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Nanotechnology For Better Healing

Nanofibers for the healing of wounds can become a new technique to promote faster healing with less scarring. The application of these tiny fibres that consist of peptides can be manifold. The fibers can self-assemble into a mesh that can help heal areas affected by trauma. A mesh of the fibers applied to a bleeding wound can help the surgeon to stop the bleeding.The fibres can "knit" an injury,but they also can work in repairing areas of trauma in vital organs and restore tissue. Researchers have raised the possibility of application for the central nervous system too. So far the experience has come from animal experiments. Nanotechnology has been applied in animals, where the optic nerve had been severed and with the application of nanofibers the nerve could be "knitted" together and as a result the vision was restored.
The research comes from the Institute of Technology from Cambridge, Massachusetts where Rutledge Ellis-Behnke,PhD reported that healing of the nerve could be observed already within 24 hours. An incidental finding was that bleeding could be stopped when nanofibers were applied.This technique is unlike any other like cauterization. It is fast and as a result blood loss during surgery can be minimized and time needed for surgical procedures can be decreased, which translates into a faster recovery time for the patient.
Researchers are optimistic about the potential for clinical use, as the fibers are biodegradable and are excreted through the urine within 3-4 weeks or taken up by the tissue adjacent to the treatment site in the body.

From: JAMA. 2007;297:31 (Jan.3, 2007)

Less Invasive Surgery Through Body Orifices

Natural orifice transluminal endoscopic surgery (NOTES) has become increasingly popular during the last few years. This is not surprising, as a surgical procedure which does not need an incision is less threatening for the patient. Unsightly skin scars are not a concern and recovery is usually less complicated. Procedures have become more varied. Transvaginal procedures have been performed for a number of years, such as vaginal hysterectomies.
In 2004 Anthony Kalloo, a gastroenterologist from John Hopkins University reported on the feasability and safety of gastrointestinal surgery and research has proceeded at a stunning rate. The idea behind NOTES is to use a body orifice (the oral cavity in the case of gastro-intestinal surgery) as an entry point to the surgical area. An incision into the abdominal wall is avoided.

The concept of minimally invasive surgery is not new, as laparoscopic procedures for gallbladder surgery and hernia repair are currently in use. Joint surgery through arthroscopic surgery is common and surgery to the pineal gland in the brain has been performed by using the nostrils as an entry to the area.
Experience in gastrointestinal surgery through natural orifice transluminal endoscopic surgery at this point is limited. Seven transgastric appendectomies have been performed by the surgeons Dr. N.Reddy and Dr.V.G Rao in Hyderabad, India.
The research group from John Hopkins is aware that this new technique will revolutionize surgeries, but there is the sentiment that things should not be rushed. The procedures need to be thoroughly researched to ensure that they are safe and beneficial to surgical patients. To this effect the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) has been formed in the US, which promotes research and monitors safety of these new approaches of less invasive surgeries.

From: MD Consult news, January 3, 2007: "New procedure aims to avoid surgery"

Prevent Type 2 Diabetes With Diet And Moderate Exercise
The almost epidemic proportions of Type 2 diabetes has raised grave concern, but healthcare providers agree that adult onset diabetes is not just a disease that strikes out of the blue. Patient education remains a basic concern, as there are factors that predispose people to the disease. There are known risks for those who are over weight and when inactivity is the main lifestyle. Family history plays a role and ethnic origin can make the patient more vulnerable to the development of diabetes. Population groups at risk are African-Americans, Native Indians, Pacific Islanders, Hispanic-Americans and Asian-Americans. There is a stage which is known as pre-diabetes. The blood glucose level is elevated, but it is not high enough that the condition is labeled as a full-blown diabetes. The good news is that with screening of the blood sugar the first signs of elevation can be detected with a blood sugar monitor at home. This way this condition can be picked up and the progression to diabetes can be avoided with proper diet and exercise.

In a large study of the Diabetes Prevention Program people who lost 7 % of their body weight and exercised 150 minutes per week cut their risk of developing type 2 diabetes by 58%. For patients in the age group over 60 the risk was reduced by 70%.
It is important that all persons who are at risk are screened. The laboratory tests involve fasting overnight, after which the fasting glucose levels are checked. A glucose tolerance test is the second test. After overnight fasting the patient receives a glucose-rich drink and blood sugar levels are monitored afterwards to establish how well the glucose is metabolized. These tests are inexpensive and are usually covered by health insurance.

Dec. 25, 2006/January 1, 2007 issue of U.S. News & World Report, page 55

Acetaminophen Overdosing Hazards

The FDA has expressed some concerns about the self-medicating with acetaminophen as this can led to an acetaminophen overdose. The over-the-counter medication is commonly used and especially in the winter season many sufferers of colds or influenzas will keep it handy. It is readily available, not only in pharmacies but also in supermarkets under the generic name or under brand names such as the commonly used Tylenol. It exists in dosages for adults and there are pediatric preparations like Children's Tylenol. Acetaminophen is also a common ingredient in cold remedies. Every vial displays a clear warning that the content is enough to cause serious harm. Dosage instructions are also clearly spelled out.
More than 200 million people take Tylenol each year and 400 people die of liver failure every year, as they have accidentally taken too much.
Dr. Charles Cain from the New York Presbyterian Hospital has cautioned that overdoses can happen relatively easy. A patient is not to exceed 4 grams of acetaminophen per day. If the pain reliever is taken every 4 hours instead of the recommended interval of 6 hours, such as 2 extra-strength Tylenol at 500 mg each and some cold medication is added to that, patients may easily reach 4-6 grams of acetaminophen per day. If this practice continues for a few days, it can lead to liver damage, because the liver cannot keep up with the elimination of the drug. Other substances metabolized by the liver such as alcohol can become a serious hazard, if they are combined with acetaminophen. The effects of alcohol slow down the elimination of Tylenol by the liver. It is for this reason that it is important to observe closely how much of the medication is taken in total: if a patient is already taking Tylenol for headaches, more acetaminophen (Tylenol) in the form of an over-the-counter cold medication should not be added as toxic levels would be reached.
These medications have to be used with an eye to overall daily use and the amount used over a period of time. Used with care acetaminophen remains very safe.

From: December 20, 2006 online issue of Time

Ballroom Dancing Improves Heart Health

It has been pointed out that there is not such a notion "It's too late now to think of an exercise program".
Researchers led by Dr. Romualdo Belardinelli, director of cardiac rehabilitation from the Lancisi heart Institute in Ancona, Italy took a close look at 110 patients with stable chronic heart failure. The average age of the patients was 59 years and 89 of them were men. The group was assigned different physical activities. Forty-four patients used an exercise bike or exercise treadmill three times a week for 8 weeks. Forty- four other patients chose to participate in 21-minutes of ballroom dancing consisting of waltzes (alternating slow and fast) three times per week. A third group of 22 patients had no exercise. Heart rates during exercise training and dancing were similar at 110 respectively 113 beats per minute. Cardiopulmonary fitness improved at a similar rate in both groups. Oxygen consumption increased by 16 % in the exercise group and by 18% in the dance group. In other words, exercise fitness had significantly improved in these two groups.
Quality of life as measured by the Minnesota Living With Heart Failure Questionnaire improved significantly more in the ballroom dance group, particularly in the emotional domain.
The findings are not just of significance to patients with heart failure. It is the observation that ballroom dancing seems to be a more effective way to get people into an exercise program who otherwise would not be interested in this. For some people it is simply more enjoyable to dance and enjoy social interaction as an additional benefit than running on a treadmill.

From: The Medical Post Dec. 19, 2006, page 17

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