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Nattokinase May Soon be Sold as Aspirin Replacement to Treat Thromboses

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What Is Nattokinase?
Nattokinase is a potent fibrinolytic (anti-clotting) enzyme complex extracted and highly purified from a traditional Japanese food called Natto. Natto is a fermented cheese-like food that has been used in Japanese culture for more than 1,000 years for its popular taste, and as a folk remedy for heart and vascular diseases. Research has shown that Nattokinase supports the body in breaking up and dissolving the unhealthy coagulation of blood. In fact, it has been shown to have four times greater fibrinolytic activity than plasmin.4

click & see the pictures….…...Natto……...Nattokinase

How is it made?
Natto is produced by a fermentation process by adding the bacteria Bacillus subtilis to boiled soybeans. The resulting Nattokinase enzyme is produced when Bacillus subtilis acts on the soybeans. While other soy foods contain enzymes, it is only the natto preparation that contains the specific Nattokinase enzyme.

How was Nattokinase discovered?… Japanese researcher Dr. Hiroyuki Sumi had spent many years searching for a natural thrombolytic agent that could successfully dissolve blood clots associated with heart attacks and stroke. Finally in 1980, after testing more than 173 natural foods, Sumi found what he was looking for.

Natto, a traditional Japanese soy cheese(commonly eaten for breakfast in Japan), was dropped onto an artificial thrombus (fibrin) in a petri dish and allowed to stand at 37ºC (approximately body temperature). Over the next 18 hours, the thrombus around the natto completely dissolved! Sumi named the newly discovered enzyme Nattokinase, which means “enzyme in natto.” Dr. Sumi remarked that Nattokinase showed “a potency matched by no other enzyme.”

 

You may click to see :Natto and Nattokinase

The American Academy of Orthopedic Surgeons has said that taking aspirin may not prevent deep vein thrombosis (DVT), which is the formation of a clot in the blood vessels, usually in a vein deep within the legs or hips.

How does  Nattokinase work
Nattokinase enhances the body’s natural ability to fight blood clots, and has an advantage over blood thinners because it has a prolonged effect without side effects.

*Supports normal blood pressure
*Prevents blood clots from forming
*Dissolves existing blood clots
*Dissolves fibrin
*Enhances the body’s production of plasmin and other clot-dissolving agents, including urokinase

Research studies
Nattokinase has been the subject of 17 studies, including two small human trials. In 1990, Dr. Sumi’s research team published a series of studies demonstrating the fibrinolytic effects of Nattokinase.9 Here are some of them:

Dissolves blood clots

Researchers from JCR Pharmaceuticals, Oklahoma State University, and Miyazaki Medical College, tested Nattokinase on 12 healthy Japanese volunteers (6 men and 6 women, between the ages of 21 and 55). The researchers gave the volunteers 7 ounces of natto (the food) before breakfast, and then tracked fibrinolytic activity through a series of blood plasma tests....click & see

In one test, a blood sample was taken and a thrombus (clot) was artificially induced. The amount of time needed to dissolve the clot was cut in half within 2 hours of treatment, compared to the control group. Additionally, the volunteers retained an enhanced ability to dissolve blood clots for up to 8 hours.9

Dr. Sumi’s team also induced blood clots in a major leg vein in male dogs that had been given either four capsules of Nattokinase (250 mg per capsule) or four placebo capsules. Angiograms (x-rays of blood vessels) showed that the blood clots in the dogs that received Nattokinase had completely dissolved within 5 hours of treatment, and that normal blood circulation had been restored. Blood clots in the dogs who received the placebo showed no sign of dissolving 18 hours after the treatment.9

Researchers from Biotechnology Research Laboratories and JCR Pharmaceuticals Co. of Kobe, Japan, tested Nattokinase’s ability to dissolve a blood clot in the carotid arteries of rats. Animals treated with Nattokinase regained 62 percent of blood flow, whereas those treated with plasmin regained just 15.8 percent of blood flow.19

In another laboratory study, endothelial damage was induced in the femoral arteries of rats that had been given Nattokinase. In normal circumstances, a thickening of the artery walls and blood clotting would occur, but they were both suppressed because of Nattokinase’s fibrinolytic activity.

A recent study found that airline passengers given three daily doses of nattokinase were less likely to develop a DVT during a flight.


Helps reduce high blood pressure

Human volunteers with high blood pressure were given 30 grams of natto extract (equivalent to 7 ounces of natto food), orally for 4 consecutive days. In 4 out of 5 volunteers, the systolic blood pressure decreased on average from 173.8 to 154.8. Diastolic blood pressure decreased on average from 101.0 to 91.2. This data represents about a 10.9 percent drop in systolic blood pressure and a 9.7 percent drop in diastolic blood pressure.5911

Wistar rats that were given natto extract showed a significant drop in systolic blood pressure also, from an average of 166 to 145 in just two hours, which further decreased to an average of 144 in 3 hours. This data represents an approximate 12.7 percent drop in systolic blood pressure also, from an average of 166 to 145 in just two hours, which further decreased to an average of 144 in three hours. This data represents an approximate 12.7 percent drop in systolic blood pressure within two hours.5,9,11

These tests all indicate that Nattokinase generates a heightened ability in the body to dissolve blood clots.

