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Pistachio Nuts Significantly Lower Cholesterol Levels

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]A study has found that a diet containing nuts, including pistachios, significantly lowered total and LDL-cholesterol levels, in addition to triglycerides. The 600 subject, 25 clinical trial study, conducted in seven counties, is the most comprehensive study of its kind and further substantiates the evidence that nuts can help reduce the risk of cardiovascular disease.

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The report, authored by Dr. Joan Sabaté, set out to quantify the cholesterol–reducing benefits of various nuts, such as pistachios, by analyzing previously published human clinical trials.

The authors reviewed the results of 25 human clinical trials published from 1992 through 2007. The analysis included data from 583 men and women, aged 19 to 86 years old. Among the studies, nut consumption ranged from less than one ounce to 4.75 ounces per day. The average daily intake for the meta-analysis was 67 grams per day or 2.4 ounces.

The results found that when 67 grams of nuts were consumed, triglycerides were reduced by 10.2 percent among those with high triglyceride levels at the onset of the study; and total and LDL-cholesterol were lowered by 5.1 percent and 7.4 percent, respectively. Individuals with higher baseline LDL-cholesterol levels also experienced a greater reduction in total and LDL-cholesterol levels compared to those with normal baseline LDL levels. Subjects following a typical Western-diet also experienced a greater reduction in total and LDL-cholesterol levels (-7.4 percent and – 9.6 percent, respectively) compared to a low-fat (-4.1 percent and -6.0 percent, respectively) or a Mediterranean diet (-4.1 percent and -6.0 percent, respectively).

Another important finding was that greater cholesterol lowering benefits were seen in individuals with a lower BMI compared to those with a higher BMI. Additionally, cholesterol levels were reduced in a dose-dependent result, with benefits seen in as low as a one-ounce serving per day; the greatest benefits were seen when 20 percent of calories were consumed daily from nuts. For the typical 2,000-calorie diet, 20 percent equals 400 calories of nuts or 2.4 ounces (about 120) pistachios.

“Enjoying a handful or two of in-shell pistachios may provide significant heart health benefits,” said Martin Yadrick, immediate past-president of the American Dietetic Association. “They are known to also improve blood vessel function, blood sugar control, act as potent antioxidant and offer weight management benefits, all of which are important for improving heart health.”

With more than 30 different vitamins, minerals and beneficial phytonutrients, in-shell pistachios are a nutrient-rich snack. In fact, pistachios provide more potassium and phytosterols than any other nut and are the only nut to contain the carotenoids, lutein and zeaxanthin. They also have one of the highest antioxidant capacities of all nuts.

Source:Elements4Health

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Raynaud’s disease

Definition:-
Raynaud’s disease is a condition that causes some areas of your body — such as your fingers, toes, tip of your nose and your ears — to feel numb and cool in response to cold temperatures or stress. In Raynaud’s disease, smaller arteries that supply blood to your skin narrow, limiting blood circulation to affected areas.

Click to see the pictures of  Raynaud’s  diseas

Raynaud’s disease (also known as “Primary Raynaud’s phenomenon” where the phenomenon is idiopathic, and Raynaud’s syndrome (secondary Raynaud’s), where it is caused by some other instigating factor. Measurement of hand-temperature gradients is one tool used to distinguish between the primary and secondary forms.

It is possible for the primary form to progress to the secondary form.

Symptoms:-
Raynaud’s disease is more than simply having cold hands and cold feet, and it’s not the same as frostbite. Signs and symptoms of Raynaud’s depend on the frequency, duration and severity of the blood vessel spasms that underlie the disorder.

The list of signs and symptoms mentioned in various sources for Raynaud’s phenomenon includes the 51 symptoms listed below:

•Symptoms usually affect fingers, toes, nose, lips or earlobes
•Skin color changes
•Skin whiteness then blueness then redness
•Cold sensitivity
•Pallor (whiteness)
•Cyanosis (blueness)
•Redness (rubor)
•Finger symptoms
*Finger color changes
*Finger pallor
*Finger tingling
*Finger redness
*Finger numbness
*Finger sensitivity
*Finger pain

•Toe symptoms
*Toe color changes
*Toe numbness
*Toe redness
*Toe pallor
*Toe sensitivity
*Toe pain

•Nose symptoms
*Nose color changes
*Nose numbness
*Nose redness
*Nose pallor
*Nose sensitivity
*Nose pain

•Earlobe symptoms
*Earlobe color changes
*Earlobe numbness
*Earlobe redness
*Earlobe pallor
*Earlobe pain
•Lip symptoms
*Lip color changes
*Lip numbness
*Lip redness
*Lip pallor
*Lip sensitivity
*Lip pain

•Episodic attacks – lasting minutes or hours
•Small blood vessel constriction (vasospastic attacks)
•Symmetric symptoms – usually both hands or both feet rather than just one
•Both hands and both feet – primary Raynaud’s affects all 4; secondary Raynaud’s typically affects either hands or feet but not both.

•Other areas affected – hands and feet most common but others are possible
*Nose symptoms
*Lips symptoms
*Ear lobes symptoms

Causes:-
Doctors don’t completely understand the cause of Raynaud’s attacks, but blood vessels in the hands and feet appear to overreact to cold temperatures or stress:

*Cold temperatures. When your body is exposed to cold temperatures, your extremities lose heat. Your body slows down blood supply to your fingers and toes to preserve your body’s core temperature. Your body specifically reduces blood flow by narrowing the small arteries under the skin of your extremities. In people with Raynaud’s, this normal response is exaggerated.
*Stress. Stress causes a similar reaction to cold in the body, and likewise the body’s response may be exaggerated in people with Raynaud’s.


