eat it!






    If they sell food in a restaurant it can't be that bad for your health and blood pressure right? Sorry, Dorothy you're not in Kansas anymore! You are responsible to watch out for yourself. When it comes to blood pressure control be proactive A fast food chain recently introduced a burrito with 920 calories,nearly 2000 mg of sodium and 23 grams of saturated fat. They were proud! Remember the movie Field of Dreams "If you build it they will come", well many food sellers seem to have put a spin on that "If you make it(and dump lots of salt and fat on it)they will eat it"! An expert panel on blood pressure said lower the salt in your food(among other things).
















    Your doctor does not know why you have high blood pressure. Don't look for a new doctor because they don't know why your blood pressure is high either(an exaggeration, sometimes there is an identifiable cause) but in 80 to 90 percent of cases people have what is called essential hypertension. A fancy moniker for "we don't know why". But even though medical science doesn't why most people have high blood pressure doctors can treat high blood pressure successfully. Many people will need blood pressure medication. But an expert panel said lifestyle changes can impact your blood pressure too!





    About 65 million Americans are walking around with high blood pressure a.k.a hypertension. And many of them don't even know it! Almost one billion people worldwide have high blood pressure.What is blood pressure anyway? Your body needs oxygen rich blood all the time. Your heart is the master pump that pumps blood. But blood pressure is more complicated than just the heart. The pressure is created by the heart but the arteries and channels that carry the blood also exert a pressure. An analogy is the way fuel flows in a car. In a car the fuel is pumped from the fuel pump. When you put your foot on the accelerator more fuel is pumped to meet demand. When you exercise your heart pumps harder to meet demand. The fuel flows through pipes to the parts of the engine. If the pipes get clogged it is harder for the fuel to be distributed, similarly resistance in the arteries can force the blood pressure up. If there is a leak in the system the pressure can drop. If you lose alot of blood the pressure drops and you can go into shock.





    Even though we don't know why most people have high blood pressure( some people do have identifiable factors like kidney problems) we do know many things that affect the pressure. If you are angry, angry at the traffic,angry at your boss and pretty much just plain always angry there's a good chance it's showing up in your pressure. Adrenalin gets pumped into your system, the nerves are stimulated. The nerves attached to the artery walls can alter the blood pressure. Anger and stress, especially chronic (long term) anger and stress are correlated with high blood pressure and heart problems.



  • Psychosocial Factors and Progression From Prehypertension to Hypertension or Coronary Heart Disease

  • Stress and High Blood Pressure: What's the Connection?

  • Anger, Chronic Stress Tied to Heart Disease

    The blood pressure experts conference a.k.a. JNC7 layed out five lifestyle modifications for reducing blood pressure. Many people with high blood pressure need medication. People need to see a doctor to find out if they have high blood pressure and how it needs to be treated. Additionally, learning stress control techniques like meditation and some non drug avenues can help get a handle on blood pressure. Some ways were listed in the Seventh Report of the JNC on Prevention,Detection,Evaluation and Treatment of High Blood Pressure.














    Important note: These are general recommendations. Always ask your doctor first for guidelines that are specific to your medical condition.


  • Weight Loss
    Doctors see it all the time. A man or woman whose blood pressure is always on the high side loses weight and all of a sudden voila! no more high blood pressure. "Weight loss is an important lifestyle modification in reducing blood pressure. A reduction of 10 lb can help reduce blood pressure or prevent hypertension. A reduction of approximately 20 lb (9 kg) may produce a reduction in systolic blood pressure of 5 to 20 mm Hg".



    "The DASH (Dietary Approaches to Stop Hypertension) study looked at the impact of foods on high blood pressure. The study results indicate that people who: increased calcium intake to more than 1200 mg/day, lowered fats to less than 26% of calories, and increased fiber, potassium and magnesium in their diets each day decreased systolic blood pressure (the top blood pressure number) by 5.5 mm Hg and diastolic blood pressure (the bottom number) by 3 mm Hg".




  • "The DASH eating plan
    outlines a diet rich in fruits and vegetables; high in low-fat dairy products, potassium, magnesium, and calcium; and low in total saturated fats. Following this plan has been shown to produce mean reductions of 6 mm Hg in systolic blood pressure and 3 mm Hg in diastolic blood pressure, and combining the plan with a reduction in sodium intake produces additional blood pressure reduction".