Restores blood circulation

This is one of the most dramatic, documented stories about the effects of Nattokinase. A 58-year-old man had a blood clot in the retina of his right eye that caused fluid build up and bleeding. He started losing his vision in that eye and was admitted to a university hospital, where researchers prescribed a 3-ounce dose of natto to be taken before bed every night, in order to get the benefit of Nattokinase.

The man’s bleeding completely stopped by the tenth day, and by the 20th day, his vision returned and he was released from the hospital. He continued to eat natto twice a week. When he had a retinal angiogram two months later, it showed that the blood clot was completely gone.12

The traditional Japanese food Natto has been used safely for more than 1,000 years. The safety record of its potent fibrinolytic enzyme, Nattokinase, is based upon the long-term traditional use of the food and recent scientific studies.

Nattokinase has many benefits including its prolonged effects, cost effectiveness, and its ability to be used preventatively. It is a naturally occurring, food-based dietary supplement that has demonstrated stability in the gastrointestinal tract, as well as to changes in pH and temperature. It is definitely a nutritional supplement to consider adding to a cardiovascular health maintenance plan.

While currently it is rarely used clinically, the article in the JAAPA suggests that further clinical trials of nattokinase may cement its potential health benefits.

Resources:
*Better Health Research :
*Smart Publications :
*http://www.naturalypure.com/NattokinasePlus.htm

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Ailmemts & Remedies

Pulmonary Embolism

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Definition:-
Pulmonary embolism (PE) is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism). Usually this is due to embolism of a thrombus (blood clot) from the deep veins in the legs, a process termed venous thromboembolism. A small proportion is due to the embolization of air, fat or amniotic fluid. The obstruction of the blood flow through the lungs and the resultant pressure on the right ventricle of the heart leads to the symptoms and signs of PE. The risk of PE is increased in various situations, such as cancer and prolonged bed rest..

You may click to see more pictures of Pulmonary Embolism
Pulmonary embolism is a condition that occurs when one or more arteries in your lungs become blocked. In most cases, pulmonary embolism is caused by blood clots that travel to your lungs from another part of your body — most commonly, your legs.

Symptoms:-
Symptoms of PE are sudden-onset dyspnea (shortness of breath), tachypnea (rapid breathing), chest pain of a “pleuritic” nature (worsened by breathing), cough and hemoptysis (coughing up blood). More severe cases can include signs such as cyanosis (blue discoloration, usually of the lips and fingers), collapse, and circulatory instability. About 15% of all cases of sudden death are attributable to PE.

On physical examination, a pleural rub may be audible by stethoscope over affected areas of the lung. Strain on the right ventricle may be detected as a left parasternal heave, a loud pulmonary component of the second heart sound, raised jugular venous pressure, and more rarely leg swelling.

A fever though usually low grade is present in 14% of people with pulmonary embolism.

Symptoms of pulmonary embolism include difficulty breathing, chest pain on inspiration, and palpitations. Clinical signs include low blood oxygen saturation and cyanosis, rapid breathing, and a rapid heart rate. Severe cases of PE can lead to collapse, abnormally low blood pressure, and sudden death.

Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs. These blood clots most commonly originate in the deep veins of your legs, but they can also come from other parts of your body. This condition is known as deep vein thrombosis (DVT).

Occasionally, other substances can form blockages within the blood vessels inside your lungs. Examples include:

*Fat from within the marrow of a broken bone
*Part of a tumor
*Air bubbles

It’s rare to experience a solitary pulmonary embolism. In most cases, multiple clots are involved. The lung tissue served by each blocked artery is robbed of fuel and may die. This makes it more difficult for your lungs to provide oxygen to the rest of your body.

Because pulmonary embolism almost always occurs in conjunction with deep vein thrombosis, some doctors refer to the two conditions together as venous thromboembolism (VTE).

Causes:-

In 9 out of 10 cases, pulmonary embolism (PE) begins as a blood clot in the deep veins of the leg (a condition known as deep vein thrombosis). The clot breaks free from the vein and travels through the bloodstream to the lungs, where it can block an artery.Click to see to learn more

Diagnosis:-
The diagnosis of PE is based primarily on validated clinical criteria combined with selective testing because the typical clinical presentation (shortness of breath, chest pain) cannot be definitively differentiated from other causes of chest pain and shortness of breath. The decision to do medical imaging is usually based on clinical grounds, i.e. the medical history, symptoms and findings on physical examination, followed by an assessment of clinical probability.