Blood vessels in spasm :
With Raynaud’s, arteries to your fingers and toes go into what’s called vasospasm. This narrows your vessels dramatically and temporarily limits blood supply. Over time, these same small arteries may also thicken slightly, further limiting blood flow. The result is that affected skin turns a pale and dusky color due to the lack of blood flow to the area. Once the spasms go away and blood returns to the area, the tissue may turn red before returning to a normal color.

Cold temperatures are most likely to trigger an attack. Exposure to cold can be as simple as putting your hands under a faucet of running cold water, taking something out of the freezer or exposure to cold air. For some people, exposure to cold temperatures isn’t necessary. Emotional stress alone can cause an episode of Raynaud’s.

Raynaud’s may be partly an inherited disorder.

In extreme cases, the secondary form can progress to necrosis or gangrene of the fingertips.

Raynaud’s phenomenon is an exaggeration of vasomotor responses to cold or emotional stress. More specifically, it is a hyperactivation of the sympathetic system causing extreme vasoconstriction of the peripheral blood vessels, leading to tissue hypoxia. Chronic, recurrent cases of Raynaud phenomenon can result in atrophy of the skin, subcutaneous tissues, and muscle. In rare cases it can cause ulceration and ischemic gangrene.

It is important to distinguish Raynaud’s disease from syndrome. In order to diagnose these two forms of Raynaud’s, a doctor may look for signs of arthritis or vasculitis, and may conduct a number of laboratory tests.

Primary Raynaud’s (disease):
Raynaud’s disease, or “Primary Raynaud’s”, is diagnosed if the symptoms are idiopathic, that is, they occur by themselves and not in association with other diseases. Some refer to Primary Raynaud’s disease as “being allergic to coldness”. It often develops in young women in their teens and early adulthood. Primary Raynaud’s is thought to be at least partly hereditary, although specific genes have not yet been identified.

Smoking worsens frequency and intensity of attacks, and there is a hormonal component. Caffeine also worsens the attacks. Sufferers are more likely to have migraine and angina than controls.

Secondary Raynaud’s (syndrome):
Raynaud’s syndrome, or “Secondary Raynaud’s”, occurs secondary to a wide variety of other conditions. Secondary Raynaud’s has a number of associations:

Connective tissue disorders:
*scleroderma
*systemic lupus erythematosus
*rheumatoid arthritis
*Sjögren’s syndrome
*dermatomyositis
*polymyositis
*mixed connective tissue disease

*cold agglutinin disease

*Ehlers-Danlos Syndrome

Eating disorders
*anorexia nervosa

Obstructive disorders :
*atherosclerosis
*Buerger’s disease
*Takayasu’s arteritis
*subclavian aneurysms
*thoracic outlet syndrome


Drugs :
*Beta-blockers
*cytotoxic drugs – particularly chemotherapeutics and most especially *bleomycin
*ciclosporin
*ergotamine
*sulfasalazine
*anthrax vaccines whose primary ingredient is the Anthrax Protective Antigen


Occupation :
*jobs involving vibration, particularly drilling
*exposure to vinyl chloride, mercury
*exposure to the cold (e.g. by working packing frozen food)


Others :
*hypothyroidism
*cryoglobulinemia
*malignancy
*reflex sympathetic dystrophy
*carpal tunnel syndrome
*Magnesium Deficiency
*Erythromelalgia, (the opposite of Raynaud’s, with hot and warm extremities) often co-exists in patients with Raynaud’s)
It is important to realize that Raynaud’s can herald these diseases by periods of more than 20 years in some cases, making it effectively their first presenting symptom. This can be the case in the CREST syndrome, of which Raynaud’s is a part.

Patients with Secondary Raynaud’s can also have symptoms related to their underlying diseases. Raynaud’s phenomenon is the initial symptom that presents for 70% of patients with scleroderma, a skin and joint disease.

Raynaud’s phenomenon which is limited to one hand (or to one foot) is referred to as Unilateral Raynaud’s. This is an uncommon form, and it is always secondary to local or regional vascular disease. It commonly progresses within several years to affect other limbs as the vascular disease progresses.

Risk factors:-
Risk factors for primary Raynaud’s include:

*Your gender. Primary Raynaud’s affects women more than men.
*Your age. Although anyone can develop the condition, primary Raynaud’s often begins between the ages of 15 and 30.
*Where you live. The disorder is also more common in people who live in colder climates.
*Your family history. Additionally, a family history appears to increase your risk of primary Raynaud’s. About one-third of people with primary Raynaud’s have a first-degree relative — a parent, sibling or child — with the disorder.

Risk factors for secondary Raynaud’s include:

*Associated diseases. These include conditions such as scleroderma and lupus.

*Certain occupations. People in occupations that cause repetitive trauma, such as workers who operate tools that vibrate, also may be more vulnerable to secondary Raynaud’s.

*Exposure to certain substances. Smoking, medications that affect the blood vessels and exposure to chemicals such as vinyl chloride are associated with an increased risk of Raynaud’s.
Complications:–
If Raynaud’s is severe — which is rare — blood circulation to your fingers or toes could permanently diminish, causing deformities of your fingers or toes.

If an artery to an affected area becomes blocked completely, sores (skin ulcers) or dead tissue (gangrene) may develop. Ulcers and gangrene can be difficult to treat.

Diagnosis:-
Examinations & Tests:
To diagnose Raynaud’s, your doctor will ask detailed questions about your symptoms and medical history and conduct a physical examination. Your doctor may also run tests to rule out other medical problems that may cause similar signs and symptoms, such as a pinched nerve.

Your doctor may perform a simple test called a cold-stimulation test during your office visit. This test may involve placing your hands in cool water or exposing you to cold air, to trigger an episode of Raynaud’s.

