To: National Desk, Health Reporter

Contact: Mark Forstneger of ACFAS, 773-693-9300 ext. 1306 or forstneger@acfas.org

CHICAGO, Oct. 18 /U.S. Newswire/ — With the observance of National Diabetes Awareness Month in November, the American College of Foot and Ankle Surgeons (ACFAS) reminds the 20 million Americans with diabetes that following simple foot care tips can reduce their risk of toe, foot or leg amputations.

People with diabetes are 10 times more likely to have a lower limb amputated than people without diabetes, according to the American Diabetes Association. The disease can cause poor blood circulation and nerve damage in the feet, making them vulnerable to developing ulcers, infections, deformities and brittle bones.

The ACFAS consumer Web site FootPhysicians.com provides these foot care tips for people with diabetes:

– Inspect feet daily for injuries that could lead to dangerous ulcers.

– Gently wash feet in lukewarm (not hot!) water.

– Moisturize feet, avoiding the area between the toes.

– Never trim corns or calluses; this can lead to serious infections.

– Inspect the inside of shoes before wearing.

People with diabetes must always be vigilant, and see a foot and ankle surgeon at the first sign of trouble. Early treatment can keep diabetic foot problems from progressing, and reduce the risk of amputations.

—

The American College of Foot and Ankle Surgeons (ACFAS) is a professional society of more than 6,000 foot and ankle surgeons. Founded in 1942, the College’s mission is to promote research and provide continuing education for the foot and ankle surgical specialty, and to educate the general public on foot health and conditions of the foot and ankle through its consumer website, http:/ /www.footphysicians.com.

http://www.usnewswire.com/

(c) 2006 U.S. Newswire 202-347-2770

(c) 2006 U.S. Newswire. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Charrette, Mark N

Whenever I’m asked why I recommend custom-made, flexible orthotics to many of my patients, my reply is simple: Orthotics enhance the proprioceptive response of the entire lower extremity (including the foot), and help to stabilize the pelvis and spine. And when I’m asked about my idea of the optimal orthopedic appliance, my reply is again simple. My idea of the optimal orthopedic appliance is an orthotic that supports all three arches of the foot within normal ranges of motion during weight-bearing and allows for flexible locomotion. In essence, it’s a device that allows movement within normal ranges, blocks excessive motion and does not restrict normal motion.

Proprioceptive Noise

When joints in the feet (or any joints, for that matter) misalign/ subluxate/fixate or are somehow irritated, a neurological event I refer to as “proprioceptive noise” occurs. A brief overview of the model known as dysafferentation explains why a variety of symptoms (some not usually associated with dysfunctional joints) are eliminated or reduced with attention to extravertebral/extremity joints.

The two main types of sensory receptors that innervate joint structures are nociceptors and mechanoreceptors. Nociceptors (type 4 mechanoreceptors) depolarize (fire) via noxious mechanical stimuli and the chemical mediators released in response to injured tissue. Mechanoreceptors (types 1, 2 and 3) depolarize solely via mechanical stimuli, such as that associated with touch and normal body movements. Nociceptors are located in nearly every tissue of the body, while examples of mechanoreceptors are golgi tendon organs, muscle spindles, Meissner’s/Pacinian/Ruffini corpuscles and Merkel’s receptors.1

The neurological research of Hooshmand demonstrates how restricted joint motion causes an increase in nociceptive axons (A- delta and C fibers) and a decrease firing of large-diameter mechanoreceptor axons (A-beta fibers).2 It is important to remember that a chief function of mechanoreceptor input is to inhibit nociception at the level of the spinal cord.

Simply stated, proprioceptive noise is the excessive firing of nociceptors due to decreased mechanoreception. If one restricts normal joint motion, nociceptors excessively fire, since mechanoreception is decreased. This is the main reason I believe rigid orthotics are not optimal for most patients - they have the potential to restrict normal joint motion and thus create excessive nociceptor firing. As we know, when a joint is restricted at one level, it can create hypermobility in the joint/joints above. Therefore, mechanically, when foot motion is restricted, the potential for hypermobility in knees, hips and sacroiliac joints increases.