The most commonly used method to predict clinical probability, the Wells score, is a clinical prediction rule, whose use is complicated by multiple versions being available. In 1995, Wells et al. initially developed a prediction rule (based on a literature search) to predict the likelihood of PE, based on clinical criteria. The prediction rule was revised in 1998 This prediction rule was further revised when simplified during a validation by Wells et al. in 2000. In the 2000 publication, Wells proposed two different scoring systems using cutoffs of 2 or 4 with the same prediction rule. In 2001, Wells published results using the more conservative cutoff of 2 to create three categories. An additional version, the “modified extended version”, using the more recent cutoff of 2 but including findings from Wells’s initial studies were proposed. Most recently, a further study reverted to Wells’s earlier use of a cutoff of 4 points to create only two categories.

There are additional prediction rules for PE, such as the Geneva rule. More importantly, the use of any rule is associated with reduction in recurrent thromboembolism.

The Wells score:
*Clinically suspected DVT – 3.0 points
*Alternative diagnosis is less likely than PE – 3.0 points
*Tachycardia – 1.5 points
*Immobilization/surgery in previous four weeks – 1.5 points
*History of DVT or PE – 1.5 points
*Hemoptysis – 1.0 points
*Malignancy (treatment for within 6 months, palliative) – 1.0 points

Traditional interpretation

*Score >6.0 – High (probability 59% based on pooled data)
*Score 2.0 to 6.0 – Moderate (probability 29% based on pooled data)
*Score <2.0 – Low (probability 15% based on pooled data)

Alternate interpretation.
:-
*Score > 4 – PE likely. Consider diagnostic imaging.
*Score 4 or less – PE unlikely. Consider D-dimer to rule out PE.

Blood tests:-
In low/moderate suspicion of PE, a normal D-dimer level (shown in a blood test) is enough to exclude the possibility of thrombotic PE.

When a PE is being suspected, a number of blood tests are done, in order to exclude important secondary causes of PE. This includes a full blood count, clotting status (PT, APTT, TT), and some screening tests (erythrocyte sedimentation rate, renal function, liver enzymes, electrolytes). If one of these is abnormal, further investigations might be warranted.

Non-invasive imaging:-
CT pulmonary angiography (CTPA) is a pulmonary angiogram obtained using computed tomography (CT) with radiocontrast rather than right heart catheterization. Its advantages are clinical equivalence, its non-invasive nature, its greater availability to patients, and the possibility of identifying other lung disorders from the differential diagnosis in case there is no pulmonary embolism. Assessing the accuracy of CT pulmonary angiography is hindered by the rapid changes in the number of rows of detectors available in multidetector CT (MDCT) machines.[14] A study with a mixture of 4 slice and 16 slice scanners reported a sensitivity of 83% and a specificity of 96%. This study noted that additional testing is necessary when the clinical probability is inconsistent with the imaging results.[15] CTPA is non-inferior to VQ scanning, and identifies more emboli (without necessarily improving the outcome) compared to VQ scanning

Ventilation/perfusion scan (or V/Q scan or lung scintigraphy), which shows that some areas of the lung are being ventilated but not perfused with blood (due to obstruction by a clot). This type of examination is used less often because of the more widespread availability of CT technology, however, it may be useful in patients who have an allergy to iodinated contrast or in pregnancy due to lower radiation exposure than CT

Ventilation/perfusion scan (or V/Q scan or lung scintigraphy), which shows that some areas of the lung are being ventilated but not perfused with blood (due to obstruction by a clot). This type of examination is used less often because of the more widespread availability of CT technology, however, it may be useful in patients who have an allergy to iodinated contrast or in pregnancy due to lower radiation exposure than CT.

Low probability diagnostic tests/non-diagnostic tests:-

Tests that are frequently done that are not sensitive for PE, but can be diagnostic.

*Chest X-rays are often done on patients with shortness of breath to help rule-out other causes, such as congestive heart failure and rib fracture. Chest X-rays in PE are rarely normal,[18] but usually lack signs that suggest the diagnosis of PE (e.g. Westermark sign, Hampton’s hump).

*Ultrasonography of the legs, also known as leg doppler, in search of deep venous thrombosis (DVT). The presence of DVT, as shown on ultrasonography of the legs, is in itself enough to warrant anticoagulation, without requiring the V/Q or spiral CT scans (because of the strong association between DVT and PE). This may be valid approach in pregnancy, in which the other modalities would increase the risk of birth defects in the unborn child. However, a negative scan does not rule out PE, and low-radiation dose scanning may be required if the mother is deemed at high risk of having pulmonary embolism.

Electrocardiogram findings:-
Electrocardiogram of a patient with pulmonary embolism showing sinus tachycardia of approximately 150 beats per minute and right bundle branch block.An electrocardiogram (ECG) is routinely done on patients with chest pain to quickly diagnose myocardial infarctions (heart attacks). An ECG may show signs of right heart strain or acute cor pulmonale in cases of large PEs – the classic signs are a large S wave in lead I, a large Q wave in lead III and an inverted T wave in lead III (“S1Q3T3”). This is occasionally (up to 20%) present, but may also occur in other acute lung conditions and has therefore limited diagnostic value. The most commonly seen signs in the ECG is sinus tachycardia, right axis deviation and right bundle branch block. Sinus tachycardia was however still only found in 8 – 69% of people with PE.

