Cardiac PET Scan (Positron Emission Tomography)

A Cardiac PET Scan is an investigation that uses the position of radioactive substances within the body to give an idea about its function. Those parts of the body that are the most active need energy, and the energy that it uses is sugar (also called glucose). A PET scan uses a specially created substance that the body thinks is sugar, and takes it up into the cells. This substance is called a 'tracer', and it is almost exactly like sugar, but has a small radioactive part attached to it.

A Cardiac PET Scan uses this same technique, but uses different tracers and some different techniques to get a good idea about the function and blood flow to the heart. Often it is combined with a CT scan so that the doctor can see both the structure and function of the heart.

PET scans work to identify the cellular changes that occur in the body during disease.

During a PET scan, the patient is given a substance called a tracer, typically a chemical found in the body (oxygen, glucose, nitrogen, fluorine) which has been tagged with a radioactive atom that breaks down quickly to release positrons. The most common tracer for normal, non cardiac, PET scans has a complicated name but is mostly known as FDG (which stands for 2-[18F]fluoro-2-deoxy-D-glucose). FDG is very similar to glucose (sugar).

Once in the body FDG travels to the area of the body that is using a lot of sugar and breaks it down. In breaking down, it releases a positron. This combines with an electron from the patient sending out radioactive waves.

These waves can be detected by the PET Scanner which converts the waves into electrical signals that can be analysed by a computer. The computer can then create images of the targeted tissue's function, in a colour code. Different colours or degrees of brightness on a PET image represent different levels of tissue or organ function. In the image to the right, areas that use more sugar, and so collect more of the radioactive substance, are shaded darker.

For example, because healthy tissue uses glucose for energy, it accumulates some of the tagged glucose, which will show up on the PET images. However, cancerous tissue, which uses more glucose than normal tissue because it is growing much faster, will accumulate more of the substance and appear brighter than normal tissue on the PET images.

Therefore PET scans are commonly used to detect cancer, as the scan will detect biochemical changes in the body associated with cancer as well as the extent of spread and the possible effective treatment. Functions of the brain may also be examined in association with patients with memory loss, suspected or known brain tumours or seizure disorders.

For a Cardiac PET Scan, a different tracer is used than in a normal PET scan because uptake of sugar is not a very helpful thing to measure for the heart. For cardiac PET scans, the most common tracers are a type of ammonia with a bit of radioactive material attached to it, a substance called Rubidium and a radioactive type of Fluorine.

PET scans are generally done in an outpatient setting and preparation is usually set by your doctor. The scan does require the patient to lie still for a period of time for up to two hours, so if you feel you may have a problem with this, please talk to your doctor.

Women who suspect they may be pregnant or are pregnant need to notify their doctor as this is a radioactive procedure and could have effects on an unborn foetus.

The PET scanner is a donut-ring shaped apparatus with an attached table that moves into the scanning ring. Initial scans may be done before you are taken into a special injection room where the tracer is administered, usually intravenously.

It will then take 30-90 minutes for the substance to travel through your body and accumulate. During this time you may be asked to rest quietly to allow the substance to travel through the body. You will then be asked to lie still on the scanner table and it will move in through the scanner ring.

During the scan, which can take from thirty minutes to two hours, you must lie very still to allow for clarity of the images. After the scan there are no restrictions to daily activity, but it is recommended you drink plenty of water to flush your system of the tracer.

PET scans are beneficial as they demonstrate the biochemical changes in the body, whereas a CT or MRI scans identify anatomical changes.

A PET Scan therefore helps to identify problems at the level of their activity and function, which might change long before any changes in body structure (such as a tumour) become apparent.

This allows for earlier diagnosis and more effective treatment of diseases such as cancer, and also more detailed imaging of other conditions. There is little risk involved with the intravenous administration of the radioactive "tracer" as the tracer has a short decay time of only a few hours and is quickly removed from the body.

A cardiac PET scan is useful because it can give very precise images, is not greatly affected by the fast changing blood flow in the heart and can give information about how much of the tracer ends up in different parts of the heart. This is important because it can give doctors information about damage to the heart, and show areas that may have problems with low amounts of blood flow.

The risks associated with a PET scan are very small, and are due to reactions to the radioactive "tracer" injected. The level of tracer given to a patient is very tiny, and the chances of a reaction occurring are incredibly low. PET scans can sometimes show areas of high activity which may be mistaken for cancers. Inflammatory conditions like rheumatoid arthritis or tuberculosis absorb a large proportion of the tracer, and so can cause confusing results.A PET scan is less accurate in certain situations: Slow-growing, less active tumours may not absorb much tracer.Small tumours (less than 7mm) may not be detectable.High levels of blood sugar can cause the cells to absorb this normal sugar rather than the radioactive, injected kind. Patients are usually fasted for 4 hours before a PET scan, and blood sugar levels measured to lower the chances of this happening.The radioactive substance has a very short decay and therefore appointments must run on schedule.PET scans are a very expensive form of imaging, and are not readily available. They often accompany other scans such as CT and MRI in order to be diagnostically effective.

After a PET scan, the doctor will receive an image of the patient displaying the different amounts of activity present in different parts of the body. An image of a combined CT Scan and PET scan is seen to the right. Different colours represent different levels of tracer and so can show different levels of blood flow.

For a normal PET scan, if there is cancer present in the body, this area will appear to be more active and so PET scans are often used to determine if a cancer has spread to other parts of the body, or to see how advanced a cancer is. A PET scan is not as accurate for very small cancers however, so very early scans may not show anything.

Cardiac PET scans could show a doctor that blood flow to the heart is completely normal but could also show that things are going wrong. The doctor would be looking for any parts of the heart that did not get an adequate amount of the tracer as this would show that it is also not getting enough blood.

Di Carli MF, Dorbala S. Integrated PET/CT for cardiac imaging. The Quarterly Journal of Nuclear Medicine and Molecular Imaging, 2006; 50, 1: 44.Positron Emission Tomography: Assessment Report. Medicare Services Advisory Committee, 2000. Commonwealth of Australia.Khorsand A, Graf S, Eidherr H, Wadsak W, et al. Gated Cardiac 13N-NH3 PET for Assessment of Left Ventricular Volume. The Journal of Nuclear Medicine, 2005; 46 (12): 2009.Soben P, Udelson KE. 'Thoracic Assessment of myocardial viability by nuclear imaging in coronary heart disease' [online], UpToDate, 2006. Available at URL: http://www.uptodate.com (last accessed 13/07/06)Stark P. 'Thoracic positron emission tomography' [online], UpToDate, 2006. Available at URL: http://www.uptodate.com (last accessed 13/07/06)



This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Cognitive-Behavioural Therapy CBT

Cognitive Behavioural Therapy (CBT) is a type of therapy used to treat many different problems, especially psychiatric problems such as depression and anxiety. CBT has its roots in the late 1950s and was officially formed in the late seventies. Since then it has been shown to be a very effective way to help people overcome a variety of problems. CBT is an umbrella term that encompasses many different types of therapy that are all based on the same ideas. The principle is that first there is a thought, this triggers a feeling and this changes a person's actions. The problem is that in many people these thoughts are based on 'incorrect beliefs'. The aim of CBT is to correct these beliefs and this will lead to a change in thoughts leading to a change in feelings and finally a change in behaviour.