Unreliable Sensations

With joint subluxation/hypomobility, nociceptors will excessively fire, potentially creating a pain sensation and/or a variety of symptoms. First, let’s discuss the conscious sensation of pain. Furman and Gallo write, “While the brain can process several trillion bits of information per second, it appears that we are perhaps only consciously aware of 50 bits of information per second at any given time.”3 Since pain is a conscious sensation, it is understandable why a prominent chiropractor writes, “A clear indication that using the conscious perception of pain to determine the need for care is hugely inadequate and inaccurate. How can any scientist knowingly rely on less than 50/3 trillionths of the information and claim it to be a valid analysis?”4 Again, simply put, most subluxated feet are not painful.

Next, let’s look at the potential symptomatology created by excessive nociceptor firing. Dysafferent input can and does produce a variety of symptoms that one would not usually associate with dysfunctional joints. Cabell authored research stating that “nociceptor activity reflexively activates the sympathetic nervous system.”5 Research by Nansel and Szlazak suggests that nociceptive input from dysfunctioning joints can cause symptoms such as sweating, pallor, nausea, vomiting, abdominal pain, sinus congestion, dyspnea, cardiac palpitations, and chest pain that mimics heart disease.6

Turning Down the Noise

As chiropractors, we deal with the neurological integrity of the human body. In addition to relieving symptoms classically associated with joint dysfunction/subluxation, we can and do affect the autonomie nervous system. As Patterson states, “Adjustments to decrease nociceptor input to the spinal cord seem to be an effective way to decrease the hyperexcitable central state.”7 The hyperexcitable central state is the reflexively activated sympathetic nervous system.

So, as a chiropractor, anything I can do to decrease the nociceptive bombardment of the spinal cord (proprioceptive noise) ultimately will benefit the patient by decreasing the potential for pain and inhibiting the sympathetic nervous system. That is why I use custommade, flexible orthotics.

References

1. Guyton A. Basic Neuroscience (2nd edition). Philadelphia: W.B. Saunders, 1991.

2. Hooshmand H. Chronic Pain: Reflex Sympathetic Dystrophy, Prevention and Management. Boca Raton, FL: CRC Press, 1993:33-35.

3. Furman ME, Gallo FP. The Neurophysics of Human Behavior: Explorations at the Interface of the Brain, Mind, Behavior, and Information. Boca Raton, FL: CRC Press, 2000.

4. Chestnut J. The 14 Foumlational Premises for the Scientific and Philosophical Validation of the Chiropractic Wellness Paradigm, 2002.

5. Cabell J. “Sympathetically Maintained Pain.” In: Willis W, ed. Hyperalgesia and Allodynia. New York: Raven Press, 1992.

6. Nansel D, Szlazak M. Somatic dysfunction and the phenomena of visceral disease simulation: a probable explanation for the apparent effectiveness of somatic therapy in patients presumed to be suffering from visceral disease. J Manip Physiol Ther 1995;18:379- 397.

7. Patterson M. The spinal cord: participant in disorder. J Manip Physiol Ther 1993;9(3):2-11.

Mark N. Charrette, DC, a 1980 graduate of Palmer College of Chiropractic, resides in Las Vegas. For more information, including a brief biography, a printable version of this article and a link to previous articles, please visit Dr. Charrette’s columnist page online: www.chiroweb.com/columnist/charrette.

Copyright Dynamic Chiropractic Oct 12, 2006

(c) 2006 Dynamic Chiropractic. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Lucy Sweet

IF you believe everything you read, us girls are supposedly cuckoo about Choos, barmy about Blahniks, and have slavering daydreams about kitten heels.

Yep, women love everything about shoes (Oh, and chocolate, of course. And hot, hunky firemen). Well, I must be missing a chromosome.

While I’ll happily share a Milky Way with a strapping man with a large hose, when it comes to actually shelling out money for sensible, everyday footwear, I get the heebie-jeebies

Oh, I can buy stupid, unwearable, nasty shoes till the cows come home, but sensible shoes remind me of those long Back To School afternoons in Clarks, trying on brown sandals and watching my foot get squished in that measuring machine.

All the joy I usually get from shopping evaporates when I’m confronted with acres of practical black and brown leather. I’d rather buy pipe lagging and pile cream.

