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Mental health crisis hotline launched in the Philippines

Amid the rising suicide prevalence in the country, the Department of Health (DOH) yesterday launched a mental health crisis hotline aimed at helping curb the problem.

Health Secretary Francisco Duque III said the National Center for Mental Health (NCMH) crisis hotline will operate 24/7 to provide counseling for those at risk of committing suicide and other people suffering from mental health conditions.

The new NCMH crisis hotline can be reached at 0917-899 8727 or 989-8727.

“Everyone is enjoined to support the dissemination of the hotline numbers,” Duque said as he noted the many lives that can be saved with the use of the hotline.

Duque said mental illness is a major public health concern in the country, with many patients reluctant to seek medical treatment due to stigma.

He said without the proper necessary intervention, many of those who are suffering from mental conditions take their own lives.

Data showed that 3.2 percent of every country’s population is likely to commit suicide.

Studies indicated that suicide is the second leading cause of death among people aged 29 to 59 years old worldwide.

The Goulbourn Foundation, which also operates a 24-hour suicide prevention hotline in coordination with the DOH, reported that three young people committed suicide last week.

The foundation said the youngest suicide victim they have recorded was a seven-year-old child.

There is still no available data on the national prevalence of mental illness in the Philippines, but the DOH said a study is underway to determine the extent of the problem.

Duque said records from the NCMH showed the government-run institution has an average of 7,500 in-patients and serves up to 65,000 outpatients annually.

“The NCMH figure could be an indicator of the gravity of mental health problem in the country,” he said.

Duque expressed optimism that the health problem could be addressed with the implementation of the Mental Health Act.

He said the law mandates the DOH to develop a national suicide prevention strategy, which now includes the establishment of the NCMH crisis hotline.

NCMH officer-in-charge Allan Troy Baquir said the hotline would help people who are experiencing anxiety and depression as well as health workers who need guidance in handling their patients with mental illness.

Operating on a P7-million budget, the hotline will assess the needs of the callers and refer them to proper specialist or medical facilities if necessary.

Also yesterday, the DOH launched programs under the Kalusugan at Nutrisyon ng Mag-Nanay Act.

The new program aims to boost children’s health and reduce stunting and malnutrition.

Duque said the DOH would provide pregnancy and after birth medical services to both mothers and infants.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Vaginal Microcirculation: Non-Invasive Anatomical Examination of the Micro-Vessel Architecture, Tortuosity and Capillary Density

Aim
To describe the vaginal microcirculatory architecture and capillary density parameters using side stream dark field imaging (SDFI), and determine feasibility and reliability of this method.
 
 
Methods
In nine healthy female volunteers SDFI measurements were performed at two different time points in the luteal phase of the menstrual cycle. Non-invasivetissue micro-angioarchitecture and vaginal capillary density measurements were assessed independently by two observers. Agreement was expressed with mean differences between the measurements of both observers and the limits of agreement. Inter- and intra-observer agreement was quantified with the intra-class  orrelation coefficient (ICC).
 
 
Results
Vaginal microcirculatory assessment with the SDFI device was easy in use, painless and well accepted by theparticipants. Morphologically, the vaginal microcirculation revealed an array of single hairpin-shaped capillary loopsdistributed homogeneously across an imaged tissue segment. The intra-observer assessment of the capillary densitymeasurements (comparing two measurement time points of one observer) showed good agreement with an ICC ranging from 0.62 to 0.85. The inter-observer assessments of the capillary density measurements (comparing assessments of two observersaton etimepoint)revealed very good agreement, with small differences between observers and an ICC of more than 0.9.
 
 
Conclusions
This is the first report on both microcirculatory architecture and quantitative microcirculatory parameters of the vagina with the use of SDFI. Micro-vessels of the vagina show a recognizable pattern in our study population of young, healthy women. SDFI gives a reproducible assessment of the vaginal microcirculation offering the researcher a wide field of applications.
 

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.


The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Have you heard of Tere’s inspiring diabetic story?

“My Doctor told me I have less than a year to live if I won’t let them amputate my leg, but I didn’t let them . . . here’s how I am still alive now!”

When doctors initially told 60-year-old Theresa “Tere” Schaufer that she had diabetes, she went into denial for 20 years.

“I was diagnosed with diabetes 20 years ago, and only when my doctor told me that they needed to cut my leg, did I realize that my diabetes was serious,” she says.

 

A major contributing factor

“Doctors told me the only way to survive this fight was to amputate my leg,” Schaufer says.  

She acknowledges that she had lived an unhealthy lifestyle for many years. Working in a restaurant as a cashier, she did very little exercise, ate fast food and drank sodas on a regular basis.

