One of the most common foot maladies people suffer from is plantar fasciitis.
Like most people, doctors typically think of the foot as somehow separate from the rest of the body–they focus on treating only the foot and don’t look at the other physiological systems or diet and lifestyle factors that go into creating these problems in the first place.
If you want to heal a chronic foot problem, you need to treat your whole body.
So, my job as a holistic podiatrist is to stimulate the pathway to healing (primary inflammation) and block the pathway to plantar fasciitis and other forms of foot pain (chronic inflammation).
The most common treatment for the condition is cortisone, a powerful steroid that blocks inflammation.
Treating Your Feet from the Ground Up: Diet/Lifestyle Changes to Heal Plantar Fascitiis There are two factors we need to consider when treating plantar fasciitis.
The second is identifying burdens on the immune system that make primary inflammation less efficient.
Proper hydration facilitates cellular repair, and most people don’t get enough water.
The goal is to work with, not against, the immune system so we can effect a complete healing.
I have been treating patients who come to see me with plantar fasciitis using the steps above for over 30 years.
Teen moms at long-term cardiovascular risk The new study found that women who had their first pregnancy before the age of 20 had a much greater long-term risk of cardiovascular disease than women who became mothers after that age.
She explained: Women who participated in our study came from five very different study sites.
We observed a relatively consistent association in which early childbearing was associated with greater cardiovascular disease risk across study sites, which supports the validity of our results.”
Strengths and limitations of the study In addition to the diverse sample of the study, Prof. Pirkle spoke to MNT about its other strengths, such as the researchers having used the laboratory-based version of the FRS to measure heart disease risk. “Because this version of the [FRS] largely uses biomarker measures (e.g., blood test results) and clinical measures (such as blood pressure),” Prof. Pirkle explained, “it is less prone to the biases often encountered in observational epidemiological studies that rely on participant self-report.”
This puts the study respondents at risk of memory loss, which may have biased the results, says the team.
Prof. Pirkle shared with us an additional potential limitation, which also has to do with the advanced age of the participants. “Because the IMIAS includes study sites from middle-income settings,” she explained, “especially Brazil and Colombia, where premature mortality was high when these women were younger, there is a possibility that we only selected ‘survivors’ for our study.” “The first mechanism,” Prof. Pirkle went on, “relates to the consequences of adolescent pregnancy and childbirth […] Adolescents who have children early in life may have [fewer] opportunities to finish school and to earn sufficient incomes over their lifetimes.”
Future research “This suggests that the consequences of adolescent childbearing,” said Prof. Pirkle, “such as less social and economic opportunities, are driving the association that we observed in our study.”
“The idea is that by the end of the fellowship the teams will build an actual thing for people to use,” says KT Gillett, who does community outreach for Blue Ridge Labs.
Last year, the fellowship program tackled issues of social justice.
Helping older adults is this year’s theme.
Seniors Innovating for Seniors At 71, the second-oldest fellow in this year’s program is Eileen McGinn—an “expert” because she is living older age.
Though McGinn’s team is not exactly sure what shape their project will ultimately take, she says that rather than just starting with solutions on a white board, they’ve decided to jump in and actually form Second Act, a NYC support group for women “seniorpreneurs.” She explains that other city programs that train entrepreneurs are geared toward younger people willing to work insane hours; unlike those programs, Second Act is for older women who want to use a skill to supplement their Social Security by $500 to $1,200 a month “so they can live like human beings.” All of the ideas the teams are presenting today are devised to tackle issues faced by older adults.
“To me, going into Blue Ridge Labs was like going into a different culture.
Get McGinn talking about the project that her team is building, and she positively lights up.
Since late June, they’ve been holding regular workshops with seniorpreneurs, including a cake baker, a woman who imports crafts from Africa and a children’s book writer.
They needed somebody to pay attention to them.” McGinn isn’t just helping to lead Team Second Act.
After doing a life inventory, she has decided to return to a previous career teaching English as a Second Language—that is, after the Blue Ridge Labs fellowship is over.
While more sleep sounds good to most people, a new study is saying that more assaults are committed once the clocks fall back.
Researchers from the University of Pennsylvania say the number of assaults go up by nearly 3 percent right after the country sets their clocks back one hour, CBS Philadelphia reports.