As a result the only wearable things Iown are a pair of Converse with enormous holes in the sides and some boots with the soles coming off.

Compo from Last of The Summer Wine may as well be my stylist.

Meanwhile, under my bed, there’s such a huge selection of platforms, glitter wedges, patent slingbacks and custard-yellow monsters that I could single-handedly provide the wardrobe for the Pan’s People Comeback Tour 2007.

So when the sole of my boot started flapping on the stairs the other day like a squeaky rubber chicken, my husband decided to act. ‘I’m going to buy you some new ones,’ he said.

That sentence would probably make most women go weak at the knees, but not me. Boots are a big commitment. You have to wear them all winter, so selecting them is so much more involved than swiping the nearest pair of pounds 5 sequinned pumps off theshelf in a frenzy.

Plus, they fall into the brown and black leather category of dullness, and are also especially infuriating this year because I haven’t been able to find a single pair I like.

At first glance, they all look roughly the same, but then you realise that they either make you look like a Lithuanian hooker or there are so many bells, whistles, zips, buckles and slouchy bottoms on them that you may as well audition for Aladdin.

Soon, I was in boot hell. Regardless of the fact that someone was willing to pay out pounds 100 to kit my flapping, stinky feet out in something fabulous, everything looked wrong.

They pinched, they were too big, they didn’t have my size, they swamped my legs, or they were so tight they wouldn’t fit over my calves.

(Would it kill these bootmaking layabouts to put a bit of elastic in there so that lardy legged ladies can walk down the street without getting deep vein thrombosis?)

It was such a practical shopping trip that all I needed was my mum to do up the buckle for me and ask me if they rubbed at the back.

Eventually, I got so fed up I found the first pair of plain looking boots I could and headed for the till.

They ticked all the boxes. They were black, shiny, ladylike, and so ordinary you wouldn’t remember themif they saved your family from a burning building. “You can exchange them,” said the assistant. “As long as you wear them on the carpet and notoutside.”

The next day, I had an indoor boot/carpet marathon. I paced and paced, examining them from all angles. I realised they were really uncomfortable and I didn’t like them.

In fact, they made me look like a member of the Gestapo.

So after all that I have to brave the High Street again. The never-ending quest continues, and I’m no closer to finding a sensible shoe that fits.

Although, I think I might be a real woman, because instead I’ve seen a great pair of shiny, trashy, polka-dot stilettos that make a chocolate-coated fireman look dull in comparison.

Ok, so they’re not sensible, but they’re a lot more fun than boring boots. And if all else fails, I can always donate them to Pan’s People.

‘My big selection of platforms, glitter wedges, patent slingbacks and yellow monsters could provide the wardrobe for the Pan’s People Comeback Tour’

l.sweet@dailyrecord.co.uk

(c) 2006 Daily Record; Glasgow (UK). Provided by ProQuest Information and Learning. All rights Reserved.

 

By Kathleen Fackelmann

Eating two to three servings of vegetables every day might help keep the mind sharp in old age, a study suggests today.

The new findings add to the scientific evidence suggesting that a diet packed with vegetables might shore up the memory and protect against Alzheimer’s.

Martha Clare Morris of the Rush University Medical Center and her colleagues studied 3,718 Chicago residents ages 65 and older. Each senior filled out a diet questionnaire and took at least two memory tests during a six-year period.

Test scores usually worsen slightly as time goes on, but seniors who said they ate 2.8 servings of vegetables a day saw their rate of cognitive change slowed by 40% during the study. A serving in the study was defined as a half-cup.

“People who ate more vegetables could think faster and had better memories,” Morris says. Green leafy vegetables such as spinach, kale or romaine lettuce provided the most benefit, she says.

The oldest people in this study, those at highest risk for Alzheimer’s, showed the most memory protection when they reported eating a vegetable-laden diet. The study appears in today’s Neurology.

At the same time, the study found fruit consumption was not associated with a brain benefit. Other researchers have found fruit to be associated with protection, so experts still recommend fruit.