Echocardiography findings:-
In massive and submassive PE, dysfunction of the right side of the heart can be seen on echocardiography, an indication that the pulmonary artery is severely obstructed and the heart is unable to match the pressure. Some studies  suggest that this finding may be an indication for thrombolysis. Not every patient with a (suspected) pulmonary embolism requires an echocardiogram, but elevations in cardiac troponins or brain natriuretic peptide may indicate heart strain and warrant an echocardiogram.

The specific appearance of the right ventricle on echocardiography is referred to as the McConnell sign. This is the finding of akinesia of the mid-free wall but normal motion of the apex. This phenomenon has a 77% sensitivity and a 94% specificity for the diagnosis of acute pulmonary embolism.

Combining tests into algorithms:-
Recent recommendations for a diagnostic algorithm have been published by the PIOPED investigators; however, these recommendations do not reflect research using 64 slice MDCT.[12] These investigators recommended:

*Low clinical probability. If negative D-dimer, PE is excluded. If positive D-dimer, obtain MDCT and based treatment on results.

*Moderate clinical probability. If negative D-dimer, PE is excluded. However, the authors were not concerned that a negative MDCT with negative D-dimer in this setting has an 5% probability of being false. Presumably, the 5% error rate will fall as 64 slice MDCT is more commonly used. If positive D-dimer, obtain MDCT and based treatment on results.

*High clinical probability. Proceed to MDCT. If positive, treat, if negative, additional tests are needed to exclude PE.

Pulmonary Embolism Rule-out Criteria:-
The Pulmonary Embolism Rule-out Criteria, or PERC rule, helps assess patients in whom pulmonary embolism is suspected, but unlikely. Unlike the Wells Score and Geneva score, which are clinical prediction rules intended to risk stratify patients with suspected PE, the PERC rule is designed to rule-out risk of PE in patients when the physician has already stratified them into a low-risk category.

Patients in this low risk category without any of these criteria may undergo no further diagnostic testing for PE: Hypoxia – Sa02 <95%, unilateral leg swelling, hemoptysis, prior DVT or PE, recent surgery or trauma, age >50, hormone use, tachycardia. The rationale behind this decision is that further testing (specifically CT angiogram of the chest) may cause more harm (from radiation exposure and contrast dye) than the risk of PE.[24] The PERC rule has a sensitivity of 97.4% and specificity of 21.9% with a false negative rate of 1.0% (16/1666).

Treatment:-
In most cases, anticoagulant therapy is the mainstay of treatment. Acutely, supportive treatments, such as oxygen or analgesia, are often required.

Anticoagulation:-
In most cases, anticoagulant therapy is the mainstay of treatment. Heparin, low molecular weight heparins (such as enoxaparin and dalteparin), or fondaparinux is administered initially, while warfarin, acenocoumarol, or phenprocoumon therapy is commenced (this may take several days, usually while the patient is in hospital). It however may be possible to treat low risk patients as outpatients. An ongoing study is looking into the safety of this practice. Warfarin therapy often requires frequent dose adjustment and monitoring of the INR. In PE, INRs between 2.0 and 3.0 are generally considered ideal. If another episode of PE occurs under warfarin treatment, the INR window may be increased to e.g. 2.5-3.5 (unless there are contraindications) or anticoagulation may be changed to a different anticoagulant e.g. low molecular weight heparin. In patients with an underlying malignancy, therapy with a course of low molecular weight heparin may be favored over warfarin based on the results of the CLOT trial. Similarly, pregnant women are often maintained on low molecular weight heparin to avoid the known teratogenic effects of warfarin, especially in the early stages of pregnancy. People are usually admitted to hospital in the early stages of treatment, and tend to remain under inpatient care until INR has reached therapeutic levels. Increasingly, low-risk cases are managed on an outpatient basis in a fashion already common in the treatment of DVT.

Warfarin therapy is usually continued for 3–6 months, or “lifelong” if there have been previous DVTs or PEs, or none of the usual risk factors is present. An abnormal D-dimer level at the end of treatment might signal the need for continued treatment among patients with a first unprovoked pulmonary embolus.

Thrombolysis:-
Massive PE causing hemodynamic instability (shock and/or hypotension, defined as a systolic blood pressure <90 mmHg or a pressure drop of 40 mmHg for>15 min if not caused by new-onset arrhythmia, hypovolemia or sepsis) is an indication for thrombolysis, the enzymatic destruction of the clot with medication. It is the best available medical treatment in this situation and is supported by clinical guidelines.

The use of thrombolysis in non-massive PEs is still debated. The aim of the therapy is to dissolve the clot, but there is an attendant risk of bleeding or stroke. The main indication for thrombolysis is in submassive PE where right ventricular dysfunction can be demonstrated on echocardiography, and the presence of visible thrombus in the atrium.

Surgical management:-
Surgical management of acute pulmonary embolism (pulmonary thrombectomy) is uncommon and has largely been abandoned because of poor long-term outcomes. However, recently, it has gone through a resurgence with the revision of the surgical technique and is thought to benefit selected patients

Chronic pulmonary embolism leading to pulmonary hypertension (known as chronic thromboembolic hypertension) is treated with a surgical procedure known as a pulmonary thromboendarterectomy.

