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Nathan Goodyear

STRESS, DIURNAL CORTISOL AND BREAST CANCER SURVIVAL | eCampus CancerPEN - 0 views

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    Stanford University looked at stress, diurnal cortisol pattern and breast cancer survival using...you guessed it, salivary cortisol
Nathan Goodyear

Low Cortisol, High DHEA, and High Levels of Stimulated TNFα, and IL-6 in Wome... - 0 views

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    low cortisol pattern with elevated DHEA found in women with PTSD.  Additionally, elevated levels of TNF-alpha and IL-6 were found. Hormone evaluation was tested through saliva.
Nathan Goodyear

Cholesterol-lowering therapy and cell membranes. Stable plaque at the expense of unsta... - 0 views

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    This article tells it all in the conclusion: "Changing our current practice pattern could take many years, but we may one day prescribe cholesterol-raising medications to certain patients". The long term effect of lowering cholesterol MAY stabilize plaques (not reduce), but at the expense of the brain. So, we may all have stable plaques, but we just won't know it because our brains will be fried.
Nathan Goodyear

JAMA Network | JAMA Internal Medicine | Trends in Androgen Prescribing in the United St... - 0 views

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    A review of the prescribing patterns of androgens in the US.  Up to 25% of men are prescribed Testosterone without a test evaluation--scarry!
Nathan Goodyear

PCRM | Analysis of Health Problems Associated with High-Protein, High-Fat, Carbohydrate... - 0 views

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    nice review of some of the problems associated with a high fat ,high protein diet.  These effects are seen in those utilizing long term dietary patterns of high protein and high fat intake.  
Nathan Goodyear

Estradiol-17β Upregulates Pyruvate Kinase M2 Expression to Coactivate Estroge... - 0 views

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    This is an important study.  Study found that Estradiol increased the transcription of pyruvate kinase M (PKM2)production in endometrial stromal cells.  This increase in PKM2 shifted metabolism to a aerobic glycolysis pattern similar to the Warburg effect described in cancer.  Additionally, increased PKM2 via Estradiol increased ER alpha transcription and functioned as a ER alpha coactivator.
wheelchairindia9

Karma 8020 Wheelchair - 0 views

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    Heavy duty wheelchair can either be manually-operated or motorized, each with its own pros and cons. A manual heavy-duty wheelchair gives full control of motion to the user, but the added weight from the reinforcements makes pushing or propelling the wheelchair much harder than normal. A motorized heavy duty wheelchair offers a solution to this dilemma, but is often more expensive and harder to maintain than a manual wheelchair. Some designs offer a combination of both, with a small motor assisting those pushing the wheelchair. The proper choice between types of Heavy Duty wheelchair depends largely on the user's expected level of activity. Heavy duty wheelchairs typically have larger seats than conventional wheelchairs. The frames of these wheelchairs can be made from several different reinforced metals, although a titanium wheelchair is often the most popular choice. The wheels themselves are made of thicker rubber than normal, preventing any possible failure due to the greater amount of weight supported. Most makes of heavy duty wheelchairs fold like regular wheelchairs, making storage relatively easy despite the wheelchair increased size. Heavy Duty Wheelchair specialy design for disabled and handicapped persons. They are two types of Heavy Duty Wheelchair for handicapped and disability product like- Karma 8020 X Heavy Duty Wheelchair Karma 8520 Heavy Duty Wheelchair Karma 8020 X Heavy Duty Wheelchair: It comes with detachable swing away footrests. The wheel chair has flip-back armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 K.G. Designed for maximum strength & weight capacity for people over 250 lbs. These end to be heavier and wider. This heavy duty bariatric wheelchair has seat dimensions of 24 inches wide by 18 inches deep to accommodate a weight capacity of up to 400 lbs. This wheelchair is dual axle, which means that the floor to seat heigh
Nathan Goodyear

Environmental Estrogen Exposure During Fetal Life: A Time Bomb for Prostate Cancer: End... - 0 views