The surprising findings added that assaults actually went down by three percent when daylight saving time starts in March as Americans lose an hour of sleep. “Sleep problems have previously been associated with increased antisocial and criminal behavior, so we were surprised to find that increased sleep was associated with increased offending,” said Richard Perry University’s Adrian Raine in a press release. “You think, ‘If I don’t get a lot of sleep, I’m going to be cranky and angry.’
Your intention is to act more aggressively, but your behavior does not reflect that because you’re tired.
You’re too lethargic,” doctoral student Rebecca Umbach theorized.
Although the study found that moving the clocks back resulted in an uptick in violence, leaping forward comes with its own side effects.
Car accidents, workplace injuries, and suicides all reportedly increase the Monday after clock moves forward in March.
Given the reported negative impacts at both ends of daylight saving time, a number of states have debated if the practice should be stopped forever.
In a later tweet, he wrote, “My thoughts, condolences and prayers to the victims and families of the New York City terrorist attack.
The incident is being investigated as terrorism, officials said.
Six people were declared dead at the scene and two were pronounced dead at the hospital.
Five of those killed were Argentinians, a group of friends celebrating the 30th anniversary of graduates of the Polytechnic School in their hometown, the country’s Ministry of External Affairs said in a statement.
New York City police work in Manhattan after a rental truck drove down a busy bicycle path and struck people on Tuesday, October 31.
At least eight people were killed and nearly a dozen were injured in the incident, which is being investigated as terrorism, according to multiple law enforcement sources.
Saipov was born in the central Asian nation of Uzbekistan and came to the US in 2010, two law enforcement sources told CNN.
Law enforcement sources said Saipov most recently lived in New Jersey.
He was arrested by the Missouri State Highway Patrol in October 2016 after a warrant was issued when he failed to show in court for a misdemeanor offense.
He saw police officers ducking for cover.
A Pennsylvania bill mandating a drug formulary for workers compensation that passed the state’s senate last week has been welcomed by insurer advocates but is opposed by trial lawyers, who say it’s an attempt to curb utilization review organizations.
936, passed Oct. 25 on a 34-16 vote, the Pennsylvania Department of Labor and Industry would select a “nationally recognized, evidence-based prescription drug formulary appropriate for resolving issues related to drugs prescribed for or related to the treatment of work-related injuries, including, but not limited to, the type, dosage, and duration of prescriptions,” according to the bill’s latest text.
Formularies have long been used by medical insurers to control prescription costs by listing the drugs that insurers will cover.
The bill is an attempt to control the decisions of utilization review organizations through the cost of getting certified, said Larry Chaban, a Pittsburgh-based workers compensation attorney and member of the Pennsylvania Association for Justice, a trial lawyer organization.
The bill also does not address the issue of opioids and reduces physician choice, Mr. Chaban said.
“A formulary is going to deal not just with opioids.
But insurance trade associations, including the Insurance Federation of Pennsylvania and the American Insurance Association, support the bill.
“What it does is bring a consistent and high quality of medical care to injured workers,” he said.
“One of them was limiting the cost of compound creams to 10% over the actual cost to the pharmacy, and we also offered an amendment that would require doctors to check the opioid registry before they wrote a prescription for opioids,” said Mr. Chaban.
936 will now go to the state House of Representatives.
In 1984 Judith Mackay gave up clinical practice in Hong Kong to devote herself to tobacco control in low and middle income countries—unpaid and virtually alone, but driven by her rage at the industry’s lies and misrepresentations.
Now 74, she has advised many governments since then and helped turn the tide against tobacco.
Born in Yorkshire and educated at Edinburgh University, Mackay moved to Hong Kong in 1967.
She has overcome intimidation, suspicions of spying, and scepticism from (mostly male) political leaders with her combination of charm and determination—once drafting an anti-tobacco law in Mongolia by working an all-nighter because she had a plane to catch the next day.
She has written or cowritten a dozen health atlases, morphing statistics into maps and colourful graphics.
In 2009 she won the inaugural BMJ Lifetime Achievement award.
What was your best career move?
Moving from curative to preventive medicine in 1984, albeit with a huge loss of income.
What was the worst mistake in your career?
