Wednesday, 30 July 2014

Obesity Complication of Chronic Venus Insufficiency

By Kyle J. Norton

Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese. 

How to calculate your BMI index
BMI= weight (kg)/ height (m2)

Chronic venous insufficiency or CVI is defined as a condition of swelling in the veins in the leg due to blood accumulation as result of the veins no longer working effective in pumping oxygen-depleting blood back to the heart.

 How Obesity associates with Chronic Venus Insufficiency
1. In the examination of 36 limbs in 23 nonobese individuals and 44 limbs in 22 obese individuals of the study of "Impact of obesity on venous hemodynamics of the lower limbs" by Willenberg T, Schumacher A, Amann-Vesti B, Jacomella V, Thalhammer C, Diehm N, Baumgartner I, Husmann M., posted in PubMed, researchers filed the conclusion that Lower limb venous flow parameters differ significantly between healthy obese and nonobese individuals. These findings support the mechanical role of abdominal adipose tissue potentially leading to elevated risk for both venous thromboembolism and chronic venous insufficiency.

2. According to the study of "Obesity and impaired venous function" by van Rij AM, De Alwis CS, Jiang P, Christie RA, Hill GB, Dutton SJ, Thomson IA., posted in PubMed, researchers found that The CEAP clinical stage of venous disease is more advanced in obese patients than non-obese patients with comparable anatomical patterns of venous incompetence. This may be the result of raised intra-abdominal pressure reported in previous studies, leading to greater reflux, increased vein diameter and venous pressures.

3. In the study of "Clinical presentation and patterns of venous reflux in Thai patients with chronic venous insufficiency (CVI)" by Kanchanabat B, Wongmahisorn Y, Stapanavatr W, Kanchanasuttirak P, Manomaiphiboon A., posted in PubMed, the group found that Thai patients with CVI were relatively young. Visible varicose veins, pain, oedema and inflammation were uncommon and most patients could maintain their usual activities despite advanced venous disease. An association with obesity was not common. Despite a low prevalence of a history of previous DVT, the prevalence of deep vein reflux was high and commonly combined with superficial venous reflux.

4. In the observation of 40,095 individuals from 803 registers of primary care in Poland of the study of "The influence of environmental factors in chronic venous insufficiency" by Jawien A., posted in PubMed, Jawien A. indicated that in the other developed countries was reported. It was more common in women, but female sex was not found to be a strong risk factor. Among the risk factors most closely associated with CVI were age, family history of varicose veins, and constipation, whatever the sex. This is in keeping with findings from recent epidemiologic studies. Obesity and lack of physical activity were strongly associated with CVI in women, more so than in men.

5. According to the study of "[Influence of environmental risk factors on the development of chronic vein insufficiency]" [Article in Polish] by Sudoł-Szopińska I, Błachowiak K, Koziński P., posted in PubMed, researchers wrote that this paper presents basic information on CVI epidemiology, etiopathogenesis and pathophysiology and also reviews the literature on the following CVI risk factors: obesity, lack of physical activity, dietary habits, including constipation, pregnancy, genetic factors as well as prolonged sedentary or upright position during job performance.

6. Etc.

Treatments of Obesity and Chronic Venus Insufficiency
1. According to the study of "In situ hemodynamics of perforating veins in chronic venous insufficiency" by Delis KT, Husmann M, Kalodiki E, Wolfe JH, Nicolaides AN., posted in PubMed, researchers found that In addition to an increase in diameter, perforator incompetence is characterized by significantly higher mean and peak flow velocities, volume flow, and venous volume displaced outward, and a lower flow pulsatility. Differences in early reflux enable a better hemodynamic stratification of incompetent perforators in CVI classes. In the presence of deep reflux, incompetent perforators sustain further hemodynamic impairment. In situ hemodynamics enable quantification of the function of perforators and can be used in the identification of the clinically relevant perforators and the impact of surgery.

2. In the study of "Effect of external valvuloplasty of the deep vein in the treatment of chronic venous insufficiency of the lower extremity" by Wang SM, Hu ZJ, Li SQ, Huang XL, Ye CS., posted in PubMed, researchers concluded that External valvuloplasty of the femoral vein combined with surgical repair of the superficial venous system improved the hemodynamic status of the lower limbs, restored valvular function more effectively, and achieved better outcomes than surgical repair of the superficial venous system alone.

3. Etc.
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Quesadillas, a perfect recipe for the end of summer

Recipe attributed to 30 minutes vegetarian recipes by Marie-laude Morin, Publisher Robert Rose at www,robertrose.ca

Fresh basil leaves add an explosion of flavor top this quesadillas. in a perfect recipe for the end of summer.