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    environmental toxins that have estrogenic activity, i.e. BPA alter the prostate stem cells.  These and other xenoestrogens, as they are collectively called, increase the sensitivity of the prostate to estrogen.  This increases the risk of prostate Ca.  This just sets the pattern of signal interpretation and sensitivity.  Add in the continued estrogenic environment, add in the excess weight, the increased aromatase activity and resultant estrogen production and one has all the ingredients for prostate cancer.
Nathan Goodyear

Serum oestradiol levels in male partners of infer... [Andrologia. 2014] - PubMed - NCBI - 0 views

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    Study points to association of low Estradiol and spermatogenesis in males in infertile couples.  The authors eluded to the association of low Estradiol with low Testosterone, and BMI which is the likely etiology.  Low BMI will result in low aromatase activity.  For men, the majority of Estradiol production occurs from Testosterone via aromatase activity.  Estradiol likely exists in a "U" shaped pattern of benefit: to low hinders optimal physiologic function and contributes to inflammation and disease in men.
Nathan Goodyear

Hypothalamic-Pituitary-Testicular Axis Disruptions in Older Men Are Differentially Link... - 0 views

  • 0.4–2% annual decline
  • the age trend in free T was more substantial (−1.3% per annum)
  • The core hormonal pattern with increasing age is suggestive of incipient primary testicular dysfunction with maintained total T and progressively blunted free T associated with higher LH.
  • ...16 more annotations...
  • Obesity was associated with progressively lower total and free T independent of the simultaneous decrease in SHBG.
  • our data highlight the fact that LH was unchanged or even lower in older men in the face of lower T in obesity, suggesting that there may be a failure at the hypothalamic-pituitary level.
  • a change in BMI from nonobese to obese may be equivalent to a 15 yr fall in T.
  • This pattern supports the hypothesis that different underlying mechanisms influence the functions of the HPT axis: age predominantly affects testicular function, whereas obesity impairs hypothalamic/pituitary function.
  • the effects of aging on testicular function can be moderated by increased LH compensation for many decades
  • obesity impairs hypothalamic/pituitary function independent of age, arguably an adaptive response for which there should be no compensatory mechanism.
  • the concurrent but opposite (and separate) effects of obesity and age on SHBG
  • SHBG was negatively associated with increasing strata of obesity
  • Obesity is associated with insulin resistance (28), and the increased circulating insulin inhibits hepatic SHBG synthesis
  • the SHBG increase with age may be related to relative IGF-I deficiency (27), although this has not been directly proven.
  • Obesity is associated with peripheral and central insulin resistance (30) and proinflammatory cytokine production (TNFα and IL-6) from adipocytes (31) and central nervous system endocannibinoid release (32), all of which are potential candidates for abrogating hypothalamic endocrine and downstream reproductive axis functions.
    • Nathan Goodyear
       
      The HPA axis effect may be the result of inflammation.
  • The relationship between obesity and T can be bidirectional: low T may be the cause rather than consequence of obesity
  • chronic alcohol abuse is known to suppress LH (40), our data showed no significant association among the three hormones or SHBG and alcohol intake.
  • increase in total T in smokers occurs through a primary increase in SHBG with a compensatory rise in LH
  • the effects of obesity (BMI or waist circumference) was by far the most important determinant of variance in total T, whereas age per se was important for SHBG, LH, and free T with comorbidity and smoking being comparatively minor contributors
  • It is noteworthy that these predisposing lifestyle and health factors are modifiable. This implies that the apparent age-related decline in T may constitute a barometer of health and thus be potentially preventable and/or reversible.
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    Age induced decline in Testosterone is more associated with a decline in leydig cell function and thus elevated LH will be associated.  In contrast, obesity is more of a HPA axis disruption and thus LH may be normal to low.  The pulse amplitude is decrease.  No change in pulse frequency is noted.   With obesity, a decline in TT and fT was independent of SHBG. Aging is associated with a greater decrease in fT versus TT.
Nathan Goodyear

