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Monday, November 5, 2007

Cerebral Palsy (CP) -- The Four Major Classifications

CP is divided into four major classifications/types to describe the different movement impairments. These classifications reflect the area of brain damaged. The four major classifications are:
  • Spastic
  • Athetoid/Dyskinetic
  • Ataxic
  • Mixed

In 30 percent of all cases of CP, the spastic form is found along with one of the other types. There are a number of other, less prevalent types of CP, but these are the most common.


Spastic cerebral palsy is by far the most common type, occurring in 70% to 80% of all cases. People with this type are hypertonic and have a neuromuscular condition stemming from damage to the corticospinal tract, motor cortex, or pyramidal tract that affects the nervous system's ability to receive gamma amino butyric acid in the area(s) affected by the spasticity. Spastic CP is further classified by topography dependent on the region of the body affected; these include:

  • spastic hemiplegia (one side being affected). Generally, injury to the left side of the brain will cause a right hemiplegia and injury to the right side a left hemiplegia. Childhood hemiplegia is a relatively common condition, affecting up to one child in 1,000.
  • spastic diplegia (whole body affected, but the lower extremities affected more than the upper extremities). Most people with spastic diplegia do eventually walk. The gait of a person with spastic diplegia is typically characterized by a crouched gait. Toe walking and flexed knees are common. Hip problems, dislocations, and side effects like strabismus (crossed eyes) are common. Strabismus affects three quarters of people with spastic diplegia. This is due to weakness of the muscles that control eye movement. In addition, these individuals are often nearsighted. In many cases the IQ of a person with spastic diplegia is normal.
  • spastic quadriplegia (Whole body affected; all four limbs affected equally). Some children with quadriplegia also suffer from hemiparetic tremors; an uncontrollable shaking that affects the limbs on one side of the body and impairs normal movement. A common problem with children suffering from quadriplegia is fluid buildup. Diuretics and steroids are medications administered to decrease any buildup of fluid in the spine that is caused by leakage from dead cells. Hardened feces in a quadriplegia patient are important to monitor because it can cause high blood pressure. Autonomic dysreflexia can be caused by hardened feces, urinary infections, and other problems, resulting in the overreaction of the nervous system and can result in high blood pressure, heart attacks, and strokes. Blockage of tubes inserted into the body to drain or enter fluids also needs to be monitored to prevent autonomic dysreflexia in quadriplegia. The proper functioning of the digestive system needs to be monitored as well.

Occasionally, terms such as monoplegia, paraplegia, triplegia, and pentaplegia may also be used to refer to specific manifestations of the spasticity.


This type symptoms can be caused by damage to the cerebellum. Forms of ataxia, such as Bruns' Frontal Ataxia, and Friedreich's Ataxia are less common types of Cerebral Palsy, occurring in at most 10% of all cases. Some of these individuals have hypotonia and tremors. Motor skills like writing, typing, or using scissors might be difficult, as well as problems with balance, especially while walking. It is common for individuals to have difficulty with visual and/or auditory processing of objects.

Athetoid or dyskinetic

or dyskinetic is mixed muscle tone - sometimes hypertonia and sometimes hypotonia. People with athetoid CP have trouble holding themselves in an upright, steady position for sitting or walking, and often show involuntary motions. For some people with athetoid CP, it takes a lot of work and concentration to get their hand to a certain spot (like scratching their nose or reaching for a cup). Because of their mixed tone and trouble keeping a position, they may not be able to hold onto objects (such as a toothbrush or pencil). About one-fourth of all people with CP have athetoid CP. The damage occurs to the extrapyramidal motor system and/or pyramidal tract and to the basal ganglia. It occurs in 40% of all cases.


Cerebral palsy (CP) -- Causes, Signs and Symptoms

  • Cerebral refers to the affected area of the brain, the cerebrum (however the centres have not been perfectly localised and the disease most likely involves connections between the cortex and other parts of the brain such as the cerebellum)

  • Palsy refers to disorder of movement.

Cerebral palsy (CP) is a group of disorders that hinder control of movement. It is caused by an injury to the brain during pregnancy, around the time of birth, or shortly after birth. This brain damage may be caused by several factors depending on the type, the onset, and the health history of mother and child. CP is either congenital (present at birth) or acquired after birth.

CP is caused by damage to the motor control centers of the young developing brain and can occur during pregnancy (about 75 percent), during childbirth (about 5 percent) or after birth (about 15 percent) up to about age three. Eighty percent of causes are unknown; for the small number where cause is known this can include infection, malnutrition, and/or head trauma in very early childhood.

Cerebral Paralysis was first identified by English surgeon William Little in 1860. Little raised the possibility of asphyxia during birth as a chief cause of the disorder. It was not until 1897 that Sigmund Freud, then a neurologist, suggested that a difficult birth was not the cause but rather only a symptom of other effects on fetal development. Research conducted during the 1980s by the National Institute of Neurological Disorders and Stroke (NINDS) suggested that only a small number of cases of CP are caused by lack of oxygen during birth.


The causes of CP remain unclear,with debate over the years giving no obvious answers. The incidence in developed countries is approximately 2.12–2.45 per 1000 live births. Incidence has not declined over the last 60 years despite medical advances (such as electro-fetal monitoring) because these advances allow extremely low birth weight and premature babies to survive. It can result from a variety of conditions:

Infection During Pregnancy

Rubella, cytomegalovirus, and toxoplasmosis can cause severe damage to the nervous system of the fetus and result in cerebral palsy. The central nervous system infections, trauma, consecutive hematomas, and placenta abruptio can cause it too.

Premature birth

Between 40% and 50% of all children who develop cerebral palsy were born prematurely. Premature infants are at higher risk in part because their organs are not yet fully developed, increasing the risk of asphyxia and other injury to the brain, which in turn increases the incidence of CP. Periventricular leukomalacia is an important cause of CP.

Asphyxia, hypoxia of the brain, birth trauma, toxins, lead poisoning, physical brain injury, shaken baby syndrome, incidents involving hypoxia to the brain (such as near drowning), and encephalitis or meningitis --

Recent research has demonstrated that intrapartum asphyxia is not the most important cause, probably accounting for no more than 10 percent of all cases; rather, infections in the mother, even infections that are not easily detected, may triple the risk of the child developing the disorder, mainly as the result of the toxicity to the fetal brain of cytokines that are produced as part of the inflammatory response. Low birthweight is a risk factor for CP--and premature infants usually have low birth weights, less than 2.0kg, but full-term infants can also have low birth weights. Multiple-birth infants are also more likely than single-birth infants to be born early or with a low birth weight.

The three most common causes of asphyxia in the young child are: choking on foreign objects such as toys and pieces of food; poisoning; and near drowning.


Some structural brain anomalies such as lissencephaly cause symptoms of CP, although whether that could be considered CP is a matter of opinion (some people say CP must be due to brain damage, whereas these people never had a normal brain).

Jaundice severe jaundice can result in brain damage. After birth, other causes include.

Rh Incompatibility – can cause jaundice This is a condition where the mother's immune system attacks the fetus

Oxygen Shortage – a shortage of oxygen during birth can cause brain damage to the child.

– a stroke in the fetus can occur if the mother suffers from coagulation disorders

– drug or alcohol use can result in brain damage

– bleeding in the brain of the infant after birth can cause brain damage

Kidney/Urinary Tract Infections
– can also lead to brain damage

Rare chromosome
-- Often this goes along with rare chromosome disorders and CP is not genetic or hereditary.

Signs and Symptoms

The Characteristic

All types of CP are characterized by abnormal muscle tone, posture (i.e. slouching over while sitting), reflexes, or motor development and coordination.

There can be joint and bone deformities and contractures (permanently fixed, tight muscles and joints).

The Classical Symptoms

The classical symptoms are spasticity, spasms, other involuntary movements (e.g. facial gestures), unsteady gait, problems with balance, and/or soft tissue findings consisting largely of decreased muscle mass. Scissor walking (where the knees come in and cross) and toe walking are common among people with CP who are able to walk, but taken on the whole, CP symptomatology is very diverse.