I naively thought in 1984 that it might be possible to work on tobacco control …
Two weeks after his injury in an officer-involved shooting, the man charged with attacking the officer before being shot has been arrested and handed a no-contact order.
Donald Joseph Miller, 51, is charged with felony counts of robbery with serious bodily injury and simple assault on a peace officer related to his alleged attack on a Bismarck police officer on Oct. 15 at the Bismarck Motor Motel.
He was arrested Friday afternoon and is held at the Burleigh-Morton County Detention Center, pending $150,000 cash bond. “It is our policy not to release the name of an officer involved in a shooting until the investigation is complete,” Sgt.
Mark Buschena said, “the same way we don’t release any other person’s name in a case until that investigation is complete and that person is either charged, or the case is closed and no charges are brought, in which case the name becomes releasable.”
Furthermore, the officer has invoked his victim rights under Marsy’s Law, Buschena added, “so we won’t be releasing his name.”
The Bismarck Tribune was able to identify the officer as Justin Antonovich through Miller’s no-contact order and a current roster of licensed North Dakota peace officers which indicates Antonovich’s employment with Bismarck Police.
Both men were taken to a hospital, where the officer was treated for eye and face injuries and later released.
Miller required surgery for his gunshot wound. “He can come back to work but will not be performing field duties until the investigation and findings are complete,” he said.
Shared decision making for diagnostic decisions is understudied and differs from treatment decision making.
Zackary D Berger and colleagues discuss how uncertainty and stakes should shape the conversation Patient centred diagnosis is best practised through shared decision making; an iterative dialogue between doctor and patient, which respects a patient’s needs, values, preferences, and circumstances Shared decision making for diagnostic situations differs fundamentally from that for treatment decisions.
This has important implications when considering its practical application The nature of dialogue should be tailored to the specific diagnostic decision; scenarios with higher stakes or uncertainty usually require more detailed conversations In 2001, the National Academy of Medicine set out its vision to prioritise patient centred care: to ensure that clinical decisions “respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care.”1 Similar aims also exist in UK health strategy.2 Patient centred care is best delivered through patient-clinician relationships that foster shared decision making; an approach that has been shown to encourage health promoting behaviours, reduce inappropriate or unnecessary use of care, and improve patient and clinician satisfaction.345 Shared decision making and diagnosis Shared decision making goes beyond simple information exchange: it emphasises collaborative, often iterative, deliberation between patients, family, and clinicians, to advance the desired outcomes identified by the patient (fig 1⇓).678910 Fig 1 Conceptual model of patient centred diagnosis.
Clinical context includes the presenting patient concern, the clinician’s role, and the clinical setting.
Considering this and the patient’s (or family’s) overall goals of care, a dialogue between clinician and patient or family should be used to agree on a patient centred diagnostic plan.
This deliberation should cover patient preferences that are global (such as the patient’s capacity and …
Progressive and Prognosis Value of Notch Receptors and Ligands in Hepatocellular Carcinoma: A Systematic Review and Meta-analysis
We searched databases for studies that evaluated the expression of Notch receptors and/or ligands in human HCC tissue.
HCC is the fifth most common malignancy and second leading cause of cancer-related death worldwide; its 5-year survival rate is 15–17%3.
Therefore, early screening, early diagnosis, and initial treatment are appropriate ways to determine the prognosis of patients with liver cancer, which is important.
Numerous related factors and molecular pathways are involved in the pathogenesis and progression of HCC.
The Notch signaling pathway is composed of Notch receptors (Notch 1–4), Notch ligands (Delta 1,3,4; Jagged 1–2) and intracellular effector molecules and is a highly conserved intercellular signal transduction pathway.
The Notch signaling pathway is pleiotropic, and activation of this pathway not only plays an important role in the development and differentiation of normal cells but also plays an important role in the evolution of the disease, especially in corresponding tumor formation8,9.
In recent years, studies on the role of the Notch signaling pathway in carcinogenesis and suppression of primary HCC have made progress.
Some studies suggest that expression of Notch receptors or ligands in HCC can inhibit the proliferation of HCC cells, while the opposite view is that high expression of some Notch receptors or ligands, such as Notch 1 or Jagged1, can promote the differentiation of liver tumor and tumor vascular proliferation.
