Friday 26 June 2015

Diet and lifestyle changes for healthy kidneys



Lifestyle changes:
  • Normal blood pressure = less work for the kidneys.
  • Normal blood glucose = health cardiovascular system = healthy kidneys.
  • Normal blood cholesterol = less work for the kidneys.
  • Physical activity = good blood pressure, glucose and cholesterol levels = healthy kidneys.
  • Normal weight = less work for the kidneys.
  • No smoking = healthy cardiovascular system = healthy kidneys.
Nutrition guidelines:
  • Less salt and sodium = normal blood pressure = less work for the kidneys.
  • Less protein foods = less work for the kidneys.
    • Animal-protein Foods:
      • Chicken
      • Fish
      • Meat
      • Eggs
      • Dairy
    • Plant-protein Foods:
      • Beans
      • Nuts
      • Grains
  • Less phosphorus = less work for the kidneys.
    • Foods Lower in Phosphorus:
      • Fresh fruits and vegetables
      • Breads, pasta, rice
      • Rice milk (not enriched)
      • Corn and rice cereals
    • Foods Higher in Phosphorus:
      • Meat, poultry, fish
      • Bran cereals and oatmeal
      • Dairy foods
      • Beans, lentils, nuts
      • Colas
  • Good potassium = less work for the kidneys.
    • Foods Higher in Potassium
      • Oranges, bananas
      • Potatoes, tomatoes
      • Brown and wild rice
      • Bran cereals
      • Dairy foods
      • Whole wheat bread and pasta
      • Beans and nuts
    • Foods Lower in Potassium:
      • Apples, peaches
      • Carrots, green beans
      • White bread and pasta
      • White rice
      • Rice milk
      • Cooked rice and wheat cereals, grits
  • Right amount of water = less work for your kidneys.
    • Do not drink more or less than you normally do - listen to your body.
  • Healthy heart = less work for your kidneys.
    • Grill, broil, bake, roast, or stir-fry foods, instead of deep frying.
    • Cook with olive oil instead of butter.
    • Trim fat from meat and remove skin from poultry before eating.
    • Heart-healthy Foods:
      • Lean cuts of meat, like loin or round
      • Poultry without the skin
      • Fish
      • Beans
      • Vegetables
      • Fruits
      • Low-fat milk, yogurt, cheese
  • Less alcohol = healthier kidneys.

Thursday 4 June 2015

Universal lifestyle behaviors that promote longevity




Buettner talks about universal lifestyle behaviors that promote longevity, why they're so hard to adopt in the U.S., and how one town undertook its own Blue Zone experiment, to great effect.

Are you also interested in taking the True Happiness Test? Or the Vitality Test?

Thursday 28 May 2015

Effects of abdominal binding on field-based exercise responses in Paralympic athletes with cervical spinal cord injury





Effects of abdominal binding on field-based exercise responses in Paralympic athletes with cervical spinal cord injury.

Christopher R. West, Ian G. Campbell, Victoria L. Goosey-Tolfrey, Barry S. Mason, Lee M. Romer

Abstract

Abdominal binding has been shown to improve resting cardiorespiratory function in individuals with
cervical SCI, but it is not yet clear whether this approach improves the exercise response.

Objectives: To determine the effects of abdominal binding on parameters relating to wheelchair sports performance in highly-trained athletes with cervical SCI.

Design: Repeated-measures field-based study.

Methods: Ten Paralympic wheelchair rugby players with motor-complete SCI (C5–C7) completed a series of exercise tests in two conditions (bound and unbound). The following parameters were assessed: agility and acceleration/deceleration performance; cardiorespiratory function and gross efficiency during submaximal wheelchair propulsion; anaerobic performance and propulsion kinematics during a 30s Wingate test; repeated sprint performance during a 10 × 20 m test; and aerobic performance during a repeated 4 min push test.