Inferior vena cava filter:-
If anticoagulant therapy is contraindicated and/or ineffective, or to prevent new emboli from entering the pulmonary artery and combining with an existing blockage, an inferior vena cava filter may be implanted.

Prognosis:-
Mortality from untreated PE is said to be 26%. This figure comes from a trial published in 1960 by Barrit and Jordan,[38] which compared anticoagulation against placebo for the management of PE. Barritt and Jordan performed their study in the Bristol Royal Infirmary in 1957. This study is the only placebo controlled trial ever to examine the place of anticoagulants in the treatment of PE, the results of which were so convincing that the trial has never been repeated as to do so would be considered unethical. That said, the reported mortality rate of 26% in the placebo group is probably an overstatement, given that the technology of the day may have detected only severe PEs.

Prognosis depends on the amount of lung that is affected and on the co-existence of other medical conditions; chronic embolisation to the lung can lead to pulmonary hypertension. After a massive PE, the embolus must be resolved somehow if the patient is to survive. In thrombotic PE, the blood clot may be broken down by fibrinolysis, or it may be organized and recanalized so that a new channel forms through the clot. Blood flow is restored most rapidly in the first day or two after a PE. Improvement slows thereafter, and some defects may remain permanently. There is controversy over whether or not small subsegmental PEs need to be treated at all[40] and some evidence exists that patients with subsegmental PEs may do well without treatment.

Predicting mortality:-
The PESI and Geneva prediction rules can estimate mortality and so may guide selection of patients who can be considered for outpatient therapy.

Underlying causes:-
After a first PE, the search for secondary causes is usually brief. Only when a second PE occurs, and especially when this happens while still under anticoagulant therapy, a further search for underlying conditions is undertaken. This will include testing (“thrombophilia screen”) for Factor V Leiden mutation, antiphospholipid antibodies, protein C and S and antithrombin levels, and later prothrombin mutation, MTHFR mutation, Factor VIII concentration and rarer inherited coagulation abnormalities.

Epidemiology:-

Risk factors:-
The most common sources of embolism are proximal leg deep venous thrombosis (DVTs) or pelvic vein thromboses. Any risk factor for DVT also increases the risk that the venous clot will dislodge and migrate to the lung circulation, which happens in up to 15% of all DVTs. The conditions are generally regarded as a continuum termed venous thromboembolism (VTE).

The development of thrombosis is classically due to a group of causes named Virchow’s triad (alterations in blood flow, factors in the vessel wall and factors affecting the properties of the blood). Often, more than one risk factor is present.

*Alterations in blood flow: immobilization (after surgery, injury or long-distance air travel), pregnancy (also procoagulant), obesity (also procoagulant)

*Factors in the vessel wall: of limited direct relevance in VTE

*Factors affecting the properties of the blood (procoagulant state):

*Oestrogen-containing hormonal contraception
*Genetic thrombophilia (factor V Leiden, prothrombin mutation G20210A, protein C deficiency, protein S deficiency, antithrombin deficiency, hyperhomocysteinemia and plasminogen/fibrinolysis disorders).
*Acquired thrombophilia (antiphospholipid syndrome, nephrotic syndrome, paroxysmal nocturnal hemoglobinuria)

Prognosis:-
Once anticoagulation is stopped, the risk of a fatal pulmonary embolism is 0.5% per year

Prevention:-
If you are in hospital for surgery or because of illness, your doctor will suggest some leg exercises you can do, to ensure you keep your legs moving. You will be encouraged to drink plenty of fluids (or may have fluids via a drip if you are unable to drink).

If you are having major surgery, you may be given injections of heparin before your surgery to reduce your risk of getting a DVT or pulmonary embolism. You may also be given elastic compression stockings to wear or a device called an intermittent compression pump to keep the blood flowing through your legs.

*Compression stockings (also called TED or thrombo-embolic deterrent stockings) are usually worn to help maintain circulation and reduce the risk of blood clots forming in the veins of your legs. They come in different sizes and will be checked by nursing staff every day to make sure that they’re the correct size and fit for you. You might be asked to wear them after you have had surgery.

*Intermittent compression pumps help to dissolve blood clots by compressing the calf and/or thigh muscles of your leg. They are usually used straight before or during surgery.

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:-

Researchers May Have Found an Efficient Way to Detect Pulmonary Embolisms


http://en.wikipedia.org/wiki/Pulmonary_embolism
http://www.mayoclinic.com/health/pulmonary-embolism/DS00429/DSECTION=causes

http://hcd2.bupa.co.uk/fact_sheets/html/Pulmonary_embolism.html

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Health Alert

Fit Enough to Fly

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Families are scattered all over  the globe and they travel to stay in touch. Airplanes are safe, despite the high flying altitude, relatively lower partial pressure of oxygen, variable air circulation, low humidity, sustained periods of noise, vibration and turbulence.
…………….
The rapid changes that occur during a flight (typically during descent) can give rise to ear pain, a blocked feeling, ringing in the ears, giddiness, hearing loss or even rupture of the eardrum. These complications are more likely if the Eustachian tube (connecting the ear and throat) is blocked by allergy, colds, sinusitis or middle ear infections. Chewing gum and frequent swallowing during descent can help ease the discomfort.