The effects of cerebral palsy fall on a continuum of motor dysfunction which may range from virtually unnoticeable to"clumsy" and awkward movements on one end of the spectrum to such severe impairments that coordinated movements are almost impossible on the other end of the spectrum.

Babies born with severe CP often have an irregular posture; their bodies may be either very floppy or very stiff. Birth defects, such as spinal curvature, a small jawbone, or a small head sometimes occur along with CP. Symptoms may appear, change, or become more severe as a child gets older. Some babies born with CP do not show obvious signs right away.

The Bone

In order for bones to attain their normal shape and size, they require the stresses from normal musculature. Osseous findings will therefore mirror the specific muscular deficits in a given person with CP. The shafts of the bones are often thin (gracile).

When compared to these thin shafts (diaphyses) the metaphyses often appear quite enlarged (ballooning). With lack of use, articular cartilage may atrophy, leading to narrowed joint spaces. Depending on the degree of spasticity, a person with CP may exhibit a variety of angular joint deformities. Because vertebral bodies need vertical gravitational loading forces to develop properly, spasticity and an abnormal gait can hinder proper and/or full bone and skeletal development.

People with CP tend to be shorter in height than the average person because their bones are not allowed to grow to their full potential. Sometimes bones grow at different lengths, so the person may have one leg longer than the other.

The Secondary Conditions

Secondary conditions can include :

  • seizures,
  • epilepsy,
  • speech or communication disorders,
  • eating problems,
  • sensory impairments,
  • mental retardation,
  • learning disabilities,
  • and/or behavioral disorders.

From Many Sources

Wednesday, October 24, 2007

Epilepsy -- Myths and Facts

Myth: People with epilepsy are "epileptics."

Fact: The word "epileptic" should not be used to descrbe someone who has epilepsy, as it defines a person by one trait or problem. A label is powerful and can create a limiting and negative stereotype. It is better to refer to someone as "a person with epilepsy" or to a group of people as "people with epilepsy."

Myth: People with epilepsy are seldom brain-damaged.

Fact: Epilepsy is a disorder of brain and nerve-cell function that may or may not be associated with damage to brain structures. Brain function can be temporarily disturbed by many things, such as extreme fatigue; the use of sleeping pills, sedatives, or general anesthesia; or high fever or serious illness. "Brain damage" implies that something is permanently wrong with the brain's structure. This kind of damage may occur with severe head injury, cerebral palsy, Cerebral palsyA condition with various combinations of impaired muscle tone and strength, coordination, and intelligence.Close or stroke, or it may occur long before birth, with malformation or infection. Injuries to the brain are the cause of seizures in some people with epilepsy, but by no means all of them.

Brain injuries range from undetectable to disabling. Although brain cells usually do not regenerate, most people can make substantial recoveries. Brain damage, like epilepsy, carries a stigma, and some people may unjustly consider brain-injured patients "incompetent."

Myth: A seizure disorder is epilepsy.

Fact: Because some people fear the word "epilepsy," they use the term "seizure disorder" in an attempt to separate themselves from any association with it. However the term seizure disorder means the same thing as epilepsy. A person has epilepsy or a seizure disorder if he or she has had two or more seizures that "come out of the blue" and are not provoked—even if the problem first develops in adulthood or is known to be caused by something like a severe head injury or a tumor.

Myth: Seizures cause brain damage.

Fact: Single tonic-clonic seizures lasting less than 5-10 minutes are not known to cause brain damage or injury. However, there is evidence that more frequent and more prolonged tonic-clonic seizures may in some patients injure the brain. Prolonged or repetitive complex partial seizures (a type of seizure that occurs in clusters without an intervening return of consciousness) also can potentially cause long-lasting impairment of brain function.

Some people have difficulty with memory and other intellectual functions after a seizure. These problems may be caused by the aftereffects of the seizure on the brain, by the effects of seizure medicines, or both. Usually, however, these problems do not mean that the brain has been damaged by the seizure. There may be a cumulative, negative effect of many tonic-clonic or complex partial seizures on brain function, but this effect appears to be rare.

Myth: People with epilepsy are usually cognitively challenged.

Fact: People with epilepsy usually are not intellectually challenged. Many people mistakenly believe that people with epilepsy are also intellectually or developmentally challenged. In the large majority of situations, this is not true. Like any other group of people, people with epilepsy have different intellectual abilities. Some are brilliant and some score below average on intelligence tests, but most are somewhere in the middle. They have normal intelligence and lead productive lives. Some people, however, may have epilepsy associated with brain injuries that may cause other neurological difficulties that affects their thinking, remembering, or other cognitive CognitivePertaining to the mental processes of perceiving, thinking, and remembering; used loosely to refer to intellectual functions as opposed to physical functions.Closeabilities. The cognitive problems may be the only problem in most people. Less frequently, some people have other developmental problems that can affect the way they function and live.

Myth: People with epilepsy are violent or crazy.

Fact: The belief that people with epilepsy are violent is an unfortunate image that is both wrong and destructive. People with epilepsy have no greater tendency toward severe irritability and aggressive behaviors than do other people.

Many features of seizures and their immediate aftereffects can be easily misunderstood as "crazy" or "violent" behavior. Unfortunately, police officers and even medical personnel may confuse seizure-related behaviors with other problems. However, these behaviors merely represent semiconscious or confused actions resulting from the seizure. During seizures, some people may not respond to questions, may speak gibberish, undress, repeat a word or phrase, crumple important papers, or may appear frightened and scream. Some are confused immediately after a seizure, and if they are restrained or prevented from moving about, they can become agitated and combative. Some people are able to respond to questions and carry on a conversation fairly well, but several hours later they cannot remember the conversation at all.

Myth: People with epilepsy are mentally ill.

Fact: Epilepsy is not the same as mental illness and in fact, the majority of people with seizures do not develop mental health problems. Yet recent research is showing that problems with mood, such as anxiety and depression, may be seen more frequently than previously thought. The causes are not always known. In some people, the cause and location of the seizures may affect certain brain areas and contribute to mood problems. In others, side effects of treatments and the challenges of living with epilepsy may affect a person's feelings and behavior. If these problems occur, a variety of treatments are available.

Myth: Epilepsy is necessarily inherited.

Fact: Most cases of epilepsy are not inherited, although some types are genetically transmitted (that is, passed on through the family). Most of these types are easily controlled with seizure medicines.

Myth: Epilepsy is a life-long disorder.

Fact: Generally, people with epilepsy have seizures and require medication for only a small portion of their lives. About 60 % of people who develop seizures have epilepsy that can be easily controlled and is likely to remit or go away. However, about 25 % may develop difficult to control seizures and likely will require lifelong treatment. More than half of childhood forms of epilepsy are outgrown by adulthood. With many forms of epilepsy in children and adults, when the person has been free of seizures for 1 to 3 years, medications can often be slowly withdrawn and discontinued under a doctor's supervision.

Myth: Epilepsy is a curse.

Fact: Epilepsy has nothing to do with curses, possession, or other supernatural processes, such as punishment for past sins. Like asthma, diabetes, and high blood pressure, epilepsy is a medical problem.

Myth: Epilepsy should be a barrier to success.

Fact: Epilepsy is perfectly compatible with a normal, happy, and full life. The person's quality of life, however, may be affected by the frequency and severity of the seizures, the effects of medications, reactions of onlookers to seizures, and other disorders that are often associated with or caused by epilepsy.

Some types of epilepsy are harder to control than others. Living successfully with epilepsy requires a positive outlook, a supportive environment, and good medical care. Coping with the reaction of other people to the disorder can be the most difficult part of living with epilepsy.

Acquiring a positive outlook may be easier said than done, especially for those who have grown up with insecurity and fear. Instilling a strong sense of self-esteem in children is important. Many children with long-term, ongoingic illnesses—not only epilepsy but also disorders such as asthma or diabetes—have low self-esteem. This may be caused in part by the reactions of others and in part by parental concern that fosters dependence and insecurity. Children develop strong self-esteem and independence through praise for their accomplishments and emphasis on their potential abilities.

Famous people with epilepsy include Julius Caesar, Socrates, Alexander the Great, Tchaikovsky, Van Gogh, Dostoyevski, Dickens, Dante, da Vinci, Mozart and Alfred Nobel.


