Monday, November 22, 2010
The Nervous System
Conditions both within the body and in the environment are constantly changing. The nervous system directs the complex processes of the body's internal environment and also provides a link to the external world. This allows us to respond to changes both from internal sources as well as form external stimuli.
The nervous system is broken down into two major part: the central nervous system, which includes the brain and spinal cord, and the peripheral nervous system, which includes all nerves, which carry impulses to and from the brain and spinal cord. These include our sense organs, the eyes, the ears, our sense of taste, smell and touch, as well as our ability to feel pain.
Central Nervous System
Spinal Cord
The spinal cord is a long bundle of neural tissue continuous with the brain that occupies the interior canal of the spinal column and functions as the primary communication link between the brain and the rest of the body. The spinal cord receives signals from the peripheral senses and relays them to the brain.
The spinal cord is a long bundle of neural tissue continuous with the brain that occupies the interior canal of the spinal column and functions as the primary communication link between the brain and the rest of the body. The spinal cord receives signals from the peripheral senses and relays them to the brain.
Brain Stem
The brain stem is the part of the brain that connects the cerebrum and diencephalons with the spinal cord.
The brain stem is the part of the brain that connects the cerebrum and diencephalons with the spinal cord.
Medulla Oblongata
The medulla oblongata is located just above the spinal cord. This part of the brain is responsible for several vital autonomic centers including:
The medulla oblongata is located just above the spinal cord. This part of the brain is responsible for several vital autonomic centers including:
- the respiratory center, which regulates breathing.
- the cardiac center that regulates the rate and force of the heartbeat.
- the vasomotor center, which regulates the contraction of smooth muscle in the blood vessel, thus controlling blood pressure.
The medulla also controls other reflex actions including vomiting, sneezing, coughing and swallowing.
Pons
Continuing up the brain stem, one reaches the Pons. The pons lie just above the medulla and acts as a link between various parts of the brain. The pons connect the two halves of the cerebellum with the brainstem, as well as the cerebrum with the spinal cord. The pons, like the medulla oblongata, contain certain reflex actions, such as some of the respiratory responses.
Continuing up the brain stem, one reaches the Pons. The pons lie just above the medulla and acts as a link between various parts of the brain. The pons connect the two halves of the cerebellum with the brainstem, as well as the cerebrum with the spinal cord. The pons, like the medulla oblongata, contain certain reflex actions, such as some of the respiratory responses.
Midbrain
The midbrain extends from the pons to the diecephalon. The midbrain acts as a relay center for certain head and eye reflexes in response to visual stimuli. The midbrain is also a major relay center for auditory information.
The midbrain extends from the pons to the diecephalon. The midbrain acts as a relay center for certain head and eye reflexes in response to visual stimuli. The midbrain is also a major relay center for auditory information.
Diencephalon
The diencephalons is located between the cerebrum and the mid brain. The diencephalons houses important structures including the thalamus, the hypothalamus and the pineal gland.
The diencephalons is located between the cerebrum and the mid brain. The diencephalons houses important structures including the thalamus, the hypothalamus and the pineal gland.
Thalamus
The thalamus is responsible for "sorting out" sensory impulses and directing them to a particular area of the brain. Nearly all sensory impulses travel through the thalamus.
The thalamus is responsible for "sorting out" sensory impulses and directing them to a particular area of the brain. Nearly all sensory impulses travel through the thalamus.
Hypothalamus
The hypothalamus is the great controller of body regulation and plays an important role in the connection between mind and body, where it serves as the primary link between the nervous and endocrine systems. The hypothalamus produces hormones that regulate the secretion of specific hormones from the pituitary. The hypothalamus also maintains water balance, appetite, sexual behavior, and some emotions, including fear, pleasure and pain.
The hypothalamus is the great controller of body regulation and plays an important role in the connection between mind and body, where it serves as the primary link between the nervous and endocrine systems. The hypothalamus produces hormones that regulate the secretion of specific hormones from the pituitary. The hypothalamus also maintains water balance, appetite, sexual behavior, and some emotions, including fear, pleasure and pain.
Cerebellum
The functions of the cerebellum include the coordination of voluntary muscles, the maintenance of balance when standing, walking and sitting, and the maintenance of muscle tone ensuring that the body can adapt to changes in position quickly.
The functions of the cerebellum include the coordination of voluntary muscles, the maintenance of balance when standing, walking and sitting, and the maintenance of muscle tone ensuring that the body can adapt to changes in position quickly.
Cerebrum
The largest and most prominent part of the brain, the cerebrum governs higher mental processes including intellect, reason, memory and language skills. The cerebrum can be divided into 3 major functions:
- Sensory Functions - the cerebrum receives information from a sense organ; i.e., eyes, ears, taste, smell, feelings, and translates this information into a form that can be understood.
- Motor Functions - all voluntary movement and some involuntary movement.
- Intellectual Functions - responsible for learning, memory and recall.
Meninges
The meninges are made up of three layers of connective tissue that surround and protect both the brain and spinal cord. The layers include the dura mater, the arachnoid and the pia matter.
The meninges are made up of three layers of connective tissue that surround and protect both the brain and spinal cord. The layers include the dura mater, the arachnoid and the pia matter.
