Day: 05/31/2013

Double-Dose Tamiflu No Better Than Standard Dose for Severe Flu.

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A double dose of oseltamivir (Tamiflu) offers no advantage over single-dose therapy among children and adults with severe influenza, according to a BMJ study.

Some 325 patients (three-quarters children) hospitalized with severe flu in Southeast Asia were randomized to either double-dose oseltamivir (150 mg twice daily, or pediatric equivalent) or standard treatment (75 mg twice daily, or equivalent). Detected viruses included various subtypes of seasonal influenza, 2009 pandemic flu, and avian flu.

The proportion of patients with no detectable viral RNA on day 5 did not differ between the groups (roughly 70%). In addition, the groups did not differ with respect to clinical failure or in-hospital mortality. Findings generally were consistent regardless of patient age or flu type.

The authors say their results “do not support routine use” of double-dose therapy in severe flu. Editorialists agree, adding that the results “could help to preserve oseltamivir stocks during a future pandemic.”

Source: BMJ

Intense But Short Exercise Is All You Need to Boost Calorie Burning.

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Story at-a-glance

  • Recent research demonstrates that high intensity interval training burns more calories in less time. Just 2.5 minutes, divided into five 30-second sprint intervals at maximum exertion, each followed by four minutes of light pedaling to recuperate, can burn as much as 220 calories
  • Anaerobic exercises also increase insulin sensitivity and glucose tolerance, and promote production of human growth hormone—all of which are critical components of optimal health. Previous research has shown that just three minutes of high intensity exercise per week for four weeks can result in a 24 percent improvement in insulin sensitivity
  • If you’re ready to take your fitness routine to the next level, you may want to consider skipping breakfast and work out on an empty stomach. This is a form of intermittent fasting that can greatly contribute to improved weight loss, as it shifts your body into fat burning mode
  • The combination of high intensity interval training, avoiding grain carbs and sugars, especially fructose, and exercising in a fasted state, can help you become increasingly fat adapted, which is the preferred metabolic state of the human body

If you have a difficult time fitting exercise into an already crammed schedule, you’ll be excited to know you can reap truly remarkable results in a very limited amount of time. Can you carve out 20 minutes two to three times a week?

If so, you can dramatically improve your overall fitness and health – as long as you engage in high-intensity interval training, that is.

Research presented at the Integrative Biology of Exercise VI meeting1, 2 in Colorado on October 10-13 this year, demonstrated that high-intensity interval training burns more calories in less time – a mere 2.5 minutes, divided into five 30-second sprint intervals at maximum exertion, each followed by four minutes of light pedaling to recuperate, can burn as much as 220 calories.

According to lead researcher Kyle Sevits:3

“You burn a lot of calories in a very short time… Nearly all the calories are burned in those 2.5 minutes; you burn very few during the rest period.”

Besides burning more calories, high-intensity interval training, which is part of my total Peak Fitness program, has also been shown to produce greater health benefits overall than conventional aerobic training, such as increasing insulin sensitivity and glucose tolerance – both of which are critical components of optimal health. Back in April, I reported on a study that found doing just three minutes of high-intensity exercise per week for four weeks, could lead to a 24 percent improvement in insulin sensitivity.

Another important benefit of high-intensity interval training is its ability to naturally increase your body’s production of human growth hormone (HGH), also known as “the fitness hormone.” HGH is a synergistic, foundational biochemical underpinning that promotes muscle and effectively burns excessive fat.

It also plays an important part in promoting overall health and longevity. This too is something you cannot get from conventional, aerobic endurance training. Other benefits associated with high-intensity interval training include:

Decrease in body fat Improved muscle tone
Improved athletic speed and performance Ability to achieve your fitness goals much faster
Increase in energy and sexual desire Firmer skin and reduces wrinkles

Are You Maximizing the Health Benefits from Your Fitness Routine?

The key that unlocks the many health benefits associated with exercise is intensity. To perform anaerobic exercises correctly, regardless of how you do them (sprinting outdoors, using a stationary bike or elliptical machine, or using weights), you’ll want to raise your heart rate to your anaerobic threshold, and to do that, you have to give it your all for those 20 to 30 second intervals.

Different studies will use different intervals of exertion and recuperation. For example, in the featured study, 30-second bouts of exertion were separated by four-minute rest intervals. I use and recommend the program developed by Phil Campbell, where you go all out for 30 seconds, followed by 90 seconds of recuperation. If you do the recommended eight repetitions, you’ll be done in 20 minutes or less.

Depending on your level of fitness when you’re first starting out, you may only be able to do two or three repetitions of the high-intensity intervals. That’s okay. As you get fitter, just keep adding repetitions until you’re doing eight during your 20 minute session. Here’s a summary of what a typical interval routine might look like using an elliptical:

  • Warm up for three minutes
  • Exercise as hard and fast as you can for 30 seconds. You should be gasping for breath and feel like you couldn’t possibly go on another few seconds. It is better to use lower resistance and higher repetitions to increase your heart rate
  • Recover for 90 seconds, still moving, but at slower pace and decreased resistance
  • Repeat the high-intensity exercise and recovery 7 more times

Greater Intensity = Greater Need for Recovery

To optimize results, do these types of peak exercises twice or three times a week. Again, you only need about 20 minutes per session, and you don’t even need a gym membership to do them. If you have beach access, you may want to take to sprinting barefoot by the water’s edge. However, before you give it a go, make sure to review some basic safety guidelines, which I discussed in depth in my previous article, Proper Sprinting and Warm-Up Techniques to Optimize Your Workout and Avoid Injury.