“Don’t throw out your oranges — just step up your vegetable intake,” says Elizabeth Edgerly of the Alzheimer’s Association. Foods that reduce the risk of heart disease might protect the brain, she says. That heart-healthy diet includes whole grains, fish such as salmon, and a wide variety of fruits and vegetables, particularly the dark-skinned ones that are thought to contain high levels of brain-protective substances called antioxidants, she says. (c) Copyright 2005 USA TODAY, a division of Gannett Co. Inc.

 

By Richard Harkness

Q: I would like to understand calcium metabolism more fully, especially how the parathyroid and thyroid glands are involved. Could you explain?

A: Calcium builds bone and helps prevent the bone-weakening disorder osteoporosis. This workhorse mineral also is essential for muscle contraction, blood clotting, and normal heart rhythm.

Here’s a brief primer on calcium metabolism.

The body maintains blood levels of calcium within a set range. Vitamin D, parathyroid hormone, and calcitonin work together to accomplish this. Calcitonin is a hormone secreted by the thyroid gland in the neck.

Vitamin D increases the body’s absorption of dietary calcium. Low vitamin D levels stimulate the release of parathyroid hormone from the four parathyroid glands, which surround the thyroid gland. The hormone works to increase blood levels of calcium in a number of ways.

It stimulates the digestive tract to absorb more calcium and signals the kidneys to activate more vitamin D, which further increases calcium absorption. It also stimulates the kidneys to excrete less calcium in the urine.

If needed, parathyroid hormone also can steal calcium from bones. Calcitonin, in contrast, slows the loss of calcium from bone. It’s important to get adequate amounts of both calcium and vitamin D to prevent bone breakdown.

Q: I came across an article about Noni. I read that it’s high in potassium. I have sciatica problems and am taking potassium and trying to eat foods high in potassium.

Noni seems to be a good source of potassium, but the article said that the high amount of potassium in Noni might not be good for people with kidney problems. I’ve had kidney stones before. Will potassium cause me to have kidney stones again?

A: Noni is a dietary supplement claimed to boost the immune system, slow aging, and protect the heart, among other unsubstantiated claims.

It sounds like you might be misinterpreting some things.

You seem to imply that you’re taking potassium for your sciatica condition. It’s true that low potassium levels can cause muscle cramps and pain. However, sciatica pain is different. It occurs when the sciatic nerve is pinched or aggravated in some way. The two sciatic nerves, one on each side of the body, run from the lower spine down the legs.

The statement “the high amount of potassium in Noni might not be good for people with kidney problems” likely refers to impairment of general kidney function. If your kidneys are not working properly, they might not be able to eliminate potassium efficiently, allowing potassium blood levels to climb too high. That would be the reason for the caution about potassium intake.

If you’re trying to get extra potassium for another reason suggested by your doctor, Noni would provide lots of potassium, but reports link it to liver toxicity. There are common dietary sources of potassium that would not present such risks, including bananas, oranges, potatoes, raisins and yogurt.

E-mail Richard Harkness at rharkn@aol.com.

(c) 2006 Sunday Gazette - Mail; Charleston, W.V.. Provided by ProQuest Information and Learning. All rights Reserved.

 

Many of us are advised to take up a health and fitness programme for reasons other than personal motivation! We may be suffering health problems, injuries or require to adjust our weight in some way in order to offset any future implications. Such instructions will generally come from our GP or indeed as a result of peer pressure or even media influence.

When this is the case motivation to adhere to a programme can be difficult to achieve, lets therefore have a look at how best to generate a habit of exercise when the motivation level is low and the desire to use the gym is nominal.

The principle areas of health where exercise will help include, lowering blood pressure, lowering cholesterol levels and lowering the risk of any number of ailments through reducing weight. Weight is considered one of the largest indicators of health in society, principally because we can attribute so many potential risks to the carrying of excess weight and body fat. The health risks listed above are well known, however, we should also consider that excess weight will increase the likelihood of arthritis or osteoporosis taking hold in later years.

Such physical issues can be reduced and minimised fairly easily by means of a regular exercise programme involving aerobic type activity and some form of resistance training.

The second key benefit to exercise is related to our perception and feeling of wellbeing. Over half the UK population will suffer from some sort of depression as they go through their lives. Furthermore, virtually all of us can relate to a feeling of poor self worth or self esteem at certain points. Exercise has the wonderful ability to help us feel better. Any sort of activity releases adrenalin and endorphins into our blood stream that help to make us feel better. Energy levels will increase, sleep patterns will improve and stress levels will drop. In short exercise has the potential to carry greater benefits than any pharmaceutical drug you care to mention.