People with Disability or Disorder -- Myths and Facts

Myth: People with disabilities are brave and courageous.
Fact: Adjusting to a disability requires adapting to a lifestyle, not bravery and courage.

Myth: All persons with hearing disabilities can read lips.
Fact: Lip-reading skills vary among people who use them and are never entirely reliable.

Myth: All persons who use wheelchairs are chronically ill or sickly.
Fact: The association between wheelchair use and illness may have evolved through hospitals using wheelchairs to transport sick people. A person may use a wheelchair for a variety of reasons, none of which may have anything to do with lingering illness.

Myth: Wheelchair use is confining; people who use wheelchairs are "wheelchair-bound."
Fact: A wheelchair, like a bicycle or an automobile, is a personal assistive device that enables someone to get around.

Myth: People with disabilities always need help.
Fact: Many people with disabilities are independent and capable of giving help. If you would like to help someone with a disability, ask if he or she needs it before you act.

Myth: The lives of people with disabilities are totally different than the lives of people without disabilities.
Fact: People with disabilities go to school, get married, work, have families, do laundry, grocery shop, laugh, cry, pay taxes, get angry, have prejudices, vote, plan and dream like everyone else.

Myth: People who are blind acquire a "sixth sense."
Fact: Although most people who are blind develop their remaining senses more fully, they do not have a "sixth sense."

Myth: People with disabilities are more comfortable with "their own kind."
Fact: In the past, grouping people with disabilities in separate schools and institutions reinforced this misconception. Today, many people with disabilities take advantage of new opportunities to join mainstream society.

Myth: Non-disabled people are obligated to "take care of" people with disabilities.
Fact: Anyone may offer assistance, but most people with disabilities prefer to be responsible for themselves.

Myth: Curious children should never ask people about their disabilities.
Fact: Many children have a natural, uninhibited curiosity and may ask questions that some adults consider embarrassing. But scolding curious children may make them think having a disability is "wrong" or "bad." Most people with disabilities won't mind answering a child's question.

Myth: It is all right for people without disabilities to park in accessible parking spaces, if only for a few minutes.
Fact: Because accessible parking spaces are designed and situated to meet the needs of people who have disabilities, these spaces should only be used by people who need them.

Myth: Most people with disabilities cannot have sexual relationships.
Fact: Anyone can have a sexual relationship by adapting the sexual activity. People with disabilities can have children naturally or through adoption. People with disabilities, like other people, are sexual beings.

Myth: There is nothing one person can do to help eliminate the barriers confronting people with disabilities.
Fact: Everyone can contribute to change.


Cerebral Palsy (CP) -- Myths and Facts

Myth: Everyone with cerebral palsy is retarded. NOT TRUE!
: Some people with CP have above average intelligence. Because CP means damage to the brain.

Myth: Everyone with cerebral palsy has a learning disability. NOT TRUE!
: While some people with CP have learning disabilities many others with CP do not.

Myth: People with cerebral palsy are being punished for their sins. NOT TRUE!
: Our disability has a medical or physiological cause. We are not bad people.

Myth: People with cerebral palsy should not be employed because they might have an accident or will cause an embarrassing seen. NOT TRUE!
People with cerebral palsy are very productive workers and are an asset to anyone who hires them.

Myth: People with cerebral palsy should not be allowed to play physical games because they might get hurt. NOT TRUE!
People with CP participate in all kinds of sports including track, horseback riding, recess, and wheelchair sports.

Myth: People with cerebral palsy should go to special schools
Special schools provide for the needs of CP children. At a special school the treatment of a C.P child focuses on speech, movement & education. Given the right input, the sky is the limit for a C.P. child.

Myth: People with CP should not be allowed to get married and have kids. NOT TRUE!
Many people with CP have gotten married and have had kids. Most people with CP make wonderful loving parents.

Myth: People with CP are possessed by evil spirits. NOT TRUE!
Nothing possesses us or anybody else. We are simply who we are.

Myth: CP is the primary cause of death. NOT TRUE.
Early detection and treatment is vital.

Myth: There are corelation among CP with Heredity, Contagious, and Progressive.
There aren't corelation.

Myth: CP is cureable by drug or surgery.
Drugs and Surgery cannot cure this condition. These might be recommended to avert further complications.

Myth: People with CP are dangers. NOT TRUE.
We will not hurt you or make you sick. We will not bite. And we are very friendly.

From many source

Monday, September 24, 2007

Grapefruit Juice -- The Facts About It Interactions with Certain Medications

Researchers have identified that chemical as the one that allows grapefruit juice to interact with certain medications. The furanocoumarins in the grapefruit juice are metabolized by the enzyme cytochrome P450 3A4. That enzyme exists in the cells of the intestine. Grapefruit juice can decrease its intestinal activity. The enzymes in the liver must then focus on breaking down the furanocoumarins in the grapefruit juice.

The liver also contains cytochrome P450. Because the liver contains that enzyme, it can breakdown many of the medications that enter the body. The liver metabolizes those medications, creating their disease-fighting or condition-preventing components.

Scientists have known for a while about the ability of grapefruit juice to interact with certain drugs. A clinical trial first brought such interactions to light. During a clinical trial for calcium blockers, the research team wanted to disguise the alcohol aftertaste left by the drug. They did not want trial participants to know whether or not they had received the drug.

Grapefruit and drug interactions
The following drugs are known to have potentially serious interactions with grapefruit products, tangelos and
Seville oranges.

Drug name

Type of drug

Carbamazepine (Carbatrol, Tegretol)

An anti-seizure medication

Buspirone (BuSpar), clomipramine (Anafranil) and sertraline (Zoloft)


Diazepam (Valium), triazolam (Halcion)


Felodipine (Plendil), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular) and possibly verapamil (Isoptin, Verelan)

Calcium channel blockers used to treat high blood pressure

Saquinavir (Invirase) and indinavir (Crixivan)

HIV medications

Simvastatin (Zocor), lovastatin (Mevacor, Altoprev) and atorvastatin (Lipitor), simvastatin-ezetimibe (Vytorin)

HMG-CoA reductase inhibitors used to treat high cholesterol

Cyclosporine (Neoral, Sandimmune), tacrolimus (Prograf) and sirolimus (Rapamune)

Immunosuppressant drugs

Amiodarone (Cordarone)

A drug used to treat and prevent abnormal heart rhythms (arrhythmias)


Pain relief medication

Sildenafil (Viagra)

Erectile dysfunction medication

Interaction with the calcium blockers

The clinical researchers decided to use grapefruit juice as the "cover-up substance." They then found that the grapefruit juice could interact with the calcium blockers. Scientists have since found dozens of other medications that can interact with grapefruit juice.

Interaction with certain drugs used to lower the blood level of cholesterol

As the liver works to breakdown the grapefruit juice, the drug builds-up in the body. That leads to a breakdown of the body muscles. The breakdown products flood the urinary system, and that can cause a catastrophic kidney failure.

Interaction with certain antibiotics

A patient on clanthromycin, erythromycin or troleandomycin should be counseled against drinking grapefruit juice. The combination of antibiotic and grapefruit juice can cause diarrhea. The interaction of the juice with the drug can slow the drug's ability to fight the infectious organism.

Usually the pharmacist puts a warning label on medications that interact with grapefruit juice. Unfortunately, a number of patients fail to heed or even read such labels. In a hospital setting, a person on erythromycin might be told not to order grapefruit juice. Still, an unknowing hospital volunteer might offer that patient a cup of juice-grapefruit juice.

Interaction with the antiepileptic drug carbamazeprine

Such a drug might be used as an alternative to a more common antiepileptic, such as phenytoin. That substitution might occur if a woman on phenytoin has chosen to become pregnant. Her doctor might warn her not to drink grapefruit juice, since juice would seem like a "good" drink for a pregnant woman.

Interaction with certain the treat high blood pressure drugs

That interaction can produce irregular heart rhythms. Ironically, some blood pressure medications lower the level of potassium in the body. That can be corrected by eating a different fruit-a banana.

