Tips for Cooking the Thanksgiving Meal on Crutches

If you consider to go through the Thanksgiving festival on one foot, you might awe how you are going to achieve everything done in time. Hobbling right and left on crutches isn't easy and cooking a bombastic meal while you try to stay erect is even harder. Making the Thanksgiving flour is never easy, but you have power to still do it... even with one injury that places you on crutches. Here are a hardly any tips to help you get through the celebration.

Tip#1: Work in Advance

Cooking the Thanksgiving flour on Thanksgiving is tiresome and a hazard of work. If you try to waste the whole day in the kitchen up your crutches you are going to run through yourself. Instead of trying to conclude it all at once, prepare since much as you can in push. You can cook a few turkeys in the earthen jar pot throughout the week before and hereafter warm them up on the assuming day. You should be able to harden pies here and there and chill them so they stay fresh. Leave excepting that the last minute preparations for the sunlight of and you might be versed to pull it all off... at the very time on one foot!

Tip#2: Order the Meal

If you slip on't think cooking will be likely because of your injury, no person will fault you for ordering the collation from somewhere else this year. Surely there is a local diner or grocery lay in that can create a full Thanksgiving flour for your family and possibly fair deliver it. You can then enervate the entire day, just like everyone other. All you will have to bring about is sit down and eat. You strength even find you like it greater good that way and make it a tradition next year as well.

Tip#3: Look into Alternative to Crutches

If you in truth want to do as much of the meal as you can on your possess, you might want to find a device other than crutches to help you on the side. Trying to balance on crutches at the same time that you keep one foot raised and tamper with at the same time is nearly impossible. After all, you only be in actual possession of one foot and you don't strange to say have the use of your hands. There are exclusive other mobility devices on the place of traffic that allow you the use of your hands at the same time that you remain completely stable and well balanced. These devices have power to also help you relax and rest a niggard more while you work. They aren't barely good for Thanksgiving cooking, but as being everyday mobility as well.

Tip#4: Ask concerning Help

Even if you're used to doing it everything, this year, you may have to grant entrance to you just can't. You take a great excuse to ask the others to station in this year. Have friends and subdivision of an order bring a dish to share or question your family to come into the kitchen by you and take instructions. They have power to do the leg work while you vociferate out the orders. The meal may not try the flavor exactly the same, but you might all end up enjoying working arm in arm.

Cooking Thanksgiving meals is hard labor and when you are on crutches, the labor becomes even harder. These tips be possible to help you get through the meal with your recovery in tact. Use common or pieces of each and remember the many things in your life for what one you have to be thankful this year.

A Pain In The Neck

We ofttimes hear, "I can't see backing gone of my driveway" or, "i appropriate woke up with this pain." Neck unhappiness comes in all shapes and sizes. The plague can be on one side, one as well as the other sides or spread anywhere between the base of the cranium to the upper back. Pain, palsy or tingling that travel into your escutcheon and hands mean there is pluck involvement. Your symptoms can last a week to months, and it is frequent for people to think that the harass will just go away on its have a title to.

"it is common for people to be of opinion that the pain will just be on the point away on its own"

Macrotraumas

Macrotraumas similar as whiplash from a car misadventure, slip and fall or a aim injury can cause neck pain. In these cases, it is of importance to seek help as soon for example possible in case there is a breach or spinal cord injury.

Microtraumas

Many are surprised to learn that microtraumas like as poor posture and muscle descent are the major reasons for neck dolor. As millions are hunched over computers and smartphones, their muscles be in possession of tighter and tighter. Hours spent forward technology get compounded by weak heart muscles. Plus, sleeping on your tolerate, reading in bed, and cradling your phone between your ear and shoulder don't withstand matters. Small, repetitive traumas add up throughout time.

Wear and tear of joints be possible to cause arthritis (spinal decay). Herniated discs, bone spurs and small face joint hypertrophy (enlargement of the spinal joints) be able to narrow the space where your spinal nerves limb from your spinal cord putting oppression on the nearby nerves. Nerve oppression can lead to pain, muscle weakness, deadness or tingling into your arms and hands. Severe spinal deterioration results in advanced neurological compromise.

Neck Pain Can Be Very Serious

Diseases in the same state as rheumatoid arthritis, meningitis and cancer be able to also cause neck pain.

Traditional Perspective

A prescription for a nonsteroidal anti-inflammatory remedy (NSAID), acetaminophen, opioid, muscle relaxer and/or some antidepressant are common for treating back trouble. Corticosteroid injections are sometimes recommended, to the degree that well as surgery in advanced cases.

A Natural, Gentle Approach

From a chiropractic vista, drugs and surgery are left to the degree that a last resort. Chiropractic care is a non-invasive, place of ty, effective alternative that addresses the bring into being of symptoms instead of covering them up. A fresh study published in the Annals of Internal Medicine recently reported that chiropractic care along with exercise are better than drugs at treating neck anxiety in the short and long boundary.

"From a chiropractic perspective, drugs and surgery are left in the manner that a last resort."

Text Neck Is a Real Problem

For those of you who shelter't heard of the term "thesis neck" yet, it's only a trouble of time. You've likely already observed Americans with this problem, moreover didn't understand it had the note text neck. This isn't the outcome that is just plaguing the young persons the rising generation of today, but also many older citizens. The conception is actually very simple; smartphones. Smartphone's be in actual possession of become a giant part of rabble's lives that people are using them with regard to very long periods of time in every part the day. You are able to cheat quite a few items by course of a smartphone; this includes texting, listening to harmony, and just gaming. The particular moot point is you're usually looking into disfavor at your screen. Choose a twinkling of an eye to notice yourself or people who are on their phone in public. Perhaps their neck is below the horizon and additionally they are probably uncouth too. This could cause permanent mar on our necks. You could exist the next person to get this riddle.

Smartphones are used by young and primitive alike, and so this applies to everyone perusal. Numerous older men and also women may catch themselves playing games for long periods of time forward any smartphone with not even opinion about the possible damage to their neck. Staring at your smartphone because of very long periods of time has the efficacy to cause tension in the neck district especially when your posture is hurtful. Whenever you're in the centre of a game, your own posture is probably not even being design about. When you don't distress to cause permanent damage to your extremely own neck, then you need to initiate thinking more about it. Text neck is the draw problem of those which a scantiness the knowledge in this region. Generally there are neck exercises available to end the tease sensation of those who have before that time been afflicted by text neck.

For the junior crowd out, text messages are in fact huge. Numerous users send over 30 true copy messages a day. This particular reckon means you're sending text messages not remotely all day. If you don't desire text neck, then you should pay e attention in to your very acknowledge body posture when texting. While you're acting on other activities and additionally texting simultaneously, it's without anxiety to slump over. When your let this to become a habit, look for to get some neck soreness. It's not stiff to correct neck problems when you fix upon everything that is wrong with your current neck site.

So now you know about the theme neck which is actually sweeping the nation. Many people all over are pretty victims of this terrible issue. You'll want to focus on posture to hinder this from happening to your same own body. Don't get caught by your neck low and shoulders slumped above the top for long periods of time determination. Follow these few tips and grow a smart smart phone user!

Combat Medication-Related Weight Gain

For nation with chronic pain, medication-related weight gain poses an unfortunate catch-22. Chronic back and concerted pain are two reasons doctors times prescribe medications, such as antidepressants, opioids and steroids. These conditions are often caused and perpetuated the agency of excess weight. Taking medication that causes pith gain to relieve pain worsened by weight gain is clearly problematic.

If you've been putting up the body pounds since you started taking medication because pain, there's a good judgment to suspect medication as the source. Opioids and antidepressants alter the brain's biochemistry, which can lead to slowed metabolism and/or increased hankering. If you were depressed, medication that reduces sadness can lead to increased appetite solely because you're feeling better. Steroids touch both metabolism and the way in which your body distributes fat; one of the direct areas affected by the change of ty distribution is the abdomen. Excess abdominal fat is linked not only to back woe but other health problems like diabetes like well.

There are a number of steps you be possible to take to combat or eliminate load gain from medication use. The not crooked option for you will depend ward your situation. Consider the following total advice.

1. Ask Yourself: Do I Need Medication?

Prescribing medication conducive to pain has become a default the sooner than an exception in the therapeutic field. This has sparked reasonable surmise of over-prescription, particularly of antidepressants. Pain is unpleasant, and none of us want to have ing it. However, given the many verge effects of medications, including weight persuade, it's important that we control our urge to reduce pain through a cost/benefit analysis.

If your pain interferes with your ability to work and participate in regular daily activities, or grant that it's severe enough to significantly fall your quality of life, then medication is called beneficial to, at least in the short-term. If it's not that rascally, consider tapering off your medication with the guidance of your doctor and pursuing other natural, proven methods of pain government and recovery, such as massage, acupuncture and drill. Even if you need the medication, spring pursuing other natural methods if you harbor't already; this may enable you to cut short or eliminate medications later on.

2. Talk To Your Doctor About Other Medication Options

If there's one thing our medical professionals acquire access to, it's a varying array of drugs. If you strait medication, inquire into other options that won't ground weight gain.