“If the doctor tells you you’re a diabetic, don’t ignore it. Don’t get to where I am. The sooner you accept things, the better it is for your health.”

Only after her doctor advised amputation did she realize the seriousness of her situation. Schaufer’s lifestyle had a hugely negative impact on controlling her diabetes. 

 

It was very painful!

Schaufer had puss from underneath her foot and necrotic toe. “After the doctor examined my foot, it was like decaying,” she says. “I couldn’t handle the pain. It was excruciating!” She was given less than a year to live because of her poor lifestyle.

 

I started to accept the situation.

Schaufer finally accepted her fate as a diabetic after the doctor told her that her leg would have to be amputated.

“I saw it coming. The pain was terrible. I could no longer handle it. At this point I was prepared; whatever came had to be.”

 

Unexpected turn of events

“I was browsing a support page I found on the web and read about a colleague’s experience with the microcirculation therapy she had tried. She noted that it had an amazing effect on her diabetic foot ulcer,” Schaufer says.

Right there on the support page, the woman raved, “There is this new technology you can buy online, D’OXYVA, which was voted one of the Top 10 Diabetes Care Solution Providers 2018! I didn’t have to amputate my leg because of this amazing product. In just four weeks, I can see my diabetic foot ulcer improving!”

“I read these words, and it gave me the hope I’d been praying for,” noted Schaufer.

She only had a month before her scheduled amputation, and without hesitation, she used the remaining days to try out D’OXYVA. She ordered the product online and closely collaborated with their in-house support.

“I was under D’OXYVA therapy for one month, taking it twice a day, once in the morning and once before bed as advised. It was very easy to use and non-invasive. In the first few days, I was skeptical as I wasn’t seeing any improvements, but I continued anyway and followed their suggested therapy guide,” Schaufer explains.

 

Thankful for D’OXYVA

When it was time for her to go back to her doctor and give her consent to amputate, her doctor was shocked to see her leg.

“What happened?” Those were the exact words my doctor asked upon seeing my leg after only a month. “Your wounds seemed to be healing from the inside,” my doctor said.

After a thorough check-up and the usual diagnostic check of my foot’s PI (perfusion index), he said the words that I never expected to hear. “We don’t need to amputate your leg anymore, but you need to continue whatever you’ve been doing for the past month.”

I then introduced him to D’OXYVA, and he was amazed by how this product had saved me.

 

Helping others

“I’m on my third month of D’OXYVA therapy, and it does amazing things for my health! I don’t think I have thanked D’OXYVA enough for this chance to live longer. I wouldn’t have the outlook on life that I have now,” Schaufer continues cheerfully.    

She is now also leading a healthy life. “This changed how I live my life, and I will continue sharing my experience as much as I can to help others.”

Schaufer often spends time with other “to-be-amputees” struggling to deal with their situation. “God gave me my situation to help others,” she maintains.

One of the ladies she counselled remarked how Schaufer had helped her tremendously. “She told me that I gave her her life back,” Schaufer says, breaking into tears.

“I’m in a way thankful for what I have been through with my diabetes because, without it, I wouldn’t have stumbled across my strength and my ability to help others.”

HOW CAN D’OXYVA HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Anesthesia, Microcirculation, and Wound Repair in Aging

Abstract

Age-related changes in skin contribute to poor wound healing after surgical procedures. Changes in skin with age include a decline in thickness and composition, a decrease in the number of most cell types, and diminished microcirculation, the process that provides tissue perfusion, fluid homeostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause further disruption of the microvasculature of aged skin; however, perioperative management can be modified to minimize damage to aged tissues. Judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension are examples of adjustable variables that support microcirculation. Anesthetic agents influence microcirculation in a number of ways, including cardiac output, arterial pressure, and local microvascular changes. The authors examined the role of anesthetic management in optimizing microcirculation and potentially improving postoperative wound repair in older persons.

Aged skin is at increased risk of poor postoperative wound healing. Changes in the cutaneous microcirculation with aging contribute to this risk. This review examines the role of anesthesia management in microcirculatory function.

SURGICAL wound repair is a major problem in the older population, who are at increased risk of wound dehiscence and infection. As a specific example, surgical site infections (SSIs) are common (approximately 500,000 cases annually in the United States), lead to worse patient outcome (patients who develop SSI are twice as likely to die), and are an enormous economic burden (1–10 billion dollars annually). Many factors contribute to age-related changes in skin5 and subsequent vulnerability to impaired wound healing and infection. Changes in skin with age (fig. 1) include a decline in epidermal and dermal thickness and composition, as well as a decrease in the number of most resident cell types. The dermal–epidermal junction is flattened and the microcirculation is diminished. The latter is defined as blood flow through arterioles, capillaries, and venules and is the key system that affects the entire skin surface. In the aging patient, the microcirculation in the skin is reduced by 40% between the ages of 20 and 70 yr. The microcirculation provides tissue perfusion, fluid hemostasis, and delivery of oxygen and other nutrients. It also controls temperature and the inflammatory response. Surgical incisions cause disruption of the microcirculation in the skin as manifested by local edema resulting from vasodilation and increased vascular permeability.