Interaction with the drugs sisdenafil and tadalafil

Those names probably mean little to the average reader. The reader would certainly recognize the names on the medications that contain those two chemicals-Viagra and Cialis.

Men have yet another reason to keep in mind the ability of grapefruit juice to interact with certain drugs. Grapefruit juice interacts with finasteride, a drug used to treat benign prostatic hyperplasia.

Sugestion to Avoid Serious Interactions

If you take any of these drugs, you should completely avoid grapefruit products, tangelos and Seville oranges, unless otherwise directed by your doctor. Waiting to take these medications, ”even up to 24 hours”, after you drink grapefruit juice will not prevent an interaction.

Talk to your doctor or pharmacist if you have concerns about the effect of grapefruit products on any of the medications you take.

From many source

Grapefruit Juice -- Drug Interactions

Fenomenon Diet of the 80s

In 80s, we can say that if you wanted guaranteed weight loss, the grapefruit diet was the plan to follow. Providing no more than 800 calories a day, the grapefruit diet menu involved eating lots of 'fat-burning' grapefruit to kick-start your metabolism. It same as much black coffee as you liked, some daily protein (mainly boiled eggs) and the odd piece of dry toast.

At the time, nutrition experts dismissed it as another fad diet. They explaining that the 'fat-burning' properties of grapefruit were, in fact, a myth and any weight loss that occurred was due to the extremely low and potentially dangerous calorie intake.

The Warning

But two decades on, it seems these nutritionists may need to rethink their views on the popularity of grapefruit as a 'diet food' if the results of a study published earlier this year to be believed. The latest research, the simple act of adding grapefruit and grapefruit juice to your diet, really can aid weight loss. But unlike the seriously restricted diet of the 80s, you get these results without changing what else you eat.

While this research might tempt you to fill up on grapefruit to boost your weight loss campaign, if you’re taking any medications you might want to speak to your GP first or check the literature that comes with your medication.

This is because a wealth of research shows that grapefruit juice can interact with a number of medications, potentially causing serious side effects. It works by inhibiting an enzyme in the intestines that’s responsible for the natural breakdown and absorption of many medications. When the action of this enzyme is blocked, blood levels of these medications increase and this can lead to potentially toxic side effects.

Research suggests that flavonoids and/or furanocoumarin compounds are the substances in grapefruit juice that block the enzyme in the intestines. Many drugs appear to be affected by grapefruit juice so if you are taking any medication, it’s essential to check whether you can safely consume grapefruit juice. In the meantime, it’s likely that grapefruit segments may also interact with certain medications so you’d be wise to consult your GP before eating lots of grapefruit. Other citrus fruits don’t seem to have any effect.

The Research

Grapefruit juice provides many nutrients, such as vitamin C and lycopene. But chemicals in grapefruit interfere with the enzymes that break down (metabolize) certain drugs in your digestive system. This can result in excessively high levels of these drugs in your blood and an increased risk of serious side effects.

The exact chemicals in grapefruit juice that cause this interaction aren't known. But these chemicals are present in the pulp and peel of grapefruit as well as in the juice. For this reason, any grapefruit products can interact with certain medications. Include dietary supplements that contain grapefruit bioflavonoids. If you avoid grapefruit, you may also want to avoid tangelos, a hybrid grapefruit, and Seville oranges, a type of bitter orange often used to make marmalade and compotes. They may have a similar effect.

The study included 100 obese people who were divided into three groups. The first group ate half a grapefruit before each meal three times a day. The second group drank grapefruit juice before each meal. The third group received no grapefruit. No other changes were made to their diets.

After 12 weeks, those participants who ate grapefruit with each meal lost, on average 3.6lb. Only a third of a pound a week, but pretty good considering they didn't make any other changes to their diet. Meanwhile, those who drank grapefruit juice three times a day lost 3.3lb in the 12 weeks. By comparison, the grapefruit-free participants lost, on average, only 0.5lb.

But weight loss wasn't the only health benefit seen when grapefruit or the juice was consumed. The research also found the grapefruit-consuming participants had lower levels of insulin, a hormone that regulates blood sugar levels and fat metabolism, which in turn might help to reduce the risk of diabetes or stroke.

The Theory

The researchers believe grapefruit contains unique plant compounds that reduce insulin levels, which in turn promotes weight loss.

The link between raised insulin levels and excess weight is complicated and multifaceted. To start with, high levels of insulin may indicate that sugar isn't efficiently utilised for energy with the result that it's more likely to be stored as fat. Secondly, high levels of insulin can make people feel hungry so that they eat more. And finally, high levels of insulin prevent the body from breaking down fat. Add these together, and it's easy to see why lower levels of insulin may promote weight loss. What exactly it is in grapefruit that has this insulin-lowering effect remains unclear.

Care needs to be taken when interpreting the results. It's the first study of it's kind and even the researchers believe more work needs to be carried out before recommendations are made regarding grapefruit intake. Fortunately, a larger study is already planned for later this year.

When it comes to reducing the risk of diabetes, experts also believe we should err on the side of caution before recommending vast amounts of grapefruit.

Nutrition experts also agree that more research is needed before rushing out to stock up on grapefruit. Most tend to agree with the nutritionalists of the 80s and say it's unlikely that grapefruit has any magical properties in terms of aiding weight loss in the absence of other diet or lifestyle changes. It's perhaps more likely that participant’s lost weight simply because they were taking part in a study and, as a result, were more focussed on their food intake and exercise habits.

From many source

Saturday, September 22, 2007

Night Eating Syndrome (NES) -- Sign Diagnose, Symptoms, Triggers, Prevention and Treatment

Do You Have Night-eating Syndrome?
  • You eat 50 percent or more of your daily food intake after dinner
  • You have no appetite for breakfast
  • You have trouble falling and/or staying asleep
  • When you wake up during the night you often eat
  • The foods you eat at night are mostly carbohydrates
When you’re spending more time each night in the kitchen than in the bedroom, you may have a newly identified eating disorder. Called night-eating syndrome (NES), the condition is characterised by a lack of appetite for breakfast; the consumption of more than 50 percent of daily calories after the evening meal, and waking up, at least, once a night to consume high-carbohydrate snacks. To receive a diagnosis of NES, symptoms must have continued for a minimum of three months.

If you have any combination of these signs, consult your doctor.

What is Night Eating Syndrome?

A new eating disorder spells a nightmare for those who suffer from it. Night eating syndrome is an eating disorder that has only been recognized as such since 1999, and affects between 1 and 2% of the population. NES is also characterized as a sleeping disorder. NES is often accompanied by or confused with sleep-related eating disorder (SRED), although the two are distinct.

Night Eating Syndrome is a disorder where the affected individual wakes multiple times during the night and is unable to fall back asleep unless they eat something. Foods eaten during the binge are often high caloric in content and unhealthy. The night eating behavior seems totally beyond the effected individual's control. For these individuals, 35% or more of their calories are eaten after dinnertime. Following the night binge, the person is often not hungry in the morning. Individuals suffering from Night Eating

This is an ongoing, persistent behavior, unlike the occasional late snack or skipped meal that most people have from time to time. In fact, people with this disorder are often unaware of their nocturnal meals, although some feel they won't be able to sleep without eating first. ( Note: a person falls asleep more easily on a full stomach. ) Among those who are aware of their night eating, there is often an emotional component; the diet of the night eater is comfort food.

What are the symptoms or behavior of NES?

People who suffer from night eating syndrome generally:
  • Skip breakfast, and go several hours after waking before their first meal.
  • Consume at least half their calories after dinner. (Many sources would list this as after 9 or 10 pm; dessert is generally not included, if one is eaten. ). Late night binges almost always consist of carbohydrates. However, this eating is typically spread over several hours, which is not consistent with a typical eating binge as seen in other eating disorders.
  • Suffer from depression or anxiety, often in connection with their eating habits. These night eating episodes typically bring guilt rather than hedonic enjoyment.
  • Has trouble sleeping in general; see insomnia. Is more likely than the general public to sleepwalk.

To be considered a bona fide disorder, this pattern should continue for two months or more. Syndrome are often caught in the vicious cycle of binge eating during the night and eating less during the day.

Are there Specific Triggers for NES ?

