Archive for the ‘Healthy bones Osteoporosis Rheumatic’ Category

• (Русский) Течение диабета во время беременности и роды.

  Date: 2010.10.28 | Category: Healthy bones Osteoporosis Rheumatic | Response: 0

• WHEN YOU KNOW YOU HAVE BRITTLE BONES: MANAGEMENT OF THE PROBLEM

  Date: 2009.04.01 | Category: Healthy bones Osteoporosis Rheumatic | Response: 0

  Careful management under your doctor’s supervision can probably reduce the rate of further bone loss, possibly stop loss of bone and even gradually strengthen your skeletal mass.
  

  If you have secondary osteoporosis due to another disease or condition, treatment of this other ailment early enough to save your bone mass can be beneficial. If, for instance, you can reduce your need for drugs to combat inflammatory arthritis, or hyperthyroidism, you may be able to prevent the loss to your skeleton that these can cause, apart from age-related bone loss. Here are further useful ideas for your fight against osteoporosis:
  

  1. Have regular bone-density tests performed by your personal physician or at your local clinic, every three to six months depending on severity, so your skeletal mass can be monitored.
  

  Eliminate as many ‘negative factors’ as you can (e.g., stop or cut down smoking and drinking) and ‘accentuate the positive’ (e.g., eat well, drink plenty of lowfat milk, get as much exercise as you can manage, and be out in the sunshine!).
  

  Keep a daily log of dietary calcium and vitamins and other supplements (perhaps utilizing your home computer). Calcium should be at least 1200 to 1500mg each day.
  

  Check that your bed is comfortable with firm support; a sheet of % in (2cm) plywood beneath the mattress is an instant and inexpensive solution, or try a water bed.
  

  Immediately after back injury, or when you have strained muscles, ice packs will help reduce swelling and inflammation. Rest as much as you can.
  

  If your back problem is stiffness on waking, try warmth to soothe and relax: a warm bath, the warm sun, warm heating pads.
  

  Massage can increase the flow of blood to your back and relax muscles.
  

  Gentle stretching exercises can flex your back muscles; swimming can give you gentle exercise while supporting your body.
  

  Prolonged sitting can place more stress on your back than standing, since your pelvis is not supporting you in that position. Change positions often, whether in bed, at home, or at work, and be sure your chair has a back-rest, preferably adjustable.
  

  Women should look critically at the heel height of their shoes and discard any pair with heels of more than 1.5 in.
  

  Use painkillers sparingly – they can be addictive, and if pain is masked, you could further injure your back unknowingly.
  

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• OSTEOPOROSIS: HAVE YOUR OVARIES BEEN REMOVED?

  Date: 2009.04.01 | Category: Healthy bones Osteoporosis Rheumatic | Response: 0

  In some surgical cases, it is essential to remove ovaries because they are either diseased or damaged, but unfortunately some physicians routinely recommend healthy ovaries be taken out at the time of hysterectomy if a woman is approaching natural menopause anyway. They reason that such surgery would prevent possible ovarian cancer at a later date – a cancer which is often fatal because it is difficult to diagnose early. But removal of ovaries before natural menopause involves abrupt loss of oestrogens and a 50 per cent risk of the rapid onset of osteoporosis if hormone replacement therapy is not prescribed.
  

  Christopher E. Cann, Ph.D. of the University of California at San Francisco, recently conducted a three-year study of forty-seven women (white-, yellow-, and brown-skinned), aged between twenty-four and forty-eight who had undergone oophorectomies (removal of ovaries). His report revealed that they lost spinal mineral content at an alarming average rate of 9 per cent the first year after the operation. Two women had lost more than 20 per cent!
  

  There are several kinds of hysterectomies and it is important to know the differences:
  

  Partial hysterectomy means the removal of the uterus and cervix. Subtotal hysterectomy is the removal of the uterus but not the cervix.
  

  Total hysterectomy or hysterectomy and bilateral salpingo oophorectomy is the removal of uterus, tubes and ovaries.
  

  Hysterectomy and unilateral salpingo oophorectomy is the removal of one tube and one ovary.
  

  Radical hysterectomy is the removal of tubes, ovaries, uterus, cervix and pelvic lymph nodes.
  

  When a woman undergoes a partial hysterectomy or has only one ovary removed, her levels of hormones are usually unchanged. But a total or radical hysterectomy involving the extraction of both ovaries can cause a sudden cessation of hormone production with consequent severe menopausal symptoms, especially if the operation is performed when the woman is young or several years before natural menopause would have occurred.
  