Fig. 1.
Numerous changes in skin with age contribute to impaired wound healing.

 

Perioperative management can be modified to optimize the microcirculation. Measures that support the microcirculation include careful use of fluids, normothermia, pain control, and smoking cessation. Factors that can be influenced by intraoperative management (judicious use of fluids, maintenance of normal body temperature, pain control, and increased tissue oxygen tension) have been suggested to be beneficial as well. Most anesthetic agents also influence the microcirculation: a reduction in cardiac output and arterial pressure decreases flow in the microcirculation, whereas anesthetic-induced local microvascular changes and vasodilatation can increase perfusion. Optimization of these variables plays an important role in enhancing the microcirculation in all patients, but is especially relevant if modifications could improve postoperative wound healing in the older population.

In this review, we will use skin as a representative organ to describe age-related changes that negatively affect the microcirculation and have subsequent impacts on wound healing and the incidence of postoperative infection. We will then examine the role of anesthesia management in minimizing detrimental effects on the microcirculation. A greater understanding of these variables could promote improvements that lead to better outcomes with respect to wound repair in older patients.

Summary of Wound Repair and Aging

It has been nearly a century since it was noted that the rate of cutaneous scar formation after a wound is inversely related to the age of the patient. Four decades ago, it was observed that older age was associated with an increased risk of postoperative disruption of the surgical wound, leading to higher mortality. Recent data suggest that in patients older than 65 yr, development of SSI is associated with a two-fold increase in cost and a staggering four-fold increase in mortality.

Wound healing ensues via a sequential chain of events (with variable overlap) that includes inflammation, tissue formation, and remodeling (fig. 2). Circulating factors have a pivotal role in each of these phases. Accordingly, as we will discuss below, immediate changes in the microcirculation influence each stages of the wound-healing response in aging. As human data is lacking, we have taken data from established animal models of aging. Although animal models are not uniformly predictive of responses in human tissues, several animal models of wound healing are generally accepted.

Fig. 2.

The stages of wound healing are a sequential chain of events that include: (A) inflammation, (B) proliferation and granulation tissue formation, and (C) extracellular matrix (ECM) deposition and tissue remodeling. PDGF = platelet-derived growth factor; TGF-β1 = transforming growth factor-β1; TNF-α = tumor necrosis factor-α; VEGF = vascular endothelial growth factor.

 

Summary

Nearly every anesthesiologist who provides care to adults will participate in the care of geriatric patients. A growing older population is undergoing surgical procedures that are increasing in number and complexity. Poor healing of surgical wounds is a major cause of morbidity, mortality, and substantial economic burden. Wound healing is dependent on the microcirculation that supplies the incision area. Measures that support the microcirculation during the perioperative period have a profound effect on wound healing. Some measures such as maintenance of normal body temperature and control of postoperative pain are supported by ample evidence and have been implemented in routine clinical care. Other measures, for example, the choice of anesthesia technique and use of opioids are supported by basic research but need further clinical studies. A better understanding of the effect of aging and anesthesia on the microcirculation can potentially assist in improving postoperative wound repair, thereby benefiting a growing older population.

 

The Surgical Context of Wound Repair and Aging

Measures that support the microcirculation improve wound repair, thereby reducing the risk of postoperative dehiscence and infection.52General preoperative measures such as smoking cessation and optimal management of comorbid medical conditions have been reviewed in other contexts.53,54 For the purpose of this review, we will focus on interventions in the perioperative setting.

Oxygen Administration

Wound healing is dependent upon adequate levels of oxygen.55 Oxygen interacts with growth factor signaling and regulates numerous transduction pathways necessary for cell proliferation and migration.56 It is also an indispensable factor for oxidative killing of microbes.57 Consequently, the effects of oxygen tension on the outcome of surgical wounds have been best studied in the context of postoperative infection. Resistance to surgical wound infection is presumed to be oxygen dependent—with low oxygen tension viewed as a predictor of the development of infection,56 particularly when subcutaneous tissue oxygenation (measured by a polarographic electrode) decreases to less than 40 mmHg.58