  • A PDF of the DASH Eating Plan


    "In the PREMIER clinical trial,15 researchers assessed the impact on blood pressure of comprehensive lifestyle changes


  • reduced sodium intake,
  • increased activity
  • moderate alcohol consumption,
  • weight loss


    in addition to the DASH eating plan, compared with lifestyle changes alone or usual care (i.e., advice only). Participants in the lifestyle changes only group had a greater reduction in blood pressure than those in the usual care group, and this was further enhanced with the addition of the DASH eating plan. This was the first trial to demonstrate that all recommended lifestyle changes can be combined to reduce blood pressure successfully.





  • Limit alcohol intake


  • Strategies to Control Blood Pressure

  • Nonpharmacologic Strategies for Managing Hypertension

  • Angry thoughts, at-risk hearts
  • GUEST POST: Fashion Statements (by Bongi)

    Ladies and Germs ... Please give a hearty, clinically clean, surgically scrubbed welcome to our first guest poster - Bongi from Other Things Amanzi! Welcome my man...

    This is part of a drive to get more contributions to All Scrubbed Up. We're about a year old now and readership is growing rapidly. More content for you, our medically minded audience.

    This is part 1 of a 3 post series. If you like Bongi's work - TELL US! It's a fascinating insight into Mpumalanga medicine (and this time, what they wear!)


    - - - - -


    Fashion Statements

    sometimes we as surgeons are restricted by the most mundane of things. back in my kalafong days, more often than my first world visitors could imagine, entire theater lists would get canceled because of lack of theater attire (scrubs). this gave rise to a funny story and, indirectly to a more recent and somewhat more serious story.

    story one.

    i arrived in theater one morning in kalafong, ready and eager to operate. there were no theater pants, only tops. i quickly found out there were none available and the matron was on the verge of canceling my list. i checked my gas monkey (anaesthetist). he got one of the last pairs and was dressed for action. the sister was also appropriately attired. it was just me that couldn't enter the theater complex.

    not to be blocked by such a minor thing, which was anyway an administrative error and therefore, i reasoned, should not disrupt theater lists, i made a plan. i took a sterile drape and wrapped it around my waist like a sarong and strutted out into theater.

    my fashion statement it would seem was too much for the matron, because before i had made even 5 meters, she came rushing up to me with a clean pair of theater pants (she had apparently just created them from subatomic particles using a process of fusion) and insisted i go back to the change room to make myself decent. no fashion sense it seems.

    the second story was more recently.

    i was called to the theater at the local provincial hospital in the early hours of the morning. it seems they started a laparotomy for a gunshot abdomen and were now in deep water. i dived into my car (i reasoned i would soon be diving into their deep water with them and i wanted to get my eye in) and raced to the hospital, trying to fully wake myself up as i went. i parked and charged to theater.

    there i encountered obstacle number one. the change room door was locked. no problem, i would just go in through the main door.

    obstacle number two was the main theater doors had been locked using a piece of wood wedged through the door handles. i shouted into theater, but there was no reply. i reflected that, although they had called me in at some ungodly (but not unsurgical) hour, they had not allowed easy access. the telephone call had lead me to believe that the situation was critical. i could not let a mere locked door get in my way. i broke it down. inside i found one of the sisters sound asleep. my supplications to open the door as well as my violent attack on said door had, luckily, not disturbed her no doubt well deserved rest.

    obstacle number three awaited me in the change room. there were no shirts. at this stage i was feeling slightly less than my usual cheery self. i was in no mood to waist more time. i dressed in theater pants and entered theater with a naked torso.

    there was stunned silence. the medical officer was speechless. he started explaining his operative dilemma, but as he looked up and saw me he went quiet. if i wasn't in such a bad mood i'm sure i would have laughed. i started scrubbing. (i suppose i should say something like my godlike torso faintly illuminated by the one light in the scrub room, but that is implied, of course).


    soon i was donned with the operating gown and got to work. no longer blinded with jealousy, no doubt, the medical officer found his voice again and could explain to me the situation. my mood also improved and soon the normal intraoperative banter was being exchanged as if it wasn't 3o'clock in the morning and as if the consultant hadn't just turned up half naked after breaking down the theater door and of course as if there wasn't someone whose life hung in the balance.

    Minggu, 18 November 2007

    RISKS REWARDS OF GASTRIC BYPASS SURGERY VERSUS DIETING: IN WEIGHT LOSS SURGERY EXPERIENCE COUNTS

    RISKS REWARDS OF GASTRIC BYPASS SURGERY VERSUS DIETING: IN WEIGHT LOSS SURGERY EXPERIENCE COUNTS







    Often a topic for comedians, weight is not so funny when you are fighting a long battle, dieting with little to show to control excess weight that colors every part of your existence from your health to your social life. Many people have chosen gastric bypass surgery.














