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The Unfolding Mystery of Scleroderma

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Scleroderma, an autoimmune disease, tends to afflict middle-age women and can affect many parts of the body, inside and out.

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Lung disease, the biggest killer of scleroderma patients, is the main focus of research today..

Doctors have a growing arsenal of proven and potential treatments, some of which are risky and the subjects of current research, including stem cell transplants and powerful but toxic cancer drugs.

Like many autoimmune ailments, scleroderma remains a great unknown. Despite decades of research, the cause of this rare and complicated disease has yet to be discovered. But the good news is that doctors have a pretty clear understanding of how scleroderma progresses — a natural history, they call it — and are better than ever at extending and easing their patients’ lives.

“Lots of patients and lots of doctors used to consider it a ‘black box’ disease, a complete mystery, with little that could be done,” said Dr. Philip J. Clements of the University of California, Los Angeles, who is a scleroderma specialist. “Now there’s a body of evidence that tells us what to watch out for, and when.”

Experts now know, for example, that the gradual hardening of tissues and blood vessels that is a hallmark of scleroderma usually starts on the hands and face, with skin thickening, pitted scars and cool, pale fingertips among the earliest symptoms. Damage can then progress inward to internal organs, though the course varies widely from patient to patient. Of the 10,000 cases diagnosed among Americans each year, mainly women, a small subset will die quickly. But many others are able to manage their condition with a variety of treatments and have normal life expectancies.

Doctors also now know that if a patient’s internal organs are going to be affected as well as the skin, that is likely to happen in the first four or five years of the disease. So early diagnosis and close monitoring of the heart, lungs and kidneys are vitally important.

They have also learned that steroids, once viewed as a cure-all for immune disorders, can worsen the effects of scleroderma, especially in the kidneys, and should be used with caution.

“Learning which drugs to avoid was itself a big step,” said Dr. John Varga, the Gallagher Professor of Medicine at Northwestern University and chairman of the Medical Advisory Board for the Scleroderma Foundation, a nonprofit group that sponsors research and support for patients and families.

Kidney disease used to cause 90 percent of scleroderma-related deaths until the advent of a class of blood pressure drugs called angiotensin-converting enzyme, or ACE, inhibitors in the 1980s. ACE inhibitors prevent kidney damage by slowing down the chemicals that cause the muscles surrounding blood vessels to contract. Complications in the kidneys now account for only 14 percent of scleroderma deaths, Dr. Steen said.

The lungs are still a challenge. About 80 percent of scleroderma patients develop some form of lung problem — either pulmonary hypertension, due to hardening of the veins and arteries in the lung, or pulmonary fibrosis, in which the lung tissue becomes inflamed and then thickened with scarring. Some patients develop both. Either way, breathing becomes more difficult as the lungs become less pliable.

“If you die of a scleroderma-related problem, half of those deaths are from lung disease,” said Dr. Virginia Steen, a professor at Georgetown University and director of the Rheumatology Fellowship Program there. She wrote a seminal 2007 article that documented the shift from kidney disease to pulmonary disease as the biggest cause of death among scleroderma patients.

One successful remedy called Revatio, routinely prescribed since 2005, came from an unexpected source: Viagra. Repackaged from a little blue diamond to a round white tablet and renamed for marketing, dosage and insurance purposes, the drug works by relaxing the blood vessels and improving blood flow, whether for erectile or lung dysfunction.

“No one could understand why all these women were taking it four times a day,” said Frannie Waldron, chief executive of the Scleroderma Foundation.

Doctors also have a growing arsenal of experimental treatments and potential cures, some of which are risky.

Among them is cyclophosphamide, or Cytoxan, a powerful but highly toxic cancer drug that acts on the immune system. The drug decreases the inflammation that causes pulmonary fibrosis and has been used on scleroderma patients for the last 10 years.

But cytoxan has dangerous side effects, including an increased risk of bladder cancer, and usually is not given for more than a year. Moreover, the fibrosis seems to start again once drug treatments stop. Several studies involving the medication are under way, as well as efforts to find alternative treatments, many of them sponsored by drug companies.

Another big push involves stem cell transplant, an extremely risky process in which doctors try to reset the patient’s immune system and bypass the glitch that causes scleroderma. The procedure is the subject of a National Institutes of Health study called the SCOT trial, for Scleroderma: Cyclophosphamides or Transplantation?

Similar to a bone marrow transplant, doctors first draw the patient’s blood and extract the stem cells, the highly malleable building blocks that are thought to be free of the seeds of scleroderma. The patient is then subjected to high doses of radiation or chemotherapy with Cytoxan to kill the bone marrow. The last step is to reinfuse the stem cells, in the hopes that they replicate themselves in a healthy form free of disease.

The study will compare the benefits of the stem cell transplant with giving patients just monthly doses, but high ones, of Cytoxan. Preliminary results have been promising, several experts said.

“You’d think you’d have trouble recruiting for this,” said Dr. Arthur C. Theodore of Boston University, one of the investigators in the project. “But scleroderma patients are desperate.”

Sources
: The New York Times

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News on Health & Science

Eating Veggies Shrinks the Brain

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Scientists have discovered that going veggie could be bad for your brain-with those on a meat-free diet six times more likely to suffer brain shrinkage.

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Vegans and vegetarians are the most likely to be deficient because the best sources of the vitamin are meat, particularly liver, milk and fish. Vitamin B12 deficiency can also cause anaemia and inflammation of the nervous system. Yeast extracts are one of the few vegetarian foods which provide good levels of the vitamin.

The link was discovered by Oxford University scientists who used memory tests, physical checks and brain scans to examine 107 people between the ages of 61 and 87.