In two recent meta-analyses, one found that perioperative supplemental oxygen therapy exerts a significant beneficial effect on the prevention of SSIs,59 whereas the other suggested a benefit only for specific subpopulations.60 Although most authors suggest that supplemental oxygen during surgery is associated with a reduction in infection risk,61,62 others propose it may be associated with an increased incidence of postoperative wound infection.63Notably, in the latter report, the sample size was small and there was a difference in the baseline characteristics of the groups. A prospective trial randomizing patients to either 30 or 80% supplemental oxygen during and 2 h after surgery did not find any difference in several outcome measures including death, pulmonary complications, and wound healing.64 Of note, the administration of oxygen to aged subjects may be limited by the finding that although arterial oxygen tension did not decrease with age, there was reduced steady-state transfer of carbon monoxide in the lungs.65 This indicates that oxygen transport could be diffusion-limited in older subjects, especially when oxygen consumption is increased. Furthermore, longitudinal studies of five healthy men over 3 decades showed impaired efficiency of maximal peripheral oxygen extraction,66 suggesting that tissue oxygen uptake is reduced in the aged subjects.67 This likely reflects a decrease in the number of capillaries as well as a reduction in mitochondrial enzyme activity.68 Animal models (rabbit69 and mouse69,70 ) have suggested that aging and ischemia have an additive effect on disruption of wound healing. Consequently, the potential benefit of increasing tissue oxygen tension during surgical wound repair in older patients should be further evaluated.

 

 

Reference: http://anesthesiology.pubs.asahq.org/article.aspx?articleid=1917910

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Can Oxygen Therapy Improve Brain Blood Vessel Function in COPD Patients?

By Allison Inserro

Breathing in additional oxygen improves the function of blood vessels in the brains of people with chronic obstructive pulmonary disease (COPD), according to research published in Experimental Physiology.

The study revealed that patients with COPD are at higher risk of dementia, possibly because of lower brain oxygen levels as a result of problems with blood supply from brain blood vessels. According to other research cited in the study, giving patients with COPD additional oxygen reduced their risk of developing dementia, but the mechanisms underlying this effect had not been explored.

The latest research aimed to establish the effect of supplying additional oxygen in blood flow to the brain and blood vessel function in patients with COPD. Fourteen hypoxemia patients were included in the study, which tracked cerebral blood flow (CBF), oxygen delivery (CDO2), and neurovascular coupling (NVC), which is the relationship between local neuron activity and changes in CBF.

The researchers used ultrasound to view and measure blood flow in the brain in these patients at rest as well as before and during delivery of the additional oxygen. Ultrasound was used to measure the extent to which brain blood flow increased.

Participants began this test with their eyes shut, then opened them and read a piece of text. This test was designed to increase activity in the brain, and brain blood flow was expected to increase to provide an adequate oxygen supply.

Pairing these ultrasound measures with a measurement of blood oxygen levels allowed authors to estimate how much oxygen delivery to the brain increased during the eyes-open reading test.

Measurements were assessed, and the authors found that blood flow and oxygen delivery to the brain significantly increased during reading because blood vessels in the brain dilated in response to the greater oxygen demand when the brain was active.

Specifically, peripheral oxyhemoglobin saturation increased from 91 ± 3.3 to 97.4 ± 3% (P <.01). CBF was unaltered (593.0 ± 162.8 vs 590.1 ± 138.5 mL min−1; P = .91) with supplemental O2.

However, CDO22 (98.1 ± 25.7 versus 108.7 ± 28.4 ml dl−1; P = 0.02) and NVC improved.

The posterior cerebral artery cerebrovascular conductance increased after O2 normalization (+40%, from 20.4 ± 9.9 to 28 ± 10.4% increase in conductance; P = .04). The posterior cerebral artery cerebrovascular resistance decreased to a greater extent during O2 normalization (+22%, from −16.7 ± 7.3 to −21.4 ± 6.6% decrease in resistance; P = .04).

The cerebral vasculature of patients with COPD appears insensitive to oxygen because CBF was unaltered in response to O2 supplementation, leading to improved CDO2.

Providing extra oxygen to patients with COPD improved the function of blood vessels in the brain by increasing blood supply to meet the demands of the brain’s activity during this short test.

Other research is needed to see how long-term oxygen use would impact the function of brain blood vessels.

These improvements might provide a physiological link between oxygen therapy and a reduced risk of cerebrovascular diseases such as stroke, mild cognitive impairment, and dementia.

Ref: https://www.ajmc.com/newsroom/can-oxygen-therapy-…

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Why post-menopausal women are prone to heart attack

Why post-menopausal women are prone to heart attack Read more: https://lifestyle.inquirer.net/296431/post-menopausal-women-prone-heart-attack/#ixzz5lzYlOezl Follow us: @inquirerdotnet on Twitter | inquirerdotnet on Facebook

Recently we had a female patient in her early 60s who suffered a heart attack and fortunately survived it.