So then, why do some of us find it so hard to commit to? Firstly, you need to assess just what benefits you require and how important these are to you. Secondly decide on coping strategies and work in partnership with your GP or health practitioner to decide how best to tackle the starting of a programme. Thirdly, choose your centre and type of exercise carefully, if possible workout with a friend and speak to family to ensure you have their support.

Baby steps are the key in the beginning however like with any change to your behaviour you need to be aware that the pleasure derived will be greater than the pain of the action. This should be simple to achieve, remember that if you have never been active, then any sort of activity is a start. Start today by going for a walk, or being climbing some stairs or simple move and stretch into new positions.

Over the years I have witnessed some stories and transformations that are amazing. One Fitness First member started a programme four months after being diagnosed with a potentially deadly cancerous bone disease. Five years later she has embraced exercise and the industry so much that she now works as a personal trainer helping others. Your own journey need not take you so far, however, never be afraid to embrace new activity, it can transform your life.

* Fitness First operate 189 clubs in the UK and have one million members worldwide. For details contact newcastlemanager@fitnessfirst.com.

(c) 2006 Evening Chronicle - Newcastle-upon-Tyne. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Los Angeles Times

WASHINGTON — Federal regulators on Tuesday approved a new class of oral drugs for Type 2 diabetes that are as effective as most existing treatments and avoid common side effects, such as dangerously low blood sugar.

The Food and Drug Administration said that Merck & Co.’s Januvia, a once-daily tablet, could be taken alone or in combination with the commonly used oral diabetes medicines metformin, Actos and Avandia.

Dr. Robert Meyer of the FDA’s Office of Drug Evaluation called Januvia a “useful addition” to the treatment arsenal.

“Not everybody optimally responds to each medication, or not everybody can tolerate each medication,” he said at a news conference. “Having a new drug in a new class for such a widely prevalent disease is important.”

But Dr. John Buse, director of the diabetes center at the University of North Carolina School of Medicine and president-elect of the American Diabetes Association, said it was still uncertain how valuable the drug would prove to be.

Some commonly used older drugs “are very effective and are ridiculously cheap,” said Buse, who has consulted for many pharmaceutical companies. “The only sin they committed was becoming generic” and losing corporate marketing support.

Januvia will cost $4.86 a day, adding about $1,800 to the annual cost of treatment.

The drug is among several medicines recently approved for Type 2 diabetes, an illness linked to obesity that is reaching epidemic proportions worldwide and affects 20 million people in the United States.

Galvus, a Norvatis drug similar to Januvia, is expected to receive FDA approval next month.

People with Type 2 diabetes progressively lose their ability to produce or properly use insulin, a hormone made in the pancreas that moves sugar from the blood into cells, where it is used as fuel. A buildup of sugar in the blood not only starves cells of energy but can cause serious health complications including blindness, kidney failure and amputations.

Existing drugs act to lower blood-sugar levels in one of two ways. Sulfonylurea drugs stimulate the pancreas to release insulin, while metformin works to discourage the liver from producing sugar. Patients usually start on metformin and later add a sulfonylurea or another drug, but over time the medicines lose effectiveness and many patients need insulin shots.

Januvia and Galvus work differently. They raise the level of a hormone called GLP-1, which is produced in the intestines and stomach when blood sugar levels are elevated. The hormone in turn stimulates the pancreas to release insulin while simultaneously restraining the liver from making sugar.

(c) 2006 Tulsa World. Provided by ProQuest Information and Learning. All rights Reserved.

 

By Greeley Tribune, Colo.

Oct. 20–The Department of Public Health and Environment was awarded funding from the state office of disparities to address health problems with low-income and Latino people in the county with diabetes.

The department plans to improve health by reducing their risk of cardiovascular disease, including diabetes. This will be done by offering free bilingual classes on prevention and providing screening, which could lead to early detection, said Kelly Imus, Diabetes Disparities coordinator with the Department of Public Health and Environment.