A careful medical history will often reveal whether the condition is primary or secondary. Once this has been established, an examination is largely to identify or exclude possible secondary causes.

Digital artery pressure: pressures are measured in the arteries of the fingers before and after the hands have been cooled. A decrease of at least 15 mmHg is diagnostic (positive).

Doppler ultrasound: to assess blood flow.
Full blood count: this can reveal a normocytic anaemia suggesting the anaemia of chronic disease or renal failure.

Blood test for urea and electrolytes: this can reveal renal impairment.
Thyroid function tests: this can reveal hypothyroidism.
An autoantibody screen, tests for rheumatoid factor, Erythrocyte sedimentation rate and C-reactive protein, which may reveal specific causative illnesses or a generalised inflammatory process.
Nail fold vasculature: this can be examined under the microscope

Sorting out primary vs. secondary Raynaud’s:
To distinguish between primary and secondary Raynaud’s, your doctor may perform an in-office test called nail fold capillaroscopy. During the test, the doctor examines your nail fold — the skin at the base of your fingernail — under a microscope. Tiny blood vessels (capillaries) near the nail fold that are enlarged or deformed may indicate an underlying disease. However, some secondary diseases can’t be detected by this test.

If your doctor suspects that another condition, such as an autoimmune or connective tissue disease, underlies Raynaud’s, he or she may order blood tests, such as:

*Antinuclear antibodies test. A positive test for the presence of these antibodies — produced by your immune system — indicates a stimulated immune system and is common in people who have connective tissue diseases or other autoimmune disorders.

*Erythrocyte sedimentation rate. This blood test determines the rate at which red blood cells settle to the bottom of a tube in the space of an hour. A faster than normal rate may signal an underlying inflammatory or autoimmune disease. Autoimmune diseases are commonly associated with secondary Raynaud’s.
There’s no single blood test to diagnose Raynaud’s. Your doctor may order other tests, such as those that rule out diseases of the arteries, to help pinpoint a disease or condition that may be associated with Raynaud’s.

Modern Treatments and drugs:-

Treatment options are dependent on the type of Raynaud’s present. Raynaud’s syndrome is treated primarily by addressing the underlying cause, but includes all options for Raynaud’s disease as well. Treatment of primary Raynaud’s focuses on avoiding triggers.

General care:
*Avoid environmental triggers, e.g. cold, vibration, etc. Emotional stress is another recognized trigger; although the various sources of stress can not all be avoided, it is possible to learn healthier, more effective ways of dealing with them, which will reduce stress and its damaging physical effects overall.

*Keep your hands, feet and head warm—especially your fingers, toes, ears and nose—by wearing mittens, insulated footwear, a ski mask; by using hand and foot warmers, etc.

*Quit smoking.

*Avoid caffeine and other stimulants and vasoconstrictors that have not been prescribed to you by your doctor. Read product labels; caffeine is found not only in coffee and tea, stay-awake pills, many soft drinks and candies, but also in some cosmetics, soaps and shampoos(reference needed).

  • Exercise. Your doctor may encourage you to exercise regularly, particularly if you have primary Raynaud’s. Exercise can increase circulation, among other health benefits.
  • Control stress. Because stress may trigger an attack, learning to recognize and avoid stressful situations may help control the number of attacks.

*Make sure all your doctors know about all the medicines you take and about all the OTC remedies you use, especially hormones and drugs that regulate hormones, such as hormonal contraception, so that these professionals can make an assessment of your chemical regimen and make any changes that may be indicated. Contraception which is low in estrogen is preferable, and the progesterone only pill is often prescribed for women with Raynaud’s.

*If you are diabetic, follow your diabetes treatment plan.

Emergency measures:
*If white finger (Raynaud’s) occurs unexpectedly and a source of warm water is available, allow tepid to slightly warm water to run over the affected digits while you gently massage the area. Continue this process until the white area returns to its normal, healthy color.

*If triggered by exposure in a cold environment, and no warm water is available, place the affected digits in a warm body cavity – arm pit, crotch, or even in the mouth. Keep the affected area warm at least until the whiteness returns to its normal, healthy color. Get out of the cold as soon as possible.

Drug therapy:
*Treatment for Raynaud’s phenomenon may include prescription medicines that dilate blood vessels, such as calcium channel blockers (nifedipine) or diltiazem.  It has the usual common side effects of headache, flushing, and ankle edema; but these are not typically of sufficient severity to require cessation of treatment.

*There is some evidence that Angiotensin II receptor antagonists (often Losartan) reduce frequency and severity of attacks,and possibly better than nifedipine.

*Alpha-1 adrenergic blockers such as prazosin can be used to control Raynaud’s vasospasms under supervision of a health care provider.

*In a study published in the November 8, 2005 issue of Circulation, sildenafil (Viagra) improved both microcirculation and symptoms in patients with secondary Raynaud’s phenomenon resistant to vasodilatory therapy. The authors, led by Dr Roland Fries (Gotthard-Schettler-Klinik, Bad Schönborn, Germany), report: “In the present study, capillary blood flow was severely impaired and sometimes hardly detectable in patients with Raynaud’s phenomenon. Sildenafil led to a more than 400% increase of flow velocity.”

*Fluoxetine, a selective serotonin reuptake inhibitor, and other antidepressant medications may reduce the frequency and severity of episodes if caused mainly by psychological stress.

Surgical Intervention:
*In severe cases, a sympathectomy   procedure can be performed. Here, the nerves that signal the blood vessels of the fingertips to constrict are surgically cut. Microvascular surgery of the affected areas is another possible therapy. Infusions of prostaglandins, e.g. prostacyclin, may be tried, with amputation in exceptionally severe cases.