Results: Compared to unbound, 6 of 17 field-based performance measures changed significantly with binding. Time to complete the acceleration/deceleration test decreased (p = 0.005), whereas distances covered during the repeated 4 min push test increased (p < 0.043). Binding elicited significant reductions in minute ventilation during submaximal wheelchair propulsion (p = 0.040) as well as blood lactate accumulation and limb discomfort during the second set of the repeated 4 min push test (p = 0.012 and 0.022). There were no statistically significant effects of binding on any other variable.

Conclusions: Abdominal binding improves some important measures of field-based performance in highly-trained athletes with cervical SCI. The changes may be attributable, at least in part, to improvements in trunk stability, ventilatory efficiency and/or haemodynamics.

Wednesday 27 May 2015

Obesity and the role of adipose tissue in inflammation and metabolism



Obesity and the role of adipose tissue in inflammation and metabolism

Andrew S Greenberg and Martin S Obin

Abstract

Recent discoveries, notably of the hormones leptin and adiponectin, have revised the notion that adipocytes are simply a storage depot for body energy. Instead, adipocytes are also endocrine organs, with multiple metabolic roles in regulating whole-body physiology. Small adipocytes in lean individuals promote metabolic homeostasis; the enlarged adipocytes of obese individuals recruit macrophages and promote inflammation and the release of a range of factors that predispose toward insulin resistance. Exercise activates the AMP-activated protein kinase (AMPK) in muscle and other tissues, a pathway that increases fat oxidation and glucose transport. Importantly, the adipocyte hormones leptin and adiponectin also activate AMPK; remarkably, the same pathway is activated by certain antidiabetic agents such as thiazolidinediones. Increasingly, our understanding of the adipocyte as an endocrine organ is leading to new insights into obesity and health.

Tuesday 26 May 2015

Dietary patterns in relation to quality-adjusted life years



Dietary patterns in relation to quality-adjusted life years in the EPIC-NL cohort

Heidi P. Fransen, Joline W.J. Beulens, Anne M. May, Ellen A. Struijk, Jolanda M.A. Boer, G. Ardine de Wit, N. Charlotte Onland-Moret, Yvonne T. van der Schouw, H. Bas Bueno-de-Mesquit, Jeljer Hoekstr, Petra H.M. Peeters.

Abstract

Background

Dietary patterns have been associated with the incidence or mortality of individual non-communicable diseases, but their association with disease burden has received little attention.

Objective

The aim of our study was to relate dietary patterns to health expectancy using quality-adjusted life years (QALYs) as outcome parameter.

Methods

Data from the EPIC-NL study were used, a prospective cohort study of 33,066 healthy men and women aged 20-70 years at recruitment. A lifestyle questionnaire and a validated food frequency questionnaire were administered at study entry (1993-1997). Five dietary patterns were studied three a priori patterns (the modified Mediterranean Diet Score (mMDS), the WHO-based Healthy Diet Indicator (HDI) and the Dutch Healthy Diet index (DHD-index)) and two a posteriori data-based patterns. QALYs were used as a summary health measure for healthy life expectancy, combining a person’s life expectancy with a weight reflecting loss of quality of life associated with having chronic diseases.

Results

The mean QALYs of the participants were 74.9 (standard deviation 4.4). A higher mMDS and HDI were associated with a longer life in good health. Participants who had a high mMDS score (6-9) had 0.17 [95% CI 0.05;0.30] more QALYs than participants with a low score (0-3), equivalent to a two months longer life in good health. Participants with a high HDI score also had more QALYs (0.15 [95% CI 0.03; 0.27]) than participants with a low HDI score.

Conclusion

A Mediterranean-type diet and the Healthy Diet Indicator were associated with approximately 2 months longer life in good health.

Saturday 23 May 2015

Physical therapy is boring -- play a game instead



You’ve just been injured, and you’re on the way home from an hour of physical therapy. The last thing you want to do on your own is confusing exercises that take too long to show results. TED Fellow Cosmin Mihaiu demos a fun, cheap solution that turns boring physical therapy exercises into a video game with crystal-clear instructions.

http://www.mirarehab.com/

Educational tool: Medbullets.com


Image result for medbullets

Medbullets.com is an educational resource for medical students designed to evolve and improve over time through the communal efforts of those who use it as a learning resource. It is a simple but powerful concept.