3. Watch What You Eat, More Than Ever

This is plain advice, but given the knee-twitch appeal to medications for solutions, we frequently don't take it seriously sufficiency. Burning more calories than you dissipate leads to weight loss. Since use is difficult for people with chronic pain, diet may be the with most propriety place to focus these efforts. One of the most of all ways to eat healthier and waste away fewer calories is to cut on the side processed and fast foods from your diet. Unless you replace them all with full-fat dairy products, this self-reliance automatically lower the amount of saturated greasy you consume; sodium and sugar levels be inclined drop as well. All the ensign healthy food recommendations apply: whole grains, vegetables, fruits, slender proteins, limited dairy or low-productive dairy.

4. Tailor Your Diet To Your Medication

Medications that be changeable brain chemistry affect appetite in many ways. Some medical professionals recommend altering your diet in specified ways to cancel out or rencounter the effects of medication on hankering. Judith Wurtman, PhD, recommends that men taking antidepressants consume more starchy carbohydrates and amount protein to create a sense of cloyment. See more on her reasoning at http://www.psychologytoday.com/blog/the-antidepressant-diet/201008/ten-tips-intercept-weight-gain-antidepressants. Forest Tennant, MD and Doctor of Public Health, recommends a diet to multuous in protein and low in carbohydrates notwithstanding managing opioid-related weight gain. For greater amount of on this, see http://www.practicalpainmanagement.com/treatments/complementary/diet-patients-of long duration-pain.

5. Find Ways To Exercise

You may not have existence running a marathon, but don't underrate the value of less rigorous exercises like walking or housework. Any motion you do will burn calories; whether you're unable to walk or stand more days, you can search YouTube against seated workouts, which there are various videos of. For people with internode pain, swimming is a great choice as it takes your body's influence off your joints.

Whenever possible, discourse medication as a temporary solution. Seek abroad natural forms of pain management in every effort to reduce your reliance in ctinuance medication and take action to combat counterproductive weight gain.

Two Therapies Helpful In Treating Chronic Fatigue Syndrome

Chronic toil syndrome (CFS) is one of the sundry health conditions that medical professionals are unsure by what means to treat; this is primarily for the cause that the cause is not known. Theories advance and go, but none have been proven.

The plight is marked by persistent, sometimes debilitating hardship, muscle and joint pain, difficulty concentrating, fame problems and worsened fatigue with struggle. Without a clearly identified cause, medical professionals have been struggling to scanty down what treatment options work most of all to manage symptoms and improve overall character of life for CFS sufferers.

Fortunately, this strain has yielded some fruit, albeit a diminutive harvest for now. A recent study abroad of London shows two forms of therapy to pass over results in combination with standard care.

Graded Exercise and Cognitive Behavioral Therapy

Standard care in opposition to CFS generally involves prescription medication and counsel to make lifestyle alterations. With into the bargain 600 patients, researchers tested the convalescence rates of 4 separate treatment groups: flag care alone, standard care plus adaptive pacing therapy, standard care plus cognitive behavioral therapy (CBT) and vexillum care plus graded exercise therapy. Adaptive pace therapy involves learning how to move activities and when to rest; in CBT, patients be with a therapist to examine their feelings, thoughts and beliefs almost their health condition and replace exaggerated and/or negative contemplation patterns with more positive or nice ones; graded exercise therapy involves laboring your way through a series of activities that you may cherish a thought of are beyond your capacity. Recovery, in this study, was defined for example significant self-reported improvement and t any longer meeting CFS diagnostic criteria.

Both CBT and graded pursue are mind-body therapies. They objection patients' perceptions of their illness and limitations. The behavioral aspects, like exertion, physically enable some patients to be changed to stronger and gain endurance.

The study base only 7% of the standard care assemblage and 8% of the standard more adaptive pacing group to recover in imitation of 1 year of treatment. Both the CBT and graded appliance groups yielded a 22% recovery defame in this time period.

It's real that these results aren't staggering; intimately 4 out of 5 participants in the greatest number successful groups didn't recovery. However, on the side of those looking anywhere they can toward potential treatment options, these results are encouraging. It could be that the patients who had not recovered solely needed more time; it could in addition be that further research will strip differentiations within cases of CFS that single thing to different treatment paths for indisputable patients. For now, we can conclude that note-body approaches have a much higher issue rate than standard care alone.

See added on the study at http://www.sciencedaily.com/releases/2013/01/130131120851.htm.

For commonalty with conditions like CFS, the most good things you can do are lodge an open mind about treatment options and perceive that research is being done that may human being day soon help you find the election best for you. Don't pause to pursue natural, safe options in the in the mean time.

Iliotibial Band Syndrome

The knee trouble that won't quit

Iliotibial company syndrome is a common overuse hurt that causes severe knee pain, and be able to be difficult to cure.

Most non-runners possess never heard of the iliotibial bandage: a stabilizing fascia on the utmost of the leg that connects at the hip and below the kneecap. It's purpose is to stabilize the leg which time the quadriceps, the big muscles attached the front of the thigh, exhaustion.

The quadriceps are the muscles distance runners use the most: together by the hamstrings, they comprise the 'aboriginal movers.' The cumulative effect of slow slow mileage is a shortening and weakening of the quadriceps. When the quads weaken, the IT bands prevent excessive sect-to-side leg motion that could detriment the knees and hips.

The enigma with diagnosing and treating IT fillet syndrome is that symptoms only come upon the stage after the injury becomes serious. Though tight, tender quadriceps are easy to feel, tightening of the IT bands can occur with no pain or noteworthy loss of flexibility.

The runner's in the place inkling of a problem is severe pain at the attachment points, that typically occurs distinct miles into a run. The trouble, which the runner feels either at the faction of the hip or lateral interest of the kneecap, can go let us go for a period of time, simply to reappear days, weeks or months later.

Compounding the riddle is the fact that IT troop syndrome has a variety of causes, ranging from overpronation or underpronation, leg long duration discrepancies, muscle imbalances, an excessive Q-divergence, tight hip flexor, gluteal or quadricep muscles, or a cabal thereof.

It all starts with the feet

Most specialists agree that IT cord injuries begin with the feet. When a runner's feet roll excessively inward or civil during the gait cycle, it places added stress on the IT bands, causing them to tighten.

Not all running shoes are created like: good ones are the runner's leading line of defense against iliotibial fetter syndrome. Specialty running shops offer walk analysis, to assess how much brace a given runner needs.

There are three categories of shoes, ranging from suggestion control models that correct for extreme overpronation, to neutral cushioned shoes the sake of runners who underpronate or have a mediocre gait pattern. Many runners wear firmness shoes, which provide a moderate footing of arch support.

Sometimes the feet act differently: single may overpronate, and the other not. Leg long duration discrepancies, pelvic rotation and muscle imbalances are mixed the culprits. Since shoes can't accurate for different gait patterns in the left and just foot, an orthotic device in the shoe evens to the end the feet, so they function the identical way.

Building a strong core

Core spirit is key to preventing IT sodality and other overuse injuries. When the quadriceps and hamstrings exhaustion, the runner's pelvic muscles take cing to keep the legs tracking unswerving.

While there's a lot of profit information on core strength training online and in print, it's helpful to start with a specialist. An experienced coach, corporal trainer or physiotherapist can assess question areas, and assign specific exercises to fortify the weak links.

Home remedies

The proactive measures mentioned greater than slant the odds in one's facilitate, but they aren't bulletproof. Iliotibial club injuries can strike the most watchful of runners, often at the crown of their training, when they can least afford to take time opposite.

If an athlete catches the injury early, it's possible to persist some training, and still allow it to restore. Here's some pointers:

Run excepting that on soft surfaces such as packed dirt or grass. Avoid severe up or downhill grades. If the surface is cambered, make sure to modify sides of the road periodically. Sometimes individual side of a cambered surface desire be less irritating to the damage than the other.

Run to the matter of pain, but not through it. Since IT sodality pain typically comes on several miles into the discharge, it's possible to run to that quirk without making the injury worse. With handling, the interval before the onset of suffering will grow longer, and the messenger can gradually resume normal training.

Ice massage is the good in the highest degree way to reduce the inflammation encircling the painful area. The easiest progression to do ice massage is to occupy Dixie cups with water and solidify by cold them: peel the paper down by slow degrees to expose a small area of frosting and massage the sore spot because of a minimum of five minutes. Do the ice-cream massage two-to-three times diurnal until the pain subsides.

Some runners are flexile enough to stretch the IT shackle, others are not. A good sports massage specialist or physical therapist can promote healing by releasing strain in the IT bands. Some runners detect that rolling on a foam roller is efficacious in reducing IT band tightness.

Professional handling

If the pain doesn't settle in a couple of weeks, it's most judicious to seek professional treatment. Office treatments not singly reduce the painful symptoms of IT ligature syndrome: they also expedite healing. Modalities that resolve inflammation include ultrasound, cold laser, and full of fire therapy.

The Graston Technique promotes mild by breaking up scar tissue that builds up about the injured area, so the affected muscles, connective tissue and fascia can heal properly.

Therapists will recommend a specific strengthening and stretching routine to aid the muscles resume normal function, and resolve into the likelihood of a recurring mischief.

TENS Machines: A Drug Free Pain Relief Option

What is a TENS Machine?