  In 1981, 63,620 women in England and Wales underwent hysterectomy, and over 650,000 women in the United States had the surgery in the same year. Various surveys in the US have revealed that between 20 to 40 per cent are performed unnecessarily or for doubtful reasons. In some cases, it is used as a method of birth control, or as a way to correct menstrual irregularity, but this is a major operation, and simpler alternatives are often available. It is important to get a second opinion if your physician suggests a hysterectomy, to ensure that the surgery is essential; and it is crucial to know if both ovaries will be removed, as this will effect a surgical menopause, change your hormone level, and may trigger a rapid loss of bone mass. If ovaries are healthy, there are compelling reasons for leaving them intact – know your condition as thoroughly as possible before the operation.
  

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• MINERALIZATION IN CASE OF OSTEOPOROSIS: VITAMIN D

  Date: 2009.04.01 | Category: Healthy bones Osteoporosis Rheumatic | Response: 0

  Vitamin D is vital for the absorption of calcium into your body for proper bone mineralization. The D.H.S.S. has no recommendation for adult intake of vitamin D, but children, adolescents, pregnant/ lactating women and the housebound need 10 micrograms daily.
  

  You get most of your vitamin D from the sun, with the ultraviolet (UV) light in sunshine converting a substance in your skin to a pre-vitamin D. This pre-vitamin is then changed in the liver and kidneys to its active form, the hormone calcitriol, necessary to maintain constant blood calcium levels for the normal functioning of nerves and muscles. Your body is not actually synthesizing vitamin D while you are in the sunshine, as it takes three or four days for your system to complete the process and ‘recharge your batteries’. How much sunshine are you getting every day?
  

  Invisible UV light cannot penetrate ordinary window glass, so in order to soak up those rays you have to be outdoors. The Earth’s surface is protected by the upper layers of the atmosphere with ozone molecules in the stratosphere absorbing most of the near ultraviolet. Pollution at ground level may increase the ozone layer still further and interfere with the overall strength of the radiated light, so it is difficult to measure how much UV you are getting.
  

  According to a research team at Harvard Medical School, you need about fifteen minutes to one hour of sun exposure each day, to fill your vitamin D needs, if you are a lightly pigmented person. Transmission of light depends on the thickness of your skin’s outer layers. After you reach the age of forty or fifty, there is a steady decline in the ability of your skin to produce that pre-vitamin D, as your skin thins with age (coupled perhaps with a lesser performance from your liver). So the skin of a woman in her seventies makes about half the vitamin D produced by her twenty-year-old granddaughter under the same conditions.
  

  There are many variables: How intense is the sun? Is it winter or summer? Do you live in a northern latitude or the ‘Sun Belt’? The incidence of hip fracture is highest in the north of Scotland and lowest in the south of England, in studies related to the hours of sunshine and its effect on body stores of vitamin D.
  

  Are you at a high altitude? At high altitudes and near the equator, the UV level is greater than at sea level or in northern latitudes. How clear is the air? Do you have smog and pollution? The low angle of a winter sun blocks much of that UV light, as the rays have to pass through more of our planet’s ozone layer, and smog, smoke and fog can block out still more UV.
  

  Do you have a light or a dark skin? If your skin is naturally dark with the pigment melanin, it can screen off as much as 95 per cent of the UV light from the skin layers making pre-vitamin D. It is estimated that a black person needs five times as much exposure to the sun as a fair-skinned person to produce the same amount of vitamin D. When darker pigmented people move from the south to the lower intensity of a northern sun, they can become vitamin D-deficient. For instance, Arab and Indian women, accustomed to living in seclusion or heavily veiled, have been found deficient in the vitamin when going to live under the cloudy skies of Britain. So let the sun get to your bones!
  

  As the sun is at its strongest and most harmful between 10 a. m. and 2 p.m., sunning in the early morning or late afternoon is less damaging to your skin than the middle of the day.
  

  , If you use one of the sunblockers or sunscreens, wait about fifteen minutes when out in the sun before applying. These preparations may prevent the sun-related production of vitamin D in your skin.
  

  Beware of excessive sunbathing which is both unnecessary and unhealthy. Most people think it fashionable and fun to be tanned. Millions of fair-skinned people now live in the ‘Sun Belt’ though their skin may be sun-sensitive and burn rapidly.
  