Cerebrospinal Fluid
The cerebrospinal fluid is a clear liquid that circulates in and around the brain and spinal cord. Its function is to cushion the brain and spinal cord, carry nutrients to the cells and remove waste products from these tissues.
The cerebrospinal fluid is a clear liquid that circulates in and around the brain and spinal cord. Its function is to cushion the brain and spinal cord, carry nutrients to the cells and remove waste products from these tissues.
Peripheral Nervous System
Nerves
Nerves are made up of specialized cells, which act as little wires, transmitting information to and from the central nervous system and brain. Nerves form the network of connections that receive signals (known as sensory input) from the environment and within the body, and transmit the body's responses, or instructions for action, to the muscles, organs, and glands. Nerve cells are located outside the central nervous system or spinal cord.
Nerves are made up of specialized cells, which act as little wires, transmitting information to and from the central nervous system and brain. Nerves form the network of connections that receive signals (known as sensory input) from the environment and within the body, and transmit the body's responses, or instructions for action, to the muscles, organs, and glands. Nerve cells are located outside the central nervous system or spinal cord.
Eyes
The eyes are organs that provide us with visual information from the external world, which is transmitted and interpreted by the brain.
The eyes are organs that provide us with visual information from the external world, which is transmitted and interpreted by the brain.
Ears
The ears are the organs used for both hearing and equilibrium. The ear can be divided into three sections: the outer that includes the parts of the ear we see, and the ear canal, which connects the external ear to the middle ear. It is separated from the middle ear by the tympanic membrane or eardrum. The middle ear contains three small bones that conduct sound waves. The inner ear contains sensory receptors and the mechanisms responsible for equilibrium.
The ears are the organs used for both hearing and equilibrium. The ear can be divided into three sections: the outer that includes the parts of the ear we see, and the ear canal, which connects the external ear to the middle ear. It is separated from the middle ear by the tympanic membrane or eardrum. The middle ear contains three small bones that conduct sound waves. The inner ear contains sensory receptors and the mechanisms responsible for equilibrium.
Taste
The sense of taste is perceived through the taste buds, which are located in various parts of the mouth, but are primarily concentrated on the tongue. Taste is experienced in four different ways - sweet, sour, salty or bitter. It is interesting to note, that only substances in solution can be perceived by the taste buds.
The sense of taste is perceived through the taste buds, which are located in various parts of the mouth, but are primarily concentrated on the tongue. Taste is experienced in four different ways - sweet, sour, salty or bitter. It is interesting to note, that only substances in solution can be perceived by the taste buds.
Smell
The receptors for smell are located in the upper part of the nasal cavity in the olfactory epithelium. The sense of smell can distinguish a greater variety of substances than the sense of taste. Here too, substances that are detected by these receptors must be in solution.
The receptors for smell are located in the upper part of the nasal cavity in the olfactory epithelium. The sense of smell can distinguish a greater variety of substances than the sense of taste. Here too, substances that are detected by these receptors must be in solution.
Tactile Sensation
There are several other types of receptors located throughout the body. They are considered general senses and provide us with tactile sensations including the feeling of pressure, heat, cold, pain and touch.
There are several other types of receptors located throughout the body. They are considered general senses and provide us with tactile sensations including the feeling of pressure, heat, cold, pain and touch.
Caffeine May Trigger Gout Attacks
Nov. 11, 2010 (Atlanta) -- An extra jolt or two of caffeine may trigger a gout attack in people with the painful and often disabling arthritic condition, preliminary research suggests.
"We found that overall, as the number of servings of caffeinated beverages increased, so too did the chance of having recurrent gout attacks," says Tuhina Neogi, MD, PhD, associate professor of medicine at Boston University School of Medicine.
For example, drinking four servings of caffeinated beverages in the previous 24 hours was associated with an 80% increased risk of recurrent gout attacks, compared with having no caffeinated drinks.
Drinking more than six servings of caffeinated beverages in the previous day was associated with a 3.3-fold higher risk of a flare-up, the study of 663 gout patients suggests.
When habitual and occasional caffeine drinkers were looked at separately, the link was only observed in people with gout who typically drink less than two caffeinated beverages a day, Neogi tells WebMD.
"As little as three servings a day could do it for these people," she says.
"In contrast, in people with gout who usually have two or more caffeinated beverages a day, increasing caffeine intake doesn't appear to raise the risk of gout attacks," Neogi says.
The study does not prove cause and effect, just that there appears to be an association between higher caffeine intake in the past 24 hours and an increased risk of gout attacks. People with gout who drink a lot of revved-up beverages may share some other characteristic that makes them more prone to flare-ups, researchers say.
The findings were presented here at the American College of Rheumatology's annual meeting.
Previous research has shown that, over the long term, caffeine intake is associated with lower levels of uric acid in the body and a lower risk of developing gout among people who do not have the arthritic condition, Neogi says.
The chemical structure of caffeine is very similar to that of a medication called allopurinol, which is commonly used to lower uric acid levels in people with gout, she says. Although effective at controlling gout in the long term, allopurinol can precipitate a flare-up among patients taking it for the first time, she says.