You can also turn your weight training session into an anaerobic exercise by following the guidelines presented by Dr. Doug McGuff. The key that turns strength training into a high-intensity exercise is the speed. Reducing the speed increases the intensity.

Whichever way you choose to do them, you do not need to do high-intensity exercises more frequently than three times a week. In fact, doing so can be counterproductive, as your body needs to recover between sessions. The importance of recovery should not be overlooked, as your body needs time to rebuild itself in order to function optimally. As explained by Dr. Jeff Spencer:

“To achieve the most beneficial effects from your workouts in the shortest time it’s essential to understand the concept of total load. Total Training Load refers to the total amount of training ‘strain’ on the body over time. For example, one single super-hard workout can strain the body as much as several moderate intensity workouts done back to back can.

The Total Training Load can be increased by increasing the number of exercise repetitions, resistance, length of workout sets and by increasing the speed of repetitions and, also, by shortening the rest interval between exercise sets. If the Total Training Load is in excess too long, the body breaks down, and illness, over-training, burnout, and injury occur.”

Recovery also includes giving your body the proper nutrients it needs in the recovery phase, as your post-workout meal can support or inhibit the health benefits of exercise. For instance, fast-assimilating protein such as high-quality whey protein, eaten within 30 minutes of your workout, will essentially “rescue” your muscle tissue out of the catabolic state and supply it with the proper nutrients to stimulate repair and rejuvenation.

The Synergy Between Exercise and Diet, and Boosting Results with Intermittent Fasting

It’s well worth noting that your choice of breakfast food may play a significant role in altering your metabolic functioning, which can either improve or deter weight loss. For example, eating carbohydrates for breakfast will inhibit your sympathetic nervous system (SNS) and reduce the fat burning effect of your exercise. Instead, it activates your parasympathetic nervous system (PSNS), which promotes storage of fat – the complete opposite of what you’re aiming for.

Avoiding fructose and other grain carbohydrates is a critical element of a successful weight loss strategy. This includes sports or energy drinks and fruit juices (even if they’re freshly squeezed). Exercise cannot counteract the harmful effects of a high-fructose diet. It’s also important to remember that if you consume fructose within two hours before or after high-intensity exercise, you effectively negate the ability of the exercise to produce HGH – one of the MAJOR benefits of interval training.

If you’re ready to take your fitness routine to the next level, you may even want to consider skipping breakfast altogether and work out on an empty stomach. You can review the article I recently wrote on this here. This is a form of intermittent fasting and I believe it’s one of the most profound new developments in weight loss management. This can radically improve your ability to shift to fat burning mode and effectively burn fat rather than glucose.

Also, exercising in a fasted state can help your cells rebuild and repair, keeping them biologically young. I’ve previously interviewed fitness expert Ori Hofmekler on the issue of fasting and exercise. According to Ori, fasting actually has the surprising benefit of helping you reconstruct your muscles when combined with exercise. This is due to an ingenious preservation mechanism that protects your active muscle from wasting itself.

In a nutshell, if you don’t have sufficient fuel in your system when you exercise, your body will break down other tissues but not the active muscle, i.e. the muscle being exercised. That said, neither Ori nor I advocate starvation combined with rigorous exercise. It’s important to be sensible. And you need to consume sufficient amounts of protein in order to prevent muscle wasting. While most people need to address the foods they DO eat before considering skipping meals, intermittent fasting can provide you with many benefits, and is another tool you can experiment with to help you reach your goals. Research has shown that the combined effect of intermittent fasting (IF) with short intense exercise may help you to:

Turn back the biological clock in your muscle and brain Boost growth hormone Improve body composition
Boost cognitive function Boost testosterone Prevent depression

Being Fat-Adapted Can Help Improve Your Health

If you follow the recommendations mentioned above, which include:

  • High-intensity interval training
  • Avoiding grain carbs and sugars, especially fructose
  • Exercising in a fasted state

another side effect will eventually become apparent: you’ll become increasingly “fat-adapted.” Fat-adaption describes the ability to burn fat directly via beta-oxidation. It is the normal, preferred metabolic state of the human body, in which your body burns fat rather than glucose as its primary source of energy. Sadly, the bodies of many, if not most, Americans operate in a state of sugar-dependency, which is an abnormal metabolic state that inevitably results in insulin resistance and related chronic disease. Signs that you’re a sugar-burner and are heading down a path of disease include:

  • Low satiety
  • Persistent hunger
  • Carb cravings

As Mark Sisson explains in a recent article, if you are fat-adapted, you:

  1. Can effectively burn stored fat for energy throughout the day.

If you can handle missing meals and are able to go hours without getting ravenous and cranky (or craving carbs), you’re likely fat-adapted.

  1. Are able to effectively oxidize dietary fat for energy.

If you’re adapted, your post-prandial fat oxidation will be increased, and less dietary fat will be stored in adipose tissue.

  1. Can rely more on fat for energy during exercise, sparing glycogen for when you really need it.

Being able to mobilize and oxidize stored fat during exercise can reduce an athlete’s reliance on glycogen. This is the classic “train low, race high” phenomenon, and it can improve performance, save the glycogen for the truly intense segments of a session, and burn more body fat.

According to Sisson, once you can go three hours or more without feeling hungry, you’re on your way toward being fat-adapted. If you can handle exercising without having to carb-load, you’re probably fat-adapted. And if you can work out effectively in a fasted state, you’re definitely fat-adapted.

Source : mercola.com

Study Shows Exercise as Effective as Massage for Decreasing Post-Exertion Muscle Soreness.