*A more recent treatment for severe Raynaud’s is the use of Botox. The 2009 article studied 19 patients ranging in age from 15 to 72 years with severe Raynaud’s phenomenon of which 16 patients (84%) reported pain reduction at rest. 13 patients reported immediate pain relief, 3 more had gradual pain reduction over 1-2 months. All 13 patients with chronic finger ulcers healed within 60 days. Only 21% of the patients required repeated injections. A 2007 article describes similar improvement in a series of 11 patients. All patients had significant relief of pain.

Sometimes in cases of severe Raynaud’s, approaches other than medications may be a treatment option:

*Nerve surgery. Nerves called sympathetic nerves in your hands and feet control the opening and narrowing of blood vessels in your skin. Sometimes it’s necessary in cases of severe Raynaud’s to cut these nerves to interrupt their exaggerated response. Through small incisions in the affected hands or feet, a doctor strips away these tiny nerves around the blood vessels. The surgery, called sympathectomy, may reduce the frequency and duration of attacks, but it’s not always successful.
*Chemical injection. Doctors can inject chemicals to block sympathetic nerves in affected hands or feet. You may need to have the procedure repeated if symptoms return or persist.
*Amputation. Sometimes, doctors need to remove tissue damaged from a lack of blood supply. This may include amputating a finger or toe affected by Raynaud’s in which the blood supply has been completely blocked and the tissue has developed gangrene. But this is rare.


Alternative and Experimental (Research) Approaches:-
Lifestyle changes and supplements that encourage better circulation may be effective alternatives for managing Raynaud’s. If  one is interested, may talk to the doctor about:

*Biofeedback. Biofeedback — using your mind to control body temperature — may help decrease the severity and frequency of attacks. Biofeedback includes guided imagery to increase the temperature of hands and feet, deep breathing and other relaxation exercises. Your doctor may be able to suggest a therapist who can help you learn biofeedback techniques. Books and tapes also are available on the subject.

*Niacin. Niacin, also known as vitamin B-3, causes blood vessels to dilate, increasing blood flow to skin. Niacin supplements may be useful in treating Raynaud’s, although niacin supplements may have side effects.
*The extract of the Ginkgo biloba leaves (Egb 761, 80 mg) may reduce frequency of attacks.

*Two separate gels combined on the fingertip (somewhat like two-part epoxy, they cannot be combined before use because they will react) increased blood flow in the fingertips by about three times. One gel contained 5% sodium nitrite and the other contained 5% ascorbic acid. The milliliter of combined gel covered an area of ~3 cm². The gel was wiped off after a few seconds.

*Piracetam, a nootropic drug, can be useful as a long-term treatment for vasospastic disorders.

*Arginine, which increase nitrous oxide acts as a vasodilator

*Milder cases of Raynaud’s can often be addressed by biofeedback[23] or other techniques to help control involuntary body functions like skin temperature.

*Fish oil supplements which contain long-chain omega-3 fatty acids may help to control symptoms of primary Raynaud’s. There are few studies in the medical literature dealing with this subject. However, in one 1989 controlled, double-blinded study of 32 patients, consumption of roughly 6.5 grams of long chain omega-3 fatty acids in the form of fish oil significantly increased the time to onset or entirely prevented symptoms in response to cold in patients with primary Raynaud’s. Lower doses of fish oil such as may be commonly available from commercial vendors have not been studied and may not be as effective.

Coping with the stress and nuisance of Raynaud’s takes patience and effort. Work with your doctor to manage your condition and maintain a positive attitude. The majority of people with Raynaud’s respond to treatment..

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

 

Rersources:
http://en.wikipedia.org/wiki/Raynaud’s_phenomenon
http://www.mayoclinic.com/health/raynauds-disease/DS00433/DSECTION=lifestyle-and-home-remedies
http://www.wrongdiagnosis.com/r/raynauds_phenomenon/symptoms.htm
http://www.myfootshop.com/detail.asp?Condition=Raynauds%20Disease.

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Moles and Angel Kisses

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Mikhail Gorbachev is easily identified in photographs by a distinctive large red mark on his head. The patch is actually a birthmark — a capillary naevus — which is present from birth. One in 10 children has birthmarks on his or her body.

...…CLICK TO SEE THE PICTURE

These marks have fascinated people down the ages. In the 16th and 17th centuries, there developed a branch of astrology called moleoscopy. Specialists interpreted the “occult significance” of birthmarks and their “effect” on one’s character and destiny. The positions of the moles were linked with astrological signs. Hippocrates, the father of medicine, wrote a treatise on the link between birthmarks and health. He had the right idea. Health is a strong determinant of the future. We now know that the birthmarks are a coincidence.
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Birthmarks that are red in colour are called strawberry marks, angel kisses or stork bites. They are usually present on the eyelids, forehead or nape of the neck. They may be flat or appear slightly raised or bumpy. They are caused by an overgrowth of the small blood vessels (capillaries). They are not hereditary or cancerous and usually disappear without treatment by the age of two.

Gorbachev’s large red naevus is called a port wine stain. Such marks too are present at birth, but are much larger, do not cross the midline and unlike strawberry marks do not fade with age. Sometimes they may be associated with seizures and glaucoma in later life.

Dark slate grey or bluish marks can be present over the areas of the buttocks or back in 80 per cent of Indian babies. These are called “mongoloid spots” and to the untrained eye can be mistaken for bruises. They occur because melanocytes (pigment producing cells in the skin) get caught in the deeper layers of the skin during the development process. The marks may last till adolescence.

Café au lait spots are so called because they are a shade of brown that looks like milky coffee. They may be present at birth or appear in early childhood. If they are very large, or four or more are present, the child may be carrying the gene for neurofibromatosis. This is a condition where multiple painless bumps appear all over the face and body in adult life.