CBT is a relatively short-term form of psychotherapy (a type of counselling) that can be used for the treatment of a wide range of psychological disorders including depression, anxiety, eating disorders such as anorexia nervosa, substance abuse and personality disorders amongst others. It can also be used to help people change their lifestyles. It focuses on working on the 'incorrect beliefs' that people have. These 'incorrect beliefs' are usually unintentional but they seriously affect how people react to situations.

CBT is based on the theory a thought or idea must precede a mood, meaning there must be something that a person thinks that leads them to feel a certain way. This, in turn, will lead to the way in which people act. It also says that the way in which people act is heavily influenced by the way that they see themselves and the way that they think others see them.

Below is a simple example.
There are three people (Tom, Dick and Harry) and they all stub their toe on an uneven piece of paving. Tom thinks 'I am such a fool, everyone must think I'm clumsy and stupid'. Tom feels embarrassed and humiliated and quickly returns home.
Dick thinks 'I could have hurt myself, why doesn't the council fix such a hazard'. Dick feels stressed and angry and this reflects on his dealings with everyone he meets that day.
Harry thinks 'Ouch, I hit my toe, but I'm OK' Harry doesn't give it a second thought and it doesn't affect his day. This is a simple example but it illustrates the point.
Tom and Dick both have 'incorrect beliefs' and these beliefs result in thoughts, then feelings (embarrassed and angry) and then actions (Tom goes home while Dick is angry). Only Harry had the right response. He acknowledged that he hurt himself but realised that he was OK and went about his day as normal.

The idea behind CBT is that unwanted behaviours and moods such as depression are often caused by a certain type of thought. These thoughts have usually been held by people for a long time, remaining under the surface. Certain events 'reactivate' these types of thoughts and can cause negative moods and behaviours. These thoughts, when pulled apart and examined, are often based on the illogical ideas and 'false' beliefs that CBT aims to correct. If CBT can correct these false thoughts then in that situation in the future, the person will react differently and see things from a point of view that will not lead to a negative mood.

CBT is usually a relatively short-term treatment, with therapy lasting for up to 6 months. During individual therapy you will meet with your therapist on a regular basis and during these sessions:

At first you will set short, medium and long term goals. The therapist will also spend time on your past life and background.With the therapist, you break each problem down into its separate parts. Your therapist may ask you to keep a diary to help identify your individual thoughts and emotions.Together you will look at your thoughts, feelings and behaviours to work out if they are unrealistic, or unhelpful and how they affect you.The therapist will then help you to work out how to change unhelpful thoughts, feelings and behaviours.It's easy to talk but much harder to actually change. So, after you have identified what you can change, your therapist will recommend 'homework' where you will practise these changes in your everyday life.Then at each meeting you discuss how you've managed since the last session.

In CBT people are asked about some situations and their views about the world. They are asked what situations they feel the most negative in and then asked to try and find out exactly why these situations make them feel that way. People are asked to look really hard at these situations and think whether or not the thoughts that lead them to feeling that way are logical or not. Over time it is hoped that people will be able to think in a way that leads to a more positive outlook and behaviour.

There is also a 'behavioural' aspect to CBT that is especially important early in the treatment. People are often asked to schedule positive experiences and things that they enjoy so that there is always something to look forward to. They are also encouraged to reward positive thinking with enjoyable experiences. There is now a new form of CBT that is computer based. This Computerized Cognitive Behavioural Therapy has been shown to be effective for anxiety and depression and more work is underway to see where else it could be useful. The advantage of computerized behavioural therapy is that it requires fewer resources and therefore has the potential to become more widely available.

CBT is an effective method of treating various types of problems. It is relatively short-term and gives people many skills that can be applied to every situation, even after treatment has finished. CBT is especially effective when combined with pharmacological (drug) treatments because they both work together to improve the symptoms. It has even been shown that CBT can change the way the brain works in much the same way as medications. Even in the absence of drug therapy, or if someone is hesitant to begin drug therapy, CBT alone often provides a good treatment. The people who get the most out of CBT seem to be those that are thoughtful and have the ability to self-reflect on situations and are open to change.

While CBT is actually one of the shorter types of treatment for some people it may still seem too long. Also, it is not a 'cure' for any illness and while it does provide a lot of help, it does not completely remove the symptoms, especially if the person is continually in a stressful environment. There are also some conditions that CBT alone does not work very well for and these may require both drug treatment as well as other types of psychotherapy -of which there are many.

CBT has been shown to be effective in the following conditions. However this list is continually growing as more research is done into the use of CBT.

Below are two examples of how CBT can work in certain situations. Although both are greatly simplified they illustrate the principle of CBT.

You've had a bad day, feel fed up, and so go out shopping. As you walk down the road, your friend, who seems deep in thought, walks by and, apparently, ignores you.
You think: He ignored me, he must not like me, I will ignore him.
You feel: Low, sad, rejected
You Do: Go home, you start ignoring the person, the friendship is over.
This shows several points. Firstly there is the false belief that because your friend didn't see you they don't like you. Then it becomes a 'self fulfilling prophecy' because if you ignore your friend they will become upset and eventually stop being your friend.

CBT will work on changing your assumptions. For example, your friend seemed deep in thought, maybe something has just happened to them? It would be good to get in touch with them to find out if everything is OK. Another example. "Overfilling the swimming pool is the last straw in my relationship with my parents. The whole garden will have to be re-landscaped. The footings may need to be replaced." Here the problem is magnification. The trigger was overfilling the swimming pool, this combined with magnification leads to the thought that the garden is ruined, leading to feelings of anger, leading to an argument with the parents. CBT will try to change this view, if the pool is overfilled it does not mean that the whole garden is ruined, there is no need to feel angry and there is really no reason to argue with the parents.

The American Institute of Cognitive Therapy. Cognitive Therapy, Cognitive Behavioural Therapy [Online]. [Cited 22/09/2007]. Available at URL: http://www.cognitivetherapynyc.com/default.asp?sid=768Sadock BJ, Sadock VA. Pocket Handbook of Clinical Psychiatry. Philadelphia, Lippincott, Williams and Wilkins, 2005.Scott J. Cognitive Therapy of Affective Disorders: a Review. Journal of Affective Disorders. 1996; 37; I - I I.Stuart RJ, Blecke D, Renfrow M. Cognitive Therapy for Depression. American Family Physician. 2006;73:83-6, 93.Parker G, Roy K, Eyers K. Cognitive behavior therapy for depression? Choose horses for courses. The American Journal of Psychiatry. 2003; 160, 5; 825.Timms P (Ed.). Cognitive Behavioural Therapy. Royal College of Psychiatrists 2007.Cavanagh K, Shapiro DA, Berg SV, Swain S etal. The effectiveness of computerized cognitive behavioural therapy in routine care. British Journal of Clinical Psychology 2006; 45: 499-514.Zaretsky AE, Rizvi S, Parikh SV. How Well Do Psychosocial Interventions Work in Bipolar Disorder?. Canadian Journal of Psychiatry 2007; 52(1): 14-22.Roth A, Fonagy P. What works for whom: A critical review of psychotherapy research (2nd ed.). New York: Guilford Press 2004.James A, Soler A,Weatherall R. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database of Systematic Reviews 2005, Issue 4.Jones C, Cormac I, Silveira da Mota Neto JI, Campbell C. Cognitive behaviour therapy for schizophrenia. Cochrane Database of Systematic Reviews 2004, Issue 4. McGurk SR, Mueser KT. Schizophrenia. Lancet. 2004; 363: 2063-72.Shaw K, O'Rourke P, Del Mar C, Kenardy J. Psychological interventions for overweight or obesity. Cochrane Database of Systematic Reviews 2005, Issue 2Feeney GF. Connor JP, Young R, Tucker J, McPherson A. Improvement in measures of psychological distress amongst amphetamine misusers treated with brief cognitive-behavioural therapy (CBT). Addictive Behaviors 2006; 31: 1833-43.McWelschen L, Oppen P, Dekker JM, Bouter LM, etal. The effectiveness of adding cognitive behavioural therapy aimed at changing lifestyle to managed diabetes care for patients with type 2 diabetes: design of a randomised controlled trial. BMC Public Health 2007; 7: 74-84.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Diarrhoea

