Accidental eye injuries: causes and prevention

How’s this for statistics to make you think seriously about protecting your eyes:

• More than a million people in the US have eye injuries each year.
• Accidental eye injury is one of the leading causes of vision loss and impairment.
• 90% of the said injuries are actually preventable.

Although a lot of eye injuries may occur in the workplace, many people are not aware that a lot of injuries also happen at home and at leisure time.

Here are major ways of injuring your eyes:

Fireworks and firecrackers

In almost every country, fireworks are part of national celebrations. Today is Canada Day. The 4^th of July is just around the corner. Fireworks are beautiful and fun but they can cause major injuries, including the eyes, to users as well as to bystanders. Keep firecrackers out of little children’s sight and reach. Not only are they fire hazards, they can also cause injuries.

Chemicals

Those who are dealing with chemicals in the workplace wear eye protection gear. I’ve worked in a lab before and knew the risks and the precautionary measures. What we tend to forget is that household chemicals can also be hazardous and can cause permanent eye damage. Medicine.Net recommends that

when using household chemicals, read instructions and labels carefully, work in a well-ventilated area and make sure to point spray nozzles away from you.

Machinery and appliances

Household appliances and machinery can also cause eye injuries. Look at your hobby room, your workshop. Do you wear protective eyewear when you use that electric saw? That potter’s wheel? The kitchen blender? Any other moving machinery?

How about the lawnmower or the power trimmer? Projectiles in the form of stones, branches and pieces of debris can shoot from these machines during use. These projectiles present risk not only for the machine operator but for the bystanders as well.

Sports and recreation

Sports and other recreational activities are fun but they can cause eye damage, too. A blow from a hockey stick, puck, or ball can have some devastating effect on the eye. In April, I posted a resource post on Sports Eye Safety.

So what do we do in case of an eye injury?

Medicine.Net recommends:

• Injuries such as cuts, chemical burns or foreign bodies stuck in the eye are emergencies. Don’t try to treat these yourself - contact your Eye M.D. or emergency room for help immediately.
• Even a seemingly light blow can cause a serious eye injury. If a black eye, pain or visual problem occurs after a blow, contact your Eye M.D. or emergency department immediately.
• In case of a chemical burn to the eye, flush the eye with clean water and seek emergency medical treatment immediately.

For more information about eye injury prevention, check out recommendations by the American Academy of Ophthalmology

               

Green tea and prostate cancer

Another reason to drink green tea - at least for men. A recent study reports that consumption of green tea may slow down the progression of prostate cancer. The study looked at 26 men, aged 41 to 72 years old who were diagnosed with prostate cancer and due to undergo radical prostatectomy.

The study patients were given a daily dose of four capsules of Polyphenon E, which is equivalent to about 12 cups of concentrated normally brewed green tea, for 12 to 73 days until the day before surgery. They were monitored for serum concentrations of the following biomarkers: hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF) and prostate specific antigen (PSA). HGF and VEGF levels are especially relevant because they are good prognostic indicators of metastasis.

The results showed that consumption of Polyphenon E led to a significant reduction in levels of HGF, VEGF and PSA markers, even up to 30% in some cases.

According to researcher Dr. James A. Cardelli, professor and director of basic and translational research in the Feist-Weiller Cancer Center, LSU Health Sciences Center-Shreveport

“The investigational agent used in the trial, Polyphenon E (provided by Polyphenon Pharma) may have the potential to lower the incidence and slow the progression of prostate cancer”.

Green tea is rich in antioxidant phytochemicals such as polyphenols, catechins and flavanols. It is said that green tea contains more antioxidant compared to other drinks such as black tea, wine or hot chocolate because of the minimal oxidation it undergoes during its production. This is not the first study to demonstrate the health benefits of green tea. Several studies have demonstrated the cardiovascular benefits of green tea.

Another study by Italian researchers “demonstrated that consumption of green tea polyphenols reduced the risk of developing prostate cancer in men with high-grade prostate intraepithelial neoplasia (HGPIN).”

Japanese researchers reported that green can prevent lifestyle-related chronic diseases such as cardiovascular disease and cancer.

In 2003, Dutch researchers reported that tea is “the most consumed drink in the world after water, well ahead of coffee, beer, wine and carbonated soft drinks.” Unfortunately, this trend has changed since then as carbonated drinks became more and more popular.