  Sunlamps and sunbeds using UV light have been popular for providing a tan in winter and more recently tanning salons have been established in some cities. Dermatologists agree that concentrated doses of UV can cause skin damage, so the potential for short- or long-term injury is there, whether the UV radiation is from sun or lamp, with the result being premature wrinkles and, more seriously, a risk of malignant melanoma. This once-rare cancer has been doubling about every twelve years since World War II with a death rate in women faster than from any other malignancy other than lung cancer. Queensland, Australia, had an influx of fair-skinned people after World War II, and seven to ten years later they saw a large increase in melanoma there. If you notice any changes in colour or size of moles or scar tissue, see your doctor immediately.
  

  The elderly need to take special precautions against overexposure to the sun and high temperatures, particularly if you are obese or have diabetes or heart disease. Certain types of drugs can create a vitamin D deficiency, but others when combined with excessive sunshine, can bring on photosensitive or phototoxic effects. Drugs that can create problems when taken along with heavy doses of sunshine are: some tranquillizers, anti-hypertensives, diuretics, tetracycline antibiotics, sulpha drugs, oral diabetic drugs and quinidine. If you are taking any prescription or non-prescription medicines, check first with your doctor or pharmacist for possible reactions in strong sunlight.
  

  And make sure your eyes are protected during sunning -research suggests that prolonged exposure to UV over many years can contribute to the premature development of cataracts and tumours.
  

  Getting a healthy exposure to sunshine every day is the best way for your body to acquire vitamin D, but there are dietary sources if you can’t get outdoors or if skies are smoggy.
  

  Because medical authorities were concerned several years ago about possible deficiencies in vitamin D, with few natural sources in food, it was decided to fortify certain items. Margarines and lowfat spreads are required by law to be fortified with 2.25 micrograms of vitamin D per ounce. Some dairies and food firms also fortify skimmed or semi-skimmed milk, evaporated milks, yogurts, dried milk powders and breakfast cereals.
  

  Other foods with naturally present vitamin D are some saltwater fish (herrings, salmon and sardines, for instance), cod-liver oil and halibut-liver oil, egg yolks, liver and cheese.
  

  Vitamin D is stable in cooking and not lost by heating or processing, but it is affected by rancidity in oils. Hence if oils, butter and margarine become rancid, the active vitamin is destroyed.
  

  For better absorption, it’s more desirable to get this vitamin from sunshine, but you may need supplementary amounts of vitamin D, especially in winter, if you are:
  

  breast-feeding, or
  

  elderly, living in a town or housebound,
  

  a shift-worker (nurse, for example) working mainly at night,
  

  heavily wrapped in clothes, and
  

  rarely eat dairy products.
  

  use heavy make-up.
  

  The NACNE report (from the National Advisory Committee on Nutrition Education) also recommends that Asian schoolchildren be given vitamin D supplements.
  

  By springtime you may have depleted your store of vitamin D. Records indicate that bones fracture most frequently in winter and early spring, when daylight is short, sunshine scarce and when vitamin D and calcium reserves are low. Multi-vitamin preparations usually contain vitamin D, and calcium supplements are often augmented by the vitamin.
  

  However, you can have too much of a good thing: because vitamin D is fat-soluble and stored in the liver, large quantities from over-supplementation can be toxic, cause kidney damage, or trigger the creation of kidney stones. The toxic dose varies among individuals, but toxicity has occured at levels as low as 50 to 125 micrograms daily. When large amounts of vitamin D supplements (over 25 micrograms) are taken without sufficient calcium, bone depletion may occur. (In contrast, your skin has a built-in system that shuts down synthesis of vitamin D after a certain amount of UV exposure, eliminating the danger of toxic effects from sunning.)
  

  Discuss your needs with your doctor before embarking on any tablet supplementation.
  

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• CAUSES OF OSTEOPOROSIS: CARE OF YOUR TEETH

  Date: 2009.04.01 | Category: Healthy bones Osteoporosis Rheumatic | Response: 0

  Periodontal disease can be either an indication of poor oral hygiene or a warning that underlying bone is becoming porous. It is often called gingivitis in its earlier stages, then periodontal disease as the condition advances, when tooth and bone loss may occur. The 1978 Adult Dental Health Survey reported that 91 per cent of adults with their own teeth suffer in varying degrees with this disease of the gums and tooth-supporting tissues – conditions that can result in the loss of underlying alveolar bone containing the tooth sockets.
  