Metabolic endotoxemia: a molecular link between obesity and cardiovascular risk - 0 views

  • Weight gain has been associated with a higher gut permeability
  • a high-fat diet promotes LPS absorption
  • higher concentrations of fatty acids impair intestinal barrier integrity
  • ...37 more annotations...
  • The starting point for innate immunity activation is the recognition of conserved structures of bacteria, viruses, and fungal components through pattern-recognition receptors
  • TLRs are PRRs that recognize microbe-associated molecular patterns
  • TLRs are transmembrane proteins containing extracellular domains rich in leucine repeat sequences and a cytosolic domain homologous to the IL1 receptor intracellular domain
  • The major proinflammatory mediators produced by the TLR4 activation in response to endotoxin (LPS) are TNFα, IL1β and IL6, which are also elevated in obese and insulin-resistant patients
  • Obesity, high-fat diet, diabetes, and NAFLD are associated with higher gut permeability leading to metabolic endotoxemia.
  • Probiotics, prebiotics, and antibiotic treatment can reduce LPS absorption
  • LPS promotes hepatic insulin resistance, hypertriglyceridemia, hepatic triglyceride accumulation, and secretion of pro-inflammatory cytokines promoting the progression of fatty liver disease.
  • In the endothelium, LPS induces the expression of pro-inflammatory, chemotactic, and adhesion molecules, which promotes atherosclerosis development and progression.
  • In the adipose tissue, LPS induces adipogenesis, insulin resistance, macrophage infiltration, oxidative stress, and release of pro-inflammatory cytokines and chemokines.
  • the gut microbiota has been recently proposed to be an environmental factor involved in the control of body weight and energy homeostasis by modulating plasma LPS levels
  • dietary fats alone might not be sufficient to cause overweight and obesity, suggesting that a bacterially related factor might be responsible for high-fat diet-induced obesity.
  • This was accompanied in high-fat-fed mice by a change in gut microbiota composition, with reduction in Bifidobacterium and Eubacterium spp.
  • n humans, it was also shown that meals with high-fat and high-carbohydrate content (fast-food style western diet) were able to decrease bifidobacteria levels and increase intestinal permeability and LPS concentrations
  • it was demonstrated that, more than the fat amount, its composition was a critical modulator of ME (Laugerette et al. 2012). Very recently, Mani et al. (2013) demonstrated that LPS concentration was increased by a meal rich in saturated fatty acids (SFA), while decreased after a meal rich in n-3 polyunsaturated fatty acids (n-3 PUFA).
  • this effect seems to be due to the fact that some SFA (e.g., lauric and mystiric acids) are part of the lipid-A component of LPS and also to n-3 PUFA's role on reducing LPS potency when substituting SFA in lipid-A
  • these experimental results suggest a pivotal role of CD14-mediated TLR4 activation in the development of LPS-mediated nutritional changes.
  • This suggests a link between gut microbiota, western diet, and obesity and indicates that gut microbiota manipulation can beneficially affect the host's weight and adiposity.
  • endotoxemia was independently associated with energy intake but not fat intake in a multivariate analysis
  • in vitro that endotoxemia activates pro-inflammatory cytokine/chemokine production via NFκB and MAPK signaling in preadipocytes and decreased peroxisome proliferator-activated receptor γ activity and insulin responsiveness in adipocytes.
  • T2DM patients have mean values of LPS that are 76% higher than healthy controls
  • LPS-induced release of glucagon, GH and cortisol, which inhibit glucose uptake, both peripheral and hepatic
  • LPSs also seem to induce ROS-mediated apoptosis in pancreatic cells
  • Recent evidence has been linking ME with dyslipidemia, increased intrahepatic triglycerides, development, and progression of alcoholic and nonalcoholic fatty liver disease
  • The hepatocytes, rather than hepatic macrophages, are the cells responsible for its clearance, being ultimately excreted in bile
  • All the subclasses of plasma lipoproteins can bind and neutralize the toxic effects of LPS, both in vitro (Eichbaum et al. 1991) and in vivo (Harris et al. 1990), and this phenomenon seems to be dependent on the number of phospholipids in the lipoprotein surface (Levels et al. 2001). LDL seems to be involved in LPS clearance, but this antiatherogenic effect is outweighed by its proatherogenic features
  • LPS produces hypertriglyceridemia by several mechanisms, depending on LPS concentration. In animal models, low-dose LPS increases hepatic lipoprotein (such as VLDL) synthesis, whereas high-dose LPS decreases lipoprotein catabolism
  • When a dose of LPS similar to that observed in ME was infused in humans, a 2.5-fold increase in endothelial lipase was observed, with consequent reduction in total and HDL. This mechanism may explain low HDL levels in ‘ME’ and other inflammatory conditions such as obesity and metabolic syndrome
  • It is known that the high-fat diet and the ‘ME’ increase intrahepatic triglyceride accumulation, thus synergistically contributing to the development and progression of alcoholic and NAFLD, from the initial stages characterized by intrahepatic triglyceride accumulation up to chronic inflammation (nonalcoholic steatohepatitis), fibrosis, and cirrhosis
  • On the other hand, LPS activates Kupffer cells leading to an increased production of ROS and pro-inflammatory cytokines like TNFα
  • high-fat diet mice presented with ME, which positively and significantly correlated with plasminogen activator inhibitor (PAI-1), IL1, TNFα, STAMP2, NADPHox, MCP-1, and F4/80 (a specific marker of mature macrophages) mRNAs
  • prebiotic administration reduces intestinal permeability to LPS in obese mice and is associated with decreased systemic inflammation when compared with controls
  • Cani et al. also found that high-fat diet mice presented with not only ME but also higher levels of inflammatory markers, oxidative stress, and macrophage infiltration markers
  • This suggests that important links between gut microbiota, ME, inflammation, and oxidative stress are implicated in a high-fat diet situation
  • high-fat feeding is associated with adipose tissue macrophage infiltration (F4/80-positive cells) and increased levels of chemokine MCP-1, suggesting a strong link between ME, proinflammatory status, oxidative stress, and, lately, increased CV risk
  • LPS has been shown to promote atherosclerosis
  • markers of systemic inflammation such as circulating bacterial endotoxin were elevated in patients with chronic infections and were strong predictors of increased atherosclerotic risk
  • As a TLR4 ligand, LPS has been suggested to induce atherosclerosis development and progression, via a TLR4-mediated inflammatory state.
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    Very nice updated review on Metabolic endotoxemia
wheelchairindia9