"Given the potential conflicting effects of caffeine on gout attack risk, we evaluated whether caffeinated beverage intake was associated with the risk for recurrent flare-ups," Neogi says.
Participants were asked to log on after having their next attack and answer an extensive questionnaire about medication, foods, and drinks they had consumed in the 24 hours prior to the attack. Three months after being free of flare-ups, they were asked to answer the same questions.
The researchers asked about all types of caffeinated beverages, including coffee, tea, soft drinks, and high-energy drinks such as Red Bull as well as non-caffeinated beverages.
Participants were predominantly white (89%), male (78%), and college educated (58%).
The link between increased intake of caffeinated beverages in the prior 24 hours and a higher risk for recurrent gout attacks was present even after accounting for other fluid intake.
In contrast, non-caffeinated coffee, tea, soda, and juices were not associated with an increased risk of gout attacks, Neogi says.
The researchers did not ask participants about the amount of sugar in their beverages. Therefore, the findings cannot be compared to that of another study presented at the meeting showing that women who drink one or more servings of sugary soda a day may be increasing their risk for developing gout, she adds.
That said, "It's a way to accumulate a large number of patients in a short period of time. It's good for generating hypotheses" that can then be tested in more rigorous clinical trials, Sundy tells WebMD.
Neogi defends the use of the Internet for studies like this, pointing out that it allows each person's caffeine intake prior to an attack to be compared to her intake when she is attack-free.
"That way, you don't have to have to worry about whether factors like age, weight, and lifestyle affected the results [which you do when one group of people is compared with another]. Plus, it's doubtful that caffeine affects a college-educated, high-paid person more than a poor, college dropout," she says.
Further research is needed, Neogi agrees. In the meantime, "people with gout who are already habitual caffeine drinkers probably do not need to change their habits, given that long-term caffeine intake can potentially lower uric acid levels," she says.
"But the person who doesn't drink a lot of caffeine on a regular basis should be aware that drinking more than usual may potentially trigger an attack. And I would not advise someone with gout to start drinking coffee as a way to lower uric acid levels due to its short-term effects," Neogi says.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: American College of Rheumatology 2010 Annual Scientific Meeting, Atlanta, Nov. 6-11, 2010.Tuhina Neogi, MD, PhD, associate professor of medicine, Boston University School of Medicine.John S. Sundy, MD, PhD, professor of medicine, Duke University Medical Center, Durham, N.C.
"We found that overall, as the number of servings of caffeinated beverages increased, so too did the chance of having recurrent gout attacks," says Tuhina Neogi, MD, PhD, associate professor of medicine at Boston University School of Medicine.
For example, drinking four servings of caffeinated beverages in the previous 24 hours was associated with an 80% increased risk of recurrent gout attacks, compared with having no caffeinated drinks.
Drinking more than six servings of caffeinated beverages in the previous day was associated with a 3.3-fold higher risk of a flare-up, the study of 663 gout patients suggests.
When habitual and occasional caffeine drinkers were looked at separately, the link was only observed in people with gout who typically drink less than two caffeinated beverages a day, Neogi tells WebMD.
"As little as three servings a day could do it for these people," she says.
"In contrast, in people with gout who usually have two or more caffeinated beverages a day, increasing caffeine intake doesn't appear to raise the risk of gout attacks," Neogi says.
The study does not prove cause and effect, just that there appears to be an association between higher caffeine intake in the past 24 hours and an increased risk of gout attacks. People with gout who drink a lot of revved-up beverages may share some other characteristic that makes them more prone to flare-ups, researchers say.
The findings were presented here at the American College of Rheumatology's annual meeting.
Caffeine's Chemical Structure Similar to Standard Gout Medication
Gout occurs when too much uric acid, a normal byproduct of DNA metabolism, builds up in the body. This leads to crystal formation. The crystals deposit in the joints, causing painful swelling.Previous research has shown that, over the long term, caffeine intake is associated with lower levels of uric acid in the body and a lower risk of developing gout among people who do not have the arthritic condition, Neogi says.
The chemical structure of caffeine is very similar to that of a medication called allopurinol, which is commonly used to lower uric acid levels in people with gout, she says. Although effective at controlling gout in the long term, allopurinol can precipitate a flare-up among patients taking it for the first time, she says.
"Given the potential conflicting effects of caffeine on gout attack risk, we evaluated whether caffeinated beverage intake was associated with the risk for recurrent flare-ups," Neogi says.
Short-Term Caffeine Intake Linked to Gout
The researchers turned to the Internet to recruit 633 participants who had experienced a gout attack within the past year. Medical records were used to confirm their gout diagnosis.Participants were asked to log on after having their next attack and answer an extensive questionnaire about medication, foods, and drinks they had consumed in the 24 hours prior to the attack. Three months after being free of flare-ups, they were asked to answer the same questions.
The researchers asked about all types of caffeinated beverages, including coffee, tea, soft drinks, and high-energy drinks such as Red Bull as well as non-caffeinated beverages.
Participants were predominantly white (89%), male (78%), and college educated (58%).
The link between increased intake of caffeinated beverages in the prior 24 hours and a higher risk for recurrent gout attacks was present even after accounting for other fluid intake.
