Friday, 1 August 2014

Obesity Complication of Peripheral Vascular Disease

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)

 Peripheral Vascular Disease is defined as a condition of obstruction of arteries as a result of hardening and narrowing of the arteries which supply blood to the lower extremity.

 How Obesity associates with Peripheral Vascular Disease
According to the study of "Abdominal obesity and peripheral vascular disease in men and women: a comparison of waist-to-thigh ratio and waist circumference as measures of abdominal obesity" by Lu B, Zhou J, Waring ME, Parker DR, Eaton CB., posted in PubMed, researchers indicated in abstract that WTR is associated with PVD in men and women. In contrast, WC is associated with PVD in women, but not in men. Well-controlled prospective studies are needed to assess these two measures of body fat distribution and its association with the development of PVD in men and women.

2.In a study of "The risk of general and abdominal adiposity in the occurrence of new vascular events and mortality in patients with various manifestations of vascular disease" by Kanhai DA, Kappelle LJ, van der Graaf Y, Uiterwaal CS, Visseren FL., posted in PubMed, researchers found that :General adiposity is associated with an increased risk for vascular mortality in CAD patients and a decreased risk for (vascular) mortality in PAD patients.International Journal of Obesity.

3. In the study of "
Patients with coronary, cerebrovascular or peripheral arterial obstructive disease differ in risk for new vascular events and mortality: the SMART study" by Achterberg S, Cramer MJ, Kappelle LJ, de Borst GJ, Visseren FL, van der Graaf Y, Algra A; SMART study Group., posted in PubMed, researchers found that Patients with a recent CVD or PAOD have almost twice the risk for future vascular events than those with CAD.

4. According to the study of "Peripheral vascular disease and peripheral neuropathy in individuals with cardiometabolic clustering and obesity: National Health and Nutrition Examination Survey 2001-2004" by Ylitalo KR, Sowers M, Heeringa S., posted in PubMed, researchers suggested that Obesity and clustering markedly increased the likelihood of LEDs in this sample and identified a group for whom preventive activities may reduce the risk of future disability.

5. In the abstract of "Obesity and fat distribution as predictors of aortoiliac peripheral arterial disease in middle-aged men" by Jakovljević B, Stojanov V, Lović D, Paunović K, Radosavljević V, Tutić I., posted in PubMed, researchers found that This study has identified the quantity of fat tissue (body fat over 26.5%) and its visceral distribution (waist-hip ratio over 1.02) as predictors of aortoiliac PAD in middle-aged men. Body mass index, a crude indicator of obesity, should be combined with these parameters when assessing the risk for aortoiliac PAD.

6. in the study of "Relationship of obesity distribution and peripheral arterial occlusive disease in elderly men" by Planas A, Clará A, Pou JM, Vidal-Barraquer F, Gasol A, de Moner A, Contreras C, Marrugat J., posted in PubMed, the study indicated that Abdominal fat distribution, but not total body fatness, is associated with peripheral arterial occlusive disease, independently of concurrent cardiovascular risk factors.

7. Etc.


Treatments of Obesity and Peripheral Vascular Disease
1. In abstract of the study of "
The prognostic impact of general and abdominal obesity in peripheral arterial disease" by Giugliano G, Brevetti G, Laurenzano E, Brevetti L, Luciano R, Chiariello M., posted in PubMed, researchers concluded that Abdominal obesity and, to a lesser degree, general obesity worsen the prognosis of PAD patients independently of possible confounding factors. Weight reduction should be integrated in the active management of these patients.

2. According to the abstract of "The management of combined coronary artery disease and peripheral vascular disease" by Cassar A, Poldermans D, Rihal CS, Gersh BJ., posted in PubMed, researchers wrote that Coronary artery disease (CAD) and peripheral vascular disease (PVD) remain highly prevalent in the population due to population ageing, smoking, diabetes, unhealthy lifestyles, and the epidemic of obesity, and frequently coexist. The management of combined CAD and PVD is a common challenge and brings with it numerous clinical dilemmas. The goal of this article is to review the prevalence of PVD and its major impact upon prognosis in patients with known CAD and in turn to review the impact of CAD upon the prognosis of patients with PVD. This review will also highlight issues related to the peri-operative evaluation and management of patients going to vascular surgery, including medical optimization as well as the performance and timing of coronary revascularization.