“Diabetes is a huge problem and is the ninth leading cause of death in Colorado,” Imus said. “It is more common in Hispanics and in African Americans.”

The grant, which was awarded Tuesday, will provide funding to establish those initiatives and support community education programs for people with risk factors for developing diabetes or are diagnosed with diabetes.

According to the department, people with diabetes also have a higher risk for other health problems including heart disease, stroke, high blood pressure, blindness, kidney disease and amputations.

—–

Copyright (c) 2006, Greeley Tribune, Colo.

Distributed by McClatchy-Tribune Business News.

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By STEVE MITCHELL

Novocell said Thursday it has determined the necessary conditions for turning human embryonic stem cells into insulin-producing cells, a finding that moves the prospect of using these cells to treat diabetes closer to the clinic.

Some work remains to be done before the cells are ready for patients, but the company anticipates phase 1/2 trials could begin as early as 2009.

Our plan is to submit an IND towards the end of 2008 and get approval for phase 1/2 trials in the beginning of 2009, said Emmanuel Baetge, Novocell’s chief scientific officer and senior author of the study, which Nature Biotechnology published online Thursday.

Baetge told United Press International the company has already met with the Food and Drug Administration about its human embryonic stem cell line, which was isolated under good manufacturing practices.

The company plans to conduct additional animal studies the rest of this year and into next year. This would put it on track to perform scale-up in 2007 and conduct safety and efficacy studies in 2008, Baetge said.

In the study, the researchers developed a process for differentiating human embryonic stem cells into insulin-producing pancreatic endocrine cells. The technique, which mimics the normal development that occurs in the body, could be used for generating insulin-producing cells that could be transplanted into type 1 diabetes patients.

Baetge said it’s important to note that although the cells they generated produced insulin at nearly the levels found in adult pancreatic islet cells, they do not produce the hormone efficiently in response to glucose, or blood sugar, a critical requirement if they are to have clinical utility.

However, the cells appear to be at an earlier developmental stage, so the solution to getting them to respond to glucose may just be more development time.

That’s exactly what you find in normal human development, Baetge said. Only after birth do the beta cells begin consistently responding to glucose.

Robert Lanza, vice president of research and scientific development at Advanced Cell Technology, which is also trying to develop therapies based on embryonic stem cells, told UPI the research was a major achievement.

It’s very impressive, Lanza said. But he noted that Novocell will have to make a few tweaks before the cells are ready for the clinic.

They still need to get these cells to respond to glucose, he said. Until they do that, they’re not usable.

The efficiency of the technique also will need to be improved because only a small percent of the cells they started with actually produced insulin at the end.

To expand these cells into sufficient numbers to create a practical therapy is going to be another hurdle, Lanza said.

Another potential problem is immune rejection if cells from one person are placed into another.

Immune rejection is a problem that is going to plaque the entire field, Lanza said. We need to very much work on solving that problem.

Novocell already may have found a way around that issue.

The company’s cell encapsulation technology, which is designed to protect the cells from the body’s immune system, is currently in clinical trials.

We already have two patients implanted and they’re completely off immunosuppression drugs, Baetge said. The patients have encapsulated human primary islet allografts implanted under their skin.

So far there are no severe adverse events, he said, adding that the company plans to continue monitoring the patients without immunosuppressive drug administration, until loss of graft function.

 

U.S. medical investigators say they’ve found the cell wall of certain pneumonia-causing bacteria can cause fatal heart damage.

Investigators at the St. Jude Children’s Research Hospital have also discovered in mouse models how antibiotic therapy can contribute to such damage by increasing the number of cell wall pieces shed by dying bacteria. The team also demonstrated in a mouse model how to prevent this from happening.

The study shows pieces of cell walls from Streptococcus pneumoniae bacteria hijack a protein on the lining of the blood vessel wall and use it to slip out of the bloodstream and into the brain and heart.

The findings explain why blood stream infection with S. pneumoniae commonly leads to temporary impairment of heart function, and they suggest a way to prevent that from occurring, according to Dr. Elaine Tuomanen, chairwoman of the St. Jude Department of Infectious Diseases.

S. pneumoniae is a leading cause of pneumonia, sepsis and meningitis.

A report on this study appears in the November issue of the Journal of Immunology.