1/4 cup creamy goat cheese  60mL
3  large or small flour tortillas  3
1 zucchini thinly sliced into round  1
1/4 cup chopped onion   60mL
15  basil leaves  15
1/2 cup shredded Cheddar cheese
1. Spread goat cheese on half of each tortilla.
2. In a skillet, heat 1 tsp. (5mL) oil over medium high heat. Gently fry zucchini rounds, turning once until tender.
3. Place zucchini, tomatoes, onion, basil and cheddar cheese on top of goat cheese. Fold tortillas in half.
4. In a skillet heat 1 tsp. (5mL) oil over medium heat. Fry one quesadilla, turning once, for 2 -3 minutes per side until cheese is melted and tortilla is crispy. Repeat with remaining quesadilla, adding more oil between batches as necessary. Cut each quesadilla into 2 wedges.
Serve 4 to 6.


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Italian version of omelettes - Eggplant Frittata

Everyday Italian by Jean Pare and Sophia De Luca (Original series), Publisher Company's Coming.
You can view their website at www.companycoming.com

Frittatas are the Italian version of omelettes - except they aren't folded and they generally finish cooking under a broiler. This version includes plenty of Italian flavours from eggplant, red pepper and seasoning.
Cooking oil 2tsp. 10mL
Finely chopped peeled eggplant  11/2 cups  375 ml
Dried oregano  1/4tsp.   1mL
Large eggs  8   8
Finely chopped roasted red pepper 1/4 cup  60mL
Sliced green onion  2tbsp.  30mL
Garlic powder  1/4tsp.  2mL
Pepper 1/4tsp.  1mL
Heat cooking oil in large non-sticking frying pan on medium. Add eggplant and oregano. Cook for about 4 minutes, stirring occasionally, until eggplant is softened
Whisk remaining 6 ingredients in medium bowl. Pour over eggplant mixture. Reduce heat to medium-low, covered, for about 8 minutes until bottom is golden and top is almost set. Broil on centre rack oven for about 3 minutes until set. Cut into 6 wedges.
Tip: when baking or broiling food in a frying pan with a handle that isn't ovenproof. Wrap the handle in foil and keep it to the front of the oven, away from the element.

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Tuesday, 29 July 2014

Obesity Complication of Deep Vein Thrombosis

By Kyle J. Norton

 Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese. 

How to calculate your BMI index
BMI= weight (kg)/ height (m2)

 Deep Vein Thrombosis
is defined as a condition of blood clot in one of the deep veins of the body, especially in veins of the leg or pelvis that can lead to pain and swelling. it is not life threatening but obstruction of the blood flow in major organ may have a D. How dangerous consequence.

The Association of  Obesity and Deep Vein Thrombosis
According "Recent korean perspective of deep vein thrombosis after total knee arthroplasty" by Kim KI, Cho KY, Jin W, Khurana SS, Bae DK., in a study of 311 consecutive knees in 227 patients for total knee arthroplasty, posted in PubMed, researchers found that there were 9 cases (3.03%) of proximal DVT, 70 cases (23.57%) of distal DVT, and no symptomatic pulmonary embolism. Although this cohort had limited number of patients by a single surgeon, there is still low incidence of proximal DVT in Koreans with rare pulmonary embolism occurrence compared with those of the Western. High postoperative d-dimer levels were correlative, but no appropriate cutoff value was found. Obesity was a significant associated risk factor.

2. According to the study of "Influence of lipids and obesity on haemorheological parameters in patients with deep vein thrombosis" by Vayá A, Falcó C, Simó M, Ferrando F, Mira Y, Todolí J, España F, Corella D., posted in PubMed, researchers concluded that obesity were also independently associated with a greater risk of DVT. The  results suggest that increased EA (erythrocyte aggregation) constitute an independent risk factor for DVT. However, when associated to hyperlipidaemia and obesity it further increases thrombotic risk.

3. In the study of in 665 patients (701 ankles) who underwent primary total ankle replacementof the abstract of "Risk factors for symptomatic deep-vein thrombosis in patients after total ankle replacement who received routine chemical thromboprophylaxis" by Barg A, Henninger HB, Hintermann B., posted in PubMed, researchers indicated that osing a logistic multiple regression model we identified obesity, a previous venous thromboembolic event and the absence of full post-operative weight-bearing as independent risk factors for developing a symptomatic DVT. The incidence of symptomatic DVT after total ankle replacement and use of low-molecular-weight heparin is comparable with that in patients undergoing total knee or hip replacement.

