Monthly Archives: August 2013

Tips for dealing with obesity

Learn how to better battle obesity with this information.

Many Americans find it difficult to control their weight. There are a number of health concerns related to being overweight or obese, including but not limited to type 2 diabetes.1 However, there are ways in which people can get back on track and control their weight. It will take self control and dedication, but through a regime of diet and exercise, it's completely attainable.

Impulse control
It's not uncommon for someone who is obese to struggle with impulse control. It's much easier to enjoy the satisfaction of a cheeseburger then look ahead to how a salad could benefit the waistline in the future. Researchers from the University at Buffalo have found that there's no reason someone who is struggling with their weight can't be taught behavioral interventions to ignore those cravings.

"This research is certainly welcome news for people who have struggled to lose weight, because it shows that when people are taught to imagine, or simulate the future, they can improve their ability to delay gratification," senior author of the study Dr. Leonard Epstein said in a statement.2

A group of 24 lean females and 24 overweight women participated in the study. Through the use of behavioral assessments for determining individual motivation, professionals were able to uncover the best ways in which to reduce the inclination to engage in immediate gratification. Researchers found that the obese women controlled their impulses when taught to look toward the future.

Treatment options
When someone is struggling from obesity, they can make changes to their behavior, as well as their diet and exercise routine. The key to success is having a set of goals to achieve, these should be both short and long term.3 Other behavioral changes may include keeping a record of food intake and time spent working out. This will make it easier for the person to stick to bigger lifestyle changes revolving around physical activity and food intake.

In order to see results, someone who needs to lose 5 percent or more of their body weight should spend at least 5 hours a week exercising.4 It's best to try for moderate-intensity during a routine, but this can be broken up throughout into smaller chunks. One option is to spend 1 hour working out five days a week. That hour can be broken down further, even into 10 minute segments. It's important that someone who is on an extreme weight loss challenge to ease into the routine in order to avoid injury and discouragement.

If you are overweight and suffering from diabetes, Medex Supply can provide you with diabetic supplies, including:

1 Mayo Clinic, "Obesity: complications" June 7, 2013
2 University at Buffalo News Center, "Study: Overweight and obese women are equally capable of impulse control that lean women exhibit" August 30, 2013
3 UCSF Medical Center, "Obesity treatment"
4 National Institutes of Health, "How are overweight and obesity treated?" July 13, 2012

Chiari Malformation

In an Arnold-Chiari malformation, the brain slips down in the cranium.

In an Arnold-Chiari malformation, the brain slips down in the cranium.

More than one in 1000 people—and it’s hard to tell how many more—exhibit an interesting though not always dangerous condition called a Chiari malformation. Dr. Hans Chiari described the malformation in 1891, though the congenital form was observed as early as 1883. In this condition, the brain is mispositioned within the cranium and extends into the space where the spinal cord normally is. Singer Rosanne Cash and golfer Bobby Jones have been diagnosed with Chiari malformation.

The condition often has no symptoms, which is why it frequently goes undetected. It is often found during a seemingly unrelated examination, particularly an MRI scan related to some condition. It is likely that there are people who neither exhibit symptoms nor have any sort of diagnostic test that would find it, and the condition goes entirely undetected. However, the malformation sometimes causes severe headaches that frequently lead to a diagnosis, along with problems with balance, poor fine motor skills, difficulty swallowing, blurred vision, or tinnitus. Extreme cases can lead to scoliosis and sleep apnea.

The congenital form of Chiari malformation, known as type II, is associated with the birth defect spina bifida. Chiari I malformation occurs later in life, generally as a result of an unusual skull shape that exerts downward pressure on the brain, forcing it into an unusual position. In that position, it presses on the spine, leading to the symptoms of the condition when they do appear. It can also lead to complications such as tethered cord syndrome, in which the spinal cord, moved out of place by the brain, gets stretched around the spine, leading to nerve and muscle damage. People with Chiari malformation sometimes get excess fluid around the brain, which needs to be drained using a shunt.

When the condition has no symptoms and causes no complications, treatment is usually unnecessary, though regular MRI scans should be done to make sure it isn’t moving further and causing damage. Sometimes, a small piece of the skull is removed to give the brain more room and ease the pressure. Alternatively, a portion of the spinal column might be removed instead.

Technology in the OR

Could Google Glass change the way surgery is done?

Innovations in the health care profession seem to happen on the regular. Most recently, a surgeon used Google Glass in his operating room to complete a procedure. What's that, you ask?