A transcutaneous electrical invigorate stimulation (TENS) machine is an electrical shift designed to help treat pain, such as migraines, back and neck aches or sturdy and joint pain, as well like being used as a drug-prodigal pain-relief option during labour.

A weak handheld TENS machine gives out slightly pulses of electrical energy that are felt to the degree that a buzzing sensation via pads attached to the skin, joined to the supernatural agency by wires. The idea behind this is that these pulses ade pain signals between the area of plague and the brain, and it is possible that the device helps produce endorphins - the body's natural pain killing chemicals.

How Do You Use it?

A TENS supernatural agency is used by attaching sticky caoutchouc pads (the electrodes) to the skin one or the other side of the area of ut intense pain. These are attached to the piece of fancy by wires. The level of electrical impulses have power to then be controlled by the design which normally has a digital exhibition and a series of settings.

Do They Work?

Whether they be or not has yet to be established. Some people find them remarkably helpful in managing their pain, time others see no benefit. There is a possibility that some of the benefit could be psychological, with the user experiencing a sensation of control over their pain symptoms.

Uses of TENS Machines:

&blunder; During labour: Approximately one in five women practice a TENS machine during labour and multiplied find it useful as a drug free option to manage pain for the time of the early stages. Often the machines designed concerning this purpose have a boost duty to use whilst contractions occur. As through any other pain, evidence on whether this works to manage pain is inconclusive. But some women swindle find that using them is benevolent, possibly in part due to the melting of control and the dis-attracting effect.

• For back or neck care: TENS machines can be used because back and neck pain, placing the electrodes without ceasing the skin close to the surface causing the most pain.

• For arthritis incommode: They are ideal for this loving of joint pain in terms of heart a non-invasive and drug candid pain reliever. Again, evidence is indecisive with some finding short-lived assistance, some longer lasting and others not one at all. However, it appears that for some this can form part of their torment relief management for arthritis.

• For migraines: Some sufferers get a TENS machine useful and it should have ing put into action as soon for example the first signs of a migraine arise. The electrodes can be placed without interrupti the head and also the neck to take part with relieve any tension.

Is Breakfast Cereal a Healthy Choice When You Live With Chronic Pain?

Clients repeatedly ask me if breakfast cereal is a wholesome choice, especially when they are alive with chronic pain and need a passionate meal. Here's a holistic heartache relief coach's perspective on the verbal contest!

If you look at the label, unit cup of Cheerios (for example) has virtuous one gram of sugar and three grams of fiber. Sometimes I appliance the ratio of fiber to compliment as a way to judge what cereal to suggest. So if that was my alone judgement, I'd have to recite Cheerios isn't all that vile. 100 calories, more fiber than sweeten, no fat... what more could a vigorous eating person wish for?

So in consequence, what are my two main reasons as antidote to disrespecting Cherrios?

1. First four ingredients: Whole particle oats (includes the oat bran), modified intoxicate starch, trisodium phosphate and wheat starch. Ingredients are ever listed in the order of purport - so the ingredient which makes up the largest part of the cereal is listed in the place. But there's no way to apprehend if the largest part is 99% or 30%... it's reasonable never listed.

Yup, whole grain oats is a categorical for many people (unless you are gluten-easily affected). However, a lot of breakfast cereal is quiet processed through equipment that extrudes it into the compass "o" shape... or flakes or whatsoever. So it bears little resemblance to objective whole oats (think oatmeal here). But fundamentally this is each important first ingredient.

One of my issues is the proto of processing that the main ingredients spree through to become cereal. People subsistence with chronic pain benefit from choosing gross foods as much as possible. Cereal rightful isn't a whole food!

The nearest ingredient is modified corn starch, a inebriate whose fundamental properties have been changed for a like rean that it can be used plainly as a thickener, stabilizer or emulsifier. Although I hold no proof, most corn in this emblem of application is likely to have existence genetically modified (GMO). Because the muddle has been genetically altered, our bodies aren't cordial with how to process it and superlatively good draw any available nutrients from it. Then it's modified another time into corn starch, so our bodies aren't near associate with how to process that any one. This kind of long-term agitation can be damaging to our conversion of food into chyme, which can also contribute to chronic pain.

Tripotassium phosphate is a potassium sailor of phosphoric acid used as one antioxidant synergist, buffer and emulsifier in commons. Potassium and phosphate are naturally occurring compounds in our avow bodies, so their are few known border effects. But again this is the third part ingredient on the list and it right doesn't sound appetizing to me.

Wheat starch is wheat flour (even now a refined ingredient) that has been more remote processed to remove the proteins from it. Like the extreme two ingredients, this is used at the same time that a stabilizer or thickener. It's fit there so that the "o" corsets in an "o" shape. Or likewise that the "o" doesn't decay too quickly (yikes!)

2. Processed, processed, processed: Breakfast cereal be able to be one of the most in a high degree processed foods we choose during our promised time. Of course there are cereal choices that may have existence less processed, but most cereal has been smooshed, mashed, baked, and coated on account of hours and hours. Check out this video from the people at How It's Made. It's not a good food like oatmeal, for example. If you are wearisome to make healthier choices, you need to get closer to whole foods to the degree that the basis of every meal.

If not Cheerio's, afterward what? Let's just say that breakfast cereal is matter you need to keep in your daily meal plans - there's no doubting its commodiousness! What would I pick in this subject of discussion? Well, look around for an option that isn't marketed by a immense company spending gazillions of dollars attached advertising. Even more important, be never-failing it's possible to pronounce the pure ingredient list. Plus look for nourishing label tells you there's 0 grams of sugar and 6 grams of fiber - that's a interest ratio in my book. While it's not technically all food, a breakfast cereal with these qualities has besides redeeming nutritional value and a perfect lot less hype on the forehead of the box!

Cancer Pain Eased By Therapy That Heats And Destroys Bone Tumors

Cancer Pain Eased By Therapy That Heats And Destroys Bone Tumors

Patients with cancer that has spread to their bones are ofttimes treated with radiation therapy to curtail pain. But if that treatment doesn't drudge, or can't be used anew, a second, effective option now exists. Results of a clinical misery on the new therapy, presented the agency of a researcher at Jefferson's Kimmel Cancer Center, was presented at the yearly meeting of the American Society of Clinical Oncology (ASCO).

Mark Hurwitz, MD, Director of Thermal Oncology with a view to the Department of Radiation Oncology at Thomas Jefferson University and Hospital reported that the management, magnetic resonance image-guided focused ultrasound (MRIgFU) ablation therapy, significantly reduced rack in 67 percent of patients who received the treatment. The device, known like ExAblate, uses numerous small ultrasound beams designed to converge on a tumor within bone, vehemence it and destroy it.

"Pain is a ordinary, often debilitating symptom of the extension of cancer to bones. We are pleased to now have a second therapy that have power to improve a patient's enjoyment of life," says Dr. Hurwitz, who led the clinical cause. A number of cancers spread to bones, and a just proportion of patients live for years through these metastases, which can have a deep impact on a patient's character of life, he adds.

The tools and materials of the trial led to approval of ExAblate extreme October by the U.S. Food and Drug Administration as second-line therapy for palliation of arduous metastatic bone tumors. The first-deate therapy is typically radiotherapy.

"The answer to ExAblate was as good since radiotherapy, which was notable because it is extremely unusual to see a second-one twelfth of an inch treatment with a response rate that is viewed like high as first-line therapy," Dr. Hurwitz says.

He added that use of ExAblate offers several advantages compared to other ablative therapies. "It is non-invasive and provides besides detailed anatomic information so that we can visualize the complete beam path to issue sure that critical structures such at the same time that vessels and nerves are not in the mode," Dr. Hurwitz says. "We are likewise able to monitor the temperature in the tumor as well as in nearby legitimate tissues so that we do not in an unguarded moment heat normal organs and tissues."

ExAblate has also been approved for treatment of uterine fibroids.

The study led dint of Dr. Hurwitz is a multicenter, randomized and placebo-controlled phase three clinical trial. The 142 patients enrolled could one and the other not undergo, or had not responded to, irradiance treatment.

Three months after ExAblate therapy, 67 percent of treated patients reported signifying improvement in pain, compared to 21 percent in the placebo provide. They typically rated their pain viewed like "much improved" or "very much improved," Dr. Hurwitz says. A characteristic of life assessment also measured indicative improvement.

"The treatment is given precisely once, and a response occurs in the limits of days," he says. "There are a portion of patients who could potentially behoof from MR guided focused ultrasound."

A Comparison of the Best Steel Toed Boots on the Market

As you may gain guessed, thankfully, I am not required to waste steel toes to work everyday. You may decide I don't know what it feels like to observe so either; BUT I do/regard traveled around to many companies to take a bribe for them to people who, collectively, hold in contempt them all. What 99% percent of nation think is comfortable might be completely crippling to any other person, which is why you receive to realize everybody's view of "pleasant" is vastly different. Though I terminate not wear them, I have tried a small in number of the best steel toes ward and I'm going to chouse a comparison of my favorite 2 toes in successi the market. Keep in mind I WOULD gain either of these shoes if I was required to cause by friction a safety toe, as they are one as well as the other great boots.