Triggers for Night Eating Syndrome include
  • depression
  • anxiety
  • interpersonal stressors
  • boredom
  • prolonged dieting
  • body image dissatisfaction

Night eating may temporarily relieve the stress of these unwanted feelings, but for the night eater these episodes are unfortunately followed by feelings of guilt, shame, disgust, and further depression. For the person suffering from NES, the eating episodes usually occur in secret and any evidence is often hidden from others. Similar to Anorexics, Bulimics, and Compulsive Overeaters, individuals suffering from NES are often struggling and unhappy with their weight. It is estimated that up to one percent of the population may be suffering from NES. Like Anorexia Nervosa Bulimia Nervosa, and Compulsive Overeating, NES is a disease and cannot be cured with willpower alone.

How is NES different from Binge Eating and Bulimia?

It is different from binge eating and bulimia. Individuals with night eating disorder consume relatively small snacks (with high calorie content) at night but far more frequently. Individuals with binge eating disorder and/or bulimia have very large and infrequent binges.

Can NES be Treated?

Yes. If you suspect that a family member has NES. Suggest that your family member see an eating disorder expert. Be prepared for denial, resistance, and even anger. A doctor and/or a counselor can help them battle their eating disorder. Treatment involves counseling, and paying attention to medical and nutritional needs.

The treatment should be tailored to the individual and will vary according to both the severity of the disorder and the patient's particular problems, needs, and strengths.

NES tends to lead to weight gain; as many as 28% of those seeking gastric-bypass surgery were found to suffer from NES in one study. In fact, while sufferers are not always overweight, one in four people who are overweight by 100 lbs or more are thought to suffer from night eating syndrome. The disorder is accompanied by what sufferers describe as an uncontrolable desire to eat, akin to addiction, and is often treated chemically.

Therapy to increase the natural nocturnal rise in melatonin, reduce the body's adrenal stress response and raise leptin levels or improve leptin sensitivity are options that may help these patients overcome the disorder. Another key may involve the availability of tryptophan, an important amino acid, in the body. More than 70% of the nighttime eating to combat anxiety involved binging on carbohydrates. These foods are believed to increase the amount of tryptophan available for conversion to serotonin, the calming neurotransmitter in the brain that promotes an overall sense of well-being and, in turn, converts to melatonin.

The antidepressant drug Zoloft has shown some ability to help NES sufferers.

NOTE: Addressing hormonal and biochemical imbalances in patients with chronic eating and mood disorders can be crucial for uncovering fundamental causes and contributing factors that underlie cyclical, habitual patterns of insomnia, overeating, and depression.

From Many Source

The Recommended Dietary Allowance (RDA) -- History, Applications and Current Recommendations

The Dietary Reference Intake is a system of nutrition recommendations from the Institute of Medicine of the USA National Academy (IOM). The DRI system is used by both the United States and Canada. It is intended for the general public and health professionals.


The Recommended Dietary Allowance (RDA) was developed during World War II by Lydia J. Roberts, Hazel K. Stiebeling and Helen S. Mitchell, all part of a committee established by the U.S. National Academy of Sciences in order to investigate issues of nutrition that might "affect national defense" (Nestle, 35). The committee was renamed the Food and Nutrition Board in 1941, after which they began to deliberate on a set of recommendations of a standard daily allowance for each type of nutrient. The standards would be used for nutrition recommendations for the armed forces, for civilians, and for overseas population who might need food relief. Roberts, Stiebeling, and Mitchell surveyed all available data, created a tentative set of allowances for "energy and eight nutrients", and submitted them to experts for review (Nestle, 35). The final set of guidelines, called RDAs for Recommended Dietary Allowances, were accepted in 1941. The allowances were meant to provide superior nutrition for civilians and military personnel, so they included a "margin of safety." Because of food rationing during the war, the food guides created by government agencies to direct citizens' nutritional intake also took food availability into account.

The Food and Nutrition Board subsequently revised the RDAs every five to ten years. In the early 1950s, USDA nutritionists made a new set of guidelines that also included the number of servings of each food group in order to make it easier for people to receive their RDAs of each nutrient.


Applications include:

  • Food labels in the United States and Canada
  • Composition of diets for schools, prisons, hospitals or nursing homes
  • Industries developing new food stuffs
  • Healthcare policy makers and public health officials

In 1997, at the suggestion of the Institute of Medicine of the National Academy, the RDA became one part of a broader, more detailed set of dietary guidelines, called the Dietary Reference Intake.

Current recommendations

The current Dietary Reference Intake recommendation is composed of:

  • Estimated Average Requirements (EAR), expected to satisfy the needs of 50% of the people in that age group.
  • Reference Daily Intake (RDI), the daily dietary intake level of a nutrient considered sufficient to meet the requirements of nearly all (97–98%) healthy individuals in each life-stage and gender group.
  • Adequate Intake (AI), where no RDI has been established, but the amount established is somewhat less firmly believed to be adequate for everyone in the demographic group.
  • Tolerable upper intake levels (UL), to caution against excessive intake of nutrients (like vitamin D) that can be harmful in large amounts.

The RDI is used to determine the Recommended Daily Value (RDV) which is printed on food labels in the U.S. and Canada.


Vitamin -- Side Effects, Poisoning and Overdose

A vitamin is an organic compound required in tiny amounts for essential metabolic reactions in a living organism.The term vitamin does not include other essential nutrients such as dietary minerals, essential fatty acids, or essential amino acids, nor does it encompass the large number of other nutrients that promote health but that are not essential for life.

Vitamins are bio-molecules that act as catalysts and substrates in chemical reactions. When acting as a catalyst, vitamins are bound to enzymes and are called cofactors. For example, vitamin K is part of the proteases involved in blood clotting. Vitamins also act as coenzymes to carry chemical groups between enzymes. For example, folic acid carries various forms of carbon group – methyl, formyl and methylene - in the cell.

Until the 1900s, vitamins were obtained solely through food intake, and changes in diet (which, for example, could occur during a particular growing season) can alter the types and amounts of vitamins ingested. Vitamins have been produced as commodity chemicals and made widely available as inexpensive pills for several decades,allowing supplementation of the dietary intake.

Vitamin poisoning

Vitamin poisoning, or hypervitaminosis, refers to a condition of high storage levels of vitamins, which can lead to toxic symptoms. The medical names of the different conditions are derived from the vitamin involved: an excess of vitamin A, for example, is called "hypervitaminosis A".

High dosage vitamin A; high dosage, slow release vitamin B3; and very high dosage vitamin B6 alone (i.e. without vitamin B complex) are sometimes associated with vitamin side effects that usually rapidly cease with supplement reduction or cessation. Conversely, certain vitamins do not produce toxicity in excess levels. Vitamin C has been used in dosages over 100,000 mg for serious illness — over 1000 times the daily recommended intake — without ill effects.[citation needed] However, Vitamin C does have a pronounced laxative effect, typically when intake of vitamin C is in the range of 5-20 grams per day for a person in normal "good health".


In large doses some vitamins have documented side effects, that tend to be more severe with larger dosage. The likelihood of consuming too much of any vitamin from food is remote, but overdosing from vitamin supplementation does occur. At high enough dosages some vitamins cause side effects such as nausea, diarrhea, and vomiting. When side effects emerge, recovery is often accomplished by reducing the dosage. The concentrations of vitamins an individual can tolerate vary widely, and appear to be related to age and state of health.

High doses of mineral supplements can also lead to side effects and toxicity. Mineral-supplement poisoning does occur occasionally due to excessive and unusual intake of iron-containing supplements, including some multivitamins, but is not common. The Dietary Reference Intake recommendations from the United States Department of Agriculture define a "tolerable upper intake level" for most vitamins.

Overdose of Vitamin A -- Hypervitaminosis A

Hypervitaminosis A refers to the effects of excessive vitamin A (specifically retinoid) intake. Its occurs when the maximum limit for liver stores of retinoids is exceeded. The excess vitamin A enters the circulation causing systemic toxicity. Vitamin A in the form of betacarotene is only selectively converted into retinoids, and hence does not cause toxicity.