Diarrhoea is a common digestive disorder that virtually all people will suffer at some stage during their lives. The definition of diarrhoea varies but it can generally be taken to mean increased stool water causing an increase in stool frequency or the passage of soft stools. Passage of greater than 3 stools per day or a stool volume of greater than 200 mL suggests the diagnosis of diarrhoea.

Diarrhoea is called acute if lasts for less than two weeks or chronic if it lasts for greater than 4 weeks. Diarrhoea can occur in virtually any person regardless of their age and general health. Diarrhoea can range from a mild discomfort to a severe and life threatening illness due to the risks of dehydration. In fact diarrrhoeal diseases are one of the top causes of death worldwide and it bcomes particularly common in developing countires with poor food practices and hygiene.

Children and the elderly are particularly prone to dehydration secondary to diarrhoea. However, the great majority of cases of diarrhoea follow short courses which don't really require specific diarrhoea treatment to resolve.

Diarrhoea basically develops when there is a defect in the absorptive mechanism working in the intestines. This may be due to damage to the mucosa (lining of the bowel) from infections or inflammation or excess secretion of fluid and electrolytes from particular toxins (e.g. cholera). Sometimes there may be too much sugary material in the lumen of the bowel which draws more fluid across the membranes. In other patients the bowel may just be overactive from hormone disorders which causes very frequent bowel motions but the overall volume should remin approximately the same.

By far the most common cause of diarrhoea is infection. Most cases are just mild viral infections caused by rotavirus (which some people may refer to as the stomach flu). This can be easily spread through daycare cantres, schools or families. Bacteria such salmonella, campylobacter and shigella are other common causes of diarrhoea. These cases tend to be more severe than viral diarrhoea and are caused by eating food or drinking water contaminated with these bacteria.

Diarrhoea can sometimes be caused by parasites which are transmitted by similar mechanisms. Giardia lamblia and cryptosporidium are possible parasitic causes of diarrhoea. Chronic diarrhoea can be caused by a number of medical problems. Irritable bowel syndrome is relatively common and associated with alternating periods of diarrhoea, constipation and bloating.

Certain medications, particularly antibiotics and anti-cancer drugs can cause diarrhoea because they disrupt the normal healthy bugs in the intestines and inhibit mucosal cell regeneration respectively. Inflammatory bowel diseases which include Crohn's disease and ulcerative colitis also cause recurrent attacks of diarrhoea often stained with blood and mucus. Colorectal cancer or any other defects in the intestines may also cause diarrhoea.

The signs and symptoms of diarrhoea include:

Passage of frequent, loose and watery stools; Abdominal cramps or pain;Fever- Particularly if there is an infectious cause;Bleeding- Bacteria and parasites often can produce bloody diarrhoea (dysentery). In addition inflammatory bowel disease, polyps and colorectal cancer cause blood and mucus in the stools;Nausea and vomiting may also be present in the case of infection.

Important points in the history of diarrhoea

Your doctor will ask you lots of questions so they can try to determine the likely cause of your diarrhoea in order to treat it. These questions will include:

How long have you had diarrhoea? What is the clour and consistency of your stool? Any blood or mucus? Any other symptoms or fever? Do you have abdominal pain with the diarrhoea? Anybody else in the family sick? Have you recently been overseaes? Which medications do you take? Do you smoke? How much alcohol do you drink? Are you on a special diet?

The doctor will then briefly examine you to to check for signs of anaemia and dehydration. Your abdomen will also be caefully examined.

The doctor will then order a number of tests to determine the likely cause. These will include:

Blood tests: Looking at blood counts and haemoglobin to determine any anaemia due to bleeding and to look for the possibility of infection;Stool examination: Samples of stool will be examined under the microscope to see if there are any pathogens identifiable;Sigmoidoscopy, colonoscopy or barium examination may be used to visualise the bowel to determine if inflammatory bowel disease, polyps or suspected malignancy (cancers) are present. Patients with chronic diarrhoea often have extensive tests to determine the most likely cause.

Most cases of diarrhoea are self-limiting so treatment of diarrhoea is primarily supportive. Many patients become dehydrated so may require fluid resuscitation. If you experience diarrhoea at home you should drink lots of water to avoid dehydration and minimise your intake of caffeine and alcohol (as these aggravate diarrhoea and dehydration). You can also help yourself by eating lots of semi-solid foods such as dry toast, rice and bananas and taking probiotics (e.g. yoghurt) to replenish the good bacteria in your bowel.

If you have severe symptoms, bloody stools, fever, vomiting or persistent diarrhoea it is advisable to consult a doctor. Other diarrhoea treatment largely depends on the cause of the diarrhoea. Some patients will be given certain diarrhoea medications to decrease movements of the bowel and reduce the volume of stool such as bismuth sulphate, loperamide or codeine phosphate. However, if you have an infection, it may be better not to inhibit your bowel motions because this is the way your body is attempting to clear the body of nasty bugs. If infection is present you may require antibiotic for the diarrhoea.

Diarrhoea prevention

Washing your hand thoroughly before all meals and when preparing food;When travelling to developing countries- Drink bottled water, only drink well-cooked meals, avoid raw fruit and vegetables and milk products;When taking antibiotics, try taking probiotics such as Lactobacillus acidophilus, as this helps to replenish the natural flora that antibiotics can destroy.

Note: Probiotics are not recommended for patients having chemotherapy or who are immunosuppressed as they may have harmful effects.

Dietary management of diarrhoea

Take anti-diarrhoeal medication only as prescribed by your doctor;Drink plenty of fluids as your body may lose a lot of fluid while you have diarrhoea (e.g. water, diluted soft drinks and weak cordials);Avoid highly spiced and fatty foods, very hot or cold food/drinks, and alcohol, and limit caffeine (coffee and strong tea) as these may make diarrhoea worse;While you have diarrhoea, reduce your fibre intake by replacing wholemeal bread and cereals with white varieties. Avoid raw fruit and vegetables with skins, seeds, nuts and legumes (e.g. baked beans);Sometimes diarrhoea can cause temporary lactose intolerance, where ordinary milk may make the diarrhoea worse. In such case it may be helpful to change to soy milk or low lactose milk until diarrhoea ceases. Cheese and yoghurt in small amounts are usually tolerated;Speak with your dietitian about other dietary management strategies for diarrhoea.