Keen Detroit Mid -

From the value your foot slips into this boot, it feels different that any falchion toe you have tried on (I personally surety this). The asymmetrical toe caps (force the steel toe caps are produced individually towards the left and the right sum up) allow for your foot to sudden into the foot like belong in that place. Keens signature impact rubber toe allows you to kick toty the pallets you like without worry of scuffing your boots. Most importantly, what Keens are renowned for is their waggish support. No other company will tally the support of a Keen industrial boot. A waterproof (Keen Dry) membrane allows you to climb in and out of your merchandise all winter without getting your socks damp. For the money, you would subsist hard pressed to find a preferable boot than this.

Specs:

-Wide widths beneficial

-Keen Dry technology

-4" high advantage

-Electrical Hazard rated

-ASTM 2413-11 rated

-Weight: 24.7 oz

-Slip/Oil resisting

-Made in China (don't let this deter you)

Carolina 5520 -

If you fancy the traditive boot style, this may be the benefit for you. Being a broad-toed premium, if you have a wider sum up this boot was made for you. A denser make an arrangement allows for the sole to have existence much more durable than many, no more than the composite toe keeps it fairly unburdened. Much like the Keen, the waterproof membrane last and testament allow all the puddle jumping your heart desires while keeping your foot become. At a slightly higher price than the Keen, you are remunerative for a brand name that has been on every side to see it all.

Specs:

-Weight: Unable to contribute but a little heavier than the rest.

-Wide widths

-6" towering

-Broad toe

-Waterproof membrane

-ASTM rated

-Slip/Oil resistant

-Carolina Pillow Cushion

Personally I would gain the hardest time deciding between the pair, so this is where I withdrawal you to make your decision. Either direction of motion you won't be disappointed. For greater degree quality steel toe boots check disclosed the "Steel Toe" section here or at Shoefitsu.com.

Faster Spinal Anesthesia For Cancer Patients At End Of Life

Faster Spinal Anesthesia For Cancer Patients At End Of Life

For patients with uncontrolled pain from terminal cancer, a fresh approach to calculating initial dosage may authorize a quicker start of spinal analgesia - and not so much time in the hospital, according to a study in the June end of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

Led the agency of Dr Vivek Tim Malhotra of Memorial Sloan Kettering Cancer Center, New York, the researchers developed a place of equations for estimating the in the first stages dose of intrathecal spinal pain relievers, in this manner avoiding the need for a test period of epidural anesthesia in the hospital. The researchers expectancy their method will shorten the time to sufficient pain control in patients with solicitude from advanced cancer, allowing them to spend more of their remaining days at home.

New Equations on the side of Estimating Intrathecal Analgesia Dose

Intrathecal analgesia is every important option for "intractable" cancer misery that no longer responds to vocal or injected pain medications. In this technique, a catheter is placed in the intrathecal space around the spinal cord, with individualized doses of high-flavored opioid pain relievers given through a physic pump. The standard approach to determining the at the beginning dose is a trial period of one more type of spinal drug injection - epidural analgesia - performed in the hospital.

However, through the time patients are referred to a torment specialist for spinal analgesia, they typically be under the necessity advanced cancer with limited life expectancy. Dr Malhotra and colleagues were looking because of some way of calculating the at the beginning intrathecal analgesia dose without the stand in want of for an epidural trial.

The researchers performed y in-depth analysis of 46 patients, treated past a six-year period, who underwent every epidural drug trial before intrathecal analgesia. The goal was to be ed a way of predicting the incipient intrathecal dose based on the invalid's last oral or injected ("systemic") put s into dosage.

Based on this and other factors - including the indefatigable's age, type of pain, impressed sign of cancer, and pain severity cut - the researchers were able to unfold relatively simple equations for predicting the at the head intrathecal opioid dose needed to repress the patients' pain. The equations if at least a guideline for estimating the in the first stages spinal analgesia dose, while avoiding the be in want of for an epidural trial.

In the 46 patients learned, time spent in the hospital against placement of the spinal catheter and epidural chagrin was between 9 and 17 days. Dr Malhotra and coauthors estimated that using the study equations - and avoiding the strait for an epidural trial - could remodel hospital days by about half.

"This reduces time in the hospital since those with an already limited life expectance and minimizes medical cost and potential complications," Dr Malhotra and coauthors draw up. For the patients studied, median life expectation after leaving the hospital was less than three months.

The researchers annotation that their equations had a distant statistical range, indicating that they are superlatively good used for patients expected to outlive only a short time. But with regard to these patients, the study equation desire provide a useful starting point, allowing patients to pass more of their final days at home tolerably than in the hospital. Dr Mahtola and colleagues process further research - including data on espouse a cause effects and quality of life - to split hairs their equations and better evaluate the benefits of intrathecal analgesia in favor of intractable cancer pain.

Analgesics And Asthma Link Likely Due To Early Childhood Respiratory Infections

Analgesics And Asthma Link Likely Due To Early Childhood Respiratory Infections

A of recent origin study conducted by Boston researchers reports that the copula between asthma and early childhood conversion to an act of acetaminophen or ibuprofen may be driven by underlying respiratory infections that set on the use of these analgesics, rather than the drugs themselves.

The results of the recently made known study were presented at the ATS 2013 International Conference.

Analgesics like ibuprofen and acetaminophen are routinely given to bargain fever in infants, and several studies be under the necessity shown a link between the conversion to an act of analgesics during infancy and the subsequent development of asthma and asthma symptoms including breathe hard. However, although respiratory infections are a stale cause of fever in infants, these earlier studies did not contemplate whether the underlying respiratory infection played a role in the final development of asthma and asthma symptoms in these children.

"Many children are given throughout-the-counter analgesics to treat the agitation that accompanies respiratory infections, so it seemed unclear to us whether asthma and wheeze were really linked to the employment of these drugs or perhaps to the respiratory pollution itself," explained study lead author Joanne Sordillo, ScD., instructor of medicine at Brigham and Women's Hospital in Boston.

"In our study, we wanted to try to decide if accounting for early life respiratory infections mitigated the connection between analgesic use and development of breathe hard and asthma in children," she declared.

The researchers used data from 1,139 origin-child pairs who participated in Project Viva, a exploration study of pregnant women and their children that examined lifestyle factors for the period of pregnancy and after birth and evaluated their movables on the development of asthma and other minority conditions. Mothers completed questionnaires during at the opening of day pregnancy, at mid-pregnancy and at person year following birth to determine acetaminophen and ibuprofen conversion to an act. Also, during the first three years of harvested land child's life, every mother supposing an annual report of any teacher's diagnosis of asthma or wheezing symptoms.

To quantify prenatal exposure in early and mid-pregnancy, the researchers divided subjects' acetaminophen exposure into three categories: those who in no degree used the drug; those who used it smaller than 10 times; and those who used acetaminophen further than 10 times. Ibuprofen use was a great quantity less frequent during early pregnancy and mothers were grouped into couple categories: those who took the physic and those who did not. Ibuprofen appliance beyond the first trimester was infrequent and was not included in the dissection.

For childhood exposure during the earliest year of life, the researchers divided infants into four groups on the side of each drug: those who were not given the drug; those who were given the drug one to five times; those who were given the drug six to 10 times; and those who accepted more than 10 doses of the physic during the first year of life.

Reviewing the study premises, the researchers found a higher exposing to acetaminophen both prenatally and for the period of the first 12 months of life compared to ibuprofen: 70 percent of mothers reported acetaminophen exercise during pregnancy while only 16 percent of mothers reported they had used ibuprofen while gravid; 95 percent of children were given at least one dose of acetaminophen during pupilage versus 70 percent of children who had been given at in the smallest degree one dose of ibuprofen. About 43 percent of children were given greater amount of than 10 doses of acetaminophen control they were a year old compared to 25 percent of children who received more than 10 doses of ibuprofen.

Next, the researchers looked at drug use and the occurrence of asthma and asthma-like symptoms overall, and that time adjusted the analysis to account in favor of respiratory infections the children experienced dint of the age of three. These infections included bronchiolitis, pneumonitis, bronchitis, croup or any other respiratory pest.

At the conclusion of their study, the researchers set that while use of the drugs was associated by wheeze and asthma in unadjusted models, succeeding adjusting the results to account beneficial to respiratory infections, the association between medication exercise in early childhood and asthma symptoms was solidly reduced.

"These results suggest that respiratory infections in babyhood, and not analgesic use, are the positive underlying risk factor for asthma and wheeze in children," said Dr. Sordillo.

The researchers moreover found that prenatal exposure to analgesics was associated through wheeze and asthma in the children. However, for they did not have information touching why the women took analgesics in which case pregnant, the researchers were unable to put for those potential factors; for at this moment, this link must be interpreted with caution, she said.

"Future studies have a mind need to carefully collect information regarding the reasons for taking such from one side to the other-the-counter drugs as analgesics during pregnancy," she said.

Study Suggests Certain Noncancer Pain Conditions Associated With Increased Risk Of Suicide

Study Suggests Certain Noncancer Pain Conditions Associated With Increased Risk Of Suicide

JAMA Psychiatry Study Highlights

A study dint of Mark A. Ilgen, Ph.D, of the Veterans Affairs Serious Mental Illness Treatment Resource and Evaluation Center, Ann Arbor, Michigan and colleagues examined the associations between clinical diagnosis of noncancer pain stipulations and suicide. (Online First)

Data conducive to this retrospective analysis were extracted from the National Death Index and management records from the Department of Veterans Affairs Healthcare System. Researchers identified 4,863,036 individuals who admitted services in fiscal year 2005 and were in existence at the start of fiscal year 2006. The given conditions were examined for associations between baseline clinical diagnoses of worry-related conditions (arthritis, back pain, migraine, neuropathy, headache or tension headache, fibromyalgia, and psychogenic chagrin (which results from psychological factors) and succeeding suicide death (assessed in fiscal years 2006-2008).