A Friendly Tricycle For The Disabled Users - 0 views

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    Those of all ages whose physical disabilities restrict their movement, affect their ability to earn a living or become valued members of society. Specially designed tricycles provide a mode of transport for the physically disabled allowing them much sought after independence and an opportunity for self support. The tricycles will enable freedom of movement and less dependency on others. Most of the people who depend on these tricycles are daily wage workers who have to travel long distances every day. The regular tricycles have no suspension and the riders are prone to spinal injuries. Most of them also cannot afford good medical care, and driving these tricycles for a long time affects. To deal with the problem, come up with a model tricycle that can be very useful to people who have a disability in their lower limbs, but a strong torso. The Handy tricycle to provide the ideal cycling experience for users advancement of upper body strength and toning for athletic events. Especially valuable to triathletes and challenged, it provides the perfect way to get in shape and stay that way. The tricycle achieves the true convenience of transportation while providing easy-to-use pedaling, steering and breaking controls. These are amongst the top selling handcycles on the market today. Handy is available in upright and recumbent versions. Hand powered front wheel drive. An internal hub-based gear shifting system is built into the front wheel.This provides ultra smooth shifting and is virtually maintenance-free. The entire front frame section is removable and connects easily, quickly and securely using a bolt-on system. The seat can be repositioned quickly and easily to allow the rider to achieve an optimally efficient distance between seat and handlebars.The rear wheels are removed using a single finger push system, allowing the bike to be broken down very quickly. Defined by two ways: Fork steer: It represent the majority of handcycles. They work well for both low
Nathan Goodyear