Although hypervitaminosis A can occur when large amounts of liver are regularly consumed, most cases of vitamin A toxicity result from an excess intake of vitamin A in the form of vitamin supplements. Toxic symptoms can also arise after consuming very large amounts of preformed vitamin A over a short period of time.

Presentation of effects include:

* birth defects
* liver problems,
* reduced bone mineral density that may result in osteoporosis
* coarse bone growths
* hair loss
* excessive skin dryness/peeling


Signs of acute toxicity include nausea and vomiting, headache, dizziness, blurred vision, and loss of muscular coordination.

Recommended supplement limits

The Institute of Medicine has established Daily Tolerable Upper Levels (UL) of intake for vitamin A from supplements that apply to healthy populations, in order to help prevent the risk of vitamin A toxicity. These levels for preformed vitamin A in micrograms (µg) and International Units (IU) are:

* 0-3 years: 600 µg or 2000 IU
* 4-8 years: 900 µg or 3000 IU
* 9-13 years: 1700 µg or 5665 IU
* 14-18 years: 2800 µg or 9335 IU
* 19+ years: 3000 µg or 10,000 IU

The dose over and above the RDA is among the narrowest of the vitamins and minerals. Possible pregnancy, liver disease, high alcohol consumption, and smoking are indications for close monitoring and limitation of vitamin A administration. However, vitamin A has also been repeatedly tested and used therapeutically over several decades in larger amounts, 100,000 - 400,000 IU total dosage, for treatment of severe pediatric measles in areas where vitamin A deficiency may be present, in order to reduce childhood mortality.

Polar-bear liver

The liver of the polar bear is unsafe to eat because it is extraordinarily high in vitamin A. This danger has been recognized since at least 1597 when Gerrit de Veer wrote in his diary that, while taking refuge in the winter in Nova Zembla, he and his men became gravely ill after eating polar-bear liver.

Overdose of Vitamin B6 -- Impairment of proprioception

An overdose of pyridoxine can cause a temporary deadening of certain nerves such as the proprioceptory nerves; causing a feeling of disembodiment common with the loss of proprioception. This condition is reversible when supplementation is stopped.

Because adverse effects have only been documented from vitamin B6 supplements and never from food sources, only the supplemental form of vitamin B6 (pyridoxine) is discussed with respect to safety. Although vitamin B6 is a water-soluble vitamin and is excreted in the urine, very high doses of pyridoxine over long periods of time may result in painful neurological symptoms known as sensory neuropathy.

Symptoms include pain and numbness of the extremities, and in severe cases difficulty walking. Sensory neuropathy typically develops at doses of pyridoxine in excess of 1,000 mg per day.

However, there have been a few case reports of individuals who developed sensory neuropathies at doses of less than 500 mg daily over a period of months. None of the studies, in which an objective neurological examination was performed, found evidence of sensory nerve damage at intakes of pyridoxine below 200 mg/day.

In order to prevent sensory neuropathy in virtually all individuals, the Food and Nutrition Board of the Institute of Medicine set the tolerable upper intake level (UL) for pyridoxine at 100 mg/day for adults. Because placebo-controlled studies have generally failed to show therapeutic benefits of high doses of pyridoxine, there is little reason to exceed the UL of 100 mg/day.

Overdose of Vitamin C -- Vitamin C megadosage

Vitamin C megadosage is the consumption of vitamin C in doses which are well beyond the current Dietary Reference Intake. Proponents advocate that this dose is similar to the intake of other primates not producing vitamin C, and is required to attain concentrations reached by most other animals, who produce vitamin C.

High doses have been used in an attempt to obtain specific therapeutic effectsThere is a strong advocacy movement for such doses of vitamin C, despite a lack of conclusive scientific evidence of the purported benefits.There also exists some literature critical of governmental agency dose recommendations.

Although vitamin C can be well tolerated at doses well above the RDA recommendations, megadosing may cause side effects such as stomach upset, laxative effects, diarrhea, or kidney stones. The dose at which these effects may occur varies with the individual. Some test-tube experiments have also suggested that Vitamin C can induce production of DNA-damaging compounds, and by implication, cancer growth. However, some test-tube evidence has shown that Vitamin C is toxic to cancer cells, which has prompted new phase I toxicity trials of high doses of intravenous Vitamin C to determine its safety as a treatment modality.

Overdose of Vitamin D -- Hypervitaminosis D

Hypervitaminosis D is a state of Vitamin D toxicity. Overdose occurs at more than 100 times the recommended daily allowance (roughly one bottle of vitamin D tablets per day), over a period of months. Acute overdose requires over 50mg (ten thousand times the RDA). Foods contain low levels, and have not been known to cause overdose. Overdose has occurred due to industrial accidents, for example when incorrectly formulated pills were sold or missing industrial concentrate cans misused as cans of milk.

Symptoms and presentation

Symptoms of vitamin D poisoning include:

* Dehydration
* Vomiting
* Decreased appetite (anorexia)
* Irritability
* Constipation
* Fatigue

An excess of vitamin D causes abnormally high blood concentrations of calcium (hypercalcemia) which can eventually cause severe damage to the bones, soft tissues, and kidneys. It can also damage the kidney and produce kidney stones. Ongoing research indicates antagonism with oil soluble menatetrenone, MK-4, an internally transported natural form of vitamin K2, which is associated with bone formation and calcium retention in the bones.

Note: Hypervitaminosis D symptoms appear several months after excessive doses of vitamin D are administered. In almost every case, a low calcium diet combined with corticosteroid drugs will allow for a full recovery within a month.


Friday, September 21, 2007

Channa striata, The Fish -- The Most One of Albumin Source for Hypoalbuminemia

Curently, the snakehead murrel, Channa striata has got much of interest from people, especially for medical sector. This fish is the most one of albumin source for hipoalbumine suferer. It's good for after surgeon lesion or burning lesion.

Many causes make someone less an albumin, such as failure liver, renal, and less of nutrition. albumin has an important role for our body, because, the protein inside of a liquid blood has manage the liquid blood (plasma). Albumin has bound a bilirubin, grease abandon acid, calcium, and any type of medicine.

Loosing albumin on the human body has caused of intake or less nutrition. It causes by affiuent secretion, for example like secretion from human intestine. And a renal puncture can be causes of less albumin. This failure has recognized nephrotic syndrome or puncture a part of renal (glomerolus).

So if we get failure liver, we need particuar support nutrition from any albumin source, it could be from animal such as Channa striata, and the shape it could be a capsule, and eventhough infuse.

Scientific Classification













Binomial name:

Channa striata


C. striata


The snakehead murrel, Channa striata, is a species of snakehead. It is also known as the common snakehead, chevron snakehead, striped snakehead and aruan, and has also been classified under the binomial names Ophiocephalus striatus Bloch and Ophiocephalus vagus Peters.

It grows up to 1 m in length, though because of fishing this size is not found in the wild. It has a widespread range covering southern China, Pakistan, most of India, southern Nepal, Bangladesh, Sri Lanka and most of South-east Asia. It has more recently been introduced to the outmost parts of Indonesia, the Philippines, and Mauritius. Reports beginning in the early 20th century that it was introduced into the wild in Hawaii, particularly the island of Oahu, are the apparent result of misidentifications, according to a publication.

The only currently confirmed Hawaiian establishment of C. striata is on a commercial fish farm. Popular media and the US Fish and Wildlife Service were perpetuating this apparent mistake as recently as 2002. Early- to mid-20th century reports and texts referring to its introduction in California appear to be the result of a misunderstanding.

It is an important food fish in its native range and is of considerable economic importance. Adults are dark brown in colour with faint black bands visible across its entire body. Males and female both help to construct a nest out of water vegetation during breeding time and the eggs are guarded by the male.

It is common in freshwater plains, where it migrates from rivers and lakes into flooded fields, returning to the permanent water bodies in the dry season, where it survives by burrowing in the mud.

Source of Albumin

Eventough, in the village area, the boy who was get a circumcision, must be consuming this fish.
The disposal Channa striata extract have a positive coorelation with albumine plasma degree enhancement and for lesion surgery recover.

The process is, Channa striata flesh steaming, since we get the filtrate, and this is an extract menu for hipoalbuminemia and lesion suferrer.