3. In the study of "Angio-Seal use in patients with peripheral arterial disease (ASPIRE)" by Katzenschlager R, Tischler R, Kalchhauser G, Panny M, Hirschl M., posted in PubMed, researchers wrote that Complications (2 minor bleedings, 1 pseudoaneurysm) were not associated with high risk groups (these were: 69 antegrade punctures, 22 obese and 32 hypertensive patients). Three-month postinterventional diameter and blood velocity changes were <1%., and concluded that patients with peripheral arterial disease in the region of the puncture site and patients at higher complication risk can safely and effectively be closed with an Angio-Seal device. At the puncture site, no lumen change can be observed 3 months postinterventional.

4. Etc.
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Easy and Quick Vegan Recipe: Toast pita chips

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

This recipe can be served anywhere and anytime. The toasted iota points are a marvelous accompanied to hummus, guacamoles and dips.
Preheat over 400 degree F (200 degree C)
Baking sheet, lined with parchment paper.
4 pitas
Olive oil
Ground cumin
Paprika
1. Cut pitas into points. Place on prepared baking sheet. Brush with olive oil. Sprinkle with cumin and paprika to taste.
2. Bake in preheated oven for about 10 minutes or until bread is crispy. Let cool on pan on a wire rack. Serve 4.
Variation: Replace cumin and paprika with smoke paprika or your favorite dried herb for a different flavor.
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Vegan recipes: Cilantro Salsa

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

Thus recipe can easily to double, triple or even quadrupled to suit the number of your guests. You will soon see bottom of the bowl.
Tips: Cilantro is a magic ingredient in this recipe so don't be tempted to leave it out or substitute another herb. The salsa can be made up to 4 hours ahead of serving. Cover and let stand at room temperature -- do not refrigerate it or the tomato will lose its flavor.
1 tomato, diced   1
1/4 cup diced red onion   60mL
1/4 cup chopped fresh cilantro  60mL
1/4 cup tomato juice  60mL
1  chile pepper, chopped   1
Salt and fresh ground black pepper
In a bowl, combine tomato, red onion, cilantro, tomato juice and chile pepper. Season with salt to taste. Make about 1/12 cup (375mL)
Variation: Cilantro avocado salsa: Add I dice of avocado with the tomato.
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Thursday, 31 July 2014

Phytochemical Indole-3-carbinol (I3C) and Cervical Cancer

By Kyle J. Norton

Indole-3-carbinol is a phytochemical in the class of Indoles, by the breaking down of the glucosinolate glucobrassicin,  found abundantly in cabbage, kale, Brussels sprouts, rutabaga, mustard greens, broccoli, etc.

Cervical cancer is malignant neoplasm of the cervix uteri or cervical area caused by abnormal cells growth with alternation of cells DNA. According to the American Cancer Society's, in 2014, 12,360 new cases of invasive cervical cancer will be diagnosed with the death of  4,020 patients. The risk of cervical cancer is higher in Hispanic women followed by African-Americans, Asians and Pacific Islanders, and whites(a).
Depending to the stage and grade of the cancer, if the cancer is found in the early stahe, hysterectomy may not be needed. Other while  after sugery, chemotherapy including Cisplatin, Fluorouracil (5-FU), Mitomycin, Paclitaxel, Ifosfamide, Carboplatin, Bevacizumab and radiotherapy may be necesary, but with certain side effects. Emerging suggestion of a healthy and balanced diet to improve high serum levels of antioxidants may reduce cervical neoplasia risk(b)(c)  but other suggested that the role of diet and nutrition in the etiology of cervical cancer is not yet resolved(d) and Catalan Institute of Oncology study showed statistically nonsignificant inverse associations were also observed for leafy vegetables, root vegetables, garlic and onions, citrus fruits, vitamin C, vitamin E and retinol for invasive squamous cervical cancer (ISC)(e).