Article kindly reviewed by:

The DAA WA Oncology Interest Group
and
Food4Health (Helen Baker Dietitian-APD)

Guandalini S, Frye RE, Tamer MA. Diarrhea [online]. Omaha, NE: eMedicine; 2006 [cited 21 June 2006]. Available from: URL link Gorbach SL. Treating diarrhoea. BMJ. 1997;314(7097):1776-7. [Abstract | Full text]Kumar P, Clark M (eds). Clinical Medicine (5th edition). Edinburgh: WB Saunders Company; 2002. [Book]Longmore M, Wilkinson I, Rajagopalan SR. Oxford Handbook of Clinical Medicine (6th edition). Oxford: Oxford University Press; 2004. [Book]Diarrhea [online]. Bethesda, MD: MedlinePlus; 2004 [cited 21 June 2006]. Available from: URL linkThielman NM, Guerrant RL. Clinical practice: Acute infectious diarrhea. N Engl J Med. 2004;350(1):38-47. [Abstract]Wanke CA. Approach to the patient with acute diarrhea in developed countries [online]. Waltham, MA: UpToDate; 2006 [cited 21 June 2006]. Available from: URL link

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Female Condom

The female condom is a transparent, loose fitting, polyurethane sheath inserted into the vagina prior to sexual intercourse (either vaginal or oral). A female condom is 17 cm long, and has a flexible ring at each end. One end of the condom is closed and this end is inserted into the vagina to capture male semen during heterosexual intercourse. The other end of the condom is open, and this end remains outside the woman's vagina during sexual activity, partially covering her external genitalia. The woman's partner inserts their penis or tongue into the open end of the condom during vaginal or oral sexual activity.

Like the male condom, the female condom is a barrier method, that is, it creates a barrier between the woman's vagina and her partner's penis or mouth, which prevents the mixing of fluids during sexual activity. In doing so, the female condom provides users with a high degree of protection against pregnancy and sexually transmitted infection (STI) spread via genital fluids (e.g. HIV). As the female condom provides greater anatomical coverage than the male condom (it covers much of the woman's external genitalia in addition to the penis and vagina), it may also provide a higher degree of protection than male condoms against STIs spread through skin contact (e.g. herpes).

Female condoms have been available in Europe and the US since 1992, and have been marketed under various names, including Femidom and Reality. They first became available in Australia in 2000, where they are sold as the Female Condom.

The female condom was developed as an alternative to male condoms, in recognition that the decision to use male condoms was highly dependent on the willingness of the male sexual partner as the male condom is fitted onto the male sexual organ.

As the female condom is applied to the female genital organs, it was hypothesised that women would find it easier to initiate the use of a female condom than they would with a male condom. Because of this, it was thought that the female condom would empower women, who often lack decision making power and control in sexual relationships, to take greater control their sexual health. The female condom has been widely labelled the only "female initiated" method of preventing STIs.

The female condom works by providing a barrier which sexual fluids cannot penetrate and thus protects against both pregnancy and STIs. In terms of contraception, preventing semen and sperm from entering the vagina prevents pregnancy. Sperm cannot fertilise an egg if they are trapped in a condom.

In terms of STIs, the female condom prevents the male partner being exposed to the female partner's vaginal fluids and the female partner being exposed to the male partner's semen during heterosexual intercourse. Thus it prevents the spread of STIs which are transmitted via sexual fluids (e.g. chlamydia).

The female condom also covers some of the woman's external genitalia (e.g. the vulva, labia), and thus should provide a greater degree of protection against STIs spread through skin contact, than the male condom. During oral sex, the female condom also prevents contact between a woman's vaginal fluids and her partner's mouth.

Female condoms are suitable for use during vaginal and oral sex, but not during anal sex.

In order to protect against pregnancy, female condoms should be used at every act of penetrative vaginal intercourse when another effective contraceptive is not being used.

As an STI prevention device, female condoms should be used both for oral and penetrative vaginal sex, particularly when the partner's STI status is unknown (most typically with casual partners, but also with some regular partners). The condom should be inserted before any contact between partners' genital areas occurs.

Despite their efficacy, female condoms are not widely used and account for only 0.2% of the global condom supply. They are still not readily available in many countries and remain much more expensive than male condoms. In 2008, 34.7 million female condoms were sold worldwide.

Like male condoms, female condoms provide a barrier which is impenetrable by sexual fluids. As female condoms provide greater anatomical coverage than male condoms (they also cover much of the woman's external genitalia), they are, at least in theory, even more effective in preventing the transmission of STIs than male condoms. However while evidence is somewhat limited, it suggests that female condoms are no more effective than male condoms in practice. This appears to be because they are more difficult to use and are therefore subject to higher rates of mechanical failure (e.g. slippage, breakage).

Effectiveness in preventing pregnancy

In relation to contraceptive efficacy, the World Health Organisation reports an annual incidence of unwanted pregnancy of 5%, when female condoms are used correctly and consistently. This compares to an annual incidence of 3% with correct and consistent use of male condoms.

Effectiveness in preventing STIs

In relation to STI prevention, studies investigating the effectiveness of female condoms have examined rates of breakage and slippage, semen exposure and new cases of STI amongst female condom users. A study examining new cases of STI in female users of male and female condoms found no significant differences in incident STIs between the groups. In terms of mechanical failure, research indicates that female condoms are less likely to break but more likely to slip during sexual intercourse, compared to male condoms (0.1% breakage of female condoms vs 3.1% breakage of male condoms; and 5.6% slipping in female condoms vs 1.1% slipping in male condoms). However, a study investigating semen exposure reported no difference in the proportion of vaginal fluid samples which had been exposed to semen, between users of male and female condoms. This is despite much higher rates of mechanical failure while using female condoms (34% compared to 9% for male condoms).

Effectiveness in empowering women to negotiate condom use

In terms of their ability to empower women by enabling female initiation of barrier method use, evidence to date suggests that women are no more able to initiate the use of a female condom without their partner's consent, than they are a male condom. That the female condom is applied to the female genitalia does not negate the fact that many women lack the power to insist on its use, nor does it do away with the discrimination and stigma a woman might experience for carrying a condom (e.g. women have reported being labelled as promiscuous for carrying condoms).

Some argue that promoters of female condoms have failed to consider the widespread impact of discriminatory gender relations and, that to fulfil its STI and pregnancy prevention potential, the female condom needs to also be promoted amongst men, as a device which can increase their sexual pleasure.

Many women find inserting a female condom difficult at first, but research indicates that insertion becomes easier and less mistakes are made with practice. It is therefore recommended that women who wish to use a female condom, practice inserting them several times in a private, comfortable environment, prior to using them during sexual intercourse. It may also be necessary for women to use female condoms during several sexual encounters before they become used to the feel and appearance of female condom.