In contrast, non-caffeinated coffee, tea, soda, and juices were not associated with an increased risk of gout attacks, Neogi says.
The researchers did not ask participants about the amount of sugar in their beverages. Therefore, the findings cannot be compared to that of another study presented at the meeting showing that women who drink one or more servings of sugary soda a day may be increasing their risk for developing gout, she adds.
Internet Research for Gout and Caffeine: Pros, Cons
Using the Internet to recruit patients for a study is not ideal, as it results in a self-selected sample that is interested in the topic, says John S. Sundy, MD, PhD, a gout expert at Duke University Medical Center in Durham, N.C. Also, the group as a whole would be expected to be better educated and of higher socioeconomic status than people drawn from the general population, he notes.That said, "It's a way to accumulate a large number of patients in a short period of time. It's good for generating hypotheses" that can then be tested in more rigorous clinical trials, Sundy tells WebMD.
Neogi defends the use of the Internet for studies like this, pointing out that it allows each person's caffeine intake prior to an attack to be compared to her intake when she is attack-free.
"That way, you don't have to have to worry about whether factors like age, weight, and lifestyle affected the results [which you do when one group of people is compared with another]. Plus, it's doubtful that caffeine affects a college-educated, high-paid person more than a poor, college dropout," she says.
Further research is needed, Neogi agrees. In the meantime, "people with gout who are already habitual caffeine drinkers probably do not need to change their habits, given that long-term caffeine intake can potentially lower uric acid levels," she says.
"But the person who doesn't drink a lot of caffeine on a regular basis should be aware that drinking more than usual may potentially trigger an attack. And I would not advise someone with gout to start drinking coffee as a way to lower uric acid levels due to its short-term effects," Neogi says.
This study was presented at a medical conference. The findings should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.
SOURCES: American College of Rheumatology 2010 Annual Scientific Meeting, Atlanta, Nov. 6-11, 2010.Tuhina Neogi, MD, PhD, associate professor of medicine, Boston University School of Medicine.John S. Sundy, MD, PhD, professor of medicine, Duke University Medical Center, Durham, N.C.
Thursday, November 4, 2010
Exercise Improves Physical Function, Reduces Pain for OA Patients
Patients with osteoarthritis (OA) of the knee or hip who adhere to the recommended home physical therapy exercises and physically active lifestyle experience more improvement in pain, physical function, and self-perceived effect according to a study from researchers in The Netherlands. Research also shows that maintenance of exercise behavior and physically active lifestyle after discharge of physical therapy improves the long-term effectiveness of exercise therapy in patients with knee or hip OA. Details of the study are available online and will publish in the August print issue of Arthritis Care & Research, a journal of the American College of Rheumatology.
Individuals with OA of the hip or knee experience pain, reduced muscle strength, decreased range of joint motion, and joint instability. According to the World Health Organization (WHO) OA is one of the ten most disabling diseases in developed countries. Further WHO estimates state that 80% of those with OA have limitations in movement, and 25% cannot perform major daily life activities. Often OA patients are referred to physical therapy in order to reduce impairments and improve overall physical function to meet demands of daily living. Although exercise therapy has beneficial short-term effects, earlier research has shown that after discharge of exercise therapy the positive treatment effects decline over time and finally disappear in the long-term.
The Dutch research team conducted an observational follow-up study on 150 patients with OA of the hip and/or knee who were receiving exercise therapy. The study subjects were followed for 60 months to assess adherence to self-directed exercise (during and after prescribed physical therapy treatment period) on patient outcomes of pain, physical function, and self-perceived effect. Three forms of adherence, which is defined as the subject's behavior that corresponds to agreed recommendations by his or her physical therapist, were measured—adherence to home exercises, home activities, and increased physical activity. Researchers used a self-report questionnaire to measure participants' adherence to home exercise (e.g. muscle strengthening exercises) and activity (e.g. walking or cycling). Assessment of adherence started at baseline, and then took place again at 3, 15, and 60 months.
Patient outcomes of pain and physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The WOMAC scale ranges from best to worst, meaning lower scores represent less pain and improved physical function. Participants' physical performance was measured by the time (in seconds) it took to walk the distance of 5 meters with improvement in performance noted by a reduction in time to complete the walk.
Results show at the 3-month follow-up 57.8% of study subjects adhered to the recommended exercises and 53.8% to recommended activities. Adherence to exercise was significantly associated with a decrease in pain (-1.0 points on a scale from 0 to 20), and improvements in self-reported physical function (-2.3 points on a scale from 0 to 68) and physical performance (-0.29 seconds compared with the base-line time of 4.8 seconds to walk 5 meters (16 feet)). “Better adherence to home exercises and being more physically active improves the long-term effectiveness of exercise therapy in patients with OA of the hip and/or knee,” said lead study author, Martijn Pisters, M.Sc., PT.
A higher level of moderate or vigorous intensity physical activity was significantly associated with a decrease in pain, physical function and physical performance, as well as a positive self-perceived effect. The authors found that one hour per week more of physical activity at a moderate level resulted in an improvement in self-reported physical function of -0.24 on a scale from 0 to 68. During the physical therapy treatment period, the patients' physical activity increased by 1.5 hours of moderate or vigorous intensity physical activity per week. After the treatment period, physical activity declined by 0.5 and 1.3 hours respectively at the 15- and 60-month follow-up.