To provide new guidelines for early detection or early diagnosis, establish an individualized treatment regimen and evaluate of prognosis of HCC, this systematic review and meta-analysis observed the expression levels of Notch l–4 and Jagged l in HCC tissue, pericarcinomatous tissue and normal control tissue.
Full size image The association between the Notch receptor/ligand in HCC and non-HCC tissues.
Therapeutic siRNA targeting endothelial KDR decreases portosystemic collateralization in portal hypertension
These siRNAs were first validated in vitro, and then, their therapeutic potential on portosystemic collateralization and pathological angiogenesis was tested in vivo in mouse models of portal hypertension (portal vein-ligation).
Full size image Intracellular localization of siRNA-Cy3-lipoplexes in the vascular endothelium of mesenteric microvessels and portal vein in portal hypertensive mice.
S4 (H&E-stained mesenteric sections).
(D) Representative immunoblotting demonstrating effective reduction of KDR protein expression, by 75%, in the mesentery of siRNAKDR-lipoplex-treated portal hypertensive mice in comparison with siRNALuc-lipoplex-treated portal hypertensive animals.
(D) H&E staining in liver sections from portal hypertensive mice treated with siRNAKDR- or siRNALuc lipoplexes.
Treatment with siRNAKDR-lipoplexes markedly and significantly decreased both the formation of portosystemic collateral vessels, by 73%, and the collateral blood flow, by 64%, in portal hypertensive mice.
(C) Representative immunoblotting showing that siRNAKDR-lipoplex treatment reduced in 5 out of 6 mice the protein expression of the vascular remodeling marker TGFβ (average decrease of 64%; P value: *p = 0.041) in the portal vein, compared with siRNALuc-lipoplex-treated portal hypertensive mice.
(D) Representative immunoblotting showing that siRNAKDR-lipoplex treatment reduced in 4 out of 6 mice the protein expression of the vascular remodeling marker PDGF-B (average decrease of 57%; P value: *p = 0.029) in the portal vein, compared with siRNALuc-lipoplex-treated portal hypertensive mice.
(C) Representative immunoblotting showing decreased protein expression of the endothelial cell marker and angiogenesis index CD31 in the mesentery from siRNAKDR-lipoplex-treated portal hypertensive mice, in comparison with siRNALuc-lipoplex-treated portal hypertensive animals.
(G) Representative immunoblotting demonstrating effective reduction of KDR protein expression, by 95%, in the liver of siRNAKDR-lipoplex-treated portal hypertensive mice in comparison with siRNALuc-lipoplex-treated portal hypertensive animals.
Bile acid TUDCA improves insulin clearance by increasing the expression of insulin-degrading enzyme in the liver of obese mice
Here, we demonstrated that 15 days treatment with TUDCA reestablished plasma insulin to physiological concentrations in high fat diet (HFD) mice, a phenomenon associated with increased insulin clearance and liver IDE expression.
This effect is probably due to increased IDE expression in the liver.
TUDCA treatment reduced body and fat pad weight in the HFD + TUDCA mice (Table 1) and also returned fed/fasted blood glucose concentrations to levels similar to the CON mice (Table 1).
During the ipITT, HFD mice displayed higher blood glucose, compared with CON mice (Fig.
The treatment with TUDCA restored insulin sensitivity in HFD + TUDCA mice (Fig.
Also, plasma insulin concentration was increased in the HFD mice (Fig.
Thus, reduction in the C-peptide:insulin ratio indicates a reduced insulin clearance, as we observed in the HFD mice (Fig.
3B and C), it restored the IDE protein expression in the HFD + TUDCA to levels similar to that of CON mice (Fig.
TUDCA treatment increases insulin clearance in HFD mice.
Full size image TUDCA treatment increases IDE expression, but not activity in HFD mice.
Here, we conditionally deleted the MHC-II β-chain from myelinating Schwann cells in mice and investigated how this influenced post-traumatic intraneural inflammation and neuropathic pain using the chronic constriction injury (CCI) model.
Activation of T helper cells by MHC-II on Schwann cells thus promotes post-traumatic axonal loss and neuropathic pain.