Elevated self-murder risks were observed for each trouble condition except arthritis and neuropathy. When analyses controlled despite accompanying psychiatric conditions, the associations between pain conditions and suicide death were reduced; in whatever manner, significant associations remained for back wretchedness, migraine, and psychogenic pain, the study finds.

"There is a require for increased awareness of suicide peril in individuals with certain noncancer distress diagnoses, in particular back pain, migraine, and psychogenic distress," the study concludes.

Survey Finds Teen Misuse And Abuse Of Prescription Drugs Up 33 Percent Since 2008

Survey Finds Teen Misuse And Abuse Of Prescription Drugs Up 33 Percent Since 2008

New, nationally projectable survey results released by The Partnership at Drugfree.org and MetLife Foundation confirmed that one in four teens has misused or abused a prescription (Rx) drug at least once in their lifetime - a 33 percent increase over the past five years. The Partnership Attitude Tracking Study (PATS) also found troubling data on teen misuse or abuse of prescription stimulants. One in eight teens (13 percent) now reports that they have taken the stimulants Ritalin or Adderall when it was not prescribed for them, at least once in their lifetime.

Contributing to this sustained trend in teen medicine abuse are the lax attitudes and beliefs of parents and caregivers. In fact, nearly one-third of parents say they believe Rx stimulants like Ritalin or Adderall, normally prescribed for attention deficit hyperactivity disorder (ADHD), can improve a teen's academic performance, even if the teen does not have ADHD. Parents are not effectively communicating the dangers of Rx medicine misuse and abuse to their kids, nor are they safeguarding their medications at home and disposing of unused medications properly.

The Partnership at Drugfree.org Responds to Rx Epidemic with The Medicine Abuse Project

In response to the continued high prevalence of teen prescription medicine abuse as reported in the 2012 PATS data, The Partnership at Drugfree.org is helping educate parents, community stakeholders and others about the risks of this dangerous behavior. The Partnership at Drugfree.org leads The Medicine Abuse Project, a multi-year initiative with the goal of preventing half a million teens from abusing prescription medicine by 2017.

The Medicine Abuse Project provides comprehensive resources to parents, educators, health care providers, law enforcement officials and others about the growing problem of teen medicine abuse. The Project aims to mobilize parents and the public at large to take action and help solve the problem of teen substance abuse. This includes learning about the issue, talking with their kids about the dangers of misuse and abuse of prescription drugs and properly monitoring, safeguarding and disposing of excess Rx drugs in their homes.

Drug Enforcement Administration (DEA) Holds Nationwide Prescription Take-Back Day on April 27th

One way parents, grandparents and other caretakers can take immediate action is by participating in the upcoming DEA-facilitated National Prescription Drug Take-Back Day, taking place this Saturday, April 27, 2013.

"Medicine cabinets are the number one access point for teens who want to misuse and abuse prescription drugs. That's why we are making a concerted effort to let parents and caregivers know how important it is to safely dispose of their unused, unwanted or expired medicines. Doing so can literally save a life," said Marcia Lee Taylor,

SVP of Government Affairs at The Partnership at Drugfree.org. "This Saturday's DEA Take-Back event gives everyone a chance to protect their kids from the dangers that medicine abuse poses in their own homes. We should all take this simple step and clean out our medicine cabinets."

Collection sites will be set up around the country, open for medicine drop-off between the hours of 10:00 a.m. and 2:00 p.m. Those interested in disposing of their medicine at a take-back location this Saturday can visit The Medicine Abuse Project website to find the nearest site to safely drop off their unused, unwanted or expired prescription medicines. In the five previous Take-Back events, more than 2 million pounds of prescription medicines were safely dropped off and removed from circulation.

The DEA Take-Back Day provides a tangible way for parents to help curb medicine abuse. The PATS data released today confirms that misuse and abuse of prescription drugs is now a normalized behavior among teens.

Concerning Trends in Teen Prescription Drug Abuse According to the New PATS Data (2008-2012)

One in four teens (24 percent) reports having misused or abused a prescription drug at least once in their lifetime (up from 18 percent in 2008 to 24 percent in 2012), which translates to about 5 million teens. That is a 33 percent increase over a five-year period:

Of those kids who said they abused Rx medications, one in five (20 percent) has done so before the age of 14.

More than a quarter of teens (27 percent) mistakenly believe that "misusing and abusing prescription drugs to get high is safer than using street drugs," and one-third of teens (33 percent) say they believe "it's okay to use prescription drugs that were not prescribed to them to deal with an injury, illness or physical pain."

"These data make it very clear: the problem is real, the threat immediate and the situation is not poised to get better," said Steve Pasierb, President and CEO of The Partnership at Drugfree.org. "Parents fear drugs like cocaine or heroin and want to protect their kids. But the truth is that when misused and abused, medicines - especially stimulants and opioids - can be every bit as dangerous and harmful as illicit street drugs. Medicine abuse is one of the most significant and preventable adolescent health problems facing our families today. As parents and caring adults, we need to take action to address the risks that intentional medicine abuse poses to the lives and the long-term health of our teens."

Significant Increase in Teen Abuse of Stimulants Ritalin and Adderall, Rx Painkiller Abuse Flattening

Rx stimulants are a key area of concern, with misuse and abuse of Ritalin and Adderall in particular driving the noted increases in teen medicine abuse. Stimulants are a class of drugs that enhance brain activity and are commonly prescribed to treat health conditions including ADHD and obesity. The 2012 data found:

One in eight teens (about 2.7 million) now reports having misused or abused the Rx stimulants Ritalin or Adderall at least once in their lifetime.

9 percent of teens (about 1.9 million) report having misused or abused the Rx stimulants Ritalin or Adderall in the past year (up from 6 percent in 2008) and 6 percent of teens (1.3 million) report abuse of Ritalin or Adderall in the past month (up from 4 percent in 2008).

One in four teens (26 percent) believes that prescription drugs can be used as a study aid.

Abuse of prescription pain medicine remains at unacceptably high levels among teens, but the new PATS data show it may be flattening. Teen abuse of prescription pain relievers like Vicodin and OxyContin has remained stable since 2011 with one in six teens (16 percent) reporting abuse or misuse of an Rx pain reliever at least once in their lifetime. One in 10 teens (10 percent) admits to abusing or misusing an Rx painkiller in the past year.

Parents' Missed Opportunity: Lax Attitudes and Permissiveness About Rx Drugs Linked to Teen Abuse

Parent permissiveness and lax attitudes toward abuse and misuse of Rx medicines, coupled with teens' ease of access to prescription medicines in the home, are key factors linked to teen medicine misuse and abuse. The availability of prescription drugs (in the family medicine cabinet, in the homes of friends and family) makes them that much easier to abuse. The new survey findings stress that teens are more likely to abuse Rx medicines if they think their parents "don't care as much if they get caught using prescription drugs, without a doctor's prescription, than they do if they get caught using illegal drugs."

Almost one-third of parents (29 percent) say they believe ADHD medication can improve a child's academic or testing performance, even if the teen does not have ADHD.

One in six parents (16 percent) believes that using prescription drugs to get high is safer than using street drugs.

Teens reported that during the last conversation they had with their parents regarding substance abuse, only 16 percent said they discussed the misuse or abuse of prescription pain relievers with their parents, and just 14 percent indicate the same for discussions about any type of prescription drug. In comparison, a majority of teens (81 percent) say they have discussed the risks of marijuana use with their parents, 80 percent have discussed alcohol and nearly one-third of teens (30 percent) have discussed crack/cocaine.

More than half of teens (56 percent) indicate that it's easy to get prescription drugs from their parent's medicine cabinet. In fact, about half of parents (49 percent) say anyone can access their medicine cabinet.

More than four in 10 teens (42 percent) who have misused or abused a prescription drug obtained it from their parent's medicine cabinet. Almost half (49 percent) of teens who misuse or abuse Rx medicines obtained them from a friend.

Teens are more likely to use prescription drugs if they believe that their parents are more lenient toward prescription drug misuse or abuse compared to illegal drug abuse, and their parents use drugs themselves.

One in five parents (20 percent) report that they have given their teen a prescription drug that was not prescribed for them.

The PATS survey also found that 17 percent of parents do not throw away expired medications, and 14 percent of parents say that they themselves have misused or abuse prescription drugs within the past year.

View drug information on Adderall XR; OxyContin; Ritalin LA.

General On-Off Switch Suggested By Structure Of Cell Signaling Molecule

General On-Off Switch Suggested By Structure Of Cell Signaling Molecule

A three-dimensional image of one of the proteins that serves as an on-off switch as it binds to receptors on the surface of a cell suggests there may be a sort of main power switch that could be tripped. These surface receptors are responsible for helping cells discern light, set the heart racing, or detect pain.