How We Read Oncologic FDG PET/CT | Cancer Imaging | Full Text - 0 views

  • In early PET literature focusing on analysis of solitary pulmonary nodules, some researchers defined malignancy based on a SUVmax threshold of greater than 2.5
  • We contend that SUV analysis has virtually no role in this setting.
  • tumours grow as spheres, whereas inflammatory processes are typically linear
  • ...35 more annotations...
  • Far more important than the SUVmax is the pattern rather than intensity of metabolic abnormality and the correlative CT findings
  • Descriptively, we define SUV < 5 as “low intensity”, 5–10 as “moderate”, 10–15 as “intense” and >15 as “very intense”
  • Evolving literature suggests that intensity of uptake is an independent prognostic factor and in some tumour subtypes superior to histopathologic characterisation.
  • aerobic glycolysis
  • Our practice of thresholding the grey and colour scale to liver as detailed above results in similar image intensity to a fixed upper SUV threshold of 8 to 10
  • The advantage of using the liver as a reference tissue is also aided by this organ having rather low variability in metabolic activity
  • When the liver is abnormal and cannot be used as a reference organ, we use the default SUV setting of an upper SUV threshold of 8
  • One of the most challenging aspects of oncologic FDG PET/CT review, however, is to recognise all the patterns of metabolic activity that are not malignant and which consequently confound interpretation
  • Many benign and inflammatory processes are also associated with high glycolytic activity
  • Future articles in the “How I Read” series will address the specific details of reading PET/CT in various cancers
  • The intensity of uptake in metastases usually parallels that in the primary site of disease
  • For example, discordant low-grade activity in an enlarged lymph node in the setting of intense uptake in the primary tumour suggests it is unlikely malignant and more likely inflammatory or reactive
  • By CT criteria the enlarged node is ‘pathologic’ but the discordantly low metabolic signature further characterises this is as non-malignant since such a node is not subject to partial volume effects and therefore the intensity of uptake should be similar to the primary site
  • The exception is when the lymph node is centrally necrotic as a small rim of viable tumour is subject to partial volume effects with expectant lower intensity of uptake; integrating the CT morphology is therefore critical to reaching an accurate interpretation
  • Small nodes that are visualised on PET are conversely much more likely to be metastatic as such nodes are subject to partial volume effects.
  • The exception to this rule is tumours with a propensity for tumour heterogeneity at different sites
  • The combination of FDG and a more specific tracer, which visualises the well-differentiated disease can be very useful to characterise this phenomenon
  • “metabolic signature”
  • For the majority of malignant processes, the intensity of metabolic abnormality correlates with degree of aggressiveness or proliferative rate.
  • a negative PET/CT study in a patient with biopsy proven malignancy would be considered false-negative
  • Warburg effect
  • There, however, are a significant minority of tumours that utilise substrates other glucose such as glutamine or fatty acids as a source of the carbon atoms required for growth and proliferation
  • This includes a subset of diffuse gastric adenocarcinomas, signet cell colonic adenocarcinomas and some sarcomas, particularly liposarcoma
  • There may be a role for other radiotracers such as fluorothymidine (FLT) or amino acid substrates in this setting.
  • Some tumours harbour mutations that result in defective aerobic mitochondrial energy metabolism, effectively simulating the Warburg effect
  • patients with hereditary paraganglioma and pheochromocytoma highlight this phenomenon
  • These have intense uptake on FDG PET/CT despite often having low proliferative rate.
  • Uterine fibroids, hepatic adenomas, fibroadenomas of the breast and desmoid tumours are benign or relatively benign lesions that can have quite high FDG-avidity.
  • Metabolic activity switches off rapidly following initiation of therapy
  • Common examples where patients have commenced active therapy but the referrer is requesting “staging” includes hormonal therapy (eg. tamoxifen) in breast cancer, oral capecitabine in colorectal cancer or high dose steroids in Hodgkin’s lymphoma
  • It is therefore critical to perform PET staging before commencement of anti-tumour therapy
  • The potential advantage of routine diagnostic CT is improved anatomic localisation and definition
  • Without intravenous contrast, additional identification of typical oncologic complications such as pulmonary embolism or venous thrombosis cannot be identified
  • If the study is performed as an “interim” restaging study after commencement of therapy but before completion, in order to reach a valid or clinically useful conclusion findings must be interpreted in the context of known changes that occur at a specific timing and type of therapy
  • The most well studied use of interim PET is in Hodgkin’s lymphoma where repeat PET after two cycles of ABVD-chemotherapy provides powerful prognostic information and may improve outcomes by enabling early change of management
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    good read on the PET/CT scan reading.  They mention that tumors are spheres and inflammation is linear, yet inflammation coexists with cancer; hard to simply delineate these on simple terms. I do agree aon the metabolic signature of the PET/CT scan
fnfdoc