Decongestant nose drops will clear a blocked nose. Air travel should be avoided for 10 days if there has been a recent ear surgery or tonsillectomy.

Women often need to travel during pregnancy — as part of their jobs, because of transfers or simply to head home to have the baby. Air travel during pregnancy is safe and poses no special risks. Mid pregnancy, from the 14th to 28th week, is the safest time. In the case of multiple pregnancy (twins), a history of premature delivery, cervical incompetence, bleeding or increased uterine activity (irritable uterus), flying is inadvisable. If you need to be elsewhere for the delivery, it is better to leave before the 36th week or use an alternative mode of transport.

Most airlines refuse to allow pregnant passengers after the 36th week because of the fear that labour may set in during the flight. It is better to carry certified medical documentation about the expected date of delivery.

During pregnancy,

• the seat belt should be fastened under the abdomen, not across it;

• an aisle seat is preferable to facilitate visits to the toilet;

• try to get out of the seat every 30 minutes and walk a short distance;

• if this is not possible, flex and extend the ankles.

Babies should, preferably, not fly till they are at least seven days old.

There is a 10-day ban on air travel (not prohibited but inadvisable) after a stroke, brain surgery, an epileptic seizure, eye surgery or ear, nose or throat procedures.

Even in normal people abdominal gas increases by 25 per cent during air travel. A three to four week gap is advisable after abdominal surgery even if it is a “keyhole” or laparoscopic surgery as gas is introduced into the abdomen during the procedure. This extra gas can expand and cause the sutures to give way.

A person with congestive cardiac failure (when the heart does not function properly) should be stable for at least 10 days prior to travel.

In the case of a heart attack the person should have been stable for three to four weeks.

After pneumonia or chest surgery, a person should wait for three weeks
. Even after this time they should be able to walk unassisted for at least 50 metres without becoming breathless.

Anaemia, with haemoglobin count less than 7.5 grams per decilitre, reduces the oxygen carrying capacity of blood. This can get critical during flights.

People with fractures can travel two days after the cast has been applied. In traditional casts air can be trapped between the cast and the leg. As this air expands during the flight, it can compress the limb and cut off blood supply. If a person needs to fly immediately, the doctor needs to be informed beforehand. A bivalved or split cast, which does not trap air, can be applied.

People with mental illness should be well controlled, on medication and preferably have a companion.

Diseases are spread from one country to another by infected travellers. In the recent swine flu epidemic, the spread of the disease could be plotted by tracking the flights out of Mexico (where the epidemic started).

People with open tuberculosis or measles should also defer travel.
If a person has an infectious disease, travelling should be postponed until recovery. Infected air keeps circulating in a plane and this will result in the disease spreading.

The economy class has little legroom. The edge of the seat can compress the veins at the bent knee.
Together with the forced immobility, blood pools in the legs and the feet swell. This can result in deep vein thrombosis and pulmonary embolism. Sudden unexpected death can occur hours or days after travel.

Generally, try to drink plenty of fluids and balance any alcohol consumed with an equal amount of water. Walk around the airport while waiting. Remember, the most dangerous thing to do is to sit still with your legs crossed.

Source: The Telegraph (Kolkata, India)

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Varicose Veins

Image by me. Larger version available on Flickr.
Image via Wikipedia

Definition:
Varicose veins are most often swollen, gnarled veins that most frequently occur in the legs, ankles and feet. They are produced by a condition known as venous insufficiency or venous reflux, in which blood circulating through the lower limbs does not properly return to the heart but instead pools up in the distended veins.
CLICK & SEE
More than 25 million Americans suffer from venous reflux disease. The symptoms can include pain and fatigue in the legs, swollen ankles and calves, burning or itching skin, skin discoloration and leg ulcers. In less severe cases, thin, discolored vessels – “spider veins” – may be the only symptom.

Gender and age are two primary risk factors in the development of venous reflux. An estimated 72% of American women and 42% of men will experience varicose veins symptoms by the time they reach their sixties. Women who have been pregnant more than once and people who are obese, have a family history of varicose veins or spend a great deal of time standing have an elevated risk for the condition, but it can occur in almost anyone at almost any age. Varicose veins never go away without treatment and frequently progress and worsen over time.

Severe varicose veins can have a significant impact on the lives of people who work on their feet – nurses, teachers, flight attendants et al. Research has shown that more than two million workdays are lost each year in the US, and annual expenditures for treatment total $1.4 billion.

Symptoms
Varicose veins are swollen vessels, blue or purple in color and generally bulging above the surface of the skin. They may appear twisted or “ropey” and can be accompanied by swelling in adjacent tissue. They can be found anywhere on the leg, from the ankle up to the groin, but most commonly appear on the inside of the thigh or on the back of the calf or knee.