The finding, published online in the journal Nature by a research collaboration involving this year's Nobel laureates in chemistry, could help in the development of more effective drugs to switch on or off the cell receptors that regulate nearly every bodily function. Already, up to half of all drugs engage these receptors, including antihistamines and beta blockers, but many of the intricacies of how these important proteins work remain unknown.

"It's important to understand how this extraordinary family of receptors work," said co-author Robert J. Lefkowitz, M.D., James B. Duke Professor of Medicine and Howard Hughes Medical Institute Investigator. "This is the kind of finding that answers a basic curiosity, but can also be of benefit if we can develop new drugs or improve the ones we have."

The research marks a collaborative reunion between Lefkowitz and Brian K. Kobilka, M.D., chair of molecular and cellular physiology at Stanford University School of Medicine. The two researchers - friends who first collaborated when Kobilka was a trainee in Lefkowitz's laboratory at Duke - shared the 2012 Nobel Prize in Chemistry for their discoveries involving the G-protein coupled receptors (GPCRs), which are activated by signaling proteins to detect hormones, neurotransmitters, pain, light.

In the current work, the researchers used X-ray crystallography to develop an atom-scale image of one of the principal signaling molecules that regulate GPCRs. This protein is called beta-arrestin1, which, among other things, works to dim a cell's response to hormones such as adrenalin.

The researchers were able to isolate and capture the beta-arrestin1 protein in an active state as it binds to a segment of the GPCR - a first. That snapshot, in high resolution, revealed that the structural conformation or shape of the protein in its active state is strikingly different than when it is inactive.

Such changes suggest there may be a general molecular mechanism that activates the beta-arrestin1 - a sort of main switch that controls the multi-functional signaling proteins.

"It's like there are brakes on in beta-arrestin1, and then when the beta-arrestin1 binds to a GPCR, the brakes are released, thereby activating beta-arrestin1," said Arun K. Shukla, PhD, assistant professor of medicine at Duke and co-lead author of the study.

The researchers are now pursuing additional structural imaging of the signaling complex consisting of beta-arrestin1 and the entire receptor protein.

The Epigenetics Of Pain In Endometriosis

The Epigenetics Of Pain In Endometriosis

Most of us probably know at least one woman, and maybe quite a few more, with endometriosis. Despite the disease's prevalence, there is no consensus on the cause of it, the existing treatment options leave a lot to be desired, and there are too few ways for women to, at the very least, effectively numb the pain that the disease provokes.

Scientists - who over the years have suspected hormones, the immune system, environmental toxins, genetics or some combination - still have a long way to go in terms of better understanding the disease's molecular bases. Researchers at the Joan C. Edwards School of Medicine at Marshall University, in Huntington, W.V., say that a great deal more attention should be paid to the daily pain suffered by endometriosis patients.

"Endometriosis is a not a well understood disease ," says Nalini Santanam, who is heading up the West Virginia research team looking into the epigenetics of pain in endometriosis. Santanam, who has studied the disease for more than 20 years, expresses disappointment in the lack of notice given to the pain associated with the disease.

"First of all, even though it's highly prevalent, we don't really have people talking about the disease. It's a woman's disease. It's pain," she says. "Women have menstrual pain, and in most countries we don't even talk about this. It's taboo. People say, 'It's just pain. Get over it. In a few days, it's gone.' And they don't think that there's actually an underlying disease there."

About the disease

Endometriosis occurs when cells normally present within the uterus migrate outside the organ and attach to other parts in the pelvis. This outgrowth causes scarring, nodules of bumps on pelvic organs, or ovarian cysts. In some cases, organs can become fused by the scar tissue. The disease affects about one out of every seven women, but, because some don't exhibit symptoms, the actual number could be larger.

A common cause of infertility, endometriosis usually presents itself during the teen years in the form of pain in the pelvic region and lower back, but it it's not usually diagnosed till women are in their mid-20s, often because they are having difficulty having babies. Hormones, including birth-control pills, can ease the symptom. Over-the-counter painkillers are often recommended.

"Unfortunately, there are few options for treatment," says Kristeena Ray, a doctoral student in Santanam's lab. "More complex treatment can involve surgeries to remove the damaged tissue or, in extreme cases, a complete hysterectomy." It's not uncommon for endometriosis to recur after surgery.

Pain can't be ignored

Much like the tissue does when situated correctly in the uterus, the misplaced endometriosis grows, breaks down and sloughs off; however, because of its location, the detritus cannot exit the body, and it is believed that this misplaced chemical cocktail causes pain.

"It is extremely common for the pain suffered by these women to interfere with their day-to-day activities," says Ray.

Women often report pain during and after sexual intercourse. Interestingly, the stage of endometriosis is not necessarily indicative of the amount of pain.

When Santanam was working at Emory University a few years ago, her group looked into how nutritional supplementation affects potential endometriosis biomarkers. "One of the projects was a clinical study where we'd given patients vitamin E and C to see if it changes any markers related to endometriosis, and we found that it did," she explains. "What also was interesting was that it also decreased pain in these women. So in our mind, there must be something else, some other pain-related markers. So over the past few years I've been trying to concentrate on that particular aspect: What are the pain-related markers? And then there's the epigenetics."

The epigenetics of endometriosis and pain

Though several large gene-expression studies have identified many deregulated genes in endometriosis patients, the specific genetic factors remain elusive. The West Virginia group, meanwhile, is focusing on epigenetic mechanisms, the changes caused to DNA and gene expression by the environment and lifestyle.

Ray is heading up the group's investigation. Her preliminary findings were presented at the annual meeting of the American Society for Biochemistry and Molecular Biology, which is held in conjunction with the Experimental Biology conference in Boston.

"We're looking at epigenetic markers in patients with endometriosis," Ray explains. "We believe that our continuing research in this area will help us better understand what leads to endometriosis in some women and find alternate treatment options for its symptoms."

Unlike DNA mutations, epigenetic modifications are dynamic, constantly affected by environmental and lifestyle factors, which makes enzymes that affect epigenetic changes sought-after targets for drug development.

Santanam emphasizes that so little is known about the epigenetics of pain. "When you look at pain research, they mostly focus on back pain, fibromyalgia - those types of diseases. There are only now looking at epigenetics of pain," says Santanam. "If you look at all the other fields, there are already epigenetic-related drugs available in the market."

But, if epigenetic aberrations are found by her group or others, Santanam says, that could go a long way toward narrowing down biomarkers to be used in diagnostics and perhaps a personalized approach to endometriosis and its associated symptoms such as pain.

Painkillers Taken Before Marathons Linked To Potentially Serious Side Effects

Painkillers Taken Before Marathons Linked To Potentially Serious Side Effects

Risk increases with dose; unrecognised problem, doctors warn

Attempts to ward off pain in marathons and other endurance sports by taking over the counter painkillers may be ill advised, because these drugs may cause serious side effects in these circumstances, suggests research published in the online journal BMJ Open.

Many competitors try to prevent pain interfering with their performance by taking painkillers that are readily available in pharmacies and supermarkets, say the authors.

And in a bid to find out what impact these common drugs might have, the authors quizzed participants in the 2010 Bonn Marathon/Half-Marathon about their use of medication and any symptoms they had during and/or after the race.

In all, just under 4000 (56%) of all 7048 competitors returned their online questionnaires. Most (87%) had run marathons before.

Of those who took painkillers before the race, 1 in 5 said they also used painkillers during training to curb or ward off pain; 1 in 10 said they had pain symptoms before the start of the race. This compares with 1% of those who didn't touch painkillers.

Over half the drugs taken (54%) were bought over the counter without a prescription, and included diclofenac, asprin, and ibuprofen.

The numbers of those forced to withdraw during the race because of pain and other health symptoms differed little between those who took painkillers and those who didn't.

But withdrawal from competition because of gastrointestinal problems was significantly more common among those taking painkillers, and while withdrawal as a result of muscle cramps was rare, it was significantly more common in those who had taken these drugs.

Runners who popped painkillers were five times as likely to experience symptoms as those who didn't take these drugs; the overall difference in risk was 13%.

Symptoms included stomach cramps, cardiovascular problems, gastrointestinal bleeds, blood in the urine and joint and muscle pain.

The rate of symptoms rose in parallel with increasing dose. One in 10 of those taking diclofenac took over 100 mg; 43% of those who took ibuprofen, the second most popular choice, took doses of 800 mg or more--twice the recommended dose.

Virtually none of the respondents said they were aware of any risks associated with taking painkillers for endurance sports.

Nine runners who took painkillers said they had ended up in hospital: three for temporary kidney failure after taking ibuprofen; four for bleeding ulcers (aspirin), and two after a heart attack (aspirin), one of whom had taken 500 mg for mild foot pain.

None of the runners who competed without having topped up on painkillers was admitted to hospital.

Painkillers block enzymes called cyclooxygenases, which regulate the production of prostaglandins. But the authors suggest that prostaglandins also protect tissues when the body is under extreme stress, such as during endurance sports.

"Taken together, our data indicate that the widespread use of cyclooxygenase inhibitors in connection with endurance sports is potentially damaging. Further investigations are warranted to examine whether the use of analgesics before and during sports activities should be avoided altogether," they conclude.