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Story at-a-glance

  • A new study found exercise as effective as massage in relieving the delayed onset muscle soreness (DOMS) that often occurs a day or two after strenuous exercise
  • It is a myth that muscle soreness is caused by a buildup of lactic acid; the real cause is inflammation stemming from microscopic tears in your muscle fibers, or more specifically, microtears between your muscles and their surrounding tissues, a necessary part of the muscle strengthening and rebuilding process
  • A balanced, healthful diet is the most important step you can take to give your body the building blocks it needs for strong, resilient tissues and minimal inflammation; consuming adequate high-quality amino acids, omega-3 fats, and sulfur will help minimize exercise-induced aches and pains
  • Avoid commercial analgesics such as ibuprofen and aspirin, because they are not very helpful and come with some potentially serious side effects; natural treatments are safer and more effective

It is highly likely you have experienced the muscle soreness that sometimes follows a new or vigorous workout, which is called DOMS (delayed onset muscle soreness).

Most people have a routine for managing this discomfort, whether it’s stretching or attending a yoga class, or just soaking in a hot bath. If you ignore it, yes, it will go away on its own — but who wants to suffer in waiting?

A new study published in the Journal of Strength and Conditioning Research1 set about comparing the effects of massage versus active exercise in relieving delayed onset muscle soreness  The results may surprise you!

The researchers found exercise as effective as massage in relieving those post workout aches and pains. So the next time you think you have to dish out the dollars to see your massage therapist in order to get some relief, you might try a little “hair of the dog” instead.

Researchers concluded:

“Active exercise using elastic resistance provides similar acute relief of muscle soreness as compared with massage.

Coaches, therapists and athletes can use either active warm-up or massage to reduce daily onset muscle soreness acutely, e.g. before competition or strenuous work, but should be aware that the effect is temporary, i.e. the greatest effects occur during the first 20 minutes after treatment and diminish within an hour.”

Why Does Exercise Sometimes Cause Muscle Soreness? (HINT: It’s NOT Lactic Acid!)

For many years, it was commonly believed muscle soreness was from lactic acid buildup, but this has now been thoroughly debunked by science. The burn you feelwhile exercising is indeed lactic acid, however, your body flushes it out very quickly — within an hour of exercising.

In actuality, lactic acid is a muscle fuel, not a caustic waste product. The myth that lactic acid causes muscle soreness stems from a century-old misinterpreted frog experiment.2

Your muscles produce lactic acid from glucose, which is then taken up by your mitochondria. The more fit you are, the better adapted your muscles are at using it.

The larger your muscles become, the more mitochondria you have, and the more efficient your “lactic acid furnace” will be. Mitochondrial mass (and therefore, athletic performance) is further increased by high-intensity burst type training.

Delayed onset muscle soreness (DOMS), or the muscle soreness you’ve experienced one to two days after exercise, is actually caused by inflammation stemming from microscopic tears in your muscle fibers, or more specifically, microtears between your muscles and their surrounding tissues.

This most often occurs when you start a new exercise program, change it in some way, or resume exercising after a period of inactivity. Eccentric contractions seem to cause the most soreness, meaning movements that cause your muscle to forcefully contract while lengthening, such as the downward motion of squats or pushups.

These damaged muscles release chemical irritants that trigger mild inflammation, which awakens your pain receptors. Other theories about DOMS attribute the phenomenon to changes in osmotic pressure, muscle spasms, or differences in how your muscle cells regulate calcium.

Although science has not yet pinned down the exact process, post-workout soreness is a normal response to exertion and part of an adaptive physiological process that leads to increased strength and stamina.

The ONE Treatment to Absolutely Avoid

Relying on over-the-counter analgesics is not advised, and may not even provide much relief. Taking ibuprofen before a workout in order to reduce muscle soreness has been linked to intestinal leakage and systemic inflammation. When used long-term, it may lead to intestinal permeability, allowing bacteria and digestive enzymes to leak into your bloodstream.

Habitually using ibuprofen before workouts may also reduce your absorption of key nutrients, particularly after exercise, making it harder for your muscles to rebuild. And ibuprofen use has not been shown to reduce muscle damage or soreness. Aspirin fares no better. Research suggests the coating on aspirin, which is there to help protect your stomach, may actually be interfering with its purported benefits. It is a much better approach to treat muscle soreness with a combination of natural measures, which may require a bit of experimentation to see what works best for you.

Five Basic Approaches to Preventing Muscle Soreness

You simply can’t prevent all muscle soreness, but there are some natural ways to decrease its frequency and lessen its severity. Here are my top five approaches, which will be discussed in the remainder of this article:

  1. Optimizing your diet
  2. Exercising correctly
  3. Rest and recovery
  4. Cryotherapy (ice), heat, or even alternating between the two
  5. Tools such as EFT, earthing, and acceleration training

First and foremost, eating a balanced diet rich in fresh, organic nutritionally dense foods will give your body the building blocks it needs to form strong, resilient tissues that resist inflammation. Of course, a good diet will help you in many other ways as well! There is a great deal of excellent dietary information on our website, so please check out our complete nutrition plan. There are three very important factors in fitness nutrition:

  1. Consuming a diet high in beneficial fats (50 to 70 percent), moderate in protein, low in carbohydrates, and very low in sugar (this means ditching your sports drinks, energy drinks, and most energy bars).
  2. Getting adequate essential amino acids, especially leucine.
  3. Appropriate timing of meals, known as intermittent fasting; exercising while in a fasting state can boost muscle growth. The easiest way to accomplish this is to exercise first thing in the morning, and then have a fast-assimilating protein recovery meal 30 minutes after your workout.

Consuming fructose two hours before or after high-intensity interval exercise will decimate your body’s ability to produce human growth hormone (HGH). HGH is central to tissue repair, so if your levels are low, it follows that your muscle soreness will be greater. Carbohydrate loading is not the most beneficial way to gain muscle tone, lose fat, and boost your performance. Proteins, leucine, and other essential amino acids are important for energy and endurance, and timing meals correctly will help assure you’re getting the best results for your efforts.