Additionally, researchers noted a decline in exercise adherence upon completion of physical therapy with only 44.1% of patients and 30.1% still exercising at the 15- and 60-month follow-up, respectively. Similarly, adherence to home activities decreased at the 15- and 60-month follow-up with only with 29.5% and 36%, respectively, of study subjects being adherent. “Future research should focus on how exercise behavior can be stimulated and maintained in the long term to improve outcomes for patients with OA,” concluded Mr. Pisters.
Article: "Exercise Adherence Improving Long-Term Patient Outcome in Patients with Osteoarthritis of the Hip and/or Knee." Martijn F. Pisters, Cindy Veenhof, Francois G. Schellevis, Jos W.R. Twisk, Joost Dekker, and Dinny H. De Bakker. Arthritis Care and Research; Published Online: March 16, 2010 (DOI: 10.1002/acr.20182); Print Issue Date: August 2010.
Individuals with OA of the hip or knee experience pain, reduced muscle strength, decreased range of joint motion, and joint instability. According to the World Health Organization (WHO) OA is one of the ten most disabling diseases in developed countries. Further WHO estimates state that 80% of those with OA have limitations in movement, and 25% cannot perform major daily life activities. Often OA patients are referred to physical therapy in order to reduce impairments and improve overall physical function to meet demands of daily living. Although exercise therapy has beneficial short-term effects, earlier research has shown that after discharge of exercise therapy the positive treatment effects decline over time and finally disappear in the long-term.
The Dutch research team conducted an observational follow-up study on 150 patients with OA of the hip and/or knee who were receiving exercise therapy. The study subjects were followed for 60 months to assess adherence to self-directed exercise (during and after prescribed physical therapy treatment period) on patient outcomes of pain, physical function, and self-perceived effect. Three forms of adherence, which is defined as the subject's behavior that corresponds to agreed recommendations by his or her physical therapist, were measured—adherence to home exercises, home activities, and increased physical activity. Researchers used a self-report questionnaire to measure participants' adherence to home exercise (e.g. muscle strengthening exercises) and activity (e.g. walking or cycling). Assessment of adherence started at baseline, and then took place again at 3, 15, and 60 months.
Patient outcomes of pain and physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. The WOMAC scale ranges from best to worst, meaning lower scores represent less pain and improved physical function. Participants' physical performance was measured by the time (in seconds) it took to walk the distance of 5 meters with improvement in performance noted by a reduction in time to complete the walk.
Results show at the 3-month follow-up 57.8% of study subjects adhered to the recommended exercises and 53.8% to recommended activities. Adherence to exercise was significantly associated with a decrease in pain (-1.0 points on a scale from 0 to 20), and improvements in self-reported physical function (-2.3 points on a scale from 0 to 68) and physical performance (-0.29 seconds compared with the base-line time of 4.8 seconds to walk 5 meters (16 feet)). “Better adherence to home exercises and being more physically active improves the long-term effectiveness of exercise therapy in patients with OA of the hip and/or knee,” said lead study author, Martijn Pisters, M.Sc., PT.
A higher level of moderate or vigorous intensity physical activity was significantly associated with a decrease in pain, physical function and physical performance, as well as a positive self-perceived effect. The authors found that one hour per week more of physical activity at a moderate level resulted in an improvement in self-reported physical function of -0.24 on a scale from 0 to 68. During the physical therapy treatment period, the patients' physical activity increased by 1.5 hours of moderate or vigorous intensity physical activity per week. After the treatment period, physical activity declined by 0.5 and 1.3 hours respectively at the 15- and 60-month follow-up.
Additionally, researchers noted a decline in exercise adherence upon completion of physical therapy with only 44.1% of patients and 30.1% still exercising at the 15- and 60-month follow-up, respectively. Similarly, adherence to home activities decreased at the 15- and 60-month follow-up with only with 29.5% and 36%, respectively, of study subjects being adherent. “Future research should focus on how exercise behavior can be stimulated and maintained in the long term to improve outcomes for patients with OA,” concluded Mr. Pisters.
Article: "Exercise Adherence Improving Long-Term Patient Outcome in Patients with Osteoarthritis of the Hip and/or Knee." Martijn F. Pisters, Cindy Veenhof, Francois G. Schellevis, Jos W.R. Twisk, Joost Dekker, and Dinny H. De Bakker. Arthritis Care and Research; Published Online: March 16, 2010 (DOI: 10.1002/acr.20182); Print Issue Date: August 2010.
Tuesday, November 2, 2010
Why Are People With Stroke More Likely To Die If Hospitalized On Weekend?
People admitted to the hospital on a weekend after a stroke are more likely to die compared to people admitted on a weekday, regardless of the severity of the stroke they experience, according to new research published in the November 2, 2010, print issue of Neurology®, the medical journal of the American Academy of Neurology.
"We wanted to test whether the severity of strokes on weekends compared to weekdays would account for lower survival rates on the weekends," said Moira K. Kapral, MD, of the University of Toronto in Ontario, Canada. Kapral was with the Institute for Clinical Evaluative Sciences in Ontario when the research was done. "Our results suggest that stroke severity is not necessarily the reason for this discrepancy."