Currently, further studies are being conducted using Polyphenon E, including one in breast cancer patients.

Dr. Cardelli continues to say:

“There is reasonably good evidence that many cancers are preventable, and our studies using plant-derived substances support the idea that plant compounds found in a healthy diet can play a role in preventing cancer development and progression.”

               

Anti-hypertensive pills for everyone?

How about anti-hypertensive drugs as part of your daily routine? British researchers recommend that hypertensive drugs (not one but a combination) be given to everybody starting at a certain age regardless of the fact whether they actually have high blood pressure or not. The logic behind this recommended generalized prophylactic treatment is to avoid cardiovascular events caused by hypertension.

According to Dr Malcolm  Law and Dr Nicholas Wald of the Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London,

“Guidelines on the use of blood-pressure-lowering drugs can be simplified so that drugs are offered to people with all levels of blood pressure. Our results indicate the importance of lowering blood pressure in everyone over a certain age, rather than measuring it in everyone and treating it in some.”

This means that we should swallow a daily cocktail of anti-hypertensive drugs just like we are swallowing vitamins or nutritional supplements.

The researchers based their recommendations on a meta-analysis of 147 randomized trials that included a total of 958,000 people. The same researchers also supported the so-called polypill which contains 5 different cardiovascular drugs that include:

• a statin
• three anti-hypertensive drugs
• aspirin

The results of the meta-analysis showed that:

• People aged 60 to 69 benefit from taking hypertensive drugs regardless of blood pressure measurements.
• A combination of three drugs at half standard dose (as in the polypill) reduced the risk of coronary heart disease by approximately 46% and of stroke by 62%.
• A single antihypertensive agent at standard dose had about half the effect of the polypill

Currently, there are five main classes of blood-pressure-lowering drugs, namely:

• beta blockers
• thiazides
• ACE inhibitors
• angiotensin-receptor blockers
• calcium-channel blockers

All drugs except calcium-channel blockers were similarly effective in preventing cardiac events and strokes. The calcium-channel blockers seem to have a greater preventive effect against stroke compared to the other drugs.

Other health experts, however, are not so convinced about the arguments and the results of the meta-analysis. They question a lot of assumptions and as well as analytical methods that may not be valid. According to Dr. Franz Messerli of St Luke’s-Roosevelt Hospital Center, New York City

“A meta-analysis is like a sausage; only God and the butcher know what goes in it, and neither would ever eat any.”

Indeed, the idea of prescribing anti-hypertensives for everybody is hard to sell. It is true that hypertension can lead to cardiac events and strokes but there are factors aside from blood pressure play a role as well. Besides, many of the risk factors for cardiovascular disease are lifestyle, and therefore, modifiable factors.

Photo credit: stock. xchng

               

Summer is coming: how to prevent and check for melanoma

Resource Post for May

In preparation for the summer season, there are health observances in May that are focusing on awareness about skin cancer.

May is Melanoma/Skin Cancer Detection and Prevention Month and May 4 was Melanoma Monday and sponsored by the American Academy of Dermatology (AAD).

Identifying melanoma

It is estimated that 1 million cases of skin cancer is diagnosed in the US each year. About one in five Americans will develop skin cancer in their lifetime. Of all types of skin cancers, melanoma is the most deadly, commonly affecting young adults aged 25 to 29 years of age.

Melanoma is characterized by pigment-producing cells that grow and reproduce uncontrollably. It may suddenly on the skin or may develop on an existing mole. According to researchers at St. Louis University, the identifying signs of melanoma are:

• Asymmetry - one half is unlike the other half
• Border - irregular, scalloped or poorly defined border
• Color - varied from one area to another; shades of tan and brown, black; sometimes white, red or blue
• Diameter - while melanomas are usually greater than 6 mm (the size of a pencil eraser) when diagnosed, they can be smaller
• Evolving - a mole or skin lesion that looks different from the rest or is changing in size, shape or color

Who is at risk of developing melanoma?

Current guidelines recommend regular screening for skin cancer, especially those at high risk for the disease. The risk factors include

• People older 40 years of age
• People with a fair complexion
• People who sunburn easily
• People who have many moles
• People with a personal or family history of skin cancer
• People who spend long periods of time exposed to the sun
• People exposed to UV radiation at recreation or the work place, e.g. use of tanning salons, sunbathing, etc.