    A New England Journal of Medicine research article found that gastric bypass surgery is beneficial. "In fact, the benefit is quite dramatic. The authors studied 9,949 patients who had undergone weight loss surgery, and compared them to a control group of 9,628 severely obese individuals who did not have the surgery".




    They wrote an article about weight loss, diets and gastric bypass surgery. One is an economist and the other a writer but as they discussed the pros and cons of weight loss surgery and dieting in their New York Times column "The Stomach Surgery Conundrum", the authors of Freakonomics totally neglected to mention this article,one of the most important New England Journal research paper about weight loss surgery and it's consequences.




    As the Freakonomics boys do point out when it comes to doing surgery experience counts. You want a doctor who does many bariatric weight loss procedures. "Technological innovations, especially the use of laparoscopic procedures (using a tube that is inserted through an incision in the abdominal wall so it's less invasive) have made for considerable gains in safety and efficacy. While the operation is still dangerous in some circumstances — one study found that for a surgeon’s first 19 bariatric operations, patients were nearly five times as likely to die than patients that the surgeon later operated on — the overall mortality rate is now in the neighborhood of 1 percent.

    The editorial in the New England Journal also points out that the lowest surgical mortality is seen among surgeons who have performed more than 50 operations and preferably more than 100 operations.



    After gastric bypass surgery there was a significant reduction particularly from diabetes, heart disease, and cancer. However, the rate from causes other than disease was higher in the surgery group than in the control group".












  • Study Shows Dramatic Health Benefit From Obesity Surgery






    Dubner and Levitt also say that "a significant fraction of postbariatric patients acquire new addictions like gambling, smoking, compulsive shopping or alcoholism once they are no longer addicted to eating". In fact, the New England article does say that "Despite reductions in disease-related deaths after gastric bypass surgery, the risk of non–disease-related death, such as accidents and suicides, increased by a factor of 1.58, as compared with that in the control group. Reports reveal that a substantial number of severely obese persons have unrecognized presurgical mood disorders or post-traumatic stress disorder or have been victims of childhood sexual abuse".



  • After Weight-Loss Surgery, Some Find New Addictions



    "Not only do most patients keep off a significant amount of weight but the other medical problems that accompany obesity are also often assuaged. One recent analysis found that 77 percent of bariatric-surgery patients with Type 2 diabetes experienced “complete resolution” of their diabetes after the procedure; the surgery also helps eliminate hypertension and sleep apnea. From an economic standpoint, research suggests that the operation can pay for itself within a few years because a postbariatric patient now requires less medical care and fewer prescriptions. That’s why some insurance companies cover bariatric surgery — as more do, it will likely lead to a further spike in the volume of operations".



  • Long-Term Mortality after Gastric Bypass Surgery (this is a pdf)


  • Freakonomics in the Times Magazine: The Stomach-Surgery Conundrum


  • Freakonomics The Stomach-Surgery Conundrum


  • Laparoscopic Adjustable Gastric Bandings
  • Jumat, 16 November 2007

    WHAT TO DO ABOUT HIGH CHOLESTEROL NATURAL REMEDIES TRANS FATS WHAT ARE THE BAD AND GOOD CHOLESTEROL

    WHAT TO DO ABOUT HIGH CHOLESTEROL NATURAL REMEDIES TRANS FATS WHAT ARE THE BAD AND GOOD CHOLESTEROL


    Natural Remedies for High Cholesterol












    You hear a lot about cholesterol. Good cholesterol, bad cholesterol, triglycerides and trans fats. In general, bad cholesterol, LDL is associated with an increased chance of heart problems. HDL, "good cholesterol" is associated with less heart problems. Trans fats seem to increase the bad cholesterol, LDL.













    The Lipid Profile blood test that you take at the doctor's office provides values including:
  • Total cholesterol
  • HDL good cholesterol
  • LDL bad cholesterol
  • Triglycerides




  • Click Here to Read Natural Ways to Lower Cholesterol









    In addition other blood tests may give more data about cardiac risk including:


  • C reactive protein
  • homocysteine

    The Good Cholesterol, Trans Fats and the Bad Cholesterol: HDL and LDL


    Pfizer, the drug company, got a nasty shock when they discovered that a new blockbuster drug they were developing to increase HDL good cholesterol had too many bad side effects. So what is the cholesterol?
