For the study, researchers analyzed five years of data from the Canadian Stroke Network on 20,657 patients with acute stroke from 11 stroke centers in Ontario. Only the first stroke a person experienced was included in the study.
People with moderate to severe stroke were just as likely to be admitted to the hospital on weekends and weekdays, but those with mild stroke were less likely to be admitted on weekends in the study. Those who were seen on weekends were slightly older, more likely to be taken by ambulance and experienced a shorter time from the onset of stroke symptoms to hospital arrival on average.
The study found that seven days after a stroke, people seen on weekends had an 8.1 percent risk of dying compared to a 7.0 percent risk of dying for those seen on weekdays. The results stayed the same regardless of age, gender, stroke severity, other medical conditions and the use of blood clot-busting medications.
"Stroke is not the only condition in which lower survival rates have been linked for people admitted to hospitals on the weekends. The reason for the differences in rates could be due to hospital staffing, limited access to specialists and procedures done outside of regular hours," said Kapral. "More research needs to be done on why the rates are different so that stroke victims can have the best possible chance of surviving."
There were no differences found in the quality of stroke care, including brain scans and admission time, between weekends and weekdays.
The study was supported by the Canadian Stroke Network.
Source: American Academy of Neurology (AAN)
"We wanted to test whether the severity of strokes on weekends compared to weekdays would account for lower survival rates on the weekends," said Moira K. Kapral, MD, of the University of Toronto in Ontario, Canada. Kapral was with the Institute for Clinical Evaluative Sciences in Ontario when the research was done. "Our results suggest that stroke severity is not necessarily the reason for this discrepancy."
For the study, researchers analyzed five years of data from the Canadian Stroke Network on 20,657 patients with acute stroke from 11 stroke centers in Ontario. Only the first stroke a person experienced was included in the study.
People with moderate to severe stroke were just as likely to be admitted to the hospital on weekends and weekdays, but those with mild stroke were less likely to be admitted on weekends in the study. Those who were seen on weekends were slightly older, more likely to be taken by ambulance and experienced a shorter time from the onset of stroke symptoms to hospital arrival on average.
The study found that seven days after a stroke, people seen on weekends had an 8.1 percent risk of dying compared to a 7.0 percent risk of dying for those seen on weekdays. The results stayed the same regardless of age, gender, stroke severity, other medical conditions and the use of blood clot-busting medications.
"Stroke is not the only condition in which lower survival rates have been linked for people admitted to hospitals on the weekends. The reason for the differences in rates could be due to hospital staffing, limited access to specialists and procedures done outside of regular hours," said Kapral. "More research needs to be done on why the rates are different so that stroke victims can have the best possible chance of surviving."
There were no differences found in the quality of stroke care, including brain scans and admission time, between weekends and weekdays.
The study was supported by the Canadian Stroke Network.
Source: American Academy of Neurology (AAN)
Frequency Of Colds Dramatically Cut With Regular Exercise
If you want to reduce the frequency and severity of symptoms of colds you should do exercise at least five times a week and remain physically fit, US researchers report in the British Journal of Sports Medicine. They stress that not only do fit people have much fewer colds, but also when they do their symptoms are significantly milder compared to those who do not work out regularly.
Researchers from North Carolina, USA, monitored upper respiratory tract infection frequency and symptom severity over a 12-week period during autumn/winter in 2008 on 1,000 individuals aged 18 to 85. 60% of them were female and 40% were aged 19 to 39. 25% of them were over sixty years of age while 40% were middle aged.
Information was gathered on how often they did aerobic exercises. The participants were also asked to rate their levels of fitness with a 10 point validated scoring system. Other data was collected, including participants' diet, lifestyle, and recent stressful occurrences - factors which can have an impact on an individual's immune system response, the authors explained.
Cold symptoms were present for an average of 13 days during the winter and 8 days during the autumn (fall). The researchers reveal married older men seem to catch colds less often.
However, after factoring out the most significant factors linked to upper respiratory tract infections (colds) the scientists found that an individual's level of fitness as well as exercise frequency had the biggest impact in reducing occurrences and severity of colds.
Those who were physically fit and did exercise at least five times each week had a 43% to 46% lower frequency of colds compared to people who only did exercise once a week at the most.
The fittest participants had a 41% lower symptoms severity, while regular exercisers' severity of symptoms was reduced by 31%, the authors wrote.
The average American adult has two to four colds each year. US children have an average of between 6 and 10 colds annually. The economic toll of colds on the American economy is estimated to be approximately $40 billion annually.
The researchers say that exercise sessions trigger a temporary increase in immune system cells that circulate within the body. Although immune system cell levels soon return to normal after exercise, they probably improve the body's surveillance of pathogens - harmful bacteria, viruses and other organisms. Improved pathogen surveillance leads to fewer and less severe infections.
The authors concluded:
The term aerobic exercise was first used in the 1960s by Col. Pauline Potts, an exercise physiologist and Dr. Kenneth Cooper. They were both in the US Air Force. Dr. Cooper wondered why some physically strong individuals were poor at long-distance endurance sports. He used a bicycle ergometer to measure participants' ability to use oxygen. In 1968 he published a book titled "Aerobics", which included scientific programs using aerobic exercises. It became a bestseller. All current aerobic programs include Dr. Cooper's data as a baseline.