While MHC class I is expressed by all nucleated cells, MHC-II is generally only expressed by professional APCs (such as dendritic cells, macrophages or B cells)1,2.
Previous data indicate that Schwann cells upregulate MHC-II under conditions inducing post-traumatic neuropathic pain in female rats8.
In our study, we used the reliable and well-established chronic constriction injury (CCI) model of the sciatic nerve to test the functional relevance of MHC-II expression in Schwann cells in the context of neuropathic pain in vivo.
By conditionally deleting the MHC-II β-chain specifically in myelinating Schwann cells, we demonstrate that MHC-II expression by myelinating Schwann cells promotes post-traumatic CD4+ T cell infiltration and axonal degeneration and increases thermal hyperalgesia and mechanical allodynia in female mice in vivo.
(a) Sciatic nerves from wildtype IAbfl/fl female mice (left panel) and P0CreIAbfl/fl female mice (right panel) were dissected 7 days after chronic constriction injury (CCI) of this nerve for histological examination.
The g ratio was calculated by dividing axon circumference by myelin circumference and average g ratio values were calculated for each mouse.
(a) Thermal hyperalgesia was tested 7 days after chronic constriction injury (CCI) by placing the mouse’s hind paw from the lesioned side onto a hot plate (temperature 40 °C) and recording the latency (in seconds) until paw withdrawal (see methods).
Pooled data from three (hot plate) and two (von Frey filaments) independent experiments, respectively, with in total ≥8 female mice per group (wildtype IAbfl/fl vs. P0CreIAbfl/fl mice), are depicted.
November 2017 sees the launch of the second annual Incident Management Month by enterprise SharePoint EHS software providers Pro-Sapien.
The campaign aims to highlight the importance of improving workplace safety by promoting a culture of thorough incident management and reporting.
In the UK during 2015/2016, there were 621,000 non-fatal injuries at work (10,000 more than the previous year).
152,000 of these injuries led to over 7 days absence, meaning that 5.6 million working days were lost due to work-related ill health or injury.
Globally, 317 million accidents happen in the workplace each year, of which 2.3. million lead to a death of an employee.
Despite these figures, almost 20% of workers feel that their companies do not provide active and visible support for health and safety in their workplace, and only 60% track their employee’s engagement with safety.
Pro-Sapien, a global leader in incident management software on SharePoint, are devoting the month to highlight the need for companies to provide staff (especially senior leaders) with the right tools and knowledge to implement a safety culture which will allow organisations to both improve their safety records and instil a message that safety is important from the top down.
Murray Ferguson, Managing Director at Pro-Sapien, comments, “My favourite analogy on the importance incident management relates to the broken window theory – if you see a building with a broken window, vandals tend to smash some more.
Eventually, they might break in, steal or cause more damage inside.
Incident management can enable staff to handle the minor incidents within the workplace, such as slips, trips and falls or near misses, and by controlling and reporting these incidents and analysing the patterns behind them, there is a positive correlation with reduction of serious injuries.” Pro-Sapien will be running several events online throughout the month of November as part of Incident Management Month, including a webinar, guest articles about Incident Management from noted health and safety professionals, online discussions on Twitter & Facebook via the #IMM2017 hashtag, and a competition to encourage employee morale and engagement.
However, H. pylori have also been shown to cause the majority of stomach ulcers and are a known risk factor for stomach, or gastric, cancer.
The team focused on PPIs because a recent review and meta-analysis found an association between the long-term use of PPIs and an increased risk of stomach cancer.
In the new investigation, the scientists set out to “determine the risk of gastric cancer development among individuals who had received treatment for H. pylori with focus on the role of long-term PPIs.”
Overall, 153 people developed stomach cancer following triple therapy.
The results showed that people who took PPIs had more than twice (2.44) the risk of developing stomach cancer, whereas H2 blockers were not associated with an increased risk.
The increase in risk associated with PPIs matched the frequency of use: people who took the drugs daily had more than four times (4.55) the risk compared with those who took them weekly.
According to the researchers, this is “the first study to demonstrate that long-term PPI use, even after H. pylori eradication therapy, is still associated with an increased risk of gastric cancer.” “This finding provides strong evidence to suggest that the long-term use of PPIs still increase the risk of gastric cancer after H. pylori eradication.”