However, just because you are of the dark-haired, dark-skinned type, and you never sunburn easily doesn’t mean you don’t have to worry about UV radiation. According to a study presented at the annual meeting of the American Association of Cancer Research (AACR), certain variants of the MC1R gene increase the melanoma risk of people who are normally of low risk profile by almost two-fold. The study was presented by researchers from the Pennsylvania University.

How do we prevent skin cancer?

Here are simple tips on skin cancer prevention.

Use sunblock. It is advisable to use sun protection, even in children. Regular use of sunblock during the first 18 years of one’s life can reduce the lifetime risk by 78%. Use sunscreens which blocks UV A as well as UV B radiation. For it to be effective, a sunscreen must have a minimum sun protection factor (SPF) of 15.

Stay out of the midday sun. UV radiation is strongest at midday. Enjoy th early morning or late afternoon sun instead.

Have regular skin cancer screenings. Free skin cancer screenings are being offered by health and advocacy groups. The American Academy of Dermatology (AAD) offers free screening all over the US. You can request a notification from the AAD when there is a scheduled screening within a 50-mile radius from where you live. You can also send an eCard to family and friends to help spread awareness on skin cancer and inform about free screenings.

Do a self-check for skin cancer. By using the abovementioned signs for melanoma, you can check yourself and your family for suspicious pigmentation. The AAD also gives us instructions on how to perform a skin self-exam.

• Examine your body front and back in the mirror, then right and left sides with arms raised.
• Bend elbows and look carefully at forearms, upper underarms and palms.
• Look at the backs of your legs and feet, the spaces between your toes and on the sole.
• Examine the back of your neck and scalp with a hand mirror. Part hair for a closer look.
• Finally, check your back and buttocks with a hand mirror.

Avoid suntanning beds. Even artificial UV rays from suntanning lamps and beds can cause skin cancer.

The latest research news on skin cancer

Researchers from St. Louis University report on the effectiveness of a topical cream in treating certain melanoma. The researchers used the cream imiquimod in treating lentigo maligna (LM) which the most common type of melanoma of the head and neck. LM is “a type of “melanoma-in- situ”, the earliest stage of melanoma [which] precedes the more invasive form, lentigo maligna melanoma (LMM).” Imiquimod was used in conjunction with surgery. Skin surgery removed the invasive area while the topical cream was applied in the surrounding area. The cream supposedly can supposedly limit the area of surgery as well as minimize disfigurement and the risk of recurrence.

According to lead researcher Dr. Scott Fosko, chairman of the department of dermatology at Saint Louis University School of Medicine

“As we’re seeing melanoma in younger and younger people, in their 30s and 40s, there is a longer window for the cancer to return and a greater desire to avoid disfiguring surgery…This subtype of melanoma is becoming more and more common, and can be one of the more challenging melanomas to manage”.

In lab tests, researchers at the M. D. Anderson Cancer Center demonstrated that that the yellow spice curcumin which is also found turmeric and curry powder seems to be able to block the pathway to melanoma development.

               

Heart health strategies should be personalized

It is not just enough to tell somebody to live a healthy life. It is not enough to know one’s risk profile for cardiovascular (CV) disease. Prevention strategies should be personalized, according the health experts at the University of Exeter in the UK.

Different people will respond differently upon the news of their CV risk. Some of the responses would be:

• Fear and shpck
• Downplaying the risk in one’s own mind by benchmarking against others of the same age
• Behavioral and lifestyle changes

The response may depend on many factors, including age, gender, and sociocultural factors.

The goal is to produce interventions which are sensitive to the lives and social position of those who find themselves at ‘high risk’ of coronary heart disease (CHD) in later-middle age, and which inspire change rather than inhibit it,” say researchers, from Egenis, the ESRC Centre for Genomics in Society at the University of Exeter.

Previous primary care strategies include scaring people and boosting their vulnerability. However, the fear factor can actually hinder the desired behavioural changes.

Currently, it is a common practice in primary health care to conduct screening for certain health risks. In particular, people with family histories of certain diseases are urged to know their risk profile.

The study by the University of Exeter researchers investigated how people responded to the bad news of high risk diagnosis following coronary heart disease screening. The study participants included 38 people interviewed right after screening.