"Upper respiratory tract infection is reduced in physically fit and active adults"
David C Nieman, Dru A Henson, Melanie D Austin, Wei Sha
Br J Sports Med doi:10.1136/bjsm.2010.077875
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Researchers from North Carolina, USA, monitored upper respiratory tract infection frequency and symptom severity over a 12-week period during autumn/winter in 2008 on 1,000 individuals aged 18 to 85. 60% of them were female and 40% were aged 19 to 39. 25% of them were over sixty years of age while 40% were middle aged.
Information was gathered on how often they did aerobic exercises. The participants were also asked to rate their levels of fitness with a 10 point validated scoring system. Other data was collected, including participants' diet, lifestyle, and recent stressful occurrences - factors which can have an impact on an individual's immune system response, the authors explained.
Cold symptoms were present for an average of 13 days during the winter and 8 days during the autumn (fall). The researchers reveal married older men seem to catch colds less often.
However, after factoring out the most significant factors linked to upper respiratory tract infections (colds) the scientists found that an individual's level of fitness as well as exercise frequency had the biggest impact in reducing occurrences and severity of colds.
Those who were physically fit and did exercise at least five times each week had a 43% to 46% lower frequency of colds compared to people who only did exercise once a week at the most.
The fittest participants had a 41% lower symptoms severity, while regular exercisers' severity of symptoms was reduced by 31%, the authors wrote.
The average American adult has two to four colds each year. US children have an average of between 6 and 10 colds annually. The economic toll of colds on the American economy is estimated to be approximately $40 billion annually.
The researchers say that exercise sessions trigger a temporary increase in immune system cells that circulate within the body. Although immune system cell levels soon return to normal after exercise, they probably improve the body's surveillance of pathogens - harmful bacteria, viruses and other organisms. Improved pathogen surveillance leads to fewer and less severe infections.
The authors concluded:
Perceived physical fitness and frequency of aerobic exercise are important correlates of reduced days with URTI (upper respiratory tract infection) and severity of symptoms during the winter and fall common cold seasons.
What is Aerobic Exercise
Aerobic exercise improves our body's oxygen consumption - aerobic means with oxygen. Aerobic refers to the body's use of oxygen in its energy-generating process (metabolic process). Aerobic exercises are generally done with a moderate level of intensity for long periods, when compared to other forms of exercise. Typically, a bout of aerobic exercise involves warming up, exertion for at least 20 minutes, and then a cool down. This type of exercise involves mainly the large muscle groups.The term aerobic exercise was first used in the 1960s by Col. Pauline Potts, an exercise physiologist and Dr. Kenneth Cooper. They were both in the US Air Force. Dr. Cooper wondered why some physically strong individuals were poor at long-distance endurance sports. He used a bicycle ergometer to measure participants' ability to use oxygen. In 1968 he published a book titled "Aerobics", which included scientific programs using aerobic exercises. It became a bestseller. All current aerobic programs include Dr. Cooper's data as a baseline.
"Upper respiratory tract infection is reduced in physically fit and active adults"
David C Nieman, Dru A Henson, Melanie D Austin, Wei Sha
Br J Sports Med doi:10.1136/bjsm.2010.077875
Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
Knee strengthening exercise
Troy shares the top knee strengthening and stability exercises that help prevent injury in and around the knee and joint. A practical demonstration of how to perform a proper squat and lunge with proper alignment is also covered.
Coffee, Tea Linked to Lower Brain Cancer Risk
Researchers Say Antioxidants in Coffee and Tea May Explain Possible Reduction in Risk
By Katrina Woznicki
WebMD Health News
Oct. 22, 2010 -- Drinking about a half cup or more of coffee or tea per day is associated with a 34% reduction in the risk for glioma, a type of brain tumor, researchers report.
Researchers led by Dominique Michaud, DSc, an investigator at Brown University, and colleagues analyzed data from the European Prospective Investigation into Cancer and Nutrition longitudinal study, which includes more than 410,000 people from nine countries who were followed for about 8.5 years.
Participants answered questionnaires about their coffee and tea intake, as well as other dietary habits. Information about cancer diagnoses was obtained from national cancer registries and medical insurance records.
Overall, researchers found that drinking 100 mL or more of coffee or tea a day was linked to a reduced risk of glioma brain tumors. Men who were coffee and tea drinkers had a greater reduction in risk than women.
The study was not designed to establish a cause-and-effect relationship between drinking coffee or tea and developing brain or spinal cord tumors; researchers only observed a connection. The researchers say more studies are needed to validate these observations.
During the study period, there were 343 cases of glioma (165 men and 178 women) and 245 cases of meningioma (54 men and 191 women) diagnosed. The meninges are the tissues surrounding and protecting the brain and spinal cord. There was no association of the amount of coffee and tea drunk daily and the development of meningioma.
Coffee consumption was highest in Denmark and lowest in Italy. Tea consumption was highest in the U.K. and lowest in Spain. People who drank greater amounts of coffee or tea were often older, more educated, smoked, and had a lower body mass index -- a measurement of height and weight.