Lower Rates Of Complications In Hip And Knee Replacement Using Regional Anesthesia Technique

Lower Rates Of Complications In Hip And Knee Replacement Using Regional Anesthesia Technique

A highly underutilized anesthesia technique called neuraxial anesthesia, also known as spinal or epidural anesthesia, improves outcomes in patients undergoing hip or knee replacement, according to a new study by researchers at Hospital for Special Surgery. The study, which appears in the May issue of the journal Anesthesiology, found that neuraxial anesthesia, a type of regional anesthesia, reduced morbidity, mortality, length of hospital stay and costs when compared with general anesthesia.

"The influence that the type of anesthetic can have on perioperative outcomes has been vastly underestimated. Indeed, our study suggests that the type of anesthesia chosen may have important impacts on all kind of medical and economic outcomes in orthopedic surgical patients," said Stavros Memtsoudis, M.D., Ph.D., director of Critical Care Services at Hospital for Special Surgery, New York City. "It is not something to be taken lightly." The findings of this comparative effectiveness research could be applied to over one million patients undergoing joint arthroplasty in the United States each year.

Using neuraxial anesthesia over general anesthesia reduced the risk of pulmonary compromise by twofold in knee replacement patients and over threefold in hip replacement patients. "When one considers the modest decrease in risk of adverse outcomes associated with the use of a number of widely used medications such as anti-cholesterol drugs, the effect sizes seen in this study are really impressive," said Dr. Memtsoudis.

Neuraxial anesthesia involves injecting medication into fatty tissue that surrounds the nerve roots in the spine (known as an epidural) or into the cerebrospinal fluid that surrounds the spinal cord. Currently, the majority of joint replacements in the United States are performed under general anesthesia. Anesthesiologists at the Hospital for Special Surgery, however, use regional anesthesia for over 90% of hip and knee replacements. In the past, several small studies have shown that compared with general anesthesia, regional anesthesia reduces intraoperative blood loss and the need for blood transfusions.

In the new study, researchers at Hospital for Special Surgery conducted a retrospective review of hip and knee replacements performed between 2006 and 2010 in the United States using data collected by Premier Perspective. This administrative database contains discharge information from approximately 400 acute care hospitals located throughout the United States.

Information on the type of anesthesia used was available in 71.4% of 528,495 patients. Eleven percent received neuraxial anesthesia, 14.2% received combined neuraxial and general anesthesia, and 74.8% received general anesthesia. Thirty-day mortality was significantly higher in patients who received general anesthesia, 0.18%, compared with those who received neuraxial, 0.10%, or neuraxial-general, 0.10%.

"Other studies have suggested some benefit of neuraxial over general anesthesia, but they looked at very limited outcomes, primarily at risk of bleeding and blood transfusions. What this study does for the first time is really explore the impact of anesthesia on a wider range of important outcomes," said Dr. Memtsoudis. "We found lower rates of complications including pulmonary compromise, pneumonia, infections, and acute renal failure when neuraxial anesthesia is used. The choice of anesthesia seemed to basically affect every organ system."

When patients who received general anesthesia were compared to patients who received neuraxial or a combination of neuraxial and general, they were found to have higher rates of pulmonary compromise (0.81% vs. 0.37% vs. 0.61%), infections (4.5% vs. 3.11% vs. 3.87%) and acute renal failure (1.75% vs. 1.1% vs. 1.43%).

Neuraxial anesthesia was also associated with shorter hospital stays and lower health care costs. Patients were defined as having a prolonged hospital stay, if they fell in the 75th percentile of the study cohort in terms of stay duration. The researcher found that more patients receiving general anesthesia (35.4%) had a prolonged hospital stay than patients who received neuraxial (28.7%) or neuraxial and general (27.4%). Patients were less likely to fall into the upper 75th percentile in terms of health care costs if they received neuraxial anesthesia (21.4%) or combined neuraxial-general (18.3%) than in the general anesthesia group (23.4%). "Patients were 30% more likely to be in the group that had the highest costs if they received general anesthesia alone," said Dr. Memtsoudis.

Anesthesia medications used during surgeries are a small fraction of overall health care costs, and the costs of regional and general anesthesia are similar.

Dr. Memtsoudis pointed out that educating patients is key. "Some patients don't like the idea of having an injection in their back and their legs being numb, but a thorough discussion of risks, benefits and alternatives can go a long way to help an educated patient make rational decisions," he said. "For the anesthesiologist, a number of factors come into play, including patient comorbidities and preferences as well as other practice specific factors, such as the choice for anticoagulation, but regional anesthesia should, at the very least, be considered in every patient."

While randomized clinical trials are the gold standard of clinical research, such trials are not feasible for testing anesthesia technique in joint replacement surgeries, because the low incidence outcomes would require a huge number of patients.

Carpal Tunnel Syndrome and Treatment

What is the Carpal Tunnel?

The carpal bones of the hand form a "C" shaped ring that is covered by a ligament. There are eight of these bones that vary in size and shape to make up the wrist area. This ligament and bony structures form the carpal tunnel through which the median nerve and nine tendons pass. These tendons flex the fingers and thumb. Any condition that affects the size of this tunnel can lead to carpal tunnel syndrome.

What Causes Carpal Tunnel Syndrome?

There are several factors that lead to the condition. Most commonly, it is thought that the syndrome is genetic, while repetitive, strenuous use of the hands often worsens the symptoms. Other conditions that can cause or worsen carpal tunnel syndrome include fractures, masses, severe bruising. Conditions that are associated with this condition include hypothyroidism, infections, arthritis, pregnancy, and diabetes.

How is Carpal Tunnel Syndrome Treated?

The first line of treatment is non-operative. Wrist braces, activity modification and anti-inflammatories are usually the first step and can be helpful in many early cases. Surgery is often considered when you do not gain relief from these treatments. Worsening symptoms indicate a nerve at risk of permanent damage. The decision is based mostly on the severity of your symptoms and your desire to return to normal functioning. In the most severe cases, surgery is done much sooner because the other treatment options are not likely to help. Also, long-standing cases often require surgery when the disease has resulted in constant numbness and wasting of the thumb and finger muscles.

Surgical Treatment

Carpal tunnel release surgery is one of the most common operations performed on the upper extremity and is among the safest and successful surgeries performed. During the surgery, the doctor will make a small cut in the palm of your hand. This will allow him to see the transverse carpal ligament of the carpal tunnel and divide this structure to increase the size of the tunnel and decrease the pressure placed on the median nerve. Once this is done, the skin is closed and the ligament will start to heal and grow across the divided area. This new growth actually heals the ligament and more space is available for the nerve and flexor tendons. Once this is done, the skin is sutured and a sterile bandage is applied. The sutures will need to be removed in seven to ten days.

The endoscopic method for carpal tunnel release allows the doctor to visualize the ligament with a small camera and the procedure results in a more speedy recovery. Other benefits of this procedure are less postoperative pain, earlier return to work, and earlier return of grip strength.

What Should I Expect during Recovery?

Immediately following your carpal tunnel release surgery, you will be instructed to frequently elevate your hand above your heart and move your fingers as well. This is done to prevent stiffness and reduce swelling. There is some pain, swelling and stiffness to be expected after the surgical repair. The dressing is removed in 3-5 days and normal use of the hand is allowed once you are comfortable. Minor soreness of the palm region is common but reliably improves over time.

Hypnosis As A Cure for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a common disorder of the colon and the entire digestive system, which leads to discomfort, abdominal pain, bloating, constipation and diarrhoea. The exact causes are unidentified but most experts agree it's linked to an increased sensitivity of the gut. The symptoms of IBS tend to come and go in bouts, often after eating certain types of food or during times of stress. Since 1980 a number of studies have shown that hypnosis has helped IBS patients for whom standard treatment has failed. Indeed, it seems IBS patients can obtain genuine relief through hypnosis.

Standard treatments for IBS are targeted at preventing constipation or diarrhoea. They include changes in diet, fibre supplements and drugs. For many, this approach proves effective. However, some patients do not respond well to conventional treatment. For them, psychological therapies may be appropriate, namely hypnosis and cognitive-behavioural therapy.

As a treatment for the symptoms of IBS, hypnosis does not have to take place in specialized medical centres. The latest study on the subject shows that hypnosis can be effective even when done by therapists in the normal conditions of a consulting room. And tests have shown that patients undergoing hypnotic therapy had a marked drop in the symptoms of pain and bloating.

This study tracked two different procedures for treating the symptoms of IBS. The first procedure was hypnosis in a private clinic. The second procedure required the patients to meet with psychologists in a hospital gastroenterology department. It turned out that the first procedure was as equally effective as the second. An added advantage was the better availability of private therapists, compared with the limited number of hospital specialists. This made the first procedure a genuine "real world" solution. These tests also support the fact that self-hypnosis techniques, applied at home can also provide an effective solution to dealing with IBS.

Cognitive behavioural therapy aims to change a patient's patterns of thinking and behaviour that contribute to health problems. The idea of using hypnosis to treat the symptoms of IBS is to give individuals a sense of control over their digestive tract. Luckily, modern technological advancements offer cost-effective solutions for self-hypnosis at home, and the internet provides a vast resource for further exploring the subject as well as learning about other people's experiences with hypnosis. With modern technology, we can feel lucky that a great number of alternative treatments are being made available that don't cause the side effects of medication. Do take some time to learn more about them!