Our Beliefs

Medbullets.com is built on the following core beliefs:
  • Medical education can be improved and made more efficient.
  • With proper incentives and guidance, medical students and recent medical graduates can and will produce high-quality USMLE review content that benefits themselves and their peers.
  • Physicians and physicians-in-training should be rewarded fairly for their publishing contribution.

Tuesday 19 May 2015

Wheelchair rugby - athletes testing



Last Saturday we tested the physical and sport specific skills of our athletes in the Dutch Wheelchair Rugby Talent Selection Team with Tom Paulson. Great experience and nice results.
Posted by Testcentrum CASA Reade on Tuesday, 19 May 2015

Last Saturday we tested the physical and sport specific skills of our athletes in the Dutch Wheelchair Rugby Talent Selection Team with Tom Paulson. Great experience and nice results.

Posted by Testcentrum CASA Reade on Tuesday, 19 May 2015

Monday 11 May 2015

BMI calculator wrongly labelling thousands as obese, research shows, plus BMI and Spinal Cord Injuries


The BMI calculator used in the public health system to measure obesity rates is highly flawed and could be slapping a false fat label on thousands of Australians, new research has highlighted.

A study into the size and shape of women aged 18-44 has found that almost one-third of participants were miscalculated as obese using the BMI calculator alone, highlighting the need for body measurements, percentage body fat and muscle mass to be introduced into testing.

Read the rest.

Your waist measurement compares closely with your body mass index (BMI), and is often seen as a better way of checking your risk of developing a chronic disease.


Measuring the waist circumference in people with a SCI should be done in supine position.

Being overweight is a common problem for people with spinal cord injury (SCI). Some research shows that two out of three people with SCI are overweight. Excess weight gained after SCI is difficult to lose, and it is hard to maintain weight over time and avoid putting on extra pounds. In part this is due to a reduced ability to move freely. The higher the injury, the more difficult it is to move, stay active, and exercise. A person with a cervical SCI will have more difficulty moving compared to someone with SCI in the lower spine. The same is true for the completeness of an injury. A person with an incomplete injury who is able to walk will likely burn more calories than a person who has a complete injury and uses a wheelchair full time.


A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury.


Waist circumference is the best index for obesity-related cardiovascular disease risk in individuals with spinal cord injury.

Friday 8 May 2015

Dietary Animal and Plant Protein and Human Bone Health: A Whole Foods Approach


Image result for diet and calcium

Dietary Animal and Plant Protein and Human Bone Health: A Whole Foods Approach

Linda K. Massey

Urinary calcium excretion is strongly related to net renal acid excretion. The catabolism of dietary protein generates ammonium ion and sulfates from sulfur-containing amino acids. Bone citrate and carbonate are mobilized to neutralize these acids, so urinary calcium increases when dietary protein increases. Common plant proteins such as soy, corn, wheat and rice have similar total S per g of protein as eggs, milk and muscle from meat, poultry and fish. Therefore increasing intake of purified proteins from either animal or plant sources similarly increases urinary calcium. The effects of a protein on urinary calcium and bone metabolism are modified by other nutrients found in that protein food source.

For example, the high amount of calcium in milk compensates for urinary calcium losses generated by milk protein. Similarly, the high potassium levels of plant protein foods, such as legumes and grains, will decrease urinary calcium. The hypocalciuric effect of the high phosphate associated with the amino acids of meat at least partially offsets the hypercalciuric effect of the protein. Other food and dietary constituents such as vitamin D, isoflavones in soy, caffeine and added salt also have effects on bone health. Many of these other components are considered in the potential renal acid load of a food or diet, which predicts its effect on urinary acid and thus calcium. “Excess” dietary protein from either animal or plant proteins may be detrimental to bone health, but its effect will be modified by other nutrients in the food and total diet.