    When people talk about the good cholesterol and the bad cholesterol they are referring to HDL and LDL. HDL and LDL are lipoproteins, structures created from cholesterol and protein that travel to and from the liver carrying cholesterol..Trans fats are fats that worsen bad cholesterol. I've mentioned LDL, that is tagged with the moniker "bad cholesterol" but HDLs are called the good cholesterol because high levels of HDL seem to decrease coronary heart disease risk. Routinely doctors say that the HDL acts to carry away the bad cholesterol from the artery walls, however, there is also evidence that HDLs may interfere with LDL oxidation. Oxidation of LDL refers to a chemical process that happens on the LDL and is believed to be one of the steps in the process that leads to heart attack.


  • Click here to READ ABOUT PROBLEMS WITH ZETIA AND VYTORIN CHOLESTEROL DRUGS



    Risk Factors: More Risk Factors For Heart Disease The More You Want to Lower Your Cholesterol


    You will see different numbers listed for desirable levels of cholesterol depending on where you look. What is true is that it is even more desirable to have lower levels of bad cholesterol when you have risk factors for heart disease.



    Imagine if you will, a person with high cholesterol. Very high cholesterol. Recommendations for the "bad" LDL cholesterol vary but generally 100 or less is satisfactory. Now imagine a person with an LDL of 500 or 1000. Finally, imagine they are just twelve years old! That's the situation that confronts people who have a genetic problem with cholesterol disposal called Familial Hypercholesterolemia. Their bodies don't have the full mechanism for dealing with cholesterol LDL and as a result they are at very increased risk of heart attacks.



    FH is less severe in people with just one gene for it but people with the homozygous (double gene dose)variety of familial hypercholesterolemia can even have a heart attack in the teens or twenties if no treatment is provided. Luckily there are ways of dealing with familial hypercholesterolemia such as medication and a blood "cleansing" procedure called LDL Apharesis. Read the story of a woman who had two angioplasty procedures and a coronary artery bypass They Wash the Cholesterol Out of My Blood.




    Trans Fat Acts to Increase Bad Cholesterol: What is Cholesterol and Why The Body Manufactures Cholesterol


    Cholesterol is not all bad. The body enlists cholesterol to synthesize important molecules that it needs, molecules like the male and female hormones testosterone and estrogen, not to mention Vitamin D as well as constituents of the body's cell membranes. Cholesterol is also involved with the bile that is released to help digest a meal. Because cholesterol is a lipid, it is soluble in oil but not very soluble in water so it is transported in the relatively watery blood aboard a transport molecule. Cholesterol is manufactured in the liver and travels out of the liver aboard lipoprotein particles called VLDL which are then converted to LDL, short for Low Density Lipoproteins. Our body makes most of our cholesterol but we also get cholesterol from food we eat. Foods high in animal fat and foods that are high in saturated fats, cholesterol and trans fats are likely to raise LDL, the "bad cholesterol". As of January, 2006 food labels are mandated to list trans fats. See What Trans Fat Labels Mean: Read Them and Get Healthy


    Meds for Cholesterol: Statins The 500 Pound Gorilla of Cholesterol Meds and Zetia the (Not So) New Kid on the Block



    Right now the most "popular" class of cholesterol meds are the statins. There are six statins on the market with the newest contender being Crestor (rosuvastatin). The others include:


  • Lipitor (atorvastatin)
  • Mevacor (lovastatin)
  • pravastatin
  • fluvastatin
  • simvistatin






    Statins reduce the quantities of LDL Cholesterol. Statins block the manufacture of cholesterol in the liver by interfering with an enzyme that orchestrates cholesterol production,HMGCoa Reductase. That's why statins are called HMGCoa Reductase Inhibitors. Enzymes are chemicals called proteins that act all over the body to speed up chemical reactions. Statins work in the liver. That's why they get a blood test to check liver function when someones starts a statin and why they monitor liver function.A rare but dangerous possible side effect of statins is rhabdomyolysis characterized by muscle pain and weakness. One statin,cervistatin, was removed from the market because of problems with this phenomenon. It's the breakdown of muscle tissue and requires immediate emergency intervention. It may be the result of drug interactions between statins and other medications which result in high concentrations of the drug.

    Zetia Ezetimibe: The New (Not So) Kid on the Block



    Ezetimibe is a whole different ball game when it comes to lowering cholesterol. Zetia works in the intestine to block cholesterol absorption, not in the liver like statins. So potentially it may have fewer side effects. The downside is that so far it seems to be a mild cholesterol reducer. A combo ezetimibe/statin is Vytorin.

  • Read PROBLEMS REPORTED WITH ZETIA AND VYTORIN




    Niacin



    Niacin is a B vitamin. It can lower cholesterol and triglycerides and raise HDL. The trouble with niacin is the side effects. Hot flashes are a big problem for niacin users and sometimes they are so unpleasant that people just won't use niacin.
    Niacin can also interact with other drugs and it can raise blood sugar. Always talk with your doctor if you are contemplating using niacin.