Women who wish to use a female condom should familiarise themselves with the following instructions about the application of female condoms:

Open the packet carefully and remove the condom. Rub both sides to distribute the lubricant evenly across the condom.Choose a comfortable position for insertion (e.g. squatting, raising one leg or lying down).While holding the condom at the closed end, grasp the flexible inner ring and squeeze it with the thumb and forefinger so it becomes long and narrow.With your free hand, hold the outer lips of the vagina open and gently insert the ring up into the vagina, using the thumb and forefinger.Place your index finger inside the ring and push the condom up the vagina as far as possible, until it is above your pubic bone. (The pubic bone can be felt as a large lump by putting your finger inside your vagina and moving it up and to the front.) Once the female condom is properly inserted, the pubic bone will hold it in place and prevent it from slipping out of the vagina during intercourse.The outer ring should stay outside of the vagina.The female condom should not create any discomfort, and once properly inserted, the woman should not be able to feel it.

When having sexual intercourse using a female condom, women should:

Guide the penis with their hand into the open end of the condom, making sure it goes into the condom and not to the side. As the condom is lubricated and slippery it is easy for the penis to slip between the condom and the vagina if the penis is not carefully guided;Ensure there is enough lubricant so the condom stays in place during sex. If the condom is pulled out or pushed in, there is not enough lubricant. You can add more lubricant to either the inside of the condom or the outside of the penis;To remove the condom, twist the outer ring then pull it out. Be careful not to let the semen leak out. If the woman was not upright during intercourse, she should remove the condom from her vagina before standing up, to prevent semen leaking out;Wrap the condom in a tissue and throw it in the bin. Do not flush it down the toilet.

In addition it is important that female condom users are aware that:

male and female condoms should not be used together; andthe female condom should only be used once.

If the condom breaks during intercourse, the penis should be withdrawn immediately. If the sexual partners still wish to continue having sex, a new condom should be applied prior to any further genital contact.

As a precautionary measure against unwanted pregnancy, women who experience condom breakage should visit their general practitioner and obtain a prescription for an emergency contraception pill. Emergency contraceptives can be used up to 120 hours after intercourse, to reduce the risk of pregnancy.

Both male and female partners should also test for a range of STIs if they experience condom breakage and are unsure of their partner's STI status. Many STIs are easily treated with antibiotics once detected. However, as many STIs remain asymptomatic for extended periods of time, leaving them untreated can lead to infertility and other complications. For more information see STI.

STI prevention

The female condom is one of only two biomedical devices (the other being the male condom) which provides a high level of protection against a range of STIs in sexually active individuals. Condoms thus enable individuals who choose to be sexually active, and particularly those who choose to be sexually active with multiple partners, to reduce the risk of adverse health effects associated with sexual activity. They offer a degree of sexual freedom to individuals living in a world characterised by numerous health risks stemming from sexual activity.

Appropriate for temporary or permanent contraceptive use

As female condoms are applied immediately prior to sexual intercourse, an individual does not need to plan condom use in advance as they do for many other methods of contraceptives (e.g. hormonal contraceptive pills must be taken for extended periods). When used consistently and correctly, female condoms provide a high level of protection against unwanted pregnancy.

Made from polyurethane

Female condoms are made from polyurethane - an odourless, soft material, which has a more natural feel than the latex from which most male condoms are made. This is largely because it is thin and conducts heat more efficiently, and thus increases sensitivity.

Heat resistant

Changes in temperature or humidity do not affect the polyurethane from which female condoms are made. Male condoms on the other hand are sensitive to heat and must be stored at room temperature.

Less likely to split

Female condoms are less likely to break than male latex condoms.

Non-allergic

Unlike latex, the polyurethane with which female condoms are made does not cause allergies, thus female condoms are suitable for people with latex allergies.

Lubrication

Female condoms can be used with both oil and water based lubricants, unlike male latex condoms which must be used only with water-based lubricants.

Greater anatomical coverage

The outer ring of the female condom gives protection to the female's external genitalia. The female condom therefore provides better coverage and protection against STIs transmitted through skin contact than a male condom.

Offers flexibility in the timing of insertion and removal

The female condom can be inserted up to eight hours before intercourse and does not need to be removed immediately after male ejaculation. This gives greater sexual spontaneity than male condoms. In addition, unlike the male condom, use of the female condom is not contingent on the male partner achieving an erection.

Greater female control

As the female condom is applied to the woman's genital organs, it is theorised that it provides women with a greater sense of control over their sexual health than the male condom, which is applied to the male genital organs. While evidence suggests that women are no more able to enforce the use of female condoms than male condoms, there is also evidence that women do find it empowering to have access to a product which they wear.

Despite the many advantages of female condoms compared to male condoms, they remain a much less popular method of either contraceptive or STI protection than male condoms. Some of the disadvantages of female condoms which may create barriers to their use are discussed below.

User satisfaction

User satisfaction with female condoms, at least amongst some groups of women is low, and considerably lower than satisfaction with male condoms. For example, one study reported that only 11% of women reported that sex with the female condom felt "good" or "very good". Women also reported low levels of satisfaction with the female condom amongst their partners.

Appearance

The female condom is large and some women find its overall appearance off-putting. In addition, once inserted, the outer ring is visible outside the vagina, which can make some women and their partners feel uncomfortable.

Noise

Female condoms typically make a rustling noise during intercourse.

Difficult to use

Users of female condoms report far greater incidence of mechanical difficulties (breaking, slipping) than do users of male condoms. Most health practitioners acknowledge that inserting the female condom is difficult and requires practice.

Failure rate

While the polyurethane from which female condoms are made is impenetrable, there is the possibility that the condom will slip up inside the vagina or the penis will enter the vagina and not the condom, and lead to condom failure.

Female condoms are much more likely to slip out of place during sexual intercourse than male condoms (e.g. one study reported 5.6% rate of slippage for female condoms compared to 1.1% for male condoms). Despite the higher rate of slippage, research indicates that the risk of semen exposure is comparable between male and female condoms.

Expense and availability

Female condoms are much more expensive than male condoms and, in Australia are available only from specialty outlets like pharmacies (and not supermarkets and petrol stations). They can also be expensive compared to male condoms. However, some student services do provide free female condoms.

Female condoms are available from family planning services, community health centres and pharmacies. Some student services also distribute free female condoms.

In 2005 a new female condom called FC2 was released by the manufacturers of the female condom. While it has a similar design to the original version of the device, FC2 is made from a material called nitrile. This makes it cheaper to produce than the polyurethane version and also eliminates the noise associated with polyurethane condoms. Female condoms made from latex are also being developed, which has the potential to further reduce costs.