Amino Acids: The Building Blocks of Muscle

Amino acids are extremely important as they form the building blocks for muscle. Leucine is a powerful muscle builder. However, you should avoid amino acid isolates of leucine because, in its free form, it’s been shown to contribute to insulin resistance and may lead to muscle wasting. It’s far better to get leucine from whole foods, and the best source is a high quality whey protein.

Carnosine (which consists of two amino acids, beta-alanine and histidine) is an antioxidant that helps reduce muscle soreness by buffering acids in your muscle tissue, thereby reducing localized inflammation. Carnosine appears to be important for high-intensity anaerobic muscle performance.

Most studies find that if you want to increase athletic performance with carnosine, your best bet is to take beta-alanine instead, since beta-alanine appears to be the rate-limiting amino acid in the formation of carnosine. As your muscles accumulate hydrogen ions, their pH falls, making them more acidic. The theory is that by improving your carnosine levels, you can counteract the detrimental effect of these hydrogen ions, thereby enabling you to sustain high-intensity muscle contractions for longer periods of time.

Nutritional Support for Exercise Induced Aches and Pains

Several additional nutritional factors have been proven useful by science in preventing and resolving DOMS:

1.  Ginger: A natural pain reliever with a long history of medicinal uses, ginger (both raw and heat-treated) has been shown to reduce muscular pain by about 24 percent.
2.  Curcumin: Studies have shown curcumin (the pigment that gives the spice turmeric its vibrant yellow-orange color) is effective in relieving pain, increasing mobility, and reducing inflammation.
3.  Omega-3 fats: These beneficial fats are highly anti-inflammatory, as well as very beneficial for your heart. My favorite omega-3 fat is krill oil, which has unparalleled ability to quell pain and inflammation.
4.  Sulfur/MSM: MSM, which is 34 percent sulfur, is well known for its joint health benefits, improving metabolism, and reducing inflammation. MSM also appears to improve cell wall permeability, so it is useful in helping deliver other active ingredients. Sulfur also plays a critical role in detoxification and is the primary component in your body’s most important native antioxidant — glutathione.
5.  Astaxanthin: This natural-occurring supernutrient is a powerful antioxidant boasting an encyclopedia of health benefits, including decreased post-exertion soreness and faster recovery time. It even increases your body’s ability to metabolize fat! In a 2007 study, mice given astaxanthin showed heightened body fat reduction when given astaxanthin with exercise, compared to exercise alone.
6.  Cherries: Cherries are a proven antiinflammatory, as well as reducing your uric acid level. Cherries have been scientifically shown to help with things like arthritis and gout, and may have some usefulness for general muscle soreness. One study3 involving a group of long distance runners found that tart cherry juice significantly reduced post-exertion pain.
7.  Arnica: Homeopathic arnica was demonstrated to reduce muscle soreness among marathon runners in a 2007 study4.

Does Stretching Really Help?

Does stretching improve muscle soreness? In spite of the fact many people think it feels good, science says no — at least, passive static stretching has no benefit, which is the type of stretching most people do. On the other hand, dynamic stretching has been shown to offer benefits when used as a warm-up, which could conceivably help prevent soreness.

Dynamic stretching is an active form (such as what occurs when you perform lunges, squats, or arm circles), and this type of stretching helps improve your power, speed, agility, endurance, flexibility, and strength. My favorite type of dynamic stretching isActive Isolated Stretching or AIS, in which you hold each stretch for just two seconds. AIS works with your body’s natural physiological makeup to improve circulation and increase the elasticity of muscle joints.

Many people, in their zeal for beginning a new exercise regimen, overdo it and become extremely sore. This can destroy enthusiasm in a hurry, not to mention increasing your risk for injury. Don’t jump the gun after a major strength training session. Allow ample time for those muscles to fully recover before training them again — which may be much as 5 to 7 days. I agree withDr. Jeff Spencer’s strategy of “starting slow and finishing strong.”

Cold Water Immersion and Hot Baths

Cryotherapy, also called cold-water immersion, is a popular practice among amateur and professional athletes alike, because it helps reduce post-exertion muscle pain and inflammation, as well as speeding recovery time. In fact, cold-water baths appear to be significantly more effective than rest for reducing the pain and inflammation of DOMS. Most studies on cold water immersion report no or minimal side effects, but it will shock your body to some degree, so you need to make sure the water is not too cold, and that you do not stay in it for too long.

Alternately, you can use a cold pack, especially during the first 48 hours of soreness. Alternating heat and cold is also a good way to increase circulation and reduce inflammation. Don’t forget the benefits of a nice hot bath! Bathing in a warm tub of water, to which you’ve added 200 to 400 grams of Epsom salt, for 10 to 20 minutes, is an excellent treatment for sore, achy muscles.  The Epsom salt is also a great source of supplemental sulfur that you can absorb through your skin.

EFT, Earthing, and Acceleration Training

A simple technique called EFT (Emotional Freedom Techniques) can be an effective way to reduce pain very quickly, with very high rates of success. And it’s free! This simple technique can be learned by just about anyone, including children. If you’re interested in learning how to do this yourself, please visit my EFT guide.

And along similar lines, a pilot study5 found that grounding yourself to the earth (also called “Earthing”) might help relieve DOMS. When walking barefoot on the earth, free electrons in the ground transfer into your body through the soles of your feet. These free electrons are some of the most potent antioxidants known to man. Experiments have shown Earthing can decrease pain and inflammation, improve sleep, and make your blood less viscous, which is good for your cardiovascular health. Ideal locations for Earthing are on beach sand, close to or in the water, and on dewy grass.