4. According to the study of "Deep-vein thrombosis is associated with large uterine fibroids" by Shiota M, Kotani Y, Umemoto M, Tobiume T, Tsuritani M, Shimaoka M, Hoshiai H., posted in PubMed, researchers wrote in abstract that Pulmonary thromboembolism (PE) may occur upon a patient's first postoperative attempt of ambulation. PE is a serious complication, often leading to shock or sudden death. Reported rates of PE following gynecologic surgery are between 0.3% and 0.8%, while the incidence of postoperative deep-vein thrombosis (DVT), the major cause of PE, is between 17% and 20%. Therefore, effective preventive measures, such as preoperative assessment for asymptomatic DVT, should be considered. It is well known that DVT and/or PE are associated with large uterine fibroids, the common, benign tumor of myometrium. Here, to establish the statistical relationship between DVT risk and uterine fibroid size/weight, we assessed the preoperative DVT rate with respect to three possible risk factors: age, obesity level, and uterine size/weight.

5. In the study of 843 Japanese patients with a preoperative diagnosis of benign ovarian tumor who underwent tumorectomy or adnexectomy at our institution between July 2003 and December 201 of "Risk factors for deep-vein thrombosis and pulmonary thromboembolism in benign ovarian tumor" by Shiota M, Kotani Y, Umemoto M, Tobiume T, Tsuritani M, Shimaoka M, Hoshiai H., posted in PubMed, researchers concluded that patience with age ≥ 50 years and BMI > 25 are independent risk factors for preoperative DVT in Japan.

6. Etc.

 Treatments of Obesity and Deep Vein Thrombosis
1. According to the abstract of "Management of deep vein thrombosis to reduce the incidence of post-thrombotic syndrome" by Lowe GD., posted in PubMed, researchers found that DVT should be individually assessed for the benefits and risks of continued oral anticoagulation, including patient preferences. Risk factors for recurrent DVT include active cancer, pregnancy, continued use of oral oestrogens, male sex, obesity, recurrent thrombosis, established PTS, permanent inferior vena caval filters, residual DVT, high fibrin d-dimer and other thrombophilias. Early walking, continued high levels of physical activity and wearing compression stockings for up to two years may also reduce the risk of PTS.

2. On the study of "Predictors of chronic disease at midlife and beyond--the health risks of obesity" by Nejat EJ, Polotsky AJ, Pal L., posted in PubMed, researchers indicated that A burgeoning pandemic of obesity is well characterized. 41% of U.S. adults are projected to be obese by 2015 and obesity, a potentially modifiable risk, is emerging as a leading predictor of lifetime health. The wide spectrum of morbidities related to excess body mass includes risks for diabetes, hypertension, coronary artery disease, dyslipidemia, malignancy, venous thrombosis, degenerative joint disease, pulmonary compromise, sleep apnea, cholelithiasis, depression and overall reduced quality of life....... Aggressive efforts must be targeted towards population-based strategies to educate and sensitize all generations on contributors to and sequelae of excess body mass as obesity represents one of the few modifiable factors that impact on the quantity and quality of lifespan.

3. Etc.

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A Naturopath’s Easy Step-by-Step Guide to Overcome PCOS
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The Best Finger food without messy fingers: Cherry Tomatoes with Cheese

Recipe attributed to 30 minutes vegetarian recipes by Marie-laude Morin, Publisher Robert Rose at www,robertrose.ca


Finger food without messy fingers, each tomato is an hors d'oeuvre.
Tips:
Pignuts are the seeds of pinecones. They are fantastic nuts that becomes flavorful once they are toasted.
2 tbsp. pine nuts  30mL
25 cherry tomatoes   25
1/2 cup cream cheese softened  125 mL
Fresh parsley sprigs
1, In a skillet over medium heat, toast pine nuts, stirring constantly for 2 to 5 minutes or until golden and fragrant.
2. Cut top of cherry tomatoes. Remove seeds with small spoon.
3. In a bowl mash together cream cheese. Fill tomatoes with cream cheese mixture and place on serving platter. Garnish with a few frigs of parsley for color.
Variation: Cherry tomatoes with zesty cheese
mash 1/4 tsp. (1mL) smoke paprika and 1tsp. (5mL0 Grated lemon zest into cream cheese before adding pine nuts. make 25.
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The Best topping for pancakes or hot cereal: Breakfast Berry Compote

Everyday Italian by Jean Pare and Sophia De Luca (Original series), Publisher Company's Coming.
You can view their website at www.companycoming.com

Balsami vinegar heightens the berry flavors in this tart topping for pancakes or hot cereal. Also good served chilled over roll or bread.
Frozen mixed berries, thawed  1 cup  250mL
Sliced fresh strawberries  1 cup  250mL
Mixed fruit (or berry) jam  1/2 cup  125mL
balsamic vinegar  2tbsp.  30mL
Ground cinnamon 1/4tsp.  1mL
Combine all 5 ingredients in medium saucepan. Cook uncovered on medium for about 5 minutes, stirring occasionally, until mixture comes to a boil. Makes about 2 cups (500mL).