The technology
Google Glass is a product that was released by Google, of course. These funky glasses allow people to see the world from an entirely new perspective. Many people say that today, it seems as though society sees the world through the screens of their phones and no longer with their eyes. Well, Google Glass could change that. Some of the device's features include:1

  • Snapping photos of exactly what the wearer is seeing by saying the simple command, "take a picture."
  • Recording live performances by simply watching what you see – that means hands-free!
  • Sharing whatever is in your line of sight with others – this is what the doctor did during his surgery.
  • Having directions in your line of view, rather than looking away from the road and to the screen of your phone or navigation system to see if you just missed a turn.
  • Streaming information such as flight status when you arrive at the airport, without having to speak a command.

These are just some of the neat attributes that come along with Google Glass. And although it may be some time until this technology becomes the norm, it is a huge advancement. It may even be able to change the way in which medicine is practiced.

About the use
The doctor who is making headline news due to his use of Google Glass in the operating room is Christopher Kaeding.2 He's the director of sports medicine at Ohio State University Wexner Medical Center. Kaeding used Google Glass on August 21 when he was performing surgery to the anterior cruciate ligament in a 47-year-old woman's knee.

Why was he using Google Glass? Kaeding wanted to live stream the procedure to Dr. Robert Magnussen, an assistant professor at Ohio State, and his medical students. Not only did this provide a learning experience, but Kaeding was also able to consult with Magnussen on proper techniques and treatments during the surgery.

Following a successful procedure, Kaeding told Livescience that he did not find the device to be distracting, and even forgot it was there once things got underway.

"We just have to start using it," Dr. Clay Marsh, chief innovation officer at the medical center, told the source. "Like many technologies, it needs to be evaluated in different situations to find out where the greatest value is, and how it can impact the lives of our patients in a positive way."

And this wasn't the first time that Google Glass has been used in an OR. Back in June, a doctor in Maine used the device to live stream a gastrostomy – a simple procedure – over the internet. If the product continues to be used in this fashion, it could help doctors around the world communicate with each other during serious medical emergencies. As a result, this could have a significant effect on the level of care that surgeons and doctors are able to provide their patients.

Medex Supply provides doctors, health care practices and individuals with all the necessary medical supplies. Offering a range of products, these include:

1 Google Glass, "Welcome to a world through Glass"
2 Livescience, "Doc uses Google Glass to livestream surgery" August 27, 2013

Technology That Helps People Walk

It may seem like science fiction, but real technology is providing a new solution to people who have lost physical mobility due to stroke or other forms of brain damage. Robot suits, or exoskeletons, are coming out of the pages of comic books and being developed for patients int he real world. Experimental designs are being used right now by patients in several ongoing trials.

exoskeleton

These aren’t devices cobbled together in a cave with a box of scraps. Companies like Honda and Lockheed Martin are working on their own designs, along with some newcomers in the field such as Ekso Bionics. Some are even intended to interface with the neuromuscular system, the body’s existing infrastructure for controlling muscles. This interface will allow patients to control robotic limbs as naturally as healthy people control their own.

For now, however, most designs continue to require external controls. A stroke patient in San Jose, California, recently one type of design. His suit used battery-powered motors to help him move his legs, functionality he had lost in a stroke in June. The control center is in a computer he wore strapped to his back. The suit that volunteer tested is designed to monitor the progress of the wearer’s recover and adjust accordingly the level of assistance it provides.

Of course, as with any new technology, exoskeletons aren’t perfect. For one thing, there are severe energy limitations. The human body uses a truly staggering amount of energy. We replenish by eating, but exoskeletons need batteries, and battery life is limited. Materials also present a problem: too heavy, and they are a strain for the wearer, as well as requiring even more energy; too light, and they are also too weak to be effective and durable. Moreover, the cost is currently very high, making the technology simply unavailable to most patients.

However, companies are working to overcome the problems. The initial use is for stroke patients and soldiers who need the physical protection and enhanced strength an exoskeleton can provide. Further development may make these suits available to construction workers and other people laboring in environments where robotic power and human judgment form a good team.

Broccoli: the health food

That broccoli may be healthier than you think.

Growing up, we all remember our parents telling us to finish our vegetables at dinner. More often than not, that meant broccoli. Although many children – and adults – turn their noses up to the green food, it might be wise to add the veggies to your plate to help combat future health concerns.

Broccoli and osteoarthritis
A new study, conducted by researchers at the University of East Anglia, has found that a compound that broccoli contains may be able to prevent or slow the progress of osteoarthritis.1 Affecting millions of people across the globe, this is probably the most common form of arthritis.2

Most individuals suffer from osteoarthritis in their hands, necks, backs, knees and hips. However, it can really affect any joint. As sufferers age, the wear-and-tear on their bones causes this condition to develop, and it only gets worse from then on.