Birthmarks that are large (the size of a fist), black and sometimes hairy are called congenital naevi. They have to be watched carefully as 10 per cent can turn cancerous.

Older children may develop pigmented areas on the skin called moles. These are also called beauty marks. Marilyn Monroe and Madhubala had attractive facial moles. In the last century, moles were a fashion statement for both men and women.

A real mole is an area of skin where there is an increase in the number of melanocytes which then form a cluster. They can be flat or raised. Some may have hair growing in it. The number present increases with age and most adults have 20-40 moles. They also increase during times of hormonal change like adolescence and pregnancy. They can darken when exposed to sunlight. Some fade away with age.

Moles rarely can become cancerous. The danger signals are —

* If the mole suddenly appears after the age of 20 and seems to be increasing in size

* If the diameter is larger than the end of a pencil

* If it suddenly changes in colour

* If it itches, oozes or bleeds.

A dermatologist can remove a mole which shows any of these signs and send it for testing. Removal of a cancerous mole in the early stages is curative.

Not all pigmentations on the skin are moles. They may be “lentigenes” or brown spots that appear on the face and hands in older people, especially after exposure to sunlight. They resemble freckles. They are harmless and can be prevented by avoiding the sun.
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Black spots may appear on the chest and back as people get older. They look like blobs of dirt stuck on the skin, but cannot be picked off. These are barnacles or seborrheic keratosis. The condition may run in families. They occur because keratin, a strong natural protein normally formed in the skin, increases and forms circular whorls. They are harmless and can be left alone. Some may be cosmetically disfiguring. Others may get caught in clothing and become irritated, red and start bleeding. These can be removed by a dermatologist.
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The skin, especially in older overweight women, can form tags — small flaps of tissue that hang off the skin. These are not painful or dangerous. If they get snagged frequently on jewellery or clothing, they can be easily removed.

Source: The Telegraph (Kolkata, India)

 

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Aneurysm

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Definition:

An aneurysm (AN-u-rism) is a balloon-like bulge in an artery. Arteries are blood vessels that carry oxygen-rich blood from your heart to your body.

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Arteries have thick walls to withstand normal blood pressure. However, certain medical problems, genetic conditions, and trauma can damage or injure artery walls. The force of blood pushing against the weakened or injured walls can cause an aneurysm.

An aneurysm can grow large and burst (rupture) or cause a dissection. Rupture causes dangerous bleeding inside the body. A dissection is a split in one or more layers of the artery wall. The split causes bleeding into and along the layers of the artery wall.

Aneurysms most commonly occur in arteries at the base of the brain (the circle of Willis) and in the aorta (the main artery coming out of the heart, a so-called aortic aneurysm). As the size of an aneurysm increases, there is an increased risk of rupture, which can result in severe hemorrhage, other complications or even death.

Most aneurysms occur in the aorta—the main artery that carries blood from the heart to the rest of the body. The aorta goes through the chest and abdomen.

An aneurysm that occurs in the part of the aorta that’s in the chest is called a thoracic (tho-RAS-ik) aortic aneurysm. An aneurysm that occurs in the part of the aorta that’s in the abdomen is called an abdominal aortic aneurysm.Aneurysms also can occur in other arteries, but these types of aneurysm are less common.

About 14,000 Americans die each year from aortic aneurysms. Most of the deaths result from rupture or dissection.

Early diagnosis and medical treatment can help prevent many cases of rupture and dissection. However, aneurysms can develop and become large before causing any symptoms. Thus, people who are at high risk for aneurysms can benefit from early, routine screening.

Types:
Aortic Aneurysms:
The two types of aortic aneurysm are abdominal aortic aneurysm (AAA) and thoracic aortic aneurysm (TAA).

CLICK TO SEE    &  CLICK TO SEE

Abdominal Aortic Aneurysms:
An aneurysm that occurs in the part of the aorta that’s located in the abdomen is called an abdominal aortic aneurysm. AAAs account for 3 in 4 aortic aneurysms. They’re found more often now than in the past because of computed tomography (to-MOG-rah-fee), or CT, scans done for other medical problems.

Small AAAs rarely rupture. However, an AAA can grow very large without causing symptoms. Thus, routine checkups and treatment for an AAA are important to prevent growth and rupture.

Thoracic Aortic Aneurysms:
An aneurysm that occurs in the part of the aorta that’s located in the chest and above the diaphragm is called a thoracic aortic aneurysm. TAAs account for 1 in 4 aortic aneurysms.

TAAs don’t always cause symptoms, even when they’re large. Only half of all people who have TAAs notice any symptoms. TAAs are found more often now than in the past because of chest CT scans done for other medical problems.

With a common type of TAA, the walls of the aorta weaken, and a section close to the heart enlarges. As a result, the valve between the heart and the aorta can’t close properly. This allows blood to leak back into the heart.

A less common type of TAA can develop in the upper back, away from the heart. A TAA in this location may result from an injury to the chest, such as from a car crash.

Other Types of Aneurysms:-
Brain Aneurysms
When an aneurysm occurs in an artery in the brain, it’s called a cerebral (seh-RE-bral or SER-eh-bral) aneurysm or brain aneurysm. Brain aneurysms also are sometimes called berry aneurysms because they’re often the size of a small berry.
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The illustration shows a typical location of a brain (berry) aneurysm in the arteries supplying blood to the brain. The inset image shows a closeup view of the sac-like aneurysm.

Most brain aneurysms cause no symptoms until they become large, begin to leak blood, or rupture. A ruptured brain aneurysm causes a stroke.

Peripheral Aneurysms:
Aneurysms that occur in arteries other than the aorta and the brain arteries are called peripheral aneurysms. Common locations for peripheral aneurysms include the popliteal (pop-li-TE-al), femoral (FEM-o-ral), and carotid (ka-ROT-id) arteries.