All the time, she had been accompanying her husband to regular check-ups on his heart problem, without realizing she herself was a walking time bomb.

She has been a smoker most of her adult life. She has a strong family history of cardiovascular disease (CVD), with two male siblings undergoing heart bypass surgery in their early 50s.

Her blood pressure (BP) went on upward trend after menopause, with high cholesterol levels.

She showed no symptoms so she thought she was just fine, until she woke up in the middle of the night with severe chest tightness and shortness of breath.

She was rushed to the hospital, had an immediate declogging of the heart artery through angioplasty, and a small scaffolding-like metal called stent was inserted to keep the culprit coronary artery patent.

The same story happens so many times. Wife is so concerned about her husband with a heart problem and she neglects to have herself checked, or make sure that her lifestyle is not conducive to develop CVD.

Before menopause, women are protected by estrogen, the female reproductive hormone. This hormone has been shown to have a beneficial or cardioprotective effect on the inner layer of artery wall called endothelium.

After age 50

Endothelial dysfunction triggers the start of the atherosclerosis, which is the progressive narrowing of the artery. Estrogen prevents endothelial dysfunction, and helps maintain the flexibility of the blood vessels.

Flexible arteries can relax and expand to accommodate more blood and enhance the blood flow or circulation.

The onset of menopause is usually after the age of 50 (52 to 54 years of age on average). There are some who experience early menopause, signaled by the cessation of the monthly period at a much earlier age, even before age 40.

After menopause, estrogen decreases significantly and the heart protection is almost completely gone around eight to 10 years after menopause. This is usually when women are in their late 50s or early 60s.

Hence, the risk of developing a stroke, or heart attack, may increase and become higher in women compared to men at this age.

For those who have menopause at an early age, the increase in cardiovascular risk may occur at a much earlier age, when the women are just in their late 40s or early 50s.

Ovarian failure

The common cause is premature ovarian failure, but it may also be caused by damage to the ovaries as a result of cancer therapy and/or radiation treatments.

Another cause could be surgical removal of the ovaries if tumors in the female reproductive organs are diagnosed at a younger age.

The symptoms of premature menopause are pretty much the same as regular menopause, and include hot flashes, emotional instability or mood swing, vaginal dryness, decreased memory or comprehension, decreased libido or sex drive, and insomnia.

We have to clarify that menopause, by itself, does not cause CVD. It’s just that the levels of the heart-protective female hormones, particularly estrogen, decrease, and risk factors increase around the time of menopause.

These are increasing BP, high LDL (bad cholesterol) level, and low HDL (good cholesterol level. The triglyceride level, another bad type of fat, also increases after menopause.

A reckless lifestyle in the form of a high-carb and high-fat diet, being sedentary, smoking, and other unhealthy practices —which women could have earlier in life—starts to take its toll after menopause.

Guidelines from various heart associations remind women to really take stock of their health when they’re reaching menopause, so they can avert serious complications.

Since the cardiovascular risk in women peaks around eight to 10 years after the onset of menopause, women who are at high risk could be identified so that they could be treated more aggressively and monitored closely, preventing the complications which could occur years later.

A recently published study suggests that a relatively higher level of the male hormone called androgen or testosterone in postmenopausal women is associated with increased risks of cardiovascular complications.

The study, published in the Journal of the American College of Cardiology, followed up 2,800 postmenopausal women initially free of CVD. The women had their sex hormone levels measured at baseline.

The researchers reported that during an average of 12- year follow-up, CVD was diagnosed in 283 participants, plus clogging of the heart arteries (coronary heart disease or CHD) in 171, and heart failure in 103.

Adjustments were made to discount the effect of conventional risk factors and hormone therapy. The following findings were reported:

Male hormone

Higher total testosterone (male hormone)/estradiol ratio was linked with significantly increased risks for all cardiovascular outcomes.

Higher total testosterone appeared to significantly increase risks for CVD and CHD.
Higher estradiol (female hormone) was associated with significantly lower CHD risk, reaffirming its heart protective effect.

Does this study suggest that we should give post-menopausal women estrogen hormone therapy to prevent CVD or CHD?

I don’t think there’s good data to support that recommendation. There are also potential complications of aggressive hormone therapy which doctors are wary about.

The importance of this study is that we could identify the post-menopausal women who are at risk of suffering potentially serious cardiovascular complications, and implement risk-reducing strategies such as end to smoking, regular exercise and balanced diet.

Which type of diet is really good remains a big issue, in view of various fad diets claiming cardiovascular benefits.