According to lead author Dr. Hannah Farrimond:

“We found that patients struggled to maintain their sense of being ‘healthy’ in the face of their new ‘high risk’ status. The older they were, the more patients treated the risk of CHD as a normal part of getting older. They would downplay their sense of vulnerability by, for example, comparing their own weight and diet favourably with that of their friends.”

Most study participants already believe that they eat a healthy and balanced diet, or that their lifestyle is relatively “heart-healthier” than those of their peers. The standard dietary and physical activity rules may not be therefore acceptable or applicable in these cases.

The study results suggest that intervention and prevention programs should take into account the “social environment and age of the target group.” In addition, lifestyle change strategies should be customized to the patient’s needs.

Photo credit: Stock.xchng

               

Know your heart conditions: diastolic dysfunction

Resource post for January

About 80 million adult Americans suffer from at least one type of cardiovascular disorder. This is equivalent to 1 in every 3 adults. Diastolic dysfunction is a commonly used term nowadays in connection with diagnosis of heart disease. This term, however, is fairly new, and the dysfunction has only been identified with improved diagnostic techniques.

What is diastolic dysfunction?

Before we can understand this disorder, we first have to understand how our heart works.

“Lub-dub” This is the sound that our heart makes with each and every heartbeat. And with every beat, the heart contracts and relaxes. The contraction phase when the ventricles contract to pump blood out of the heart is called the systole. The relaxation phase when the ventricles relax and get filled with blood pumped from above by the atria is the called diastole. The “lub-dub” sound is actually made by the heart’s valves as they close and open during the contraction - relaxation cycle.

Our heart has 4 valves, namely:

• The tricuspid valve divides the right atrium from the right ventricle.
• The mitral valve divides the left atrium from the left ventricle.
• The pulmonary valve separates the right ventricle from the pulmonary artery, the big blood vessel that brings blood to the lungs.
• The aortic valve is separates the left ventricle from the aorta, the big artery that carries blood from the heart to the body.

The soft “lub” is the sound that the mitral and tricuspid valves make when they close at the start of the systole or contraction phase. The louder “dub” is the sound that the aortic and pulmonary valves make when they close at the start of the diastole or relaxation phase.

Diastolic dysfunction occurs when the relaxation or diastolic phase of the heart does not proceed normally. This has something to do with “stiff” heart muscles leading to the failure of the ventricle to relax normally. This inability of the ventricle to completely relax results in:

• the pressure in the ventricle to increase above normal.
• difficulty for the blood to enter the ventricle in the next heartbeat.

According to the American Heart Association (AHA), when not managed properly, diastolic dysfunction leads to inefficient pumping of the heart and “can cause increased pressure and fluid in the blood vessels of the lungs (pulmonary congestion). It can also cause increased pressure and fluid in the blood vessels coming back to the heart (systemic congestion).” This can eventually lead to diastolic heart failure.

According to this article in the American Academy of Family Physicians (AAFP) site

“diastolic heart failure is defined as a condition caused by increased resistance to the filling of one or both ventricles; this leads to symptoms of congestion from the inappropriate upward shift of the diastolic pressure-volume relation.”

A condition called systolic dysfunction also exists.

What causes diastolic dysfunction?

The disorder seems to be especially common in elderly women, even among those not previously diagnosed with heart disease. The following cardiovascular conditions can lead to the stiffening of the ventricles and thus diastolic dysfunction:

• aortic stenosis
• chronic hypertension
• coronary artery disease
• some forms of cardiomyopathy, e.g. hypertrophic and restrictive cardiomyopathy

How is diastolic dysfunction detected and diagnosed?

In its early stages, diastolic dysfunction does not manifest in obvious symptoms. Perhaps the earliest noticeable symptom would be dyspnea or shortness of breath. However, since this is a very common symptom for many kinds of diseases and disorders, diastolic dysfunction is often “missed” during routine medical check ups. Thus, “diastolic dysfunction may be present for several years before it is clinically evident.”

It its advanced stage, when diastolic dysfunction has progressed to the point of causing diastolic heart failure, the following symptoms and related conditions may be evident:

• Abnormal heart rhythms such as atrial fibrillation
• Periodic increase in blood pressure
• Decreased tolerance to physical exercise
• Severe breathlessness even without exertion
• Edema or accumulation of fluids in the feet and ankles
• Acute pulmonary congestion

A standard electrocardiogram or ECG unfortunately cannot easily distinguish between systolic and diastolic dysfunction. The most reliable but rather invasive diagnostic method is cardiac catheterization. As a less invasive alternative, a two-dimensional echocardiography with Doppler function can be used, although the physician must be well-trained in evaluating “the characteristics of diastolic transmitral and pulmonary venous flow pattern” in order to diagnose diastolic dysfunction.