Finally, acceleration training, also called Whole Body Vibrational Training (WBVT) can significantly accelerate tissue healing. Acceleration training essentially involves standing on a vibrating plate that works ALL your muscles and nerves at the same time.

It stimulates your white muscle fibers, which are your fast- and super-fast twitch muscle fibers, which kick-starts your pituitary gland into making more HGH. You can exercise while on this vibrating plate, or simply stand on it passively, which means any person of any age or fitness level can benefit.

Vibrational training has been demonstrated to improve circulation, increase range of motion, improve balance, decrease pain, and speed recovery from injuries. Think of acceleration training as “mechanical massage.” In my view the most effective vibrational training device on the market is the Power Plate.

Exercise Smart for Less Pain and More Gain

Remember, post exercise muscle pain is not caused by the buildup of lactic acid in your muscles, as was once believed. Rather it arises from inflammation triggered by microtears around your muscle tissue. This temporary discomfort is a natural part of your body’s natural muscle rebuilding process.

You can successfully manage this pain by making good dietary and lifestyle choices, using a few specific supplements, and by implementing tools such as cryotherapy, EFT, and Earthing — as well as continuing to exercise in moderation, even when you’re sore.

Source: mercola.com

 

Coronavirus death reported in France.

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A patient infected with the novel coronavirus has died in France, according to the health ministry.

The virus, which is similar to those which cause Sars and the common cold, emerged last year.

Out of 44 confirmed cases around the world, 23 people have now died with most infections linked to travel to the Middle East.

The virus causes pneumonia and, sometimes, organ failure. Most patients have had other health problems.

The 65-year-old, who had been travelling in Dubai, died in hospital on Tuesday.

Another patient who shared a hospital room with the man has caught the infection.

Concern?

Cases have been reported in Jordan, Qatar, Saudi Arabia, the United Arab Emirates, France, Germany, Tunisia and the UK.

Half of the 44 cases reported have been in Saudi Arabia.

In a statement earlier in May the World Health Organization said: “The greatest global concern, however, is about the potential for this new virus to spread.

“This is partly because the virus has already caused severe disease in multiple countries, although in small numbers, and has persisted in the [Middle East] region since 2012.

“Of most concern, however, is the fact that the different clusters seen in multiple countries increasingly support the hypothesis that when there is close contact this novel coronavirus can transmit from person to person.”

In February, a patient died in a hospital in Birmingham, in the UK, after three members of the same family became infected.

It is thought a family member had picked up the virus while travelling to the Middle East and Pakistan.

Prof Ian Jones, a virologist at the University of Reading, said the death was tragic, but the risks of infection were low.

“It is very rare and apart from the unusual circumstances of very close containment with already hospitalised persons, it does not seem to transfer among people.

“As a result, the overall risk remains very low and the most pressing need is to identify where the virus is coming from so that these occasional infections can be prevented.”

Source: BBC

 

What causes coronary heart disease?

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Coronary heart disease (CHD) is arguably the the UK’s biggest killer. CHD develops when the blood supply to the muscles and tissues of the heart becomes obstructed by the build-up of fatty materials inside the walls of the coronary arteries.

What is coronary heart disease?

Your heart is a pump the size of a fist that sends oxygen-rich blood around your body. The blood travels to the organs of your body through blood vessels known as arteries, and returns to the heart through veins.

Your heart needs its own blood supply to keep working. Heart disease occurs when the arteries that carry this blood, known as coronary arteries, start to become blocked by a build-up of fatty deposits.

How common is CHD?

  • CHD causes round 74,000 deaths each year. That’s an average of 200 people every day
  • In the UK, there are an estimated 2.3 million people living with the condition
  • About one in six men and one in nine women die from the disease
  • Death rates are highest in Scotland and northern England
  • In the past couple of decades, deaths from CHD have nearly halved due to better treatments

Source: British Heart Foundation

The inner lining of the coronary arteries gradually becomes furred with a thick, porridge-like sludge of substances, known as plaques, and formed from cholesterol. This clogging-up process is known as atherosclerosis.

The plaques narrow the arteries and reduce the space through which blood can flow. They can also block nutrients being delivered to the artery walls, which means the arteries lose their elasticity. In turn, this can lead to high blood pressure, which also increases the risk of heart disease. This same process goes on in the arteries throughout the body, and can lead to high blood pressure which puts further strain on the heart.

If your arteries are partially blocked you can experience angina – severe chest pains that can spread across your upper body – as your heart struggles to keep beating on a restricted supply of oxygen. You are also at greater risk of a heart attack.

Some people have a higher risk of developing atherosclerosis due to genetic factors – one clue to this is a family history of heart disease in middle-age. Lifestyle factors that increase the risk include an unhealthy diet, lack of exercise, diabetes, high blood pressure and, most importantly, smoking.

However, in the past couple of decades deaths from coronary heart disease have nearly halved, thanks to better treatments.

What happens during a heart attack?

A heart attack happens when one of the coronary arteries becomes completely blocked. This usually happens when a plaque, which is already narrowing an artery, cracks or splits open. This triggers the formation of a blood clot around the plaque, and it is this blood clot that then completely blocks the artery.

With their supply of oxygen completely blocked, the heart muscle and tissue supplied by that artery start to die. Emergency medical intervention is needed to unblock the artery and restore blood flow. This may consist of treatment with drugs to dissolve the clot or thrombus, or a small operation done through the skin and blood vessels to open up the blocked artery.

The outcome of a heart attack hinges on the amount of the muscle that dies before it is corrected. The smaller the area affected, the greater the chance of survival and recovery.