The findings are published in the November issue of American Journal of Clinical Nutrition.
Coffee and tea are very high in antioxidants, which may explain the possible protective effect against some types of brain tumors, the researchers say. However, brewing methods vary greatly country to country, which could affect the concentration of antioxidants in a given cup.
Coffee and tea are two of the most popular beverages around the world. Drinking coffee and tea has also been associated with being protective against other types of cancers and brain disorders, including Alzheimer's disease, Parkinson's disease, and liver cancer. According to the National Cancer Institute, every year there are 22,020 new cases and 13,140 deaths from brain tumors and other nervous system tumors in the U.S.
SOURCES: News release, American Society of Nutrition.Michaud, D. American Journal of Clinical Nutrition, November 2010; vol 92: pp 1145-1150.National Cancer Institute.
By Katrina Woznicki
WebMD Health News
Oct. 22, 2010 -- Drinking about a half cup or more of coffee or tea per day is associated with a 34% reduction in the risk for glioma, a type of brain tumor, researchers report.
Researchers led by Dominique Michaud, DSc, an investigator at Brown University, and colleagues analyzed data from the European Prospective Investigation into Cancer and Nutrition longitudinal study, which includes more than 410,000 people from nine countries who were followed for about 8.5 years.
Participants answered questionnaires about their coffee and tea intake, as well as other dietary habits. Information about cancer diagnoses was obtained from national cancer registries and medical insurance records.
Overall, researchers found that drinking 100 mL or more of coffee or tea a day was linked to a reduced risk of glioma brain tumors. Men who were coffee and tea drinkers had a greater reduction in risk than women.
The study was not designed to establish a cause-and-effect relationship between drinking coffee or tea and developing brain or spinal cord tumors; researchers only observed a connection. The researchers say more studies are needed to validate these observations.
During the study period, there were 343 cases of glioma (165 men and 178 women) and 245 cases of meningioma (54 men and 191 women) diagnosed. The meninges are the tissues surrounding and protecting the brain and spinal cord. There was no association of the amount of coffee and tea drunk daily and the development of meningioma.
Coffee consumption was highest in Denmark and lowest in Italy. Tea consumption was highest in the U.K. and lowest in Spain. People who drank greater amounts of coffee or tea were often older, more educated, smoked, and had a lower body mass index -- a measurement of height and weight.
The findings are published in the November issue of American Journal of Clinical Nutrition.
Coffee and tea are very high in antioxidants, which may explain the possible protective effect against some types of brain tumors, the researchers say. However, brewing methods vary greatly country to country, which could affect the concentration of antioxidants in a given cup.
Coffee and tea are two of the most popular beverages around the world. Drinking coffee and tea has also been associated with being protective against other types of cancers and brain disorders, including Alzheimer's disease, Parkinson's disease, and liver cancer. According to the National Cancer Institute, every year there are 22,020 new cases and 13,140 deaths from brain tumors and other nervous system tumors in the U.S.
SOURCES: News release, American Society of Nutrition.Michaud, D. American Journal of Clinical Nutrition, November 2010; vol 92: pp 1145-1150.National Cancer Institute.
The Alarming Symptoms Of Low Blood Pressure
Sometimes, it has been noticed that low blood pressure also goes unnoticed for long periods because of its lack of defined signs and symptoms.
If your blood pressure level is low, it can cause various problems and disorders. The organs of the body will start malfunctioning and they may suffer permanent damages. Because of the low blood pressure there would be insufficient flow of blood to the brain, which can make the sufferer feel light-headed, dizzy, or he may even faint.
Apart from all these, the body also shows some sort of symptoms that are typical when you are suffering from low blood pressure. Here are some of the symptoms of low blood pressure:
1) Light-headedness
2) Dizziness
3) Palpitations
4) Blurred vision
5) Discomfort in the chest
6) Fainting or near fainting
7) Anxiety
8) Fatigue
9) Headache/migraine
10) Shortness of breath
11) Intolerance to heat
12) Feeling cold all over
13) Bloating after meals
14) Cognitive impairment
15) Numbness or tingling sensations
16) Generalized weakness
17) Reduced pulse pressure upon standing
18) Low back pain
19) Excessive sweating
If your blood pressure level is low, it can cause various problems and disorders. The organs of the body will start malfunctioning and they may suffer permanent damages. Because of the low blood pressure there would be insufficient flow of blood to the brain, which can make the sufferer feel light-headed, dizzy, or he may even faint.
Apart from all these, the body also shows some sort of symptoms that are typical when you are suffering from low blood pressure. Here are some of the symptoms of low blood pressure:
1) Light-headedness
2) Dizziness
3) Palpitations
4) Blurred vision
5) Discomfort in the chest
6) Fainting or near fainting
7) Anxiety
8) Fatigue
9) Headache/migraine
10) Shortness of breath
11) Intolerance to heat
12) Feeling cold all over
13) Bloating after meals
14) Cognitive impairment
15) Numbness or tingling sensations
16) Generalized weakness
17) Reduced pulse pressure upon standing
18) Low back pain
19) Excessive sweating
Monday, November 1, 2010
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