The American Heart Association and Philippine Heart Association recommend eating a balanced diet consisting of: fruits, vegetables, whole grains, low-fat dairy products, poultry, fish and nuts, with less red meat and minimal sugary foods and beverages.

Aside from a healthy diet and lifestyle, adequate control of elevated BP is recommended; as well as the use of cardioprotective drugs like statins even if the cholesterol levels are not that high.

The important thing, too, is to get rid of the misconception that only men are vulnerable to heart disease, and women are spared from them.

A change of this wrong mindset is necessary so that the beloved women in our lives are not deprived of the medical care and attention they need to prevent heart attack, stroke and other cardiovascular complications.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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10 Things You Should Know About DVT

One of the most important things to talk about in relation to DVT, is varicose veins.

Deep Vein Thrombosis (DVT) is the result of blood clotting whilst it is still inside the blood vessel. In the majority of cases, painful swelling in the leg will be experienced as a ‘warning sign’ however, this is not always the case and, in some instances, no obvious symptoms will be presented.

In short, a DVT is a clot in the deep vein

Despite the fact that many people could be at risk of developing DVT, there is still much uncertainty as to how to prevent the condition from occurring, and a general lack of awareness around the importance of speaking medical treatment if you think you are suffering from the condition.

Here, to help provide some clarity on the condition, leading vascular specialist Professor Mark Whiteley of The Whiteley Clinic, shares the ten key things everyone should know:

 

DVT CAN OCCUR FOR NO APPARENT REASON

Professor Whiteley says: “Although there are some recognised risk factors for DVT, the condition can also effect people for no apparent reason. If there is a clear reason why DVT has occurred, we call it “provoked” DVT. If there is no known reason for DVT then we call it an “unprovoked” case.

Studies have shown that over 80% of hospital patients will experience a minor DVT. One in 12 people who fly long haul, over 7 hours, will also experience a minor case. However, in most cases these cases will resolve themselves and will not cause the individual any lasting problems. In fact, many people may not even know they’ve had a problem.

However, we must be careful not to trivialise DVT as some individuals will experience much more serious symptoms – such as aching/pain and swelling, clots to the lung (called pulmonary embolism) , and/or scarring of the deep vein with long-term deterioration of the leg post thrombotic syndrome (PTS).”

 

DVT PRESENTS A NUMBER OF SYMPTOMS

Professor Whiteley says: “Although in some cases there will be no symptoms associated with DVT, in others there will be some distinct warning signs. These can include: pain/swelling/tenderness in the leg (usually in the calf), a heavy aching feeling, warm skin around the affected area, or a redness to the skin. If anyone is concerned that they may be experiencing any of these symptoms, and they become breathless or experience chest pain, then they should seek medical attention immediately.”

 

PREGNANCY INCREASES YOUR RISK OF A DVT

Professor Whiteley says: “Pregnancy can increase the risks of DVT, particularly at the time of delivery. A normal adult has approximately 5L of blood. However, pregnant women increase their blood volume to 7L at the end of pregnancy. This is because women lose blood whilst giving birth and so the body produces more to keep at a safe level. Not only do women have extra blood, their body also adapts to clot blood quicker after they have given birth to stop haemorrhages.

Unfortunately, the downside of this is that it increases the risk of DVT. If a woman is pregnant and has varicose veins, then the risk is increased even more so.

 

COMPRESSION STOCKINGS ARE KEY FOR PREVENTION

Professor Whiteley says: “Wear properly measured and fitted graduated compression stockings if you are ever in a position where you cannot move easily such as on a long flight, long car journey, long coach journey etc.

 

VARICOSE VEINS ARE A SERIOUS FACTOR

Professor Whiteley says: “One of the most important things to talk about in relation to DVT, is varicose veins. Varicose veins occur when the flow of blood within a vein changes. Blood can fall backwards down your veins with gravity if the valves are not working properly – stretching the vein walls as a result. With the flow of blood changing, and the vein wall changing, this is serious potential for clots forming in the veins.

When a clot forms in a varicose vein, it is called “phlebitis”. Since 2012, it has been known that everyone with phlebitis should have a duplex scan for the following reason. If the clot is small and in a varicose vein a long way from the deep veins, then it can be treated safely with aspirin and support stockings. However, if it is within 5 cm of a deep vein, there is a risk of it causing a clot on the lung (pulmonary embolism). Of course, having varicose veins treated properly by the new endovenous techniques will stop the risks of phlebitis and any other associated problems.”

 

POOR LIFESTYLE CAN INCREASE YOUR RISK

Professor Whiteley says: “Other known factors for developing DVT are malignancy, immobility, major surgery, dehydration, smoking (particularly if combined with oral contraceptive pill) and a family history of getting DVTs (called thrombophilia).”