  Mature teeth in an adult do not significantly change their structure or calcification with altered intakes of calcium or a change in calcium metabolism. Periodontal tissues, on the other hand, do have an active interchange of available nutrients similar to bone and soft tissues in other parts of the body. Dental researchers have concluded that insufficient calcium may contribute to the loss of alveolar bone and tooth-supporting tissues; there is also a strong connection between periodontal disease and the accumulation of plaque, the sticky semi-transparent material containing food debris, bacteria and toxins that irritate and destroy gum tissue and surrounding bone. Diseased or infected gums are often the cause of bad breath.
  

  So there are two key points: (1) make sure you have adequate daily calcium in your food and (2) maintain good dental hygiene.
  

  If plaque is not brushed off your teeth every day, it hardens into calculus (tartar) which can only be removed by your dentist or dental hygienist. Build-up of plaque and calculus can lead to gum disease, which if untreated can create pockets of infection. Eventually the structures that support the teeth are destroyed, the bony sockets around the roots of teeth begin to demineralize or resorb, and as the bone is lost, the teeth become loose and fall out. Good dental hygiene is the key to prevention of gum disease, with a programme of regular visits to your dentist.
  

  Adults and teenagers should use fluoridated toothpastes and mouthwashes to help ward off dental decay and prevent gum disease. Some British toothpastes also have calcium in their formula to aid dental repair. It’s vital to brush your teeth and gums with a soft toothbrush and floss daily to remove plaque the brush cannot reach. Fluoride in toothpaste works on the surface of teeth in two ways:
  

  It stops the reproduction of Streptococcus mutans, the most powerful of many acid-making bacteria in your mouth. This bacterium feeds on the sugars and starches in your mouth and turns them into enamel-burning acid. Streptococcus mutans also is responsible for creating plaque, the gummy stuff that sticks to teeth to make a breeding spot for more bacteria; and
  

  Fluoride allows the acid-scarred surface of teeth to heal. When fluoride is present in your mouth, calcium and phosphorus from saliva fill in the microscopic pits made by acid. Without fluoride, the pits get wider and deeper, and bacteria can penetrate further into the tooth enamel.
  

  Cut down on sugar (all types: table sugar, fructose, maltose, glucose), sticky foods (like caramels, raisins, dates and soft drinks sweetened with sugar) and smoking. If you have mild periodontal disease, talk with your dentist about increasing your daily intake of calcium and vitamin C.
  

  To maintain firm gums, healthy underlying bone and strong jaw muscles, give them sufficient exercise every day: let them go to work on crisp, crunchy fresh fruits and vegetables that need plenty of biting and chewing.
  

  If you are already wearing dentures, make sure they are fitted properly and firmly – uniformly against the gums without uneven pressure on underlying bone. Brush your gums, ridges and palate with a soft brush to stimulate circulation, remove debris, and harden the tissue surface so that your dentures are most comfortable to wear.
  

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• OSTEOPOROSIS: HOW SOON TO HAVE CHILDREN, AND HOW MANY?

  Date: 2009.04.01 | Category: Healthy bones Osteoporosis Rheumatic | Response: 0

  During pregnancy there is usually a natural high level of oestrogen to promote the production of active vitamin D, encouraging calcium absorption. There are also much higher levels of progesterone during pregnancy, to conserve the bone mass. Therefore pregnancy can be beneficial to your bone mass if your daily consumption of calcium is adequate for your body and for the formation of your unborn baby. The conclusion among many doctors is that if you have not had children, your risk of osteoporosis may be higher.
  

  If, on the other hand, a teenager becomes pregnant before her bone mass has reached skeletal maturity (in 1982,90,000 teenagers in England and Wales were pregnant), and if an expectant or nursing mother does not maintain an adequate daily intake of calcium, or embarks on unwise dieting before lactation is finished, her body will steal from its own skeletal reserves to nourish the foetus and provide lactation. This explains the origin of the old saying ‘for every child, a tooth’.
  

  Similarly, in poor countries where the level of nutrition is low, pregnancy and a lengthy period of breast-feeding can have a debilitating effect on a mother’s skeleton. Whatever calcium is available goes straight to the foetus to start bone building. With an insufficient intake, the mother’s calcium reserves in her skeleton will be drawn upon.
  

  A new type of woman is becoming pregnant today – the older career woman who decides to have a family at a later date in her life. She may already be at an age when she is starting to lose trabecular bone tissue from her vertebrae, making good nutrition of vital importance, and sufficient intake of calcium essential.
  

  If you have many pregnancies at frequent intervals, with no due regard to proper nutrition, each child will represent a drain on your calcium reserves and bone strength.
  

  Many experts consider it prudent to build up calcium levels before pregnancy.
  

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