Dietary indole-3-carbinol (I3C) prevented the development of estrogen-enhanced cancers including breast, endometrial and cervical cancers(1) due to its antitumor activities associated not only with  regulation of estrogen activity and metabolism, but also modulation of ER transcription activity(2) through both antiestrogenic and estrogenic activity(3). In human cervical cancer cells, in comparison to diindolylmethane (DIM), a major in vivo product of indole-3-carbinol (I3C), both I3C and DIM caused accumulation of DNA strand breaks in three cervical cancer cell lines.  I3C  increased apoptosis in target tissues in vivo.(4). In mice study, according to the The Long Island Campus of Albert Einstein College of Medicine, showed to prevent the cervical-vaginal cancer promoted high doses of estrogen in these mices(5) and increased PTEN expression in the cervical epithelium of the transgenic mouse in vivo(6)
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References
(a) Cerical cancer (Amerrican cancer society)
(b) Diet and serum micronutrients in relation to cervical neoplasia and cancer among low-income Brazilian women by Tomita LY1, Longatto Filho A, Costa MC, Andreoli MA, Villa LL, Franco EL, Cardoso MA; Brazilian Investigation into Nutrition and Cervical Cancer Prevention (BRINCA) Study Team.(PubMed)
(c) Associations of dietary dark-green and deep-yellow vegetables and fruits with cervical intraepithelial neoplasia: modification by smoking by Tomita LY1, Roteli-Martins CM, Villa LL, Franco EL, Cardoso MA; BRINCA Study Team.(PubMed)
(d) Diet and the risk of in situ cervical cancer among white women in the United States by Ziegler RG1, Jones CJ, Brinton LA, Norman SA, Mallin K, Levine RS, Lehman HF, Hamman RF, Trumble AC, Rosenthal JF, et al.(PubMed)
(e) Dietary factors and in situ and invasive cervical cancer risk in the European prospective investigation into cancer and nutrition study by González CA1, Travier N, Luján-Barroso L, Castellsagué X, Bosch FX, Roura E, Bueno-de-Mesquita HB, Palli D, Boeing H, Pala V, Sacerdote C, Tumino R, Panico S, Manjer J, Dillner J, Hallmans G, Kjellberg L, Sanchez MJ, Altzibar JM, Barricarte A, Navarro C, Rodriguez L, Allen N, Key TJ, Kaaks R, Rohrmann S, Overvad K, Olsen A, Tjønneland A, Munk C, Kjaer SK, Peeters PH, van Duijnhoven FJ, Clavel-Chapelon F, Boutron-Ruault MC, Trichopoulou A, Benetou V, Naska A, Lund E, Engeset D, Skeie G, Franceschi S, Slimani N, Rinaldi S, Riboli E.(PubMed)
 (1) Indole-3-carbinol is a negative regulator of estrogen by Auborn KJ1, Fan S, Rosen EM, Goodwin L, Chandraskaren A, Williams DE, Chen D, Carter TH.(PubMed)
(2) Indole-3-carbinol is a negative regulator of estrogen receptor-alpha signaling in human tumor cells. by Meng Q1, Yuan F, Goldberg ID, Rosen EM, Auborn K, Fan S.(PubMed)
(3) Indolo[3,2-b]carbazole: a dietary-derived factor that exhibits both antiestrogenic and estrogenic activity by Liu H1, Wormke M, Safe SH, Bjeldanes LF.(PubMed)
(4) Indole-3-carbinol and diindolylmethane induce apoptosis of human cervical cancer cells and in murine HPV16-transgenic preneoplastic cervical epithelium by Chen DZ1, Qi M, Auborn KJ, Carter TH.(PubMed)
(5) Indole-3-carbinol prevents cervical cancer in human papilloma virus type 16 (HPV16) transgenic mice by Jin L1, Qi M, Chen DZ, Anderson A, Yang GY, Arbeit JM, Auborn KJ.(PubMed)
(6) Indole-3-carbinol prevents PTEN loss in cervical cancer in vivo by Qi M1, Anderson AE, Chen DZ, Sun S, Auborn KJ.(PubMed)

Obesity Complication of Varicose Vein

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.

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

Varicose Vein
is defined as a condition of enlarged and tortuous veins appearing blue and purple squiggly just under the skin. It can lead to blood flowing backwards, causing pain in standing or walking.

How Obesity associates with Varicose Vein
1. According to the study of "
Associations of moderate and severe overweight with self-reported illness and medical care in Dutch adults" by Seidell JC, de Groot LC, van Sonsbeek JL, Deurenberg P, Hautvast JG., posted in PubMed, researchers wrote that In men, severe overweight was associated with hypertension, especially in men under 50 years of age. In women, severe overweight was associated with hypertension, diabetes, varicose veins, asthma/bronchitis, and hemorrhoids. Increased utilization of medical care and medications were also associated with severe overweight. For moderately overweight subjects, these associations were less clear or absent.

2. In a study of "Epidemiology and risk factors for varicose veins among older people: cross-sectional population study in the UK" by Clark A, Harvey I, Fowkes FG., posted in PubMed, researchers found that Trunk varices occur very commonly in older age groups with increasing age, obesity and possibly female sex as risk factors. Associations found with DVT and hypertension were based on history alone and must be interpreted with caution.