So, what is this magical compound? It goes by the name of sulforaphane, and it may be able to slow the destruction of cartilage surrounding a person's joints. This, of course, would help to slow the onset of osteoarthritis. It's important to recognize, however, that this study was conducted on lab mice that were fed diets rich in the product.

Although you can also find sulforaphane in Brussels sprouts and cabbage, it seems to be most effective when ingested in the form of broccoli. The information that these researchers collects sets a solid foundation for reasoning that further investigations are needed. In the meantime, it may be in your best interest to up your intake of broccoli, and we've got a few suggestions for how to do so.

In a quiche
Broccoli can be enjoyed at any meal, even for breakfast. Mixed with eggs, it makes a hearty addition to the plate. You might want to try this quiche recipe,3 to get the whole family in on it:

16 ounces pre cooked, shredded potatoes
2 cups broccoli florets, chopped finely
1 3/4 cups liquid egg substitute, divided
1 cup shredded extra-sharp cheddar cheese
3/4 cup smoked ham, finely diced
3/4 cup reduced fat sour cream
1/4 cup fresh chives, minced
2 tablespoons all-purpose flour
1 tablespoon extra-virgin olive oil
1/4 teaspoon salt
1/8 teaspoon pepper

Before you start combining any of the ingredients, preheat your oven to 375 degrees Fahrenheit. Use a 9-inch spring-form pan and grease it with cooking spray, generously. First, add the potatoes, 1/4 of the egg substitute, flour, oil and salt to a medium bowl and mix it all together. Spread this over the bottom of your pan and 2 inches up the sides. Bake for 35 to 40 minutes, or until the edges begin to brown.

Fill this "crust" with the broccoli, cheese and ham. Now you can whisk the remaining egg substitute with the sour cream, chives and pepper in a medium bowl. Pour this mixture over into the pan – you may want to place it on a baking sheet in case any seeps through.

It will take about 50 to 60 minutes for this to bake all the way through. If the middle does not appear to have set, keep it in the oven a little longer. Once it's done, run a knife around the edge of the pan to loosen your quiche. Serve it in wedges and enjoy!

When looking for medical supplies to help treat osteoarthritis, Medex Supply can help you find what you need. We carry a variety of products that range from anything such as surgical supplies to respiratory equipment to pressure monitors.

1 University of East Anglia, "Broccoli could be key in the fight against osteoarthritis" August 28, 2013
2 Mayo Clinic, "Osteoarthritis: definition" April 9, 2013
3 Eating Well, "Broccoli, ham and cheese quiche" September/October 2012

Hot Flashes In The Brain

confident-woman-menopause

New research is shedding some light on heat, specifically the hot flashes—what doctors call vasomotor symptoms—many women experience, sometimes as often as several times a day, due to menopause or after a hysterectomy. Though these symptoms are known to be triggered by hormonal changes, the exact mechanism and purpose has long been a mystery.

Only humans experience menopause, though all female primates become less fertile with age. However, while other primates remain fertile for their entire lives, humans can live to see their youngest children reach age 30, age 35, or even older. The difference isn’t in length of reproductive life but overall lifespan—most primates see fertility decline around the same time, but women live longer, allowing them to be there for children and grandchildren.

The new study, at Wayne State University in Michigan, looks at hot flashes as a neurological phenomenon, in contrast to studies that had focused on the skin sensation. The researchers used neuroimaging techniques to look at what is happening in the brain during the experience. What they found is that the brain stem, which is responsible for thermal regulation, shows activity before the hot flash begins, while the areas of the brain that are involved in sensations of skin and body temperature only become active after onset. That is strong evidence that hot flashes originate in the brain. A likely hypothesis is that the sudden reduction in amounts of estrogen causes changes in the brain, to which it responds by raising the body’s temperature.

If this is the case, it would explain why hormone therapy is so effective. Hormone replacement therapy administers estrogen and progesterone to replace the natural production, which slows at menopause. Hormone replacement is not recommended as a first-line treatment, however, because it can increase the risk of serious health complications, such as heart disease, stroke, dementia, and breast and endometrial cancer. A class of antidepressants called selective serotonin reuptake inhibitors has been found effective against vasomotor symptoms. Compounds found in soy and legumes may also provide some relief.

New surgical equipment may help sleep apnea sufferers

Is your poor night's sleep caused by sleep apnea?