For more information on different types of contraception, female anatomy and related health issues, see Contraception.Gollub E, Warren M. The female condom: A guide for planning and programming, World Health Organisation. 2005. [cited 2009, March 15] available from: http://www.who.int/reproductive-health/publications/RHR_00_8/PDF/female_condom_guide_planning_programming.pdfUnited States Department  of Veteran's Affairs. Tips for using condoms and dental dams. 2008. [cited 2009, March 15] available from: http://www.hiv.va.gov/vahiv?page=sex-condomtips Padian, N.S. Buve, A. Balkus, J. et al, Biomedical Interventions to prevent HIV: evidence, challenges and new ways forward The Lancet. 2008;372:585-99.McNamee K. The female condom. Aust Fam Physician. 2000;29(6):555-7.Valappil, T. Kelaghan, J. Macaluso, M. Male and Female Condom failure among women at high risk of sexually transmitted diseases. Sex Transm Dis. 2005;32(1):35-43.Mantell, J.E. Dworkin, S.L. Exner, T.M. et al The Promises and Limitations of Female-initiated methods of HIV/STI prevention. Soc Sci & Med. 2006;63:1998-2009.Family Planning New South Wales. The Female Condom. 2009. [cited 2009, March 15] available from: http://www.fpnsw.org.au/sex-matters/factsheets/52.html Anonymous. The female condom: Still an underused prevention tool. [Editorial] Lancet Infect Dis. 2008;8(6):343.Avert. The Female Condom. 2008. [cited 2009, March 15] available from: http://www.avert.org/femcond.htm Macaluso, M. Blackwell, R. Jamieson, D.J. Efficacy of the Male Latex Condom as Barriers to Semen during Intercourse: a randomised clinical trial. Am J Epidemiol. 2007. DOI: 10.1093/aje/kwm046. [cited 2009, March 15] available from:  http://aje.oxfordjournals.org/cgi/content/abstract/kwm046v1 French. P.P. Latka, M. Gollub, E. et al. Use effectiveness of female vs male condoms in preventing sexually transmitted disease in women. Sex Transm Dis. 2003;30(5):433-9.Attorney General's Department. National Sexually Transmissible Infections Strategy 2005-08. Commonwealth of Australia. [cited 2009, March 15] available from:  http://www.health.gov.au/internet/main/publishing.nsf/Content/0333DF52D0E2F3EDCA25702A0025132F/$File/sti_strategy.pdf Kulczycki, A. Kim, D. Duerr, A. et al. The acceptability of the Female and Male Condom: a randomised crossover trial. Perspect Sex Reprod Health. 2004;36(3):114-9.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Ban trans fats!

Banning the use of trans fats in the preparation of foodstuffs is one of the most effective ways to prevent some of the world's biggest killer diseases, but many governments are not taking such action because they do not think these bans work, according to a University of Sydney study published in the Bulletin of the World Health Organisation.

Shauna Downs, lead author and researcher at the University's Menzies Centre for Health Policy at the University of Sydney, Australia said trans fats policies in Brazil, Canada, Costa Rica, Denmark, the Netherlands, the Republic of Korea and the United States of America (USA) over the last two decades had proven to be effective in removing trans fats from the food supply.

She said the study's findings were particularly relevant for low- and middle-income countries where such measures have been identified as a "best-buy" policy for health - ie one that is expected to provide a high return on investment in terms of health gains.

"We found for example, that a national ban in Denmark virtually eliminated trans fats from the food supply, while local bans in Canada and the USA were successful in removing trans fats from fried foods," Ms Downs said.

"While some of the government policies we studied imposed voluntary self-regulation and others took mandatory measures, such as labelling, local and national bans on trans fats proved to be the most effective policies for removing trans fats.

"Our findings show that these policies are not only feasible and achievable - they are also likely to improve public health."

Trans fats - also known as trans fatty acids - are naturally found in dairy and meat products but also generated by industrial processes to produce hard fats from vegetable oils. The industrially produced trans fats are also known as partially hydrogenated vegetable oils.

Consumption of trans fats is associated with an increased risk of non-communicable diseases, including cardiovascular disease, such as heart disease, as well as stroke and diabetes.

These partially hydrogenated vegetable oils are, however, favoured by the food industry and fast food outlets because they are cheap, have a long shelf life, are semisolid at room temperature, which makes them easier to use in baked products, and can withstand repeated heating.

The World Health Organization (WHO) has called for the elimination of trans fats from the global food supply in response to the rise in the prevalence of non-communicable diseases and has identified it as a "best-buy" public health intervention for low- and middle-income countries. This proposed policy measure was advocated in the Political Declaration of the High-level Meeting of the UN General Assembly on the Prevention and Control of Non-communicable Diseases in September 2011.

Dr Francesco Branca, department director for Nutrition for Health and Development at WHO, said the University study was important because it gave an overview of current policy approaches and compared their effectiveness.

"It provides a rationale for strong regulations, such as national bans, and challenges voluntary approaches, given that their outcomes have been less satisfactory than mandatory measures."

(Source: University of Sydney: World Health Organisation)

Article Date: 16/4/2013

View the original article here

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Major weight loss tied to microbes

Scientists at Harvard may have new hope for people struggling with obesity.

A study conducted in collaboration with researchers at Harvard-affiliated Massachusetts General Hospital hints at a future where doctors could deliver the weight-loss benefits of gastric bypass surgery without the surgery. In a study described in a 27 March paper in Science Translational Medicine, researchers found that the surgery caused drastic changes to microbes in the guts of mice. When those microbes were transferred into the guts of sterile mice, the result was rapid weight loss.

"Simply by colonising mice with the altered microbial community, the mice were able to maintain a lower body fat, and lose weight — about 20 percent as much as they would if they underwent surgery," said Peter Turnbaugh, a Bauer Fellow at the Faculty of Arts and Sciences' Center for Systems Biology, and one of two senior authors of the paper.

As striking as the results were, they weren't as dramatic as they might have been.

"In some ways we were biasing the results against weight loss," Turnbaugh said, explaining that the mice used in the study hadn't been given a high-fat, high-sugar diet to increase their weight beforehand. "The question is whether we might have seen a stronger effect if they were on a different diet."

"Our study suggests that the specific effects of gastric bypass on the microbiota contribute to its ability to cause weight loss, and that finding ways to manipulate microbial populations to mimic those effects could become a valuable new tool to address obesity," said the other senior author, Lee Kaplan, director of the Obesity, Metabolism & Nutrition Institute at MGH.

"We need to learn a good deal more about the mechanisms by which a microbial population changed by gastric bypass exerts its effects, and then we need to learn if we can produce these effects — either the microbial changes or the associated metabolic changes — without surgery," added Kaplan, an associate professor of medicine at Harvard Medical School. "The ability to achieve even some of these effects without surgery would give us an entirely new way to treat the critical problem of obesity, one that could help patients unable or unwilling to have surgery."

Turnbaugh warned that it could be years before the research contributes to treatment, and that any procedure tied to it would likely not be for someone looking to lose those stubborn last 10 pounds. Rather, the technique may one day help dangerously obese people who want to lose weight without the trauma of surgery.

"It may not be that we will have a magic pill that will work for everyone who's slightly overweight," he said. "But if we can, at a minimum, provide some alternative to gastric bypass surgery that produces similar effects, it would be a major advance."

While there had been hints that the microbes in the gut might change after bypass surgery, the speed and extent of the change came as a surprise.

In earlier experiments, researchers had shown that the guts of both lean and obese mice were populated by varying amounts of two types of bacteria — firmicutes and bacteroidetes. When mice undergo gastric bypass surgery, however, it "resets the whole picture," Turnbaugh said.

"The post-bypass community was dominated by proteobacteria and verrucomicrobia, and had relatively low levels of firmicutes," he said. What's more, Turnbaugh said, those changes occurred within a week of the surgery, and were lasting — the altered gut microbial community remained stable for months afterward.