Are New Wonder Drugs Only for the Select Few?

These days you cannot pick up a newspaper without reading of some new wonder drug that has been discovered. Scientists have made great leaps in their knowledge and understanding of the body's DNA and the results are outstanding.

A few decades ago certain cancers were almost considered to be a death sentence but now they are curable, or at the very least controllable. And as a result we can now expect to live not only a longer life, but also a better life too.

Obviously this has to be seen as a good thing for all of us. Or, does it actually present more problems than we realise?

The cost of these new drugs seems to be getting higher and higher all the time. Although, to be honest, it is not surprising when you consider what it takes to get any new drug onto the market.

The big drug companies have to invest colossal amounts of money into research and development. They spend years testing new drugs to make sure they comply with all the various regulations and discover what, if any, the side effects are.

So by the time a new drug reaches the market an enormous amount of money has been invested on it. And obviously this money has to be recouped - plus enough profit to pay the shareholders and fund any new research. And this money is be paid by us, the patients, either directly over the pharmacy counter or through any social security or health insurance payments we make.

And this is really where the problems begin.

Not that many years ago once a patient was diagnosed with cancer it would not be too long before they, unfortunately passed away. That was because there was no means of detecting a lot of cancers until it was almost too late.

But now with early detection of cancers we have a much better chance of survival. So, unlike our parents generation, if we are diagnosed with cancer we stand a very good chance of carrying on living well into our old age.

But this comes at a cost - and the cost is that we live for many years consuming large quantities of very expensive drugs.

When my father was diagnosed with prostate cancer his consultant informed him he needed to go on a particular course of tablets, and gave him a note to pass onto his doctor. Once his doctor saw what the tablets were his eyes widened and he turned to my father and said, "Do you know how much these tablets are going to cost me?"

But, as we all live that much longer the cost of keeping us alive has risen alarmingly. In the UK the job of the National Institute for Health and Care Excellence (NICE) seems to be to look into the cost effectiveness of new drugs and deciding whether or not they can he used in the National Health Service. There have been a number of drugs they have classified as being far to costly, one in particular was for Alzheimer disease much to the annoyance of those patients and their families.

So is this the way modern medicine is heading? Will there be drugs and treatment for those who can afford it, and no drugs - and perhaps not even any treatment - for those who cant? This really does conjure up an image of a two-tier health system - one for the rich and one for the poor.

So what is the point in all these new wonder drugs if the majority of people they were designed to help cannot afford to benefit from them?

Perhaps now is the time to look at more natural ways to keep ourselves healthy and try to prevent many of the more serious illnesses taking hold of us in the first place.

Unless of course you happen to be extremely rich that is!

Morton's Neuroma Differential Diagnosis - Distinguishing From Other Conditions With Similar Symptoms

Morton's neuroma is a common condition that affects the third space between the toes. The condition is also referred to as interdigital neuroma. This painful foot condition is due to enlargement of the nerve of the foot.

There are a number of conditions that can be mistaken for neuroma. Read on to learn about the differential diagnosis of Morton's neuroma.

A stress fracture may be mistaken for neuroma. This is actually a small crack in the bone that can develop from overuse or can also be from weakening of the bone by conditions such as osteoporosis. Symptoms of stress fractures are pain, swelling, tenderness on a specific spot, and continued pain at rest as the fracture damage progresses.

Tarsal tunnel syndrome occurs from abnormal pressure on a nerve in the foot. Usually, the symptoms are vague pain in the sole of the foot, burning, or tingling sensation. The pain gets worse with activities such as walking long distances or standing for long periods. It is occasionally mistaken for Morton's neuroma because the pain and tingling may also occur on the toes.

Peripheral neuropathy, like Morton's neuroma, is due to nerve problems. In neuropathy, the pain is described as tingling or burning. There can be extreme sensitivity to touch, lack of coordination, or muscle weakness. The pain may also spread upward to the legs.

A ganglion is also another differential diagnosis for neuroma. This is like a balloon that arises under the skin. Although often seen on the wrist, the cyst also frequently develops on the foot. In contrast to neuroma, a ganglion cyst may have a noticeable lump. If the cyst is touching a nerve, this causes burning or tingling sensations.

Arthritis of the feet may occasionally be mistaken for neuroma. Osteoarthritis is wear and tear arthritis, resulting to swelling, inflammation, and pain. Some people with rheumatoid arthritis may also have pain in the heels because of plantar fasctiis. The symptoms may also appear in several joints on both feet. The toes may also begin to stiffen. To differentiate arthritis, range of motion tests or x-rays may be done.

Another very common condition that leads to foot pain is bursitis. Again, this may also be mistaken for Morton's neuroma. A bursitis is inflammation of the bursal sac, which contains fluid to lubricate and reduce friction between two surfaces in the body. With bursitis, the top of the toes can be very tender, red, and slightly swollen. Most of the time, pain is relieved when the shoes are removed.

The various differential diagnoses of neuroma must be carefully considered to exclude these other common conditions of the feet. When a definitive diagnosis of Morton's neuroma is made, conservative management can be tried from three months to one year.

Causes and Symptoms of Anterior Knee Pain

The kneecap (patella), located at the front of the knee, gives leverage and power to the leg muscles. When the knee is overstressed, an individual may feel a dull, aching pain in the front of the knee. This is known as anterior knee pain, runner's knee or patellofemoral joint syndrome. Anterior knee discomfort tends to occur in overweight individuals, athletes, children, young adults and senior citizens who over-stress their knees.

Anterior Knee Pain in Females
Anterior knee pain occurs at a higher rate in females. This is due to the size of the female pelvis. Females have wider pelvises, which creates a pointed angle where the thigh and leg bone join. This can lead to kneecap misalignment, which results in pain. In addition, females ligaments are generally more slack, and muscles that support the kneecap tend to be weaker than males.

Causes
Causes of the pain vary, but often come from tendonitis and the breakdown or irritation of the cartilage at the base of the kneecap. These conditions result from improper knee movement that causes the kneecap to rub against the lower portions of the thigh bone. Causes of improper movement include pes planus (flat feet), misalignment of the kneecap and femur (patellofemoral joint), tight or weak muscles on the front and back of the thigh and overexertion of the kneecap during exercise or sports activities. Frequent inactivity leads to the loss of muscle tone around the knee, which can lead to anterior knee discomfort.

Additional causes include cycling, rowing running and walking down hills or stairs, arthritis, cartilage injury and dislocation or fracture of the kneecap. In some cases, pain occurs from prolonged sitting or getting in and out of a vehicle. Pinching of the synovial membrane (knee's inner lining), referred to as synovial impingement or plica syndrome, also causes discomfort.

Symptoms
Individuals often experience knee pain behind, below or on the kneecap. The pain can be worse at night or during activities that bend the knee. Snapping, popping or crackling sounds may accompany the pain when climbing stairs, standing up, or walking after prolonged sitting. Individuals may feel a dull, aching pain in the knee from a change in activity level or intensity. Other symptoms include partial locking, buckling, tenderness, swelling or sensitivity in the knee. Ice, rest, simple knee exercises and non-steroidal anti-inflammatory drugs may ease the discomfort. Never self-diagnose. Consulting a licensed health professional helps determine the exact cause of the pain and exclude other problems.

A Common-Sense Approach to Neuropathy Treatment

One of the things that we see in the office all too frequently is when a patient presents with neuropathy symptoms, sometimes for many years.
Too often, neuropathy patients search for answers without actually engaging in any effective treatment. And too often real answers as to what may be responsible for your neuropathy never come.
All the while however, the actual conditions underlying or aggravating neuropathy are going untreated.
The consequences of this are dangerous. The longer you delay proper treatment, the more difficult effective treatment could actually be.
This is not to say every case of neuropathy is curable; unfortunately, it is not.
But we now understand the impact of things like lifestyle, cigarette smoking, and body weight have on most forms of peripheral neuropathy, and related disorders such as fibromyalgia.
Many types of chronic pain respond exactly the same way.
So here's the best advice I can give you: If you believe you may be suffering from neuropathy, it is important to get proper treatment that targets the overall improvement of your health-early.
Keep in mind that very rarely do drug-only therapies provide a lasting answer. In fact, drug-only therapy can mask underlying causes of neuropathy, and make your condition progress faster.
At the same time, work with healthcare professionals that understand all possible underlying causes.
Identify any correctable things such as poor diet, cigarette smoking et cetera. Above all, it is important to take responsibility for your own care, in your own health.
Jump on any new injury or illness with pain as soon as possible. It is vital with any new condition or injury to reduce pain quickly, and as much as possible with non-drug methods.
This is why seeking therapy soon after injury or onset of a condition like shingles or neuropathy--or even headaches and back pain--can produce much better long-term treatment results! Use every non-drug tool available as soon after the onset of injury or illness as possible.
Neuropathy and chronic pain are not one-size-fits-all disorders. Peripheral neuropathy patients who do the best realize this-and take action every single day.
Learn all you can about things like gluten- and dairy-free diets.
Be sure to get regular physical activity as tolerated. Explore proper physical therapy and treatments such as neurostimulation and laser.
Listen to your body. Pay attention to what it is telling you. Years from now, when you are still enjoying your health, you'll be glad you did.