How is diastolic dysfunction managed?

As in almost every disease, early diagnosis and treatment of diastolic dysfunction is important to prevent irreversible damage to the heart.

There is no easy way to treat diastolic dysfunction. However it can be effectively managed through treatment and management of the underlying conditions, namely:

High blood pressure. Management of hypertension is essential in the management of diastolic dysfunction. The AHA gives a comprehensive review of hypertension, including online tools to check for risk factors and blood pressure monitoring.

Coronary artery disease. CAD on its own requires aggressive management strategies to prevent heart attacks. This animation on the AHA site explains clearly how CAD develops.

Aortic valve stenosis. The aortic valve can also become stiff or is misformed at birth, resulting in aortic stenosis, a condition which puts a strain on the left ventricle. Usually, this condition is relieved by surgical interventions.

Arrhythmia. Abnormal heart rhythms such as atrial fibrillation need to be managed effectively to avoid further complications. The AHA site also gives a useful animation on atrial fibrillation. More information about arrhythmias can be found here.

Currently, there is a scarcity of conclusive data on therapies specifically for diastolic heart dysfunction and failure. However, the American College of Cardiology and the American Heart Association have jointly come up with guidelines which “recommend that physicians address blood pressure control, heart rate control, central blood volume reduction, and alleviation of myocardial ischemia when treating patients with diastolic heart failure. These guidelines target underlying causes and are likely to improve left ventricular function and optimize hemodynamics.” Medications used for the management of diastolic heart failure are summarized in this AAFP article (Table 4).

Can diastolic dysfunction be prevented?

Like many heart disorders, diastolic dysfunction and heart failure are preventable.

“Primary prevention of diastolic heart failure includes smoking cessation and aggressive control of hypertension, hypercholesterolemia, and coronary artery disease. Lifestyle modifications such as weight loss, smoking cessation, dietary changes, limiting alcohol intake, and exercise are equally effective in preventing diastolic and systolic heart failure.”

Photo credits: stock.xchng

               

Diabetophobia

Diabetophobia or fear of diabetes.

What exactly is a phobia?

From dictionary.com:

“a persistent, irrational fear of a specific object, activity, or situation that leads to a compelling desire to avoid it.”

Perhaps something occurred in your life that stuck in your subconscious mind that triggers a fear of diabetes.

So what is fear?

Again, from dictionary.com:

“a distressing emotion aroused by impending danger, evil, pain, etc., whether the threat is real or imagined; the feeling or condition of being afraid.”

There are many facets to the diabetophobia. It can include fear of becoming a diabetic. Fear of hypoglycemia. Fear of needles. Fear of diabetic complications.

It often includes denial.

Denial is my personal favorite. And hey, if you are reading this…I am probably preaching to the choir.

You probably have the numbers memorized, right?

But for everyone else here they are again from the CDC press release dated June 24, 2008.

Diabetes now affects nearly 24 million people in the United States, an increase of more than 3 million in approximately two years, according to new 2007 prevalence data estimates released today by the Centers for Disease Control and Prevention (CDC). This means that nearly 8 percent of the U.S. population has diabetes.

In addition to the 24 million with diabetes, another 57 million people are estimated to have pre-diabetes, a condition that puts people at increased risk for diabetes. Among people with diabetes, those who do not know they have the disease decreased from 30 percent to 25 percent over a two-year period.

How do you deal with diabetophobia?

The best way to diffuse fear is with knowledge.

Knowledge brings not only the tools to deal with fear but also a calm acceptance that you will be able to handle your future.

A few months ago I shared a simple risk test to assess your risk for diabetes from the American Diabetes Association. Turns out ADA offers an even more in-depth risk assessment called Diabetes PHD.

“Diabetes PHD (Personal Health Decisions) is a powerful new risk assessment tool. It can be used to explore the effects of a wide variety of health care interventions, including losing weight, stopping smoking, and taking certain medications.”

Another personal favorite assessment tool that I love and hate is RealAge.