Stroke Genetics And Risk Factors | Your Health Our Priority - 0 views

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    Stroke is a cerebrovascular syndrome that involves the blockage and bursting of blood vessels in the brain. It shows a multifactorial pattern of inheritance. High cholesterol levels, high blood pressure, hypertension and obesity are the key causes of stroke besides inherited genes.
fnfdoc

Home Remedies For PCOS | Your Health Our Priority - 0 views

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    PCOS is a serious disease of the female reproductive tract identified by male pattern baldness, hirsutism, sleep apnea and infertility. Unfortunately, there is no cure for it. However, some home remedies can help ease the symptoms.
snfilms

Intraday Scalping Deal on Bank Nifty Option Call - 18 Mar 2021 - 0 views

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    শেয়ার ট্রেডিং | Intraday #ShareMarket real #SCALPING deal on reversal pattern against trend | #ShareTrading #intraday scalping technique of 18 Mar'21 on #BankNiftyOption (CALL). https://bit.ly/38jt53L Contact #snfpa on 9051355050 for online/classroom #ShareTradingCourse and admission detail. #Trainer Sanjib Nath
snfilms

Intraday Share Trading on Bank Nifty (CALL) on 31-Mar-2021 - 0 views

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    শেয়ার ট্রেডিং | Intraday #ShareMarket real deal on support line in upside flag pattern | #ShareTrading #intraday technique of 31 Mar'21 on #BankNiftyOption (CALL). #Trainer Sanjib Nath Contact #snfpa on 9051355050 for online/classroom #ShareTradingCourse and admission detail.
snfilms

Share Trading Intraday Deal - 07 Apr 2021 - 0 views

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    Intraday #ShareTrading real deal on flag pattern break out with target till next resistance line | শেয়ার ট্রেডিং #intraday technique of 07 Apr'21 on #BankNiftyOption (CALL). https://bit.ly/38jt53L Contact #snfpa on 9051355050 for online/classroom #ShareTradingCourse and admission detail. #Trainer Sanjib Nath
snfilms

Intraday Deal on Bank Nifty Call Option - 19 Apr 2021 - 0 views

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    শেয়ার ট্রেডিং - Intraday #ShareTrading real deal on double bottom pattern break out with target till pivot line | #intraday technique of 19 Apr'21 on #BankNiftyOption (CALL). https://bit.ly/38jt53L Contact #snfpa on 9051355050 for online/classroom #ShareTradingCourse and admission detail. #Trainer Sanjib Nath
snfilms

Intraday Equity (TCS) Trading - 13 Apr 2021 - 0 views

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    শেয়ার ট্রেডিং | Intraday #ShareMarket real deal on double bottom pattern break down | #ShareTrading #intraday Student's trading technique of 13 Apr'21 on #equity (TCS). https://bit.ly/38jt53L Contact #snfpa on 9051355050 for online/classroom #ShareTradingCourse and admission detail. #Trainer Sanjib Nath
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