While a heart attack will always cause some permanent damage, some areas may be able to recover if they are not deprived of blood for too long. The sooner a heart attack is diagnosed and treated, the greater the chance of recovery.

Other heart diseases

Other diseases that commonly affect the heart include:

  • Chronic heart failure – CHD is one of the main causes of heart failure. It affects around one million people in the UK, and many more have it but haven’t been formally diagnosed. Here, the heart doesn’t works effectively as a pump, and fluid gathers in the lower limbs and lungs. This causes a variety of symptoms and significantly reduces quality of life.
  • Infection – bacterial infections such as endocarditis are much rarer these days thanks to antibiotics, but can damage the valves of the heart as well as other tissues. Viral infections can damage the heart muscle leading to heart failure, or cause abnormal heart rhythms.
  • Congenital heart disease – a number of defects can develop in the heart as a baby grows in the womb. One example is a hole in the heart, also known as a septal defect. Congenital heart disease may cause abnormal blood flow and put excessive strain on the infant’s heart after it has been born.
  • Cardiomyopathy – a disease of the heart muscle that can occur for different reasons, including coronary heart disease, high blood pressure, viral infection, high alcohol intake and thyroid disease.

Source: BBC

 

 

When does your mental health become a problem?.

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One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a ‘personal weakness’ still exist.

How do we define mental health?

A person who is considered ‘mentally healthy‘ is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of ‘wellbeing’ doesn’t always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person’s ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories – neurotic and psychotic.

Neurotic conditions are extreme forms of ‘normal’ emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person’s perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

What causes mental illness?

How common are mental illnesses in the UK?

  • Anxiety will affect 10% of the population
  • Bipolar disorder will affect one in 100
  • One in every 150 15-year-old girls will get anorexia, and one in every 1000 15-year-old boys
  • 20% of people will become depressed at some point in their lives
  • OCD will affect 2%
  • Personality disorder will affect one in 10, though for some it won’t be severe
  • Schizophrenia will affect one in 100

Source: Royal College of Psychiatrists

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don’t on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

When is someone thought to be mentally ill?

A mental illness can not be ‘tested’ by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient’s symptoms and monitoring them over a period of time.

How ICD-10 classifies bipolar affective disorder:

‘A disorder characterized by two or more episodes in which the patient’s mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). ‘

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation’s International Classification of Diseases (ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.

Source: BBC

Do your hair and fingernails grow after death?

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The gruesome sight features in literature and horror films, but is it true? To find out, we need to look into the world of organ transplants.

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Your hearts stops, your blood goes cold and your limbs stiffen. Yet amidst the signs that you are no more, your fingernails continue to lengthen and your hair grows – or so we’re told.

The young narrator in Erich Maria Remarque’s novel All Quiet of the Western Front imagines the nails of a friend who has died of gangrene continuing to grow into corkscrews as the hair on his decaying skull lengthens “like grass in good soil”. It’s an idea that’s not pleasant, yet seems to endure. Is it true, though?

Not surprisingly there haven’t been many systematic studies measuring daily changes in fingernail and hair length in the dead. For hints we can turn to historical anecdotes and descriptions provided by medical students working with cadavers. Transplant surgeons are also experienced in calculating the length of time the different kinds of cells continue to function beyond death.

Different cells die at different rates. After the heart stops beating, oxygen supply to the brain is cut off. With no glucose store to rely on, nerve cells die within three to seven minutes.

Transplant surgeons must remove kidneys, livers and hearts from donors within thirty minutes of death and get them into recipients inside six hours. Skin cells, meanwhile, are longer lived. Grafts can still be successful if taken 12 hours after death.

In order for fingernails to grow, new cells need to be produced and this can’t happen without glucose. Fingernails grow by an average of 0.1mm per day, a rate which slows as we age. A layer of tissue beneath the base of the nail called the germinal matrix is responsible for producing the vast majority of the cells which form the newest-growing part of the fingernail. The new cells push the older ones forwards, making the nail appear to lengthen from the tip. Death puts a stop to the supply of glucose, and therefore to fingernail growth.

A similar process occurs for hair. Each hair sits within a follicle that drives its growth. At the base of the follicle is the hair matrix, a group of cells that divide to produce the new cells that make hair strands longer. These cells divide very rapidly, but only when supplied with energy. This comes from the burning of glucose, which requires the presence of oxygen. Once the heart stops pumping oxygen round the body in the blood, the energy supply dries up, and so does the cell division that drives hair growth.

So why do myths persist about stubble growing on dead men’s chins and fingernails lengthening? While such observations are false, they do have a biological basis. It is not that the fingernails are growing, but that the skin around them retracts as it becomes dehydrated, making them appear longer. When preparing a body, funeral directors will sometimes moisturise the fingertips to counteract this.

The skin on a dead man’s chin also dries out. As it does so it pulls back towards the skull, making stubble appear more prominent. Goosebumps caused by the contraction of the hair muscles can add to the effect.

So if your mind is plagued by images of graveyards scattered with lids pushed from their coffins by the flowing locks and grotesquely long and twisted fingernails skeletons, you can rest easy. Such scenes may feature in literature and in horror films, but not in the real world.

Source: BBC

Wireless bio-absorbable circuits could kill bacteria.

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Remote-controlled, dissolvable electronic implants have been created that could help attack microbes, provide pain relief and stimulate bone growth.

The spread of bacteria resistant to antibiotics – popularly called superbugs – is threatening to put the clock back 100 years to the time when routine, minor surgery was life-threatening. Some medical experts are warning that otherwise straightforward operations could soon become deadly unless new ways to fend off these infections are found.