Tuesday 5 May 2015

Association between being overweight and health related quality of life


Image result for quality of life

The associations between overweight, weight change and health related quality of life: Longitudinal data from the Stockholm Public Health Cohort 2002–2010

N. Döring, J. de Munter, F. Rasmussen.

Abstract

Objective

Cross-sectional studies have shown that people with obesity and overweight report lower health related quality of life (HRQoL). With a lack of longitudinal studies, this study aims to assess the association between eight-year weight change and HRQoL measured by the EQ-5D instrument and to investigate whether the association differs with regard to baseline body mass index (BMI).

Method

A population-based survey was conducted among a random sample of 31,182 individuals from Stockholm County aged 18–84 years in 2002 and reassessed in 2010 and supplemented by record linkage with regional and national registers. Multivariate Poisson regression and linear regression were conducted with adjustments for socio-demographic and health-related variables and baseline BMI category as effect modifier for the association between weight change and HRQoL.

Results

Individuals with overweight and obesity respectively have 0.014 and 0.039 lower EQ-5D indexes compared to those being normal weight. Over the eight-year follow-up, 17.6% gained moderately (≥ 5% body weight) and 13.9% gained heavily (≥ 10% body weight) in weight. In the fully adjusted analysis, heavy weight gain was associated with a significantly lower overall EQ-5D index and an increased risk of reporting impairment in all but one EQ-5D dimensions irrespective of baseline BMI category. Weight reduction had no significant preventive effect.

Conclusion

Next to obesity status itself, weight gain leads to impairment in HRQoL irrespective of BMI category at baseline while eight year weight loss seems not to have the reversed effect on HRQoL, emphasizing the importance of primary prevention of weight gain.

ScienceDirect Source

Pilates exercise for elderly



The effects of Pilates exercise training on physical fitness and wellbeing in the elderly: A systematic review for future exercise prescription.

V. Bulloa, M. Bergamina, S. Gobboa, J.C. Sieverdesb, M. Zaccariaa, D. Neunhaeuserera, A. Ermolaoa

Abstract

This systematic review aims to summarize the effects of Pilates exercise training (PET) in elderly population on physical fitness, balance and fall prevention, and its effects on mood states, quality of life and independence in the daily living activities.

Methods

Keyword “Pilates” associated with “elderly”, “aging” and “old subjects” were identified as terms for the literature research in MEDLINE, Embase, PubMed, Scopus, PsycINFO and SPORTDiscus. Only studies published in peer-reviewed journals written in English language were considered. A meta-analysis was performed and effect sizes (ES) calculated.

Results

10 studies were identified (6 RCTs and 4 uncontrolled trials); age ranged from 60 to 80 years. Overall, PET showed large ES to improve muscle strength (ES = 1.23), walking and gait performances (ES = 1.39), activities of daily living, mood states and quality of life (ES = 0.94), moderate to high effect on dynamic balance (ES = 0.77), small effects on static balance (ES = 0.34) and flexibility (ES = 0.31), while a small effect on cardio-metabolic outcomes (ES = 0.07).

Conclusions

PET should be taken into account as a way to improve quality of life in the elderly, due to the imparted benefits of fall prevention, physical fitness, and mood states. In this context, physicians might include PET as a tool for exercise prescriptions for the elderly.

Monday 27 April 2015

Basic bone science



Basic knowledge in bone science in a simple and nice way. This is the presentation I prepared for my internship in the Orthopedics and Traumatology department of the Academic Medical Center in Amsterdam.

Saturday 25 April 2015

Paralysed man walks again after cell transplant


Spinal graphic

A paralysed man has been able to walk again after a pioneering therapy that involved transplanting cells from his nasal cavity into his spinal cord.

Darek Fidyka, who was paralysed from the chest down in a knife attack in 2010, can now walk using a frame.

The treatment, a world first, was carried out by surgeons in Poland in collaboration with scientists in London.

Read the rest on bbc.news.

Monday 20 April 2015

Are you using protein powder supplements?


"These so called 'dietary supplements' are not considered to be a food or a drug in most countries and therefore the contents and purity of these products is NOT tested or closely regulated by national governments. Clearly, the burden of safeguarding athleticism and public health against contaminated dietary supplements for building muscle in athletes has been placed on the individual." 