 

A SLOW BLOOD FLOW IS CRITICAL

Professor Whiteley says: “In short, a DVT is a clot in the deep vein. Clots form because of one or more of three main reasons – changes in the composition of the blood, changes in the flow of blood, or changes in the vein wall. Any one of these, or combination of these, can increase the risk of a deep vein thrombosis.”

 

DVT CAN BE FATAL

Professor Whiteley says: “Deep vein thrombosis (DVT) is a diagnosis that will cause huge concern for many patients. However, as with many medical conditions, DVT can affect people in different ways. DVTs can be tiny, and of no significance, or can be huge and can be life threatening. Of course between these two extremes, there is also a whole scale. A duplex ultrasound scan will be able to diagnose a DVT and also assess how severe it is.

The risks associated with DVT are reduced both in the short term (clots to the lung) and in the long term (post thrombotic syndrome-swollen and discoloured leg with or without leg ulceration) if the DVT is diagnosed early and treated aggressively with anticoagulation.”

If DVT is not treated, around one in 10 people will develop a pulmonary embolism. This is a serious condition which can cause chest pain, sudden collapse and/or either gradual or sudden breathlessness.

 

EXERCISE IS KEY FOR RECOVERY

Professor Whiteley says: “People undergoing major surgery nowadays get blood thinners and support stockings to try and reduce the risk of DVT. Physiotherapists also try to mobilise patient as soon as possible after such operations. Many Surgeons today also prefer local anaesthetic procedures so that their patients can “walk in, walk out”, and keep mobile. This new “ambulatory” surgery performed in local anaesthetic clinics dramatically reduces risks of deep vein thrombosis.

Anything that increases the flow of blood in the veins will reduce the risk of clots, and therefore reduce the risk of DVT. Exercise and movement, particularly walking, is so important. Compression stockings, particularly if properly fitted, have been shown to reduce the risk of DVT but this is markedly enhanced by movement of walking. Those who cannot walk or move often require anticoagulation injections or tablets.”

 

THERE ARE MANY WAYS TO PREVENT A DVT

Professor Whiteley says: “Keep hydrated, keep active and mobile – particularly through lots of walking. Treat varicose veins as quickly as possible with an endovenous technique, under local anaesthetic, to reduce risk of DVTs occurring.”

 

Reference: https://www.femalefirst.co.uk/health/10-things-you-should-know-about-dvt-1146974.html

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Being mindful of symptoms

LEWISTOWN–Dr. Maya Lichtenstein, neurologist at Geisinger-Lewistown Hospital, said that there are a myriad of potential symptoms that could be signs of a stroke. “Any sudden changes,” said Lichtenstein, “go the E.R.”

A stroke, according to Liechtenstein, is either the result of not enough blood flow to the brain, plaque in the blood vessels or heart, each resulting in a clot, or a hemorragic bleed, resulting in a bursted blood vessel in the brain. Classic symptoms of a stroke include numbness, tingling, weakness on one side of the body and changes in speech, but other sudden changes in in understanding language, vision, vertigo or clumsiness can also be symptomatic.

“It depends on what part of the brain is damaged,” said Lichtenstein.

Treatment options for a stroke vary, depending on the type of stroke.

“If you get seen fast enough,” said Lichtenstein, for a clot, a “clot-busting medication, a form of blood thinner” can be administered via I.V. A thrombectomy, a procedure, not an operation, said Lichtenstein, is another treatment option, similar to a cardiac catheterization. A bleeding stroke often leads to lowering the patient’s blood pressure and surgically relieving pressure on the brain. Taking aspirin can also treat a stroke.

Post-stroke, Liechtenstein said that rehabilitation is important, including physical, occupational, speech, and cognitive therapies. “Aggressive therapy can continue to improve people’s symptoms,” said Lichtenstein. “Everyone thinks they’re better if they can move their arms and legs.” Lichtenstein also encourages stroke patients to be aware of their mood and possible depression, encouraging them to accept all the help available.

To avoid a stroke, Liechtenstein said patients should see their doctors regularly for preventive care and that leading a healthy lifestyle is the key, including regular exercise to keep up the heart rate and eating a diet rich in fresh fruit and vegetables, lean proteins and whole grains. Lichtenstein also encourages patients to keep control of their vascular issues, such as high blood pressure and diabetes, as well as to quit smoking, if they smoke.

