Day: 07/27/2010

Kegel exercises: A how-to guide for women

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Kegel exercises can help you prevent or control urinary incontinence and other pelvic floor problems. Here’s a step-by-step guide to doing Kegel exercises correctly.


Kegel exercises strengthen the pelvic floor muscles, which support the uterus, bladder and bowel. You can do Kegel exercises discreetly just about anytime, whether you’re driving in your car, sitting at your desk or relaxing on the couch. You can even do Kegel exercises when you’re pregnant. Start by understanding what Kegel exercises can do for you — then follow step-by-step instructions for contracting and relaxing your pelvic floor muscles.

Why Kegel exercises matter

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Illustration of muscles targeted during Kegel exercises Female pelvic floor muscles

Many factors can weaken your pelvic floor muscles, from pregnancy and childbirth to aging and being overweight. This may allow your pelvic organs to descend and bulge into your vagina — a condition known as pelvic organ prolapse. The effects of pelvic organ prolapse range from uncomfortable pelvic pressure to leakage of urine. Pelvic organ prolapse isn’t inevitable, however. Kegel exercises can help delay or even prevent pelvic organ prolapse and the related symptoms.

Kegel exercises — along with counseling and sex therapy — may also be helpful for women who have persistent problems reaching orgasm.

How to do Kegel exercises

It takes diligence to identify your pelvic floor muscles and learn how to contract and relax them. Here are some pointers:

  • Find the right muscles. Insert a finger inside your vagina and try to squeeze the surrounding muscles. You should feel your vagina tighten and your pelvic floor move upward. Then relax your muscles and feel your pelvic floor return to the starting position. You can also try to stop the flow of urine when you urinate. If you succeed, you’ve got the basic move. Don’t make a habit of starting and stopping your urine stream, though. Doing Kegel exercises with a full bladder or while emptying your bladder can actually weaken the muscles, as well as lead to incomplete emptying of the bladder — which increases the risk of a urinary tract infection.
  • Perfect your technique. Once you’ve identified your pelvic floor muscles, empty your bladder and sit or lie down. Contract your pelvic floor muscles, hold the contraction for five seconds, then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
  • Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
  • Repeat three times a day. Aim for at least three sets of 10 repetitions a day. You might make a practice of fitting in a set every time you do a routine task, such as checking email, commuting to work, preparing meals or watching TV.

When you’re having trouble

If you’re having trouble doing Kegel exercises, don’t be embarrassed to ask for help. Your doctor or other health care provider can give you important feedback so that you learn to isolate and exercise the correct muscles.

In some cases, biofeedback training may help. During a biofeedback session, your doctor or other health care provider inserts a small monitoring probe into your vagina or places adhesive electrodes on the skin outside your vagina or anus. When you contract your pelvic floor muscles, you’ll see a measurement on a monitor that lets you know whether you’ve successfully contracted the right muscles. You’ll also be able to see how long you hold the contraction.

If necessary, electrical stimulation is sometimes an option. During this procedure, your doctor or other health care provider applies a small electrical current to your pelvic floor muscles. The current makes the muscles contract, which produces a buzzing feeling. Once you get used to the sensation, you’ll probably be able to duplicate the exercise on your own.

When to expect results

If you do your Kegel exercises faithfully, you can expect to see results — such as less frequent urine leakage — within about eight to 12 weeks. For some women, the improvement is dramatic. For others, Kegel exercises simply keep problems from getting any worse. For continued benefits, make Kegel exercises a permanent part of your daily routine.

avatar v/s aliens

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Avatar and Aliens are the same goddamn movie

The Oatmeal

Irritable Bowel Syndrome in the Brain

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IBS Patients’ Brains on High Alert, With Less Control of Emotion and Pain

July 23, 2010 — Irritable bowel syndrome (IBS) may be in the brain, not in the mind.

IBS patients tend to suffer anxiety and depression, but they tire of being told their symptoms of diarrhea, constipation, and/or pain are all in their minds.

Now there’s evidence that their underlying problem may be due to the structure of their brains, says Emeran Mayer, MD, professor of medicine, physiology, and psychiatry at the University of California, Los Angeles.

“Discovering structural changes in the brain … demonstrates an ‘organic’ component to IBS and supports the concept of a brain-gut disorder,” Mayer says in a news release. “The finding removes the idea once and for all that IBS symptoms are not real and are ‘only psychological.’ The findings will give us more insight into better understanding IBS.”

Mayer, David A. Seminowicz, PhD, and colleagues at UCLA and Canada’s McGill University used sophisticated scans to compare the brain anatomy of 55 women with moderate IBS to 48 age-matched healthy women.

The finding: Thinning grey matter — the part of the brain rich in neurons — in specific areas of the brain. The affected areas involve:

  • Dampening the brain’s arousal system. IBS patients tend to be over-sensitive to (and hypervigilant for) bowel sensations.
  • Controlling emotion. Symptom-related worries and ineffective coping strategies play an important role in chronic pain syndromes.
  • Controlling pain. Brain thinning in this region was seen only in patients who listed pain as their most bothersome IBS symptom.

Importantly, brain areas linked to anxiety and depression were no different in IBS patients than in anxious or depressed people without IBS.

The findings, Seminowicz and colleagues suggest, point to a difference between IBS and chronic pain syndromes such as fibromyalgia.

In chronic pain syndromes, nerves constantly send increased pain signals to the brain. But in IBS, the brain itself seems to be amplifying pain signals it receives from the bowel.

The researchers say future studies should look at family members of IBS patients, to see if they inherited the same brain anatomy that may increase a person’s risk of IBS. If so, the studies may reveal genetic components of IBS and point the way to new treatments.