3. According to the abstract of "The risk of congestive heart failure is increased in persons with varicose veins" by Mäkivaara LA, Ahti TM, Luukkaala T, Hakama M, Laurikka JO., posted in PubMed, researchers filed the result that Marginally higher prevalence of CHF was found in persons with varicose veins than in those without (2.9% vs. 1.9%) with OR 1.6 (1.0-2.3) and sex and age adjusted OR 1.2 (0.8-1.9). The incidence of CHF was higher in subjects with varicose veins than in others (4.9 vs. 2.6 per 1000 person-years) with IDR 1.9 (1.1-2.9) and sex and age adjusted IOR 2.5 (1.4-4.6). The result was further adjusted for body mass index, arterial disease and hypertension; multi-adjusted IOR for the incidence of CHF by varicose veins was 2.1 (1.1-4.0).

4. In the study of "Incidence of varicose veins in Finland" byMäkivaara LA, Jukkola TM, Sisto T, Luukkaala T, Hakama M, Laurikka JO., posted in PubMed, researchers wrote that 157 individuals reported new varicose veins during the follow-up. The overall incidence was 13.5 per 1000 person years (8.5 for men and 19.2 for women). Female sex was an independent and statistically significant risk indicator of varicose veins (adjusted odds ratio, OR 2.4). The incidence was significantly higher at the age of 50-55 years (OR 1.6). Higher body mass index seemed to be related to higher risk of new varicose veins (OR 1.2-1.8), but the association failed to reach statistical significance. The level of education did not affect the incidence.

5. In the observation during a five-year follow-up period were studied of the study of "The risk of congestive heart failure is increased in persons with varicose veins" by Mäkivaara LA, Ahti TM, Luukkaala T, Hakama M, Laurikka JO., posted in Pubmed, researchers filed the conclusion that Our longitudinal observation is consistent with the hypothesis that persons with varicose veins have a higher risk of CHF which is not mediated through sex, age, overweight, arterial disease or hypertension.

6. Etc.

 Treatments of Obesity and Varicose Vein
1. In the abstract of " [Varicose vein surgery and obesity--experience with a new Boazul cuff in leg circumference up to 90 cm]",[Article in German], by Hermanns HJ., posted in PubMed, researcher found that The use of the bloodless limb technique for varicose vein surgery is very comfortable, especially in cases of severe varicose veins and obesity. Maintenance of operation standards and utmost care of the cuffs lead to the successful use of this procedure.

2. According to the study of "Using the Boazul cuff to reduce blood loss in varicose vein surgery" by Robinson J, Macierewicz J, Beard JD., posted in PubMed, researchers concluded that use of the Boazul cuff significantly decreases the blood loss from the avulsion sites during routine varicose vein surgery, and may encourage the surgeon to perform more avulsions.

3. Etc.


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Guacamole - The Dip for crispy nacho.

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

You will love the texture of this dip. Serve with crispy nacho.
Tip: If you like a touch of heat in your guacamole, add hot pepper sauce or a small amount of minced jalapeno pepper.
2 very ripe avocados  2
2 tbsp. freshly squeezed lemon juice  30mL
2 tsp. olive oil  10mL
1 tomato, seeded and diced   1
1 gloved garlic, minced   1
Pinch granulated sugar
Salt and freshly ground pepper
1. In food processor puree avocados until smooth. Or use a fork to smash avocado.
1. Stir in lemon juice, olive oil, tomato, garlic, sugar and salt and pepper to taste. Serve immediately as avocados have a tendency to blacken quickly. Serve 4.

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Tasty Italian with Mexican format - Prosciutto Pepper Quesadillas

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

Tasty Italian flavours in a decidedly Mexican format.
This is fusion cuisine at it finest!
Silvered red pepper  1 cup  250mL
Chopped arugula, lightly packed  1/2 cup  125mL
Chopped prosciutto (or deli) ham  1/4 cup  60mL
Grated mozzarella cheese 1 cup  250mL
Flour tortillas (9inch, 23cm diameter) 2   2
Cooking oil  1/2tsp.  2mL
Combine first 3 ingredients in small bowl.
Sprinkle 1/4 cup (60mL) cheese over half of each tortilla. Spoon red pepper mixture over cheese. Sprinkle remaining cheese over top. Fold tortillas in half to cover filling. Press down lightly.
Brush both sides of quesadilla with cooking oil. Heat large frying pan on medium. Add quesadillas. Cook for about 4 minutes until bottom is golden. Turn. Cook for about 2 minutes until bottom is golden and cheese is melted. Cuts into 4 wedges each for a total of 8 wedges.
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