Are you suffering from sleep apnea? In some instances, this is known as OSAHS, obstructive sleep apnea hypopnea syndrome, and the medical condition can cause a number of health concerns for patients. However, researchers from Wayne State University have found a surgical tool that may provide those who have been diagnosed with the condition some much needed relief.

A better understanding
Those who are unfamiliar with sleep apnea may have many questions regarding the illness. As it happens, it is a rather common medical condition that plagues a number of Americans. There are two forms of the condition:

• Central sleep apnea is caused by neurological conditions such as a stroke due to a lack of respiratory effort from the body

• Obstructive sleep apnea is the result of a closed airway, even though the body is expressing normal respiratory efforts

In some events, cases of sleep apnea are caused by a combination of these two causes. The most common form of the condition is OSAHS, which most frequently happens when an individual's windpipe closes repeatedly during sleep.1 This is extremely dangerous, because when it happens the person is unable to breath.

Diagnosis
If you or someone you know exhibits the following symptoms, it might be time to head to the doctor:

  • Lack of sleep due to waking up multiple times throughout the night
  • Snoring while asleep
  • A need to nap throughout the day because of tired feelings
  • Difficulty focusing because an inability to sleep
  • Unexplained health issues such as high blood pressure, daytime headaches or incontinence during the night

Although anyone may suffer from OSAHS, it is more common in men than women. Other contributing factors can include age, weight and potentially smoking.

Potential problems
Not only can OSAHS negatively impact an individual's social life – due to an excess of sleepiness and potential mood altering effects – it is also related to a number of other serious health concerns. For instance, the symptom of high blood pressure can lead to cardiovascular issues.2  Although obesity is a trigger of OSAHS, those who are within a reasonable weight have also had issues with diabetes mellitus due to their sleep apnea. Another major health concern that the condition can result in is liver dysfunction. Even patients who are non alcoholics have been found to have raised liver enzymes and fibrosis when a liver biopsy was conducted.

A new way to help
Dr. Ho-Sheng Lin and associates found that a transoral robotic surgery (TORS) may be beneficial in treating patients who are suffering from OSAHS. This is a technique in which doctors are able to safely remove tumors from the back of throats that are responsible for causing the condition.3

"In order to be maximally effective, the surgeon must evaluate each patient individually to identify the exact site or sites of airway obstruction and then direct the surgical treatments to address those obstructions," Lin explained in a statement.

The new device that researchers at Wayne State have developed is called the da Vinci Surgical System. The design is perfect for helping doctors successfully and safely remove those bothersome tumors. Professionals who conducted the study were able to use the da Vinci for positive outcomes in a total of 12 patients.

Find medical supplies
When it comes to medical supply equipment, Medex Supply offers professionals a full range of surgical instruments, including:

1 National Alliance on Mental Illness, "Mental illnesses: sleep apnea, what is sleep apnea?" July 2012
2 National Institutes of Health, "Obstructive sleep apnea hypopnea syndrome" June 2012
3 EurekAlert!, "New surgical tool may help sleep apnea sufferers, Wayne State research finds" August 27, 2013

Detecting Tuberculosis Early

lungs-md

There are estimated to be as many as two million tuberculosis deaths every year, and the disease is gradually getting worse. Treatment can require months-long courses of antibiotics to eliminate tuberculosis, particularly if it is active, creating a risk of liver toxicity. Moreover, drug-resistant tuberculosis is a big problem for doctors, as successive treatments become less and less effective against the disease. Many patients stop treatment after only a few weeks, hastening drug resistance and creating the possibility of the disease recurring. If the disease is inactive—as many as one in three people worldwide have tuberculosis in this latent form—it is not contagious and treatment is shorter, but still longer than most treatments take.

Five to ten percent of people with the latent form of the disease, and 30 percent of people with latent tuberculosis and HIV infection, develop active disease, in which they are contagious and show symptoms. Coughing blood is perhaps the best-known symptom, and one of the most obvious, though it doesn’t always occur. Chest pains and any cough that lasts more than two weeks could be signs of tuberculosis. Fatigue, weight loss, and poor appetite are also common. Chest x-rays and blood and tissue tests can be used to find indications of disease, though cultures can take a long time to produce results.

New research has shown that lung breakdown products are found in the blood and pulmonary fluids of tuberculosis patients, which may help identify the condition earlier than current tests can. The researchers say this is important because it can lead to starting treatment earlier and monitor treatment once it has been started. This will help reduce incidence and contagion, reducing the toll the illness takes.