The study appears in the July issue of the journal Gastroenterology.

Successful treatment for metastases from renal cell carcinoma with alternation of interferon-alpha subtypes

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we present a case in which alternation of interferon-alpha (IFN-α) treatments was effective in treating pulmonary metastases and lymph node metastases from renal cell carcinoma (RCC). A 56-year-old man underwent left radical nephrectomy under the diagnosis of left RCC. The histological diagnosis was clear cell carcinoma G2, IFN-α, pT1b. He subsequently underwent two operations for right pulmonary metastasis and right hilar lymph node metastasis. Postoperatively he was treated with intramuscular administration of natural IFN-α (Sumiferon) which prevented definite recurrence for 1 year. However, multiple pulmonary metastases and left hilar lymph node metastasis occurred 11 months after discontinuation of Sumiferon. Therefore, treatment with another natural IFN-α (OIF) was started. Although OIF was continued for 7 months, pulmonary metastases and left hilar lymph node metastasis continued to progress. Therefore, treatment was changed to Sumiferon, after which the pulmonary metastases and left hilar lymph node metastasis decreased in size. The metastases showed no progression for 16 months after switching from OIF to Sumiferon.

Effect of calcium and magnesium on neurotoxicity and blood platinum concentrations in patients receiving mFOLFOX6 therapy: a prospective randomized study

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Whether the administration of calcium (Ca) and magnesium (Mg) can reduce oxaliplatin-related neurotoxicity remains controversial. In addition, little is known about the effects of Ca/Mg on the blood level of platinum or objective tumor progression.

Patients and methods  Patients receiving modified FOLFOX6 for metastatic colorectal cancer were double-blinded and randomized to receive additional treatment with Ca/Mg or placebo before and after the administration of oxaliplatin. The plasma and ultrafiltrable concentrations of platinum during the first and fifth cycles of treatment were determined using inductively coupled plasma spectrometry.
Results  Patients were randomized to receive Ca/Mg (Ca/Mg group, n = 17) or placebo (placebo group, n = 16) before and after the administration of oxaliplatin (85 mg/m2). The incidence of neurotoxicity after six cycles was not significantly different between the two groups. Blood concentrations of platinum at each time and the area under the curve were also not significantly different between the two groups. Furthermore, the response rate (RR) and disease control rate (DCR) did not differ significantly between the two groups (Ca/Mg group: RR 36%, DCR 73%. Placebo group: RR 40%, DCR 70%, P > 0.99). The median progression-free survival time was 9.2 months in the Ca/Mg group and 8.1 months in the control group; these survival times were not significantly different (P = 0.56).
Conclusion  These data are insufficient to conclude with any certainty that the administration of Ca/Mg is not neuroprotective; however, the administration of Ca/Mg may not have any influence on antitumor activity and the blood concentration profile of platinum in patients receiving oxaliplatin-based chemotherapy.

A prospective open-label trial of gabapentin as an adjuvant analgesic with opioids for Japanese patients with neuropathic cancer pain

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Background  Neuropathic pain is regarded as one of the main causes of cancer pain refractory to standard opioid therapy in palliative care. The use of adjuvant analgesics for neuropathic cancer pain is largely empirical and the true efficacy of these adjuvant analgesics has been unknown. Gabapentin is one of the new promising anticonvulsant drugs as an adjuvant analgesic for neuropathic cancer pain.

Methods  The clinical usefulness of gabapentin in combination with opioids for Japanese patients with neuropathic cancer pain was assessed in an open-label, single-center, prospective study. Gabapentin was initiated in addition to the drugs currently being administered. The dose of gabapentin was titrated from 200 mg to a maximum dose of 2400 mg per day over 15 days, based on discussion with each patient. The primary endpoint variable was the numerical rating scale (NRS) of 0–10 measured using the brief pain inventory.
Results  From February 2007 to December 2007, gabapentin was administered to 24 patients that were already receiving an opioid without sufficient analgesia. Administration of gabapentin statistically reduced the worst-NRS, the least-NRS, and the average-NRS (7.3 → 5.8, 3.6 → 3.0, 5.8 → 4.5, respectively). Four patients (16.7%) were withdrawn from the study because of adverse events (headache, myoclonus, heartburn, bronchial asthma).
Conclusion  Although gabapentin might be regarded as a promising new adjuvant analgesic for neuropathic cancer pain, our results indicated that the decrease in pain score was of minimal clinical benefit. Controlled trials with other adjuvant analgesics are needed.

Only Certain Newer Antiepileptic Drugs Associated with Increased Risk for Suicidal Behavior

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Current use of newer antiepileptic drugs (AEDs) that pose high risk for depression is associated with increased risk for suicidal behavior, according to an industry-funded study in Neurology. (In 2008, the FDA warned that all AEDs raise suicidality risk.)

Using a U.K. general practice database, researchers matched some 450 patients with epilepsy who had displayed self-harm or suicidal behavior with some 9000 epileptic patients without such behavior. All had used at least one AED during 5.5 years’ follow-up.

Current use of newer AEDs associated with high risk for depression (e.g., levetiracetam, topiramate) raised the odds for self-harm or suicidality threefold, compared with nonuse in the past year. Barbiturates, conventional AEDs (e.g., carbamazepine, phenytoin, valproate), and newer AEDs with low risk for depression (e.g., gabapentin, lamotrigine) did not increase risk.

Editorialists call the study a “good initial attempt” but point out various limitations that might invalidate the findings; for instance, few cases were taking high-risk drugs.