Bacteria often evolve clever ways of evading chemical assaults, but they will always struggle to resist the old-fashioned way of killing them: heating them up. It takes only a relatively mild warming to kill bugs without discomfort or harm to tissues. So imagine if little electric heaters could be implanted into wounds and powered wirelessly to fry bacteria during healing before dissolving harmlessly into body fluids once their job is done.

This is just one potential application of the bio-absorbable electronic circuits made by John Rogers of the University of Illinois at Urbana-Champaign and his co-workers. The idea itself is not new: Rogers and others have previously reported biodegradable flexible circuits and electronic devices that can be safely laid directly onto skin. But their success in making their circuits wireless could prove crucial to many potential applications, especially in medicine.

The hope is that radio waves can be used both for remote control of the circuits – to turn them on and off, say, and to provide the power to run them, so that there’s no need for implanted batteries. This kind of radio-frequency (RF) wireless technology is becoming ever more widespread, in food packaging, livestock labelling, tagging of goods in shops for security and in dustbins to monitor recycling, for example.

To make RF circuits, you need semiconductors and metals. Those don’t sound like the kinds of materials our bodies will dissolve, but Rogers and colleagues used layers of non-toxic substances so thin that they disintegrate in water or body fluids. For the metal parts, they used films of magnesium at least half as thin as the average human hair. Magnesium is not only harmless but in fact an essential nutrient: our bodies typically contain about 25g (0.9oz) of it already. For semiconductors, they used silicon membranes 300 nanometres (millionths of a millimetre) thick, which also dissolve in water. They used magnesium oxide as an insulating material when required.

Power scavenger

One of the simplest but most important components of an RF circuit is an antenna, which picks up the radio waves. Rogers and colleagues made these from long strips of magnesium foil deposited onto thin films of silk. Being non-toxic, biodegradable, strong and relatively cheap, silk makes the ideal base for such devices. These antennae, typically about four inches long, dissolve completely in water in about two hours. Although being buried beneath radio wave-absorbing body tissue would hamper performance, they should still receive enough signal for low power applications the researchers are considering.

The researchers have also made a variety of standard circuit components: capacitors, resistors, and crucially, diodes and transistors. Transistors are particularly complex structures, requiring delicately patterned films of a semiconductor like silicon doped with other elements and sandwiched with metal electrodes and insulating layers. Using silicon membranes, along with magnesium and its oxide, Rogers’ team made versions that dissolve within hours.

One of the first full circuits that they have made is an RF “power scavenger”, which can convert up to 15% of the radio waves it absorbs at a particular frequency into electrical power. Their prototype, measuring about 10cm (4in) by 4cm (1.6 in), can pick up enough power to run a small commercial light-emitting diode. The team can control the rate at which these devices dissolve by fine-tuning the molecular structure of the silk sheets on which they are laid down or between which they are sandwiched. This way, they can make devices that last for a week or two – about the length of time needed to ward off bacteria from a healing wound.

As well as deterring bacteria, Rogers says that implantable, bio-absorbable RF electronics could be used to stimulate nerves for pain relief, and to stimulate bone re-growth, a process long proven to work when electrodes are placed on the skin or directly on the bone. Conceivably they could also be used to precisely control drug release from implanted reservoirs.

Source: BBC

Revision techniques – the good, the OK and the useless.

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It’s the time of year where students are poring over their books, trying to ensure they are prepared for their exams.

Revision charts, highlighter pens and sticky notes around the room are some of the methods people use to ensure information stays in their mind.

But now psychologists in the US warn many favourite revision techniques will not lead to exam success.

Universities, schools and colleges offer students a variety of ways to help them remember the content of their courses and get good grades.

These include re-reading notes, summarising them and highlighting the important points.

Others involve testing knowledge and using mnemonics – ways of helping recall facts and lists, or creating visual representations of the knowledge.

But teachers do not know enough about how memory works and therefore which techniques are most effective, according to Prof John Dunlovsky, of Kent State University.

Help – or hindrance?

He and his colleagues reviewed 1,000 scientific studies looking at 10 of the most popular revision strategies.

They found that eight out of 10 did not work, or even hindered learning.

For example, many students love to take a highlighter to their notes.

But Prof Dunlovsky’s research – published in Psychological Science in the Public Interest, a journal of the Association for Psychological Science – found that picking out individual phrases in florescent yellow, green or pink can hinder revision.

“When students are using a highlighter they often focus on one concept at a time and are less likely to integrate the information they’re reading into a larger whole,” he says.

“That could undermine their comprehension of that material.”

But he’s not suggesting that highlighters should be abandoned as he recognises they are “safety blankets” for many students.

Plan ahead

Teachers regularly suggest reading through notes and essays from lessons and making summaries.

But Prof Dunlovsky says: “To our surprise it turns out that writing summaries doesn’t help at all.

HOW THE TECHNIQUES FARED

  • Elaborative interrogation – being able to explain a point or fact – MODERATE
  • Self-explanation – how a problem was solved –MODERATE
  • Summarising – writing summaries of texts –LOW
  • Highlighting/underlining – LOW
  • Keyword mnemonics – choosing a word to associate with information – LOW
  • Imagery – forming mental pictures while reading or listening – LOW
  • Re-reading – LOW
  • Practice testing – Self-testing to check knowledge – especially using flash cards – HIGH
  • Distributed practice – spreading out study over time – HIGH
  • Interleaved practice – switching between different kinds of problems – MODERATE

“Students who go back and re-read learn as much as students who write a summary as they are reading.”

Some revision guides advise using memory aids, or mnemonics.

Prof Dunlovsky says they can work well for remembering specifics, like Richard of York gave battle in vain, which allows people to remember the colours of the rainbow,

But he warns they are not applicable to other kinds of material. “They won’t help you learn long passages or mathematics or physics.”