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Monday, 28 July 2014

Hormone Adionection - The risk of Obesity and Complications

By Kyle J. Norton

Recent study from the renowned institutions suggested that protein Adiponectin may be associated to risk of obesity. Adionection is a protein with function involved in regulating glucose levels as well as fatty acid breakdown. Therefore, it plays a causative role in the development of insulin resistance and cardiovascular disease, through probably mediated the metabolic effects of FGF21, a metabolic hormone, on glucose homeostasis and insulin sensitivity(1a).

Obesity is defined as a medical condition of excess body fat accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese. 

In a study of all the fourth-grade school children (9 or 10 years of age) in the town of Ina during 2005-2008 (N = 1675), Japan, lower levels of adiponectin complexes were associated to in the abdominal obesity group than in the non-abdominal obesity group regardless of sex. In fact the impact of abdominal obesity was larger in boys than in girls(1).

Indeed, the alternation and mutation of adiponectin gene were also found to contribute to the genetic risk towards the development of  obesity, in the south Indian population study by the Madras Diabetes Research Foundation-ICMR Advanced Centre for Genomics of Type 2 Diabetes and Dr. Mohan's Diabetes Specialities Centre(2).

But in the study of calorie-restricted low-fat and low-carbohydrate diets (LFD and LCD among overweight and obese premenopausal women, researchers suggested that in these diet patterns serum leptin, but not adiponectin is found to effect on obesity's complications(3). In support of the above, the West China Medical School study showed that Leptin, the product of the obese gene, is an adipocyte-secreted protein hormone playing a key role in the progression of obesity(4)

The Russian study indicated the evaluation of metabolic disorders and adipokine synthesis in obese patients may optimize the diagnosis of type 2 diabetes mellitus and cardiovascular diseases and to personalize diet therapy(5).

Adiponectin receptor 1 agonists, matairesinol, arctiin, (-)-arctigenin and gramine, may be potential drug-candidates for hypoadiponectin related diseases, such as obesity(6)

Taken altogether, adipokine  synthesis is associated to risk of obesity, but the question of low level of adiponectin induces obesity or obesity causes lower levels of adiponectin remains largely unknown. Leptin, another member of adipokine  may be used as biomarker in management of the progression of the disease and its complications. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying
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References
(1a) Adiponectin mediates the metabolic effects of FGF21 on glucose homeostasis and insulin sensitivity in mice by Lin Z1, Tian H, Lam KS, Lin S, Hoo RC, Konishi M, Itoh N, Wang Y, Bornstein SR, Xu A, Li X.(PubMed)

(1) Abdominal obesity and serum adiponectin complexes among population-based elementary school children in Japan: a cross-sectional study by Ochiai H1, Shirasawa T, Nishimura R, Nanri H, Ohtsu T, Hoshino H, Tajima N, Kokaze A.(PubMed)
(2) Genetic association of ADIPOQ gene variants with type 2 diabetes, obesity and serum adiponectin levels in south Indian population by Ramya K1, Ayyappa KA, Ghosh S, Mohan V, Radha V.(PubMed)
(3) Favorable effects of low-fat and low-carbohydrate dietary patterns on serum leptin, but not adiponectin, among overweight and obese premenopausal women: a randomized trial by Llanos AA1, Krok JL2, Peng J3, Pennell ML3, Olivo-Marston S1, Vitolins MZ3, Degraffinreid CR2, Paskett ED(PubMed)
(4) Synthesis and biological evaluation of novel urea- and guanidine-based derivatives for the treatment of obesity-related hepatic steatosis by Liang X1, Pei H2, Ma L3, Ran Y4, Chen J5, Wang G6, Chen L5.(PubMed)
(5) [Adipokines and the metabolism of key nutrients in patients with obesity].

[Article in Russian] by Kirillova OO, Vorozhko IV, Gapparova KM, Chekhonina IuG, Sentsova TB, Tutel'ian VA.(PubMed)
(6) Identification of adiponectin receptor agonist utilizing a fluorescence polarization based high throughput assay by Sun Y1, Zang Z, Zhong L, Wu M, Su Q, Gao X, Zan W, Lin D, Zhao Y, Zhang Z.(PubMed)