“Your RealAge is the biological age of your body, based on how well you’ve maintained it.”

If you suffer from diabetophobia you’re probably already having some anxiety.

Relax. You aren’t alone.

I took the simple diabetes risk test and faced the scary realization that I need to make some changes. I haven’t had the courage to take the PHD yet.. I will, I promise. I will.

And RealAge. Haven’t done that in a few years. A little nervous here.

See what I mean about denial? I told you, you weren’t alone.

Elizabeth Kubler-Ross’s five stages of grief from her 1969 book, On Death and Dying, explains the stages which apply to any life changing event. The stages are not simply about death, but reflect the loss of life as you know it. A diagnosis of diabetes or pre diabetes is a life changing event.

1. Denial–refusal, either conscious or unconscious to accept the facts

2. Anger–at self or others

3. Bargaining–compromising with others or a faith system

4. Depression–a period of sadness, fear and regret

5. Acceptance–dealing with the facts

The important thing is not how you move through the stages, but that you continue forward momentum. That momentum is individual, bringing you to a place of coping and to a place of re-evaluation.

Right now I’m transitioning through a few of these stages as I realize I am a pre diabetic (family history, borderline gestational diabetes, weight struggles). I realize knowledge gives me the tools to do something about this and I am trying, albeit struggling, to make the necessary changes in my life.

What about you?

Where are you? What facets of diabetophobia are you dealing with?

Where are you in the grieving process?

More importantly how will you obtain the knowledge needed to overcome diabetophobia?

               

Do you know your risk for heart disease?

Do you have an undiagnosed risk for developing cardiovascular disease (CVD)? You think it’s highly unlikely? Well, think again.

According to a British study, one in three people with high cardiovascular risk over the next years are unaware of their risk, and neither are their health care providers. In other words, it is very often that the risk remains undiagnosed until it manifests in overt symptoms. This oversight in risk assessment is especially strongest in middle-aged men.

The study conducted by Oxford University researchers in a mobile clinic looked at 71,037 men and women aged 18 and older all over England, Wales and Scotland. Tests were performed and questionnaires were filled in. The results do not look good.

• 20% of all male study participants and 6% of female participants have high likelihood of developing CVD in the next 10 years.
• CVD risk is highest in the 50 plus age group compared to others. 75% of men and 45% of women in this age group have CVD, diabetes, and are taking anti-cholesterol or anti-hypertension drugs.

Based on the results, the participants were classified as having high, medium, or low risk profiles.

People were defined as high risk if they had more than a 20 per cent chance of developing CVD over the next 10 years. This criterion is in line with the Joint British Societies Guidelines on Prevention of Cardiovascular Disease in Clinical Practice, which were issued in 2005 and endorsed by the UK’s National Institute of Health and Clinical Excellence in 2006.  

Based on their risk profiles, the participants were then given appropriate medical advice. High risk individuals were advised to see their doctor, together with their tests. Those with medium risk profiles were given verbal as well as written advice as to how to reduce the risk.

In the UK alone, almost 8 million people have been diagnosed with CVD or have recognized high risk for CVD. However, it is estimated that there are almost 4 million people out there whose risk are undiagnosed and are therefore unaware of this risk. Because of this, they do not concern about preventive measures, lifestyle changes, professional advice or early treatment. Of these, 2.8 million are male and 900,000 are females. If these figures were to be extrapolated on a global scale, the numbers are staggeringly big. There is clearly a need for more awareness of CVD risks and risk factors on the part of patients and health care providers alike.

The most common risk factors for CVD are:

• Obesity
• Lack of exercise
• Bad nutrition
• Smoking
• Genetics

So don’t think you are exempt from CVD risk. Check your lifestyle. Check with your doctor. Remember: early detection means early prevention.

Photo credit: fishmonk at stock.xchng

               

Preventing preeclampsia

You could be young, healthy, and fit with no history of hypertension. But suddenly, your blood pressure skyrockets to hypertensive levels. And the main reason is - pregnancy.