There is plenty left to uncover about what exactly is driving the weight loss in mice, the researchers said.

"A major gap in our knowledge is the underlying mechanism linking microbes to weight loss," Turnbaugh said. "There were certain microbes that we found at higher abundance after surgery, so we think those are good targets for beginning to understand what's taking place."

In fact, he said, the answer may not be the specific types of microbes, but a by-product they excrete.

In addition to changes in the microbes found in the gut, researchers found changes in the concentration of certain short-chain fatty acids. Other studies have suggested that those molecules may be critical in signaling to the host to speed up metabolism.

"To some degree, what we're learning is a comfort for people who have an issue with their weight, because more and more we're learning that the story is more complicated than just how much you exercise and how much you eat," Kaplan said.

(Source: Harvard University : Science Translational Medicine)

For more information on obesity, health and social issues, and methods of weight loss, as well as some useful tools, see Obesity and Weight Loss.
Article Date: 12/4/2013

View the original article here

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Just weight until menopause

Women tend to carry excess fat in their hips and thighs, while men tend to carry it on their stomachs. But after menopause, things start to change: many women's fat storage patterns start to resemble those of men. This indicates that there's a link between estrogen and body fat storage. This connection is well documented, but the underlying mechanisms remained poorly understood until now.

New research conducted by Sylvia Santosa, assistant professor in Concordia University's Department of Exercise Science and Canada Research Chair in Clinical Nutrition, gives us a new look at the connection between fat storage and estrogen. By examining the fat storage process at a cellular level, Santosa and co-author Michael D. Jensen of the Mayo Clinic in Rochester, Minnesota, reveal that certain proteins and enzymes are more active in post-menopausal women. These proteins correspond with fat storage. Their findings were published in the March 2013 issue of Diabetes.

"The fat stored on our hips and thighs, is relatively harmless," explains Santosa, who is also a member of Concordia's PERFORM Centre for better health through prevention. "But the fat stored around the abdomen is more dangerous. It has been associated with diabetes, heart disease, stroke and even some cancers. When post-menopausal women put on more abdominal fat, they dramatically increase their risk for these health problems. Given these dangers, it is very important to understand the how the lower levels of estrogen associated with menopause changes where fat is stored."

Santosa's research compared fat storage in pre- and post-menopausal women. The 23 women who participated in the study were in the same age range, and had similar Body Mass Indices and body fat composition. These similarities allowed Santosa to isolate the effects of estrogen on fat absorption and storage.

She and Jensen were able to examine the activity of certain enzymes and proteins that regulate fat storage in post-menopausal women's abdomens and thighs. By considering these factors together rather than in isolation, the researchers determined conclusively that the overall fat storage "machinery" is more active in post-menopausal women. In other words, these cells now store more fat than they did before menopause.

In addition, post-menopausal women burned less fat than their pre-menopausal colleagues. These changes mean that their cells are not only storing more fat, but are also less willing to part with it. This combination is a recipe for rapid weight gain. "Taken together, these changes in bodily processes may be more than a little surprising – and upsetting – for women who previously had little trouble managing their weight," comments Santosa.

Though the increased cellular activity revealed by this study was not specific to the abdominal region, more fat stored overall means more abdominal fat. Evidence of changes in the fat storage pathways after menopause is an important contribution to understanding why post-menopausal women begin to put on more visceral fat.

Says Santosa, "the information revealed by our study is valuable not only to post-menopausal women and their doctors, but to obesity studies more generally. A clearer picture of which proteins and enzymes increase fat storage makes those productive targets for future medical advances in the fight against obesity."

(Source: Concordia University : Diabetes)

For more information on menopause, including symptoms and management of menopause, as well as some useful animations and videos, see Menopause.
For more information on obesity, health and social issues, and methods of weight loss, as well as some useful tools, see Obesity and Weight Loss.
Article Date: 11/4/2013

View the original article here

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

Does This Medication Make Me Gain Weight?

(LifeWire) - In addition to poor diet and lack of exercise, one other culprit has been blamed for contributing to obesity: medication. Some of the most widely prescribed drugs in the United States -- for common conditions like diabetes, migraines, high blood pressure, depression and bipolar disorder -- have been found to cause weight gain.

Medications That Can Contribute to Weight Gain

Medication can add pounds to your figure in several ways:

Metabolism changes: Some drugs change the body's metabolism, and calories are burned more slowly.

Corticosteroids: Corticosteroids are known to stimulate appetite while reducing the body's ability to absorb glucose, which can promote fat deposits in the midsection.

Beta-blockers: Beta-blockers can cause shortness of breath and fatigue, making it difficult for patients taking them to exercise.

Calcium channel blockers: Calcium channel blockers taken for high blood pressure can cause users to retain water.

Antipsychotic medications: Drugs used to treat psychiatric conditions and mood disorders, like depression and bipolar disorder, are among those most closely associated with weight gain. It is so common with drugs like Paxil (paroxetine), Zoloft (sertraline), Clozaril (clozapine), Seroquel (quetiapine), Zyprexa (olanzapine) and Risperdal (risperidone) that researchers have called it "an epidemic within an epidemic."

As a result, the FDA has, since 2004, required manufacturers of certain antipsychotic medications to add a warning statement to doctors prescribing these drugs. The warning outlines the increased risk of diabetes and hyperglycemia that can result from use of the drugs.

Side Effects of Weight Gain

How much weight is gained varies from patient to patient and from drug to drug. Some patients may gain a few pounds over the course of a year; others experience weight gains in excess of 100 pounds in a matter of months. Because many of these drugs are taken for chronic conditions, their use over a period of several years can contribute to substantial weight gains patients often experience.

In addition to the emotional and social dimension of weight gain, patients can also experience serious health conditions -- diabetes, high blood pressure, osteoarthritis, metabolic syndrome, high cholesterol -- that are created or made worse by added weight.

Perhaps the most serious result of drug-induced weight gain is that many patients stop taking their medication or decide on their own to switch to a lower dosage. As a result, potentially serious underlying health conditions may go untreated. Lack of compliance with a drug regimen because of weight gain has been cited as a particular problem with patients taking antipsychotic and antidepressant drugs.

Some healthcare providers proactively tell their patients about the potential for weight gain when prescribing certain drugs and advise the patients to moderate their diet and increase their aerobic exercise to offset any weight increases.

Alternative Medications

All patients, regardless of condition, should talk to their healthcare provider before stopping medication or changing doses.

In many cases, your doctor may be able to recommend a drug that works just as well without the added pounds. Or, your doctor may decide to prescribe an additional drug to treat any weight gain you might experience.

Sources:

"2004 Safety Alert: Zyprexa (Olanzapine)." fda.gov. 22 Mar. 2004. Food and Drug Administration. 27 Feb. 2009 .

Deshmukh, Rashmi and Kathleen Franco. "Managing Weight Gain as a Side Effect of Antidepressant Therapy." Cleveland Clinic Journal of Medicine 70:7 (2003): 614-23. 27 Feb. 2009 .

Fenton, Wayne S. and Mark R. Chavez. "Medication-Induced Weight Gain and Dyslipidemia in Patients With Schizophrenia." American Journal of Psychiatry 163 (2006): 1697-704. 27 Feb. 2009 .