Another study found another way to reduce the impact, a novel, more effective treatment to which no resistance has been developed. The bacterium that causes tuberculosis needs energy to thrive; several treatments are being investigated that cut off its sources of energy. One line of research is focused on ways to deprive the microbe of its food. Another looks at its metabolic process and involves a chemical compound that has been found to prevent the microbe’s metabolism in lab conditions.

Retraining Rogue Immune Cells

immune cells

Regulatory T cells play an important role in the immunity process: they help the body distinguish between harmful intruders and the body itself. They work by moderating the immune response, recognizing what tissue is legitimately part of the body and preventing the effector T cells, the cells that actually carry out infection-fighting functions, from attacking those organs. The regulatory T cells are also responsible for dialing down the immune response once an invading microbe has been successfully vanquished.

When the regulatory T cells fail, the resulting condition in what is known as an autoimmune disease. These conditions occur when the immune system attacks a part of the body as though it were an infection. Common autoimmune conditions include allergies, multiple sclerosis, lupus, vitiligo, Sjögren’s syndrome, rheumatoid arthritis, type 1 diabetes, Crohn’s disease, celiac, and myasthenia gravis. These conditions mostly strike women, often have a strong genetic component, and tend to result in inflammation in the affected area. Treatment often focuses on the symptoms—the inflammation—or involves deliberately reducing immune activity, though building on the observation that regions with more parasitic infection have a lower incidence of autoimmunity, carefully controlled introduction to the body of certain types of parasites.

Now researchers are starting to develop another treatment using various types of T cells. It turns out that T cells can be taught to tell the difference between valid targets and healthy tissue in the lab. The researchers developed a technique to harvest undifferentiated, or naïve, T cells from the blood, treat them with progesterone to turn them into an inflammation-suppressing type of cell, and then reintroduce them. Unlike the immune suppression treatments currently used, this procedure has no effect on the immune system in parts of the body where autoimmunity isn’t occurring. Rather than a general dialing back, it’s a specific and targeted reduction. This precision could make it possible for the treatment to be much more aggressive.

Advancements for learning what causes diabetes

How does your stomach respond to sugar?

Do you or someone you love suffer from type 2 diabetes? This chronic condition affects the way in which your body metabolizes glucose, and can greatly affect your lifestyle. Glucose is your body's main source of fuel, so it's important that you are able to maintain certain levels throughout the day.1 If not, it can be life threatening.

Potential causes
There are a number of conditions that may increase an individual's risk for developing type 2 diabetes, but doctors aren't always certain why some people do and others don't have issues. Potential risk factors can include:

  • Age
  • Race
  • Weight
  • Family history
  • Fat distribution
  • Inactivity

Recently, researchers from the University of Adelaide may have uncovered findings that give a better understanding of what exactly is happening in a type 2 diabetic's body.

Gut taste mechanisms
In your gut, there are receptors that "taste" sweet foods that you have ingested. Health care professionals recently found that these may be defective in diabetics, which causes problems for their bodies when it comes to balancing glucose levels.

"When we talk about 'sweet taste,' most people think of tasting sweet food on our tongue, but scientists have discovered that sweet receptors are present in a number of sites in the human body," Dr. Richard Young, senior researcher on the project, explained in a statement. "Our studies show that in diabetes patients, the glucose is absorbed more rapidly and in greater quantities than in healthy adults."2

In comparison to healthy adults, those with type 2 diabetes exhibited rapid glucose uptake when the gut taste mechanisms were exposed to sweet tastes. However, healthy adults were able to regulate glucose within 30 minutes. This is because the receptors are supposed to trigger such a response that regulates the way in which glucose is absorbed by the intestine.

So, although doctors have always attributed diabetes to the pancreas and insulin, the gut also plays a significant role. If the body of someone who has type 2 diabetes is relying in these gut taste mechanisms to manage glucose, they are up against a never-ending fight.

Physicians want to conduct further research on this topic to get a better grasp on the situation. For instance, they would like to compare the differences between what happens over the course of the entire digestion period, rather than just within the first 30 minutes. Depending on what information is found, they may be successful in finding ways to better treat and manage type 2 diabetes. Plus, research to this area of the body could mean a lot of other health and nutrition problems that diabetics suffer from.

Medical supplies
Patients who have been diagnosed with type 2 diabetes can count on Medex Supply for the necessary medical supplies they require in managing the disease. Diabetic supplies available include:

1 Mayo Clinic, "Type 2 diabetes" January 25, 2013
2 EurekAlert!, "Gut taste mechanisms are abnormal in diabetes sufferers" August 23, 2013