Varicose veins are not always a serious or uncomfortable condition – for some people, small discolored vessels or minor swelling may be the only signs – but for millions of sufferers they can cause symptoms severe enough to significantly impact the quality of life. Throbbing pain, a deep ache or heavy feeling in the legs, muscle cramps, fatigue, “restless” legs, burning or itching skin, and severe swelling of the ankles can all be symptoms of venous reflux disease, the major underlying cause of varicose veins.

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If you have varicose veins, your legs may feel heavy, tired, restless, or achy. Standing or sitting for too long may worsen your symptoms. You may also experience night cramps.

You may notice small clusters of veins in a winding pattern on your leg, or soft, slightly tender knots of veins. Sometimes, the skin on your legs may change color, become irritated, or even form sores.

If you have severe varicose veins, you have slightly increased chances of developing deep vein thrombosis (DVT). DVT may cause sudden, severe leg swelling. DVT is a serious condition that requires immediate medical attention

When symptoms like these are present, they frequently curtail the patient’s activities and can even force them to miss work. Sufferers complain of being unable to walk, stand or sit for very long without feeling pain or exhaustion.

In severe cases, varicose veins can be indicators of serious circulatory problems, producing blood clots or skin ulcers that require immediate medical attention.

Diagnosis:
To determine whether venous reflux disease is causing your varicose vein symptoms, your primary care physician may conduct an examination and some tests. In some cases, you may be referred to a vein specialist at this time.  After you describe your symptoms, the doctor will examine your legs in a standing position, looking for swelling, visible veins and signs of skin changes, like discoloration, irritation or early signs of ulcers.

The next step is a “hands-on” examination – the doctor will feel your leg with his fingertips to detect swollen veins that are too deep under the skin to be visible. The groin area and the back of the calf are particular targets for inspection, and the doctor will also pay special attention to any areas of significant pain or tenderness, because that can indicate a possible blood clot or deep vein thrombosis (DVT).

If the exam produces sufficient signs of venous reflux, your doctor will probably order an ultrasound examination, a non-invasive test that provides a clear and detailed image of the circulatory system in your leg. The most sophisticated ultrasound tests use  Doppler technology – the same technology used for weather radar – that illustrate the blood flow in various shades of red and blue to show the doctor the speed and direction of the blood flow through the vein.

If the ultrasound confirms the diagnosis of venous reflux, your physician will commonly prescribe conservative measures like compression stockings as a first step in your treatment. (If the ultrasound does not indicate venous reflux, a Magnetic Resonance Imaging test may be ordered to pinpoint the source of the symptoms.) Patients exhibiting the signs or symptoms of varicose veins may request a referral to a specialist performing the VNUS Closure procedure.

Causes :

Heredity, obesity, age, trauma and standing for long periods of time have all been thought to damage venous valves and therefore cause venous insufficiency and varicose veins. Women, especially if previously pregnant, are more likely to develop varicose veins.

If you have never suffered from varicose veins, you are quite fortunate or you are in the minority as– nearly three-quarters of American women and more than 40% of men will encounter the condition by the time they reach retirement age, and venous reflux disease occurs even in teenagers.

Possible causes are:-
High blood pressure inside your superficial leg veins causes varicose veins.

Factors that can increase your risk for varicose veins include having a family history of varicose veins, being overweight, not exercising enough, smoking, standing or sitting for long periods of time, or having DVT. Women are more likely than men to develop varicose veins. Varicose veins usually affect people between the ages of 30 and 70.

Pregnant women have an increased risk of developing varicose veins, but the veins often return to normal within 1 year after childbirth. Women who have multiple pregnancies may develop permanent varicose veins.

Risk Factors
By an almost 2-1 margin, women are more likely to develop varicose veins than men. pregnancy and childbirth are major contributing factors – women who have been pregnant more than once are highly susceptible – partly because the hormonal changes that occur during pre-menstruation and menopause are known to relax vein walls and increase the chances of venous reflux. Hormone replacement therapy and birth control pills can increase the risk as well.

Other significant contributing factors for varicose veins include obesity, a family history of varicose veins, and extended periods of standing – nurses, teachers, postal workers, flight attendants and other people with “vertical” careers or activities are vulnerable to developing varicose veins, as is anyone who does a lot of heavy lifting.
Finally, the longer you live, the more likely you are to develop varicose veins.  Half of all Americans over 50 have them, as do two-thirds of women over 60.

Prevention:
There are no medically proven ways to completely prevent varicose veins. Common sense, however, tells us that relieving pressure on the veins as well as promoting muscle strength helps to keep the blood flowing in the correct direction. Exercising, losing weight, elevating your legs when resting, and not crossing them when sitting all have potential benefits. Wearing loose clothing and avoiding long periods of sitting or standing also are thought to be helpful. Wearing high-heeled shoes is not advisable because they don’t allow the calf muscles to fully contract. Other than varicose vein treatment, medical compression hosiery is the most helpful method of decreasing the symptoms of varicose veins.