The popliteal arteries run down the back of the thighs, behind the knees. The femoral arteries are the main arteries in the groin. The carotid arteries are the two main arteries on each side of your neck.

Peripheral aneurysms aren’t as likely to rupture or dissect as aortic aneurysms. However, blood clots can form in peripheral aneurysms. If a blood clot breaks away from the aneurysm, it can block blood flow through the artery.

If a peripheral aneurysm is large, it can press on a nearby nerve or vein and cause pain, numbness, or swelling.

Symptoms:–
Symptoms are linked to how big the aneurysm is, how fast it is growing and its location. Very small aneurysms which do not grow may go completely unnoticed. A large cerebral aneurysm (in the brain) may press on nerve tissue and trigger numbness in the face, or problems with the eyes.

Cerebral (brain) aneurysm symptoms:

The following symptoms may be experienced before a cerebral aneurysm ruptures:
Very severe headache that occurs suddenly
#Nausea
#Vomiting
#Eyesight problems
#Seizures (fits)
#Loss of consciousness
#Confusion
#A drooping eyelid
#Stiff neck
#Light sensitivity
If the cerebral aneurism bursts it will cause bleeding in the brain and a hemorrhagic stroke – it can also cause intracranial hematoma (blood leaks into the area surrounding the brain causing a blood clot in the skull).

Aortic aneurysm symptoms:

The vast majority of aortic aneurysms occur in the patient’s abdominal aorta. It is not uncommon for a patient to have an aneurysm and experience no symptoms for several years. Many of them are difficult to detect because of this. Some aortic aneurysms will never rupture. It is hard to predict which ones will never grow, which grow slowly, and which ones grow rapidly.

When symptoms occur, they tend to include:
A throbbing sensation in the abdomen
#Back pain
#Abdominal pain – this pain frequently spreads towards the back If the aneurysm continues to grow and presses on the spine or chest organs the patient may #experience:
#Coughing
#Loss of voice
#Breathing difficulties
#Problems swallowing

Sometimes an aortic aneurysm can be discovered by a GP (general practitioner, primary care physician) when performing a routine examination of the abdomen. He/she may detect a lump that pulses at the same rate as the patient’s heartbeat – it is often located high up in the abdomen, slightly to the right.

Causes:
The force of blood pushing against the walls of an artery combined with damage or injury to the artery’s walls can cause an aneurysm.

A number of factors can damage and weaken the walls of the aorta and cause aortic aneurysms.

Aging, smoking, high blood pressure, and atherosclerosis (ath-er-o-skler-O-sis) are all factors that can damage or weaken the walls of the aorta. Atherosclerosis is the hardening and narrowing of the arteries due to the buildup of a fatty material called plaque (plak).

Rarely, infections, such as untreated syphilis (a sexually transmitted infection), can cause aortic aneurysms. Aortic aneurysms also can occur as a result of diseases that inflame the blood vessels, such as vasculitis (vas-kyu-LI-tis).

Family history also may play a role in causing aortic aneurysms.

In addition to the factors above, certain genetic conditions may cause thoracic aortic aneurysms (TAAs). Examples include Marfan syndrome, Loeys-Dietz syndrome, and Ehlers-Danlos syndrome (the vascular type).

These conditions can weaken the body’s connective tissues and damage the aorta. People who have these conditions tend to develop aneurysms at a younger age and are at higher risk for rupture or dissection.

Trauma, such as a car accident, also can damage the aorta walls and lead to TAAs.

Researchers continue to look for other causes of aortic aneurysms. For example, they’re looking for genetic mutations that may contribute to or cause aneurysms.

Risk Factors:-

Who Is At Risk for an Aneurysm?
Certain factors put you at higher risk for an aortic aneurysm. These include:

#Male gender. Men are more likely than women to have abdominal aortic aneurysms (AAAs)-the most common type of aneurysm.
#Age. The risk for AAAs increases as you get older. These aneurysms are more likely to occur in people who are 65 or older.
#Smoking. Smoking can damage and weaken the walls of the aorta.
#Family history of aortic aneurysm. People who have family histories of aortic aneurysm are at higher risk of having one, and they may have aneurysms before the age of 65.
#Certain diseases and conditions that weaken the walls of the aorta. For more information.

Car accidents or trauma also can injure the arteries and increase your risk for an aneurysm.
Diagnosis:–
If you have aortic aneurysm, but no symptoms, your doctor may find it by chance during a routine physical exam. More often, doctors find aneurysms during tests done for other reasons, such as chest or abdominal pain.

If you have an abdominal aortic aneurysm (AAA), your doctor may feel a throbbing mass in your abdomen. A rapidly growing aneurysm about to rupture can be tender and very painful when pressed. If you’re overweight or obese, it may be hard for your doctor to feel even a large AAA.

If you have an AAA, your doctor may hear rushing blood flow instead of the normal whooshing sound when listening to your abdomen with a stethoscope.

Specialists Involved
Your primary care doctor may refer you to a cardiothoracic or vascular surgeon for diagnosis and treatment of an aortic aneurysm.

A cardiothoracic surgeon performs surgery on the heart, lungs, and other organs and structures in the chest, including the aorta. A vascular surgeon performs surgery on the aorta and other blood vessels, except those of the heart and brain.

Diagnostic Tests and Procedures:-
To diagnose and evaluate an aneurysm, your doctor may recommend one or more of the following tests.

Ultrasound :
This simple, painless test uses sound waves to create pictures of the structures inside your body. Ultrasound shows the size of an aneurysm, if one is found.