When the volunteers were retested five years later the medics found those with the lowest levels of vitamin B12 were also the most likely to have brain shrinkage. It confirms earlier research showing a link between brain atrophy and low levels of B12.

Brain scans of more than 1,800 people found that people who downed 14 drinks or more a week had 1.6% more brain shrinkage than teetotallers. Women in their seventies were the most at risk.

Beer does less damage than wine according to a study in Alcohol and Alcoholism.

Researchers found that the hippocampus-the part of the brain that stores memories – was 10% smaller in beer drinkers than those who stuck to wine.

And being overweight or obese is linked to brain loss, Swedish researchers discovered. Scans of around 300 women found that those with brain shrink had an average body mass index of 27 And for every one point increase in their BMI the loss rose by 13 to 16%.

Sources: The Times Of India

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Positive thinking

Intuitive Guidance From Within

Using Yourself As A Pendulum
Learning to trust our intuition is something that can connect us with our higher selves. Sometimes it might not seem easy to do this. Our thoughts and minds often get in the way. But by accessing our innermost self, we will find that the information we receive is usually what we truly need at that moment. One of the techniques that allows us to really get in touch with our deepest font of wisdom is using our body as a pendulum. The simple act of letting our physical being lead us in a certain direction can offer us extremely deep insights and help us find the answers we seek.

Many of us may have tried using a pendulum or crystal on a chain as a dousing tool to acquire the information we need to make decisions or even find lost objects. Using our bodies puts us much more closely in tune with our being. The process of using your body as a pendulum is to ask your higher self a question and wait for your body to respond in either a forward-tilting or backward-tilting motion. The first step is to really understand how our higher self communicates with us by centering our bodies, asking ourselves the directions for “yes” and “no,” and noting which way our body moves. For a lot of people a forward motion is “yes,” and your body tilting backward is a “no” answer. It is easier to start with simple questions at first to understand how our higher self communicates with us. As we become more used to the messages we receive and how we process them, we can start asking for more specific things such as what dosage of herbs to take or which foods would best nour! ish our bodies. Using this technique in the grocery store or when shopping for vitamins and remedies can be extremely helpful.

Since we are always present in our bodies, understanding how we can use our bodies as pendulums is a tool we can use at any given moment in our lives. Letting our bodies tell us what is happening inside of us will in turn help to guide us through not just daily but also major life decisions. The more we allow our bodies to open up and share with us the connection it has with our deeper self, the better able we will be to truly access the knowledge we hold so deeply within.

Sources : Daily Om

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News on Health & Science

Better to Be Fat and Fit Than Skinny and Unfit

Silhouettes representing healthy, overweight, ...Image via Wikipedia

Is a person’s weight really a reliable indicator of overall health?

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Some medical research is showing that it isn’t. Last week a report in The Archives of Internal Medicine compared weight and cardiovascular risk factors among a representative sample of more than 5,400 adults. Half of the overweight people and one-third of obese people in the study were “metabolically healthy.” That means that many overweight and obese adults may have healthy levels of “good” cholesterol, blood pressure, and blood glucose.

At the same time, about one out of four slim people in the study actually had at least two cardiovascular risk factors typically associated with obesity.

Being overweight or obese is definitely linked with numerous health problems. Nonetheless, researchers found the proportion of overweight and obese people who are metabolically healthy surprising.

Several studies have shown that fitness, as determined by how a person performs on a treadmill, is a far better indicator of health than body mass index. Some research has indicated that people who are fat but can still keep up on treadmill tests have much lower heart risk than people who are slim and unfit.

Sources:
New York Times August 18, 2008
Archives of Internal Medicine August, 2008; 168(15):1617-1624.

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Featured

How to Live Till a 100

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Want to live till 100 years of age? Well, do regular exercises, be married, wash hands and brush your teeth everyday.

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That’s what a new book, ‘The Long Life Equation’, by Dr Trisha Macnair suggests. In the book, the author has listed activities that add years to your life.

Macnair said washing your hands adds two years, and good dental hygiene can add six more years in your life.

But smoking, fast food, no exercise and a stressful life can strip away 20 years.

“There’s no doubt younger people take life and health for granted – more than any generation before, they idle time away watching TV or playing computer games, ignoring the activities that keep them healthy or develop meaning in their lives,” Courier Mail quoted Macnair, as saying.

“As we get older and start to feel the years slipping away, we suddenly realise how precious it is.

“But by then we may have already established habits (smoking, drinking, obesity, lack of exercise, stressful occupations) which take their toll and are difficult to reverse.

“Still, it’s never too late to change. Also, our attitudes to older age are changing so there is more freedom now to do things later in life if we are healthy and able,” she added.

A 2006 study from University of California in Los Angeles showed that men and women live healthier, wealthier, happier and longer lives when they are in a stable partnership

The study confirmed that married couples were more likely to live to an old age than their divorced, widowed or unmarried counterparts.

A stable partnership can actually add on seven years to life.

Regular exercise also adds as much as two or more years to your life.

A Harvard Alumni Study, which took into account more than 71,000 men who had graduated from Harvard University and the University of Pennsylvania between 1916 and 1954, found that those men who regularly burned 8400kJ a week while exercising lived, on average, two years longer than sedentary types.

But cigarette smoking can actually reduce 8 years from your life

Tobacco smoke contains more than 4000 chemicals, many of which are highly toxic.

A divorce can also strip away 3 years from your life, as it takes longer-lasting, emotional and physical toll on former spouses than virtually any other life stress.

Recent studies indicate that divorced adults have higher rates of emotional disturbance, accidental death and death from heart disease.

The divorced also have higher rates of admission to psychiatric facilities and make more visits to doctors than people who are married, single or widowed.

Sources: The Times Of India

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