Advanced Vein Therapies uses the latest technology and offers several vein therapies & procedures to effectively treat varicose veins.

Treatments

* VNUS Closure® (Click  to 0pen the window to go toVNUS Closure Video)
* Endovenous Laser (EVL) (Click  to View RF Thermal Ablation Device Outperforms Endovenous Laser)
* Vein Stripping………CLICK & SEE
* Phlebectomy……….CLICK & SEE

Overview
For milder cases of varicose veins and spider veins, physicians generally recommend a variety of self-help, non-surgical measures to ease discomfort and prevent the condition from worsening. These measures include exercise, losing weight, wearing compression stockings, elevating the legs and avoiding long periods of standing or sitting.

Direct medical treatments for spider veins include sclerotherapy, in which the veins are sealed with injections of a chemical solution that closes the vein walls. Spider veins can also be treated with non-invasive lasers, which cause the veins to fade and disappear.

For more severe cases of varicose veins, in which the veins bulge beyond the skin or cause significant pain and swelling, relief usually requires a medical intervention. The traditional surgical approach has been vein stripping, a procedure commonly requiring general anesthesia in which incisions are made near the knee and groin and the diseased primary vein is literally pulled from the body using a device. While reasonably effective, vein stripping generally produces significant post-operative pain and bruising, and usually requires a lengthy and uncomfortable recovery period.

In the United States, however, vein stripping has been rendered virtually obsolete by new, minimally invasive catheter technology that enables even severe varicose veins to be successfully treated in a doctor’s office under a local anesthetic in just a few minutes. A device is inserted into the diseased vein, where a catheter or fiber delivers either radiofrequency (RF) or laser energy to heat and seal the vessel. The technique is extremely successful and far less painful and traumatic to the patient than vein stripping.

Endovenous laser (EVL) devices utilize an optical fiber to deliver extremely high heat – over 700 degrees centigrade – that boils the blood in the vein to create a clotting effect that seals the vein as the device is withdrawn. Radiofrequency devices operate at far lower temperatures to heat and shrink the vein walls, limiting the impact on surrounding tissues and, according to a clinical study, causing significantly less pain and bruising than laser.

Physicians using the VNUS® ClosureFAST™ catheter, the only radiofrequency device on the market today for the treatment of venous reflux,  report that most patients return to normal activity almost immediately following the procedure, with little or no post operative pain.

Compression Stockings.
For more severe varicose veins, your physician may prescribe compression stockings. Compression stockings are elastic stockings that squeeze your veins and stop excess blood from flowing backward. In this way, compression stockings also can help heal skin sores and prevent them from returning. You may be required to wear compression stockings daily for the rest of your life. For many patients, compression stockings effectively treat varicose veins and may be all that are needed to relieve pain and swelling and prevent future problems.

When these kinds of treatments alone do not relieve your varicose veins, you may require a surgical or minimally invasive treatment, depending upon the extent and severity of the varicose veins. These treatments include sclerotherapy, ablation, vein stripping, and laser treatment.

Sclerotherapy

During sclerotherapy, your physician injects a chemical into your varicose veins. The chemical irritates and scars your veins from the inside out so your abnormal veins can then no longer fill with blood. Blood that would normally return to the heart through these veins returns to the heart through other veins. Your body will eventually absorb the veins that received the injection.

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.vnus.com/vascular-disease/varicose-veins/diagnosis-of-varicose-veins.aspx

http://www.vascularweb.org/patients/NorthPoint/Varicose_Veins.html

http://www.avtherapies.com/varicose-veins.php?gclid=CO7WodevxpsCFQ_xDAodqgvhAA

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People with Migraine Prone to Clotting

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People with migraines are more likely to develop blood clots in their veins, a study has suggested….CLICK & SEE

The research, published in the latest issue of Neurology, the medical journal of the American Academy of Neurology, found that those suffering from migraines may be more likely to develop blood clots in their veins.

In the condition, called venous thrombosis or thromboembolism, blood clots form in a vein, which can limit blood flow and cause swelling and pain. Those clots can then dislodge from the vein and travel to the heart and the lungs, which can be fatal.

The study examined 574 people in Italy age 55 and up to determine whether they had a history of migraine or migraine at the time of the evaluation. The doctors also reviewed their medical records for cases of venous thrombosis.

The Science Daily online reported that of the participants, 111 people had migraine. A total of 21 people with migraine also had one or more instances of venous thrombosis. In comparison, 35 people without migraine had the condition.

Though researchers were unable to pinpoint the reason for the link between migraine and venous thrombosis, a theory is that the blood of people with migraine may be more prone to clotting, the report said.

It was also found that people with migraine are not more likely to have hardening or narrowing of the arteries, which is contrary to a current theory.

“The thinking has been that because people with migraine are more likely to have strokes and other cardiovascular problems, that they would also have more severe and early atherosclerosis,” said study author Stefan Kiechl, of Innsbruck Medical University in Austria. He said the study provides solid evidence to refute it.

Sources: The Times Of India

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