So what does work?

Only two of the 10 techniques examined turned out to be really effective – testing yourself and spreading out your revision over time.

“Students who can test themselves or try to retrieve material from their memory are going to learn that material better in the long run”, says Prof Dunlovsky.

“Start by reading the text book then make flash cards of the critical concepts and test yourself.

“A century of research has shown that repeated testing works.”

This is because the student is more engaged and it is harder for the mind to wander.

He adds: “Testing itself when you get the correct answers appears to produce a more elaborative memory trace connected with your prior knowledge, so you’re building on what you know”.

Starting late

However the best strategy is to plan ahead and not do all your revision on one subject in a block before moving on to the next – a technique called “distributed practice”.

Prof Dunlovsky says it is the “most powerful” of all the strategies.

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Students who cram may pass the exam but they don’t retain the material. ”

Prof John Dunlovsky,Kent State University

“In any other context, students use this technique. If you were doing a dance recital you wouldn’t start practising an hour before, yet students like to cram for an exam.”

Some students will always start late on their revision.

But Prof Dunlovsky says: “Students who cram may pass the exam but they don’t retain the material.

“When they’re going to be taking advanced classes in the subject, they are going to build on the knowledge they’re developing, so I highly recommend distributed practice.

“A good dose of cramming that follows up on lots of distributive practice is the best way to go.”

So do different techniques work for different individuals? Prof Dunlovsky says “no” – the top techniques work for everyone.

And experts think this paper could help teachers and lecturers help their students.

Dr Andrew Butler, of the department of psychology and neuroscience at Duke University in the US, says: “This paper is hugely important for the field and educational practice – it’s about getting best practices into hands of educators.”

But it is likely that students will still rely on what works for them, no matter what the science says.

Lea Corinth, who is studying international business and Spanish at the University of Westminster uses the re-reading technique – rated by the researchers as being of little use.

But she says: “I read over everything until I memorise it. It doesn’t take too long.

“I make summary notes of everything important, put it in a folder and memorise everything.”

But Abdul Harmetz, who is studying history at the same university, says: “I’m a crammer – I started revising yesterday and stayed up all night for my exam today, using old school techniques like copying everything out over and over again.

“The exam went all right actually.”

Source: BBC

Care of the dying ‘society’s litmus test’.

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dying

Every minute someone in the UK dies – and most deaths still occur in hospital.

But in this week’s Scrubbing Up Prof Mayur Lakhani, chair of the Dying Matters Coalition which aims to change public attitudes towards death, dying and bereavement, says most people would prefer to die at home – and that major changes are needed to allow people the death they want.

It has been estimated that in England alone around 92,000 people do not receive the palliative care that they need when they are dying.

Many complaints about hospitals are to do with end of life care.

Meanwhile, the number of people dying each year in England and Wales is set to rise over the next 20 years.

How prepared are we as a nation to deal with this demographic time bomb? And what does the NHS in particular need to do?

‘Home is best’

The NHS is not currently geared up to help people die at home.

As a practising GP, I know this only too well. Current services are inconsistent and fragmented and nowhere near strong enough in the community. Services are part time and not 24/7, which is what dying patients need.

The default is hospital admission.

But this is not what people want.

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How we care for the dying is a litmus test for our society”

In a survey by British Social Attitudes, launched to mark Dying Matters Awareness Week, one of the strongest messages from the general public is that hospital is not the place where they want to die.

Only 7% of us say it’s the place we want to end our days, while two thirds say that home is the best place to die.

And here is the profound mismatch between our wishes and our reality.

Currently only one in five of us will die in our own home while over 50% of us will die in hospital.

A new deal is therefore needed for a 24/7 community service for patients at the end of life.

Wake-up call

What are the prospects for this happening?

Several things need to change.

We need much stronger leadership and planning.

The advent of GP led commissioning (clinical commissioning groups or CCGs) is an exciting, and unique opportunity to do something very special.

The reforms have been controversial, but for the sake of the patients everyone must rally round for better quality.

How we care for the dying is a litmus test for our society.

The attention paid to this area by this government should be applauded.

But it can go even further to deliver a stronger, caring and compassionate nation to deal with the predicted demographic change.

Earlier this spring, the House of Lords published a report which contained an urgent wake-up call to all of us by warning the UK is woefully unprepared for an ageing population.

The government should prioritise action by publishing draft proposals on how we should support older people in the last years of life.

As the number of people over the age of 85 is set to double over the next 20 years, the UK needs a new focus on health, wellbeing, housing, care and support for this emerging cohort.

Dignity and compassion

The case for change remains very strong and urgent, especially with the huge public concern in the light of the Francis report.

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Death is inevitable and not a failure”

Practically, NHS England and must accelerate improvement now and transfer resources from hospitals into communities and to develop stronger strategies for services working together.

The medical professions must play their part. They need to bring back dying into people’s homes by adopting a different approach to care.

They should recognise that death is inevitable and not a failure, and make sure dying people get the dignified and compassionate care they need, for example by encouraging the use of more advance care plans.

But we mustn’t just leave dying just to the professionals.

We all have a role to play with our families and friends to face up to death, to be better informed and more confidently plan for the end of life.

The Dying Matters Coalition is asking everyone to consider five things: write a will, record funeral wishes, plan for future care and support, register as an organ donor and tell loved ones their wishes.

We should be optimistic.

Things are improving and the number of people dying in their preferred place of care is increasing.

More and more people are talking about dying and death. But we need to go even further.

The way we care for dying people is a measure of our values, there are no dress rehearsals and only one chance to get it right.

Source: BBC