 

Reference: http://www.lewistownsentinel.com/news/local-news/2018/05/being-mindful-of-symptoms/

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Capillary damage can lead to depression

A direct link has been found between damage to capillaries (microcirculation) and depression. Researchers at Maastricht UMC+ found that microcirculatory damage increases the risk of depression by twenty to fifty per cent. Their findings on the link between microcirculation and depression were recently published in the leading scientific journal JAMA Psychiatry.

Patients with type 2 diabetes – the most prevalent disease worldwide – are twice as likely to develop depression as healthy individuals. Until now, there was no explanation for this link. However, we did know that type 2 diabetes and hypertension damages microcirculation, which is the circulation of blood in the smallest blood vessels. Poor microcirculation is relatively common in adults and does not necessarily have negative consequences, as the body is equipped with physiological reserve capacity. However, if the damage is severe, this can have a negative impact on daily functioning. The capillaries supply oxygen and nutrients to all parts of the body, including the parts of the brain that regulate mood. If this supply is disrupted, it can have a negative effect on our mood.  

 

Measurements

The researchers based their findings on a literature study and their own microcirculatory measurements obtained through MRI imaging, biomarkers in the blood and research on the capillary function in the skin and retina. The capillary measurements, carried out as part of The Maastricht Study, were exceptionally tricky. Damage to major blood vessels is relatively easy to determine, but capillaries are hard to study because the slightest movement by the test subject can disrupt the measurement and render it unreliable.

 

Image translation:
The Maastricht Study: challenges of a healthy lifestyle Measuring microcirculation in the human body.
In the brain, In the eye, Under the tongue; In the skin of the wrist, In the fingertip; In the skin of the ankle.
8000 participants (1800 of which have type 2 diabetes), 40 FTE (23 PhD candidates – 63 internships), 20 million (invested), 36 publications (in scientific journals), 9 publications (in prestigious journals).

 

Treatment

The researchers assume that microcirculatory damage can be treated with medication. Certain hypertension medications improve microcirculation to some extent, but a targeted drug for this purpose does not yet exist. Developing one will require further insight into the underlying mechanisms that cause depression. 

Marnix van Agtmaal is currently conducting PhD research on the link between microcirculatory damage and depression. He expects to complete his dissertation in early 2018. The link to the publication in JAMA Psychiatry.

HOW D’OXYVA CAN HELP?

D’OXYVA is the only fully noninvasive, completely painless transdermal (over-the-skin) microcirculatory solution that has been clinically tested to significantly improve microcirculation.

The improvement of microcirculation, i.e., blood flow to the smallest blood vessels, benefits one’s health, immune system and overall sense of well-being in a variety of ways.

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Are Veiny Arms Really a Sign You’re Super Fit?

You’ve seen the crazy photo of cyclist Pawel Poljanski’s insane leg veins after his 70-hour Tour de France pump. And the Rock boasts a pretty impressive bicep vein, too. Plus, go to any bodybuilding competition, and you’ll see a whole slew of guys with impressive vascularity as well.

What all these veiny guys have in common is that they are in tremendous shape. But is vascularity really a sign of superb fitness?First, let’s take a look at the reason your veins pop in the first place.

Your arteries carry blood away from your heart to the tissues throughout your body, like your muscles. Your veins—which have thin walls and dilate easily—pump the blood back toward your heart.

“The venous outflow is slower than arterial inflow, causing a back-up of venous blood causing higher pressure in the veins,” says Doug McGuff, M.D., author of Body By Science. That increases pressure causes the veins to “pop” out. That’s the pump you get.

But what you’re doing also plays a role in the pop, too.

“Swelling in the muscles pushes the veins out to the surface,” says Spencer Nadolsky, D.O., author of The Fat Loss Prescription. “Your muscles swell when working out and push the veins closer to the surface of your skin, which makes them more pronounced.”

You probably notice your veins popping more during weight lifting than when you’re simply taking a walk or doing other kinds of light cardio.

In general, higher-rep weight lifting with fast concentric movements—say, the part of a biceps curl when you bring the weight up toward your arm—would trigger the biggest pump, says Dr. Nadolsky.

“High intensity interval work can produce this effect as well,” says Dr. McGuff. “Muscular loading and fatigue drive arterial inflow into the muscle, so exercise that triggers this will produce venous engorgement.”

Okay, so your veins tend to pop when you’re working out, but does how veiny you get actually depend on how fit you are? Well, sort of.

The leaner you are—meaning, the less subcutaneous fat you have covering your muscles—the more pronounced your veins will look, says Dr. Nadolsy.

But it’s not just about being lean: Having low body fat along with upped muscle mass is the magic combination for veins that pop, even when you’re at rest. So in some ways, pronounced veins are an indirect sign of fitness.

 

 

Reference: https://www.menshealth.com/fitness/vascularity-and-fitness-level