    Also check out Heart Attack Counterattack: Fighting Back

    David Letterman Atherosclerosis and How Unstable Plaque May Lead to Heart Attack



    The popular entertainer, David Letterman, who has had coronary artery bypass was apparently aware of high cholesterol levels. See the story Heart Scare for Letterman. High levels of the "bad cholesterol" LDL in the coronary arteries increase the chances of atherosclerosis. Atherosclerosis refers to a process that occurs in the inner lining, the endothelium, of the arteries where complexes of cells and cholesterol called plaques develop within the artery walls. Arteries are the blood vessels that carry the oxygenated blood away from the heart to the body. The heart muscle has it's own arteries, coronary arteries, that feed it a steady flow of oxygen rich blood. Doctors often say that high cholesterol can "clog an artery" but the reality is probably more complex. Cells have receptors on their surfaces that trap LDL in the bloodstream and then internalize them for cellular use. LDL particles are major actors in an intricate process where LDL particles accumulating within the inner walls of the coronary arteries are possibly the linchpin of an intricate dance that can lead to a heart attack. The story of the relationship between cholesterol, atherosclerosis and heart disease has been built over the decades..See Cholesterol A Century of Research


    Coca Cola Launches Minute Maid Heart Wise Juice: Foods to Lower Cholesterol: Margarine and Salad Dressing Too!



    David A. Jenkins, of the University of Toronto and colleagues tested a vegetarian diet to lower cholesterol. See Diet May Cut Cholesterol As Much As Drugs Do.

    Plant sterols are molecules found in plants that resemble cholesterol and compete in the intestine with cholesterol for absorption. They have been demonstrated to lower cholesterol.Coca Cola has Minute Maid Heart Wise Juice containing Cargill Corowise phytosterols.
  • Cargill Corowise Phytosterols Information A number of other foods having plant sterols are on the market with names like
  • Benecol and
  • Take Control. The Australian Medical Journal published
  • Cholesterol-lowering with plant sterols

    See also the
  • (not so) New USDA Study Shows Plant Sterols Lower Cholesterol and
  • Sterol-Containing Margarines and Lower Cholesterol Levels



    Does Garlic Lower Cholesterol and What Impact Do Oats Have?


    It's not hard to figure out how garlic prevents infection. You eat it and nobody will come within 10 feet but what about reports that garlic can lower cholesterol? According to an analysis reported here Garlic and Cholesterol there was a mild cholesterol lowering effect attributed to garlic but apparently it's not very dramatic. Read FDA Allows Whole Oat Foods to make Health Claim On Reducing Risk of Heart Disease

    Plaque in Coronary Artery Wall Seems to be Linchpin of Coronary Artery Disease: Inflammation



    In the classic explanation of the dangers of high cholesterol, high cholesterol leads to the narrowing of the coronary arteries and a plaque may break off and block or occlude the artery. The result is little or no blood flow to the part of the heart being supplied by that artery and a heart attack. As Dr. Peter Libby points outsometimes a plaque grows so large that it virtually halts the blood flow in an artery and generates a heart attack or stroke. (he means a stroke caused by a blockage, a thrombotic stroke, but there's also another kind called a hemorrhagic stroke which is due to bleeding) Yet only 15% of heart attacks happen in this way. By carefully examining vessel walls of people who died from heart attacks, pathologists have demonstarted that most attacks occur after a plaque's fibrous cap breaks open"
    attracting a blood clot that leads to the blockage of the artery.

    See the fascinating and instructive article by Dr. Libby Atherosclerosis The New View.



    Dr. Libby, a professor at Harvard Medical School, has pointed out that the cholesterol lowering drugs seem to decrease the number of coronary events such as heart attacks even though angiograms don't necessarily show a decrease in the stenosis or narrowing of the artery. See the more technical article Molecular Bases of the Acute Coronary Syndromes






    Cholesterol Was Molecule of the Month in 1997


    Tired of centerfolds? Check out the vital statistics of this sexy molecule from when
  • Cholesterol was Molecule of the Month and if you need even more details look at
  • a more recent exposition of cholesterol from Kimball's Online and
  • from the Howard Hughes Medical Institute Cholesterol Up Close and
  • Cholesterol Subclasses.




    Risk factors for heart disease include:



  • cigarette smoking
  • high blood pressure
  • family history of heart disease
  • high cholesterol
  • overweight
  • diabetes