Computed Tomography Scan:
A computed tomography (CT) scan is a painless test that uses x rays to take clear, detailed pictures of your internal organs.

During the test, your doctor will inject a special dye into a vein in your arm. This dye highlights the aorta on the CT scan images.

Your doctor may recommend this test if he or she thinks you have an AAA or a thoracic aortic aneurysm (TAA). A CT scan can show the size and shape of an aneurysm. This test provides more detailed images than an ultrasound.

Magnetic Resonance Imaging:
Magnetic resonance imaging (MRI) uses magnets and radio waves to create images of the organs and structures in your body. This test is very accurate at detecting aneurysms and pinpointing their size and exact location.

Angiography:
Angiography (an-jee-OG-ra-fee) uses a special dye injected into the bloodstream to highlight the insides of arteries on x-ray pictures. An angiogram shows the amount of damage and blockage in blood vessels.

An angiogram of the aorta is called an aortogram. An aortogram may show the location and size of an aortic aneurysm.

Treatment:
Aortic aneurysm treatment:

The aim is to prevent the aneurysm from bursting. There are usually two choices – 1. Watch and wait. 2. Surgery. How big the aneurysm is, how fast it’s growing, and sometimes its location are vital factors in determining what treatment to use.

#If the aneurysm is small – if the patient’s aneurysm is no bigger than 1.6 inches (about 4cm) in diameter, and there are no symptoms, it may be best to tack the approach of watching-and-waiting, instead of surgery. This is also known as “watchful waiting”. In most cases the risks caused by surgery are greater than the likely risks caused by a small aneurysm. Watchful waiting usually involves an ultrasound scan every 6 to 12 months. The patient will be asked to be alert for any signs or symptoms of dissection or rupture.

Small observational studies have suggested that statins can significantly reduce the growth rate of small abdominal aortic aneurysms, Janet T. Powell, M.D., Ph.D., Professor at Imperial College and Honorary Consultant for United Healthcare in London revealed.

#If the aneurysm is medium-sized – a medium-sized aneurysm is no bigger than 2.2 inches (5.5 cm) in diameter and bigger than 1.6 inches (4 cm). It is more difficult now to weigh up the risks of surgery against the risks of a medium-sized aneurysm. The chances of both patient and doctor deciding on one or the other are pretty even.

#Large-sized or rapidly-growing aneurysm – a large aneurysm is larger than 2.2 inches (5.5 cm) in diameter, while a rapidly growing one is expanding at more than 0.5 cm every six months. In most cases the patient will require surgery. The damaged section of the aorta will be removed and replaced with a graft (synthetic tube) which is sewn into place. This is major surgery – open-abdominal or open-chest surgery. The patient will take several months to recover completely.

Endovascular surgery – this is a less invasive procedure to repair an aneurysm. A graft is attached to the end of the catheter which is inserted through an artery and threaded up into the aorta. The graft – consisting of a woven tube covered by a metal mesh support – is placed at the site of the aneurysm and stuck there will pins or small hooks. This graft strengthens the weakened section of the aorta and prevents the aneurysm from rupturing. Patients recover much faster with this procedure, and seem to have fewer complications.

CLICK TO SEE
The illustration shows the placement of an endovascular stent graft in an aortic aneurysm. In figure A, a catheter is inserted into an artery in the groin (upper thigh). The catheter is threaded to the abdominal aorta, and the stent graft is released from the catheter. In figure B, the stent graft allows blood to flow through the aneurysm.

Endovascular repair reduces recovery time to a few days and greatly reduces time in the hospital. However, doctors can’t repair all aortic aneurysms with this procedure. The location or size of the aneurysm may prevent a stent graft from being safely or reliably placed inside the aneurysm.

Long-term survival for patients undergoing surgical repair of intact abdominal aortic aneurysms has improved in recent decades, according to a Swedish study.

Thoracic aortic aneurysm treatment:

Surgery is usually required as soon as the aneurysm reaches a diameter of 2.2 inches (5.5 cm). Patients with Marfan syndrome, as well as those with close relative who had an aortic dissection may undergo surgery if the aneurysm is smaller. Beta blockers have been shown to slow down the growth of thoracic aortic aneurysms for patients with Marfan syndrome.

Cerebral (brain) aneurysm treatment:

Ruptured cerebral aneurysm treatment

Patients with brain aneurysms have two options if the aneurysm has ruptured: 1. Surgical clipping. 2. Endovascular coiling.

#Surgical clipping – the aneurysm is closed off. The surgeon removes a section of the skull to get to the aneurysm and finds the blood vessel that feeds it. A tiny metal clip is placed on the neck of the aneurysm to block off the blood flow to it.

#Endovascular coiling – a catheter is inserted, usually in the groin, and is threaded through the body to the brain where the aneurysm is located. A guide wire is used to push a soft platinum wire through the catheter and into the aneurysm. The wire coils up inside the aneurysm and disrupts the blood flow, making it clot. The clotting of the blood effectively seals off the aneurysm from the artery.

#Endovascular, noninvasive thoracic aortic aneurysm repair (TEVAR) is safer than open aneurysm repair (OAR) as it is associated with fewer cardiac, respiratory, and hemorrhagic complications, as well as a shorter hospital stay, this study revealed.

Patients whose aneurysms are coiled instead of clipped have a better survival rate over five years, according to a long-term study of the International Subarachnoid Aneurysm Trial (ISAT). However, another study found that over time outcomes are similar.

Smokers who undergo coil embolization are at a high risk of having another aneurism elsewhere later on, this study revealed .

The following cerebral aneurysm treatments help relieve symptoms as well as managing complications:

#Painkillers – usually for headaches.

#Calcium channel blockers – these stop calcium for entering cells of the blood vessel walls. They reduce the amount of widening and narrowing of blood vessels; often a complication of a ruptured aneurysm.