I recently came across some very interesting articles about the use of protein powder supplements. I suggest you read them before deciding to put them in your dietary/training program:

1. Here are the average amounts of metals we found in three servings of these protein drinks - ConsumerReport.org
3. Consumers Union, the nonprofit publisher of Consumer Reports, believes that the FDA's oversight under the Dietary Supplement Health and Education Act is inadequate to ensure that protein drinks and other dietary supplements are consistently low in steroids heavy metals and other contaminants -
ConsumerReport.org
4. Many dietary supplements are contaminated with steroid-like chemicals that cause a 'positive' doping test and that are not known to be safe - The University of Texas
5. Why Steroids Are Bad for You -  WebMD

Apart from the possible negative effects of these supplements, there is an important reason I, personally, do not use them: it is more fun and a greater challenge for me to test my limits with what I have and what my body can do and without any "external" help ;-)

Thursday 9 April 2015

2 cases with a complete proximal hamstrings rupture



Tomorrow I am going to follow an operation for a patient that had a complete rupture of his proximal hamstrings - left and right side.

Here is some very useful information for anyone that is interested:
  1. Hamstring Muscle Injuries - OrthInfo
  2. Hamstring Injuries - Orthobullets
  3. Case study: Two patients with a complete proximal rupture of the hamstring

Monday 6 April 2015

Your genes are not your medical destiny



With relatively uncommon exception, that is the rule established by ground-breaking research published over recent years, and nicely illustrated by a 2008 paper in the Proceedings of the National Academy of Sciences. That rule could, and perhaps should, remake the way you play the game of life.

Read more here.

Friday 3 April 2015

Stop doing crunches and start training your body..!


50 Bodyweight Exercises You Can Do Anywhere

Who needs a gym when there’s the living room floor? Bodyweight exercises are a simple, effective way to improve balance, flexibility, and strength without machinery or extra equipment. From legs and shoulders to chest and abs, we’ve covered every part of the body that can get stronger with body resistance alone.

Is it time to put electrophysical agents back in the physical therapy toolbox?



It’s time to smash the myths about electrophysical agents (EPAs) and put them back in the physical therapy toolbox where they belong. That will be the message from one of the profession’s leading names in EPA research, in an agenda-setting session at the WCPT Congress in May.

Here is also another beatiful website on electrotherapy.

Sunday 22 February 2015

Radiology Masterclass - free online tutorial



A very nice and simple online tutorial freely offered by Radiology Masterclass.

These tutorials, and the galleries, will give you a good foundational knowledge in the art of radiological interpretation. Before you start, please read the page on 'using the tutorials'.

The tutorials marked *** are associated with certificated online course assessments, accredited by the Royal College of Radiologists - London - UK.

Monday 16 February 2015

Deep lumbar spine & disc anatomy



The best post on internet I have found related to lumbar spine & disc anatomy. Offered by Dr. Douglas M. Gillard, DC, Associate Professor of Clinical Sciences, Published Spine Researcher.

Thursday 29 January 2015

All the clinimetrics tools you need!



A very useful list with all the clinimetrics tools you need for your assessment. It is in Dutch, but you will understand it..!

I have also created one different one here in English.

Saturday 17 January 2015

A tiny, flexible gold-plated device may be the key to restoring paralyzed humans’ spinal functions



EPFL researcher's neural implant can make paralyzed rats walk again. Soft and stretchable, it is the first of its kind that can be implanted directly on the spinal chord, without damaging it. Described in Science, this new generation device called e-Dura combines electrical and chemical stimulation.

One of the health conditions modern medicine has yet to fix is paralysis in patients who have experienced accidents affecting their spinal cords. But, CNET reports, researchers from Switzerland have already come up with a tiny, flexible, gold-plated device that can be implanted in patients to restore spinal cord functionality and allow paralyzed patients to walk again. [...]

Sunday 4 January 2015

SPINALpedia



SPINALpedia is a social mentoring network and video archive that allows the spinal cord injury community to motivate each other with the knowledge and triumphs gained from our individual experiences.