Preeclampsia, usually used synonymously with pregnancy-induced hypertension, occurs when the blood pressure of a pregnant woman increases dramatically within a short period of time usually during the second half of her pregnancy. This leads to hypertension, kidney damage, inflammation, preterm delivery and premature babies with low birth weights and presents a serious risk to the mother and to the baby. According to FamilyDoctor.org, preeclampsia commonly occurs:

• in women having their first pregnancy
• in women carrying multiples
• in women with family history of preeclampsia
• in pregnant teenagers and those above 40
• in women with hypertension or kidney problems before they got pregnant

The real cause of preeclampsia hasn´t been identified. It affects about 2 to 8% of pregnancies, making it one of the leading causes of maternal and fetal complications and death worldwide.

In this post, I am reviewing two studies on the prevention and monitoring of preeclampsia.

Blood pressure monitoring

Ambulatory blood pressure monitoring (ABPM) could help identify women with early-onset severe pre-eclampsia who are most likely to require early delivery.

according to South African researchers.

They found that by monitoring both diastolic blood pressure (DBP) and day-night blood pressure difference (DND) and combining the mean values, the onset of preeclampsia can be predicted.

The research

“studied 44 women presenting with severe pre-eclampsia between 28 and 34 weeks’ gestation, who they managed expectantly for 8 days. They measured the women’s blood pressure every 30 minutes with an automated monitor for 24-hour periods on alternate days.”

The researcher observed that Caesarean sections are significantly lower among pregnant women with normal DND and mean DBP. These women also had, on the average, longer pregnanciey and less very premature babies. Only one delivered before 32 weeks’ gestation.

The authors conclude:

“The combination of mean [DBP and DND] may be a supplementary measurement of disease severity in early onset severe pre-eclampsia and seems to be of prognostic value”

Preeclampsia and exercise

This study involved 79 women who had a previous history of pre-eclampsia and had a sedentary lifestyle. The study compared two types of exercise regime: a 40-minute moderate‑intensity walk 5 times a week and a slow, non-aerobic stretching exercise program accompanying a 40-minute video 5 times a week.

The results of the study are as follows:

15% of women in the walking group developed preeclampsia. Only 5% of women in the stretching group developed the condition.

It seems that stretching had a more protective effect against pregnancy-induced hypertension than walking. The researchers believe that stretching may induce more production of transferrin, which is

“a plasma protein that transports iron through the blood and protects against oxidative stress on the body, and that helps guard against preeclampsia.”

However, walking and other moderate forms of exercise are beneficial to the mother’s as well as the baby’s health in general, as posted before. At the same time, any form of exercise regime during pregnancy should only be performed after consultation with your doctor.

Photo credit

               

The Diabetes Prevention Program

The Diabetes Prevention Program, DPP.

The Diabetes Prevention Program was a randomized clinical trial that involved 27 diabetes centers across the United States. Additionally it included over 3000 people who were 25 years of age or older at high risk for developing Type 2 Diabetes. High risk individuals were determined due to obesity, family history for Type 2 Diabetes and elevated glucose levels. Half the participants were Caucasian and half were minorities.

The goal was to test the effectiveness of strategies to prevent or delay the onset of Type 2 Diabetes. More specifically the study goal was targeted at discovering whether either diet and exercise or the oral diabetes drug metformin could prevent or delay the onset of Type 2 Diabetes in people at high risk.

There were three study groups in the DPP:

• Group 1 had intensive training in diet, exercise, and behavior modification. This was called the Lifestyle Intervention Group.
• Group 2 had 850 mg of metformin twice a day with diet and exercise information but no intensive one-on-one counseling.
• Group3 received a placebo and diet with diet and exercise information but no intensive one-on-one counseling.
• Group 4 received the medication troglitazone. This group was discontinued due to side effects of troglitazone.

The study length was approximately 3 years with a 3 to 5 year follow up, and the results were published in the New England Journal of Medicine.

The Results:

The study conclusively found that people at high risk for Type 2 Diabetes can prevent the onset of the disease by making changes in their diet and increasing their level of physical activity. Some medications may delay the development of diabetes, but diet and exercise worked better. The Lifestyle Intervention Group resulted in a 5-10% reduction in body weight, yielding a 58% reduction in diabetes. Some individuals had a return to normal levels of blood glucose. Individuals in the metformin with standard care group reduced their risk for getting Type 2 Diabetes by 31 percent.

A final note: the exercise goal of the Lifestyle Intervention Group was only 150 minutes per week. That’s a little less than 30 minutes, 7 days a week.

Battling Books:

Conquering Diabetes: A Complete Program for Prevention and Treatment by M.D., Anne Peters

               

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