"Prescription Drugs That Cause Weight Gain." Johns Hopkins Health Alert. Jun. 2008. Johns Hopkins Medicine. 27 Feb. 2009 .

Simpson, MM, et al. "Weight Gain and Antipsychotic Medication: Differences Between Antipsychotic-Free and Treatment Periods." Journal of Clinical Psychiatry 62:9 (2001): 694-700. 27 Feb. 2009 .

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Marc Lallanilla is a New York-based freelance writer and editor. He has written extensively on health, science, the environment, design, architecture, business, lifestyle and travel.

View the original article here

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

South Beach Diet 101 ~ Phase 2 Foods to Eat ~...

South Beach Diet 101

Foods you will be eating during Phase 2 of the South Beach Diet include low-GI fruits, whole grain bread and pasta, and low-fat dairy. You can also continue to eat all acceptable Phase 1 foods. The acceptable foods include, but are not limited to:

Low-GI fruits, including ApplesBananasCantaloupeGrapesOrangesPearsStarches, including: Whole wheat bagelsWhole wheat breadSome cerealsWhole grain crackersWhole wheat pastaA variety of additional vegetables, including: Green peasCarrotsPotatoesPumpkinYamsSemi-sweet chocolateNon-fat yogurtFat-free puddingWine (1 or 2 glasses a day)You will find both a complete list of these foods in the South Beach Diet book in the section about Phase 2.

Continue: Phase 3 of The South Beach Diet >>

(Please note: In order to correctly follow The South Beach Diet, you will need to read The South Beach Diet: The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss, which is also available on CD.

You may also find the companion food guide helpful.)

South Beach Diet 101

Related Resources:
South Beach Diet 101: Phase 1
South Beach Diet 101: Phase 2
South Beach Diet Main

Suggested Reading:
The South Beach Diet by Arthur Agatston, MD
The South Beach Diet Good Fats Good Fats Guide
The South Beach Diet Cookbook
The South Beach Diet Quick & Easy Cookbook

Source:
The South Beach Diet : The Delicious, Doctor-Designed, Foolproof Plan for Fast and Healthy Weight Loss, Arthur Agatston, MD, St. Martin's Griffin (April 19, 2005 edition).

View the original article here

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More

How To Manage Boredom Eating

We all can feel bored at times, but it's important to identify boredom for what it really is. Is it that you have some time on your hands and you don't know what to do. Or is it that you are lonely or upset with your life.

Boredom is a stress and like all stresses it is either managed or it festers into a bigger stress. The problem is that many people choose food to manage the stress of boredom.

The problem is that boredom can continue for long periods but you just can't physically keep eating, so at some stage you will have to contend with your boredom without eating.

So what are you going to do? Boredom eating is only a problem if you eat too much, and eat junk foods. If your weight is OK then you only have to worry about your arteries blocking up.

Otherwise if you want to lose weight you will need to create a few strategies.

Firstly you need to recognise that boredom is just another word for stress, and decide to find a way to manage the stress you are feeling. E.g. if you are lonely, until you find a way to deal with that feeling then you are likely to keep eating to relieve your stress.

The problem isn't food it's your stress issues. You see the point, in order to solve your boredom eating you have to address the stress behind it.

At times you may not feel particularly stressed but you eat to fill some gaps. Again the question is why. Why not read a book or do some chores, or watch television, so why food. What is the feeling you are trying to achieve with food. Another question to get to the bottom of.

You're bored, you eat, you feel better, or do you. Does filling up on whatever is at hand even if you're not hungry, solve your boredom? Does it actually make you feel better? Probably not if you are honest with yourself.

The best way to manage your boredom eating stress is with weight loss Hypnosis, you can easily break the connection between food and emotions. This won't solve your boredom, everyone gets bored, but it will help you find other ways to deal with the stress.

The hypnosis is a safe gentle way to easily and comfortably change the way you feel about food.

Now if you would like to discover the missing key to women's weight loss Ian Newton invites you to go to http://www.successfulweightlossnow.com/ for men just go to http://www.nobullmensweightloss.com/

Keep healthy and happy

Ian Newton

Read More

3 Reasons to LOVE Your Workout: Confessions of a Fitness Addict

I sometimes get strange stares when I tell people I love to workout. But it's true! I look forward to that time of day when I can step away from everything else and just concentrate on my body. I have truly become an addict. I get cranky when I miss a workout and my day somehow feels incomplete. I absolutely love the feeling I get from working out.

You, too can love your workout. The longer you stick with it, the more engrained it will be in your habits and the more results you'll see. Even in 6 weeks, the results can be dramatic.

What are 3 things you can love about your workout?

1-Relieves stress

Exercise lowers cortisol, a stress hormone. You can take what could be a negative emotion like anger, frustration or anger and use it as fuel for your workout. You can successfully redirect that negative emotion into a positive outcome.

Exercise is also a great distraction to get your mind off problems and put you in a better state to be able to deal with them. If nothing else, it can get you out of the four walls you normally stare at, giving you a fresh perspective.

That deep breath and sense of calm you get while doing cardio is hard to replace with anything else. Everything feels clear - your lungs, your skin, your thoughts. It's a great time to think as you're pounding away the miles.

2-Feels great

Have you ever heard anyone say, "Man, I sure do regret that I worked out today." Probably not! But you most likely have heard someone talk about how proud she was that she DID workout today or three times this week.

It just plain feels good to workout. Exercise increases endorphins which are your body's "feel-good" chemicals. There is often a feeling of euphoria with working out; a "high." Who can't use some of that? There is a sense of accomplishment and pride that comes with it. It's what keeps people coming back time after time... and the fact that they like the way their clothes are fitting and the positive comments they are receiving from people who are noticing a change in them.

Besides, when else do you get to listen to obnoxiously loud music in the middle of the day? Playlists make great workout buddies. You can adjust your music to the type of activity you're doing, the speed at which you want to do it and your overall mood or the mood you want to have. Music is a great pick-me-up. At the end of a workout, not only will you feel good from the workout, but from the music as well.

3-See progress & succeed at something

When you work out consistently, you will see progress. You'll see progress towards your goals whether that be fat loss or muscle gain. You'll also notice that you can do things today that you couldn't do last month. You'll notice you can go longer, faster and at a higher resistance doing cardio and that it becomes easier. Maybe last week you couldn't walk on the treadmill and carry on a conversation without being winded but now you can talk with ease. Maybe you started out doing a chest press with 10 pounds and now you use 20. Progress means success. And we all like the feeling of success. If you succeed in one area, it gives you confidence to succeed in another.

Did anything of those sound familiar? You've probably heard or experienced some or all of these things already.

And here's a bonus reason to love your workout:

When you workout, it gives you added incentive to stay on your meal plan. If you go to the gym an hour a day, there are still twenty three hours in a day to screw up your results. Who wants to work that hard in the gym just to blow it with her diet? Working out regularly adds some incentive to eat right.

Stacie Dickerson is the CEO of the Healthy Lifestyle Institute for Women. Access their free article archive, become a member absolutely free and get your health & fitness tools at  http://hliwconnect.com/.

This post was made using the Auto Blogging Software from WebMagnates.org This line will not appear when posts are made after activating the software to full version.

Read More