The Channa striata phenom was ever taken to the one research by Prof. Dr. Eng. Eddy Suprayitno, MS. Full professor of biochemical Fishery Faculty of UNIBRAW( Brawijaya University, Indonesia) on 2003. The research title is Channa striata albumin for a fungsional food to solve a nutrition problem on the future, Eddy was husk away about The Channa Striata potention. "If we see from the amino acid, it has more completely structure more than another fish.

He said, for along time our people still have an image that if we consuming this fish same as we consuming a snake, it could be same because the appearance is like a snake. Whereas Channa striata life on fresh water, and the food is a worm, frog, litle fish, shrimp, insect and ketam (such as a crab).

The physc atribute, have a litle circle body, tall, convex backpart, flat abdomen, slim head. The backpart has a green and black color and abdomen has white and litle brown. And the leght has seems to be 90-110cm, so the weight of three fish could be 2kg. Eddy said, that we could see this fish in common water at Java, Sumatera, Borneo, Sulawesi, Bali, Lombok, Flores and Ambon.

So, how Channa striata can influence to interpolation the albumine? On the human body, albumine (is the one protein fraction) has syntetic by lever about 100-200 microgram/g every day. Albumine has distributing by vasculer on plasma and by extravascular.

Eddy said that sintesis albumin trouble, usualy happened on the lever cronic, renal and also less nutrition. Actually, Channa striata not only a protein source, but it can be a mineral source between zinc and another trace element which need by the body.

The Eddy’s research product was ever tried on RSU dr Saiful Anwar Malang. And the result was tested to the surgeon patient with low albumin degree (1,8 g/dl). And the result the albumin degree has normally again (3,5 - 5,5 g/dl).

Source: Jawa Pos Newspaper and

Monday, September 10, 2007

New Risk Gene For Rheumatoid Arthritis And Lupus Opens Door To More Effective Treatments

Scientists at The Feinstein Institute for Medical Research have identified a critical gene that increases a person's risk for rheumatoid arthritis and systemic lupus erythematosus, and may be involved with other autoimmune diseases.

The genetic link, described in the September 6th issue of the New England Journal of Medicine, was a collaborative effort led by Peter K. Gregersen, MD, head of The Feinstein Institute's Robert S. Boas Center for Genomics & Human Genetics. A decade ago, Dr. Gregersen helped bring together scientists from a dozen institutes to pool patients and add strength in numbers as they collectively hunt for genes. More recently, the North American Rheumatoid Arthritis Consortium (NARAC) studied a region identified on chromosome 2 in previous linkage studies conducted by the same team. In the latest study, they analyzed DNA from 2,500 patients with rheumatoid arthritis (RA) or lupus. Genetic mapping enabled them to identify STAT4 as a culprit in susceptibility to both diseases.

"This work required the collection and genotyping of thousands of RA and lupus patients and volunteers, a task that would have been difficult to accomplish without the strong partnerships we forged," said Stephen I. Katz, MD, PhD, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). The federal institute has supported NARAC since its inception.

"Identifying STAT4 as the relevant gene on chromosome 2 is very exciting," added Elaine Remmers, PhD, a lead author in the NEJM study on STAT4 and a staff scientist in the NIAMS's Genetics and Genomics Branch. "We now are faced with trying to figure out how this variant of STAT4 increases a person's risk."

About 22 percent of people in the United States inherit this particular form of STAT4. Having this variant of STAT4 confers a 30 percent increased risk for developing rheumatoid arthritis. People with two copies of STAT4 have a 60 percent increased risk, Dr. Gregersen said. Rheumatoid arthritis is a painful inflammatory condition of the joints. It is an autoimmune disease, which means the body's immune system recognizes a product in the lining of the joint as foreign and wages an attack. Patients with lupus, also an autoimmune disease, have about double the risk compared to people without this variant of STAT4.

In a companion study by Dr. Gregersen and his colleagues, STAT4 popped up as an important risk gene in a population of patients in Korea. This paper is published this month in Molecular Medicine.

One percent of people will develop rheumatoid arthritis. There are probably dozens of genes, perhaps more, involved in triggering complex diseases like rheumatoid arthritis.

"Identifying this risk gene is important because it points us in the right direction," said Dr. Gregersen, who also just completed a whole genome-wide association study of rheumatoid arthritis that will appear later this month in the NEJM. The study is online as of September 6th with an accompanying editorial. In this paper, the scientists identified another risk gene -- TRAF1-C5.

"The identification of these two new autoimmunity genes has profound significance for our understanding of these complex diseases and our ability to develop more specific diagnostic tests and therapies," said Lindsey Criswell, MD, PhD, professor of medicine at UCSF and a co-investigator on both studies.

A lot is known about the STAT4 gene and the protein it makes. STAT4 is a signaling molecule that mediates the effects of immune system cytokines such as IL12 and some types of interferon. STAT4 controls the differentiation of T- cells into TH1 cells and may contribute to the development of TH17 cells, both of which seem to have a role in maintaining chronic inflammation in the body.

Inhibiting STAT4 can prevent or ameliorate arthritis in animal models of rheumatoid arthritis, suggesting that STAT4 could be a target for new therapies. The discovery of STAT4 can ultimately help scientists unravel the triggers for the disease, help in the development of a test to confirm a diagnosis and perhaps even help predict who will respond to treatments.

The NARAC and collaborators at Celera Diagnostics previously identified PTPN22 as another risk gene in 2004. PTPN22 influences the "trigger point" for activation of T-cells -- immune cells normally called on to wage battle against infection. In autoimmune diseases like rheumatoid arthritis, PTPN22 appears to put people at higher risk of a wayward T-cell response. Dr. Gregersen said that the two genes -- PTPN22 and STAT4 -- appear to work independently to increase the risk for rheumatoid arthritis.

These are the first RA genes to be discovered since the 1980s when scientists reported detailed association with genetic variants in the HLA region known as the "shared epitope," work for which Dr. Gregersen is still widely recognized. The key to the new genetic discoveries, Dr. Gregersen said, is to have "more patients and controls. With higher numbers of volunteers, we will have more power to pull out additional new genes and figure out what they do in triggering these diseases. Continued international collaboration with colleagues at the Karolinska Institute in Stockholm will be critical for these efforts."

In addition to Drs. Gregersen, Criswell and Remmers, the NARAC investigators on the STAT4 study include Christopher Amos, PhD, of The University of Texas M.D. Anderson Cancer Center; Daniel Kastner MD, PhD, of NIAMS's Genetics and Genomic Branch; Michael F. Seldin MD, PhD, of the University of California, Davis; and Robert M. Plenge, MD, PhD, of the Brigham and Women's Hospital. Timothy W. Behrens, MD, senior director of immunology, tissue growth & repair at Genentech, Inc. was a key collaborator on the lupus research.

The NARAC team is also part of the whole genome association study to be published later this month in the NEJM. Other collaborators on this study include Lars Klareskog of the Karolinska Institute; Mark Seielstad of the Genome Institute of Singapore; and John Carulli, PhD, and Evan Beckman, MD, of Biogen Idec in Cambridge, Ma.

Headquartered in Manhasset, NY, The Feinstein Institute for Medical Research is home to international scientific leaders in Parkinson's disease, Alzheimer's disease, psychiatric disorders, rheumatoid arthritis, lupus, sepsis, inflammatory bowel disease, diabetes, human genetics, leukemia, lymphoma, neuroimmunology, and medicinal chemistry. The Feinstein Institute, part of the North Shore-LIJ Health System, ranks in the top 6th percentile of all National Institutes of Health grants awarded to research centers. Feinstein researchers are developing new drugs and drug targets, and producing results where science meets the patient.

Source: The Feinstein Institute for Medical Research

Thursday, September 6, 2007

Head Lice Prevention Month

head lice prevention monthSeptember is National Head Lice Prevention Month, which makes sense as kids go back to school. This year, instead of just focusing on treatments for head lice when your kids get a head lice infestation, work towards teaching them how to avoid getting head lice in the first place.