#A vassopressor – this is an injected drug which raises blood pressure; widens blood vessels which have remained stubbornly narrowed. The aim is to prevent stroke.

#Anti-seizure drugs – seizures may occur after an aneurysm has ruptures. Examples include levetiracetam (Keppra), phenytoin (Dilantin, Phenytek, others) and valproic acid (Depakene).

#A ventricular catheter – this can reduce the pressure on the brain caused by hydrocephalus (excess cerebrospinal fluid). The catheter, which is placed in the spaces filled with fluid inside the brain, drains the excess liquid into an external bag. It may be necessary to place a shunt system – a shunt (flexible silicone rubber tube) and a valve. The shunt system is a drainage channel that starts in the brain and ends in the patient’s abdominal cavity.

#Rehabilitation therapy – sometimes a subarachnoid hemorrhage causes brain damage, resulting in impaired speech and bodily movements. Rehabilitation therapy helps the patient relearn vital skills.

Unruptured cerebral aneurysm treatment:

The unruptured cerebral aneurysm can be sealed off with surgical clipping or endovascular coiling. Deciding on this is not easy as the risks are often equal, and sometimes higher than the potential benefits. The following will help the surgeon determine what to do:

#Exactly where the aneurysm is.
#How big the aneurysm is.
#The patient’s age.
#The patient’s general state of health
#Whether the patient has a family history of ruptured aneurysms.
#Whether the patient has any congenital conditions which may raise the risk of the aneurysm rupturing.

Patients with hypertension (high blood pressure) need to have their condition carefully monitored – proper control of hypertension significantly reduces the likelihood of a rupture.
Prevention:
The best way to prevent an aortic aneurysm is to avoid the factors that put you at higher risk for one. You can’t control all of the risk factors for aortic aneurysm, but lifestyle changes can help you reduce some risks.

Lifestyle changes include quitting smoking and controlling conditions such as high blood pressure and high blood cholesterol.

Talk to your doctor about programs and products that can help you quit smoking. Also try to avoid secondhand smoke.

Follow a healthy diet and be as physically active as you can. A healthy diet includes a variety of fruits, vegetables, and whole grains.

It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. A healthy diet is low in saturated fat, trans fat, cholesterol, sodium (salt), and added sugar.

For more information on following a healthy diet, see the National Heart, Lung, and Blood Institute’s (NHLBI’s) Aim for a Healthy Weight Web site, “Your Guide to a Healthy Heart,” and “Your Guide to Lowering Your Blood Pressure With DASH.” All of these resources include general information about healthy eating.

Talk to your doctor about the amounts and types of physical activity that are safe for you. For more information on physical activity, see the Diseases and Conditions Index Physical Activity and Your Heart article and NHLBI’s “Your Guide to Physical Activity and Your Heart.”

Follow your treatment plans for any other medical conditions you have. Take all of your medicines as prescribed.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources;
http://www.nhlbi.nih.gov/health/dci/Diseases/arm/arm_treatments.html
http://en.wikipedia.org/wiki/Aneurysm
http://www.medicalnewstoday.com/articles/156993.php

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Health Problems & Solutions

Some Health Quaries & Answers

 

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A: The manufacturers of Today claim 89 to 91 per cent efficiency, if used correctly. It is a spermicide — that is, it kills any sperm that comes into contact with it. It has to be inserted prior to intercourse and left inside for a minimum of six hours. Independent consumer surveys have placed the efficiency at around 65 per cent. The effectiveness increases to 99 per cent if used with condoms.

Invasive thymoma
——————————-
Q: I had a cough. When a chest X-ray was taken, I was found to have “invasive thymoma”. What is that?

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A: The thymus is a gland situated in front of the chest. It usually involutes and disappears after puberty. However, it can persist and grow, forming a “thymoma”. This can present at any age but is commoner after the age of 50. It causes no symptoms in a third of the people (as in your case) and is picked up only during a routine X-ray. As it is situated close to the heart, lungs and large blood vessels in the chest, it can penetrate and invade these structures forming an “invasive thymoma”.Treatment involves surgery radiation and chemotherapy. Take your doctor’s advice and go to a tertiary care hospital that specialises in cancer treatment.

Gay matter
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Q: My cousin is a homosexual. Is there any medication that can be given to him?

click & see

A: The reason for sexual orientation is still tentative and not proven. It is probably the result of a combination of genetic, hormonal and environmental factors. There have been some articles recently in biology journals speculating that sexual orientation depends on whether the person has a preponderance of male or female receptor pheromones. This is genetic. Sexual orientation is established in early childhood. This gives credence to the genetic theory. There is no scientific evidence that abnormal parenting, sexual abuse or other adverse life event influences sexual orientation. Being “gay” is not due to a chemical imbalance in the brain. There is no medication to change it.

Always tearful…click & see
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Q: My mother has tears rolling out of her left eye all the time. Please help.

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A: There is a small opening in the lower eye lid near the bridge of the nose which leads into the lachrymal (tear) duct and also opens into the nose. The opening near the eye lid seems to have become blocked . This is commoner in women after menopause and can occur for a variety of reasons. An ophthalmologist can determine if it is due to an infection or if debris has blocked it. Medical treatment for the infection involves massage, drops and ointments. If these do not work, surgery may be required.

Lump near genitalia
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Q: I have a lump on the right side of my penis. It hurts when I stand up but I cannot feel it when I lie down….click & see

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A: It sounds like you have inguinal hernia. Since it disappears when you lie down, it means the hernia is still reducible and has not become obstructed. You need to see a surgeon to have it corrected. It is not a tumour or cancer.

Source: The Telegraph (Kolkata, India)

 
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