Simple steps to avoid head lice include:

  • teach them to avoid sharing things that have been on or near another child's head, including hairbrushes, combs, hats, scarves, towels, helmets, etc.
  • make sure your child hangs up his coat and hat on an individual hook, or some other separate area, when he gets to school, instead of just throwing them in a pile with other classmates' clothing
  • regularly clean things that your child's head has direct contact with, such as car seats, pillows, head phones, etc., if you are sharing these items with other children
  • check your children regularly for nits and live head lice so that you can discover a head lice infestation as early as possible and begin treatment before it spreads to the rest of your family and your child's friends and classmates.

Matching Tea with Food

Exploring the world of connoisseur-level teas is as intoxicating as that other beverage: Wine. For wine lovers, the current fashion is not to insist that whites pair up with poultry nor drink only reds with meat. This has led to many adventuresome pairings and new taste sensations.

Fortunately, teas pairings are also open to exploration. Anyone who says blacks are only for entrees or that greens must stand alone, haven't had the pleasure (or perhaps the opportunity) to pair a wide variety of teas with every part of a menu.

Greens like Dragonwell or Sencha are wonderful with seafood or fish fillets, salads, or chicken. Blacks like Ceylon or Assam from India are soft accompaniments to beef or steak dishes or spicy foods from Mexican, Italian, or Indian cuisine. Although it is traditional to have Oolongs with Chinese dishes, one may argue that rich black Yunnan or Keemun teas offer more complexity and layers to the experience of tea pairings.

Formosa Oolong and Pouchong teas seem to demand solo drinking, quiet, and something restful to look upon. However, oolongs are delicious in many foods. Try them to flavor liquids used for cooking rice or grains. They add a wonderful punch, and like all tea, no calories, sodium, or sugar!

For desserts, seek out the chocolatey essence of a Golden Monkey. This exquisite Chinese tea is hearty, rich, and tastes perfect when infused into baked custards, chocolate cakes, or drunk as a beverage with a rich dense strawberry shortcake. Assam is another rich black tea that complements chocolate desserts yet is a surprising foil against lemony or custard dishes.

As a digestive, nothing is better, more satisfying or more calming than an aged Chinese Pu-erh, the darker, the stronger, the better. The only intentionally aged tea, it is particularly good after a multiple-course feast like a Thanksgiving or similar heavy holiday meal. If you're a milk-and-cookies snacker before bedtime, try a Fruit Medley herbal infusion instead. You'll sleep better, and will wake up feeling great.


Soya -- Benefits and Products

Soya is one of the oldest and most nutritious foods in the world. In the 11th century BC it was primarily consumed in Northern China, spreading to the west and the U.S.A. in the middle of the 18th century and only more recently to Europe. Soya is mainly used in industry and for animal feed despite the fact that it is the third most important crop world-wide today and less than 3% is consumed by humans.

What has most interested scientists in recent years is the discovery of phytochemicals and the profound benefits of Soya on human health. Soya has many nutritional advantages as it contains protein, fibre and isoflavones which have positive effects on cholesterol, bone density, menstrual and menopausal symptoms as well as preventing certain cancers. It is thought to be a wonder food by the Chinese who believe it can cure kidney disease, water retention, common colds, anaemia and leg ulcers.

In China, the soya bean has been cultivated and used in different ways for thousands of years. Soya was considered as one of the 5 holy crops, besides rice, wheat, barley and millet.

Soya beans contain high amounts of protein, including all essential amino acids (the only such vegetable source). Soya beans are also a rich source of calcium, iron, zinc, phosphorus, magnesium, B-vitamins,omega 3 fatty acids andfiber.

Heart health

The cholesterol lowering effect of Soya milk and its role of heart disease was widely recognized in the mid 90s when the results of a meta-analysis of 38 clinical studies were published. The results demonstrated that a diet with significant Soya protein reduces Total Cholesterol, LDL cholesterol (the "Bad" cholesterol) and Triglycerides.

The average consumption in these studies was 47 grams per day of Soya protein, which is a considerable amount. One way to include this is to try a Soya protein beverage or powder that may add 20 grams preserving. Soya protein was effective even in people who were already following the American Heart Association's 30 percent-fat diet. Soya protein appears to lower triglyceride levels while preserving HDL cholesterol.

Researchers Erdman & Potter in 1993 reported in the American Journal of Clinical Nutrition a 12 percent drop in cholesterol when 20 to 25 grams of Soya protein and fiber were included in the diet. Soya beans contain soluble fiber, which is known to interfere with the absorption and metabolism of cholesterol.

As a result of these findings, in 1999, FDA authorized a health claim about the relationship between Soya protein and Coronary Heart Disease (CHD) on labelling of foods containing Soya protein.

A heart health claim can be found on qualified Soya products.Health Claim:
Diets low in saturated fat and cholesterol that include 25 grams of Soya protein a day may reduce the risk of heart disease. One serving of [name of produce] provides [amount]g of Soya protein.

A few recent studies released in 2005 found that Soya only had a modest effect on cholesterol levels. The American Heart Associationno longer recommends Soya for heart disease. FDA is currently reviewing its policy on Soya health claim. So what should you do? Enjoy your Soya foods like before. It may not lower cholesterol to an extent we originally thought, but it certainly does not harm our health!

Healthy bones

Many Soya foods are naturally high in calcium (some fortified with calcium because it is a good source of a particular coagulating agent). In addition, Soya also contains magnesium and boron, which are important co-factors of calcium for bone health.

Isoflavones in Soya foods may inhibit the breakdown of bones. Daidzein, a type of isoflavone, is actually very similar to the drug ipriflavone, which is used throughout Europe and Asia to treat osteoporosis. One compelling study completed by Erdman in 1993 focused on post-menopausal women who consumed 40 grams of isolated Soya protein daily for 6 months. Researchers found that these subjects significantly increased bone mineral density as compared to the controls.

Another study published in the Archives of Internal Medicine in September 2005 also found that intake of Soya food was associated with a significantly lower risk of fracture, particularly among early post-menopausal women.

Alleviating menopausal symptoms

In Japan, where Soya foods are commonly consumed daily, women are only one-third as likely to report menopausal symptoms as in the United States or Canada. In fact, there is no word in the Japanese language for "hot flashes".

Current studies showed that Soya only helps some women alleviate menopausal symptoms. Indeed, Soya is more effective in preventing than alleviating hot flashes. Despite these findings, the North American Menopause Society in 2000 recommended that 40 - 80mg of isoflavones daily may help relieve menopausal symptoms.

Preventing cancer

Among all cancers, data on Soya and prostate cancer seems to be the most promising; many studies support its role in the prevention and possible treatment of prostate cancer.

While some studies showed Soya offers a protective effect against breast cancer, a few studies showed the estrogen-like effects in isoflavones may be harmful for women with breast cancer. American Institute for Cancer Research stresses that data on Soya and breast cancer are not conclusive, and more work is needed to be done before any dietary recommendations can be made.

What we know at this point is the phytoestrogens in Soya foods are "anti-estrogens". In other words, they may block estrogen from reaching the receptors - therefore potentially protecting women from developing breast cancer. Studies found that pre-menopausal women may benefit from eating Soya foods as their natural estrogen levels are high.

However, this may not be true to post-menopausal women. Studies found that Soya could become "pro-estrogen" in women with low levels of natural estrogen. In other words, concentrated Soya supplements may add estrogen to the body and hence increase breast cancer risk in post-menopausal women. Therefore, post-menopausal women should avoid taking concentrated Soya supplements until more is known. Eating Soya products, however, is not harmful.

Soya products

Soya beans are very versatile: soya beans can be used as whole soya beans, soya sprouts, or processed as soya milk (Calcium-fortified Soya milk), soya nuts, edamame, tofu, tempeh, soya sauce or miso. Other products such as Soya patties, Soya cheese, Soya yogurt and breakfast cereal.

Although it is still inconclusive that Soya can prevent any diseases, many studies have shown promising results. Include Soya products in your diet and enjoy the possible health benefits they may bring.

With increasing public concerns regarding genetically modified foods, look for Soya products which use non-genetically modified Soya crops in their production.

Soya is also used as ingredient for non-food products, such as candle wax and biodiesel. Soy candles are becoming more popular because they burn longer and healthier.

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