Moderate drinking is not safe during pregnancy

Even moderate drinking during the earliest months of pregnancy may be damaging, say researchers in Leeds.

Their study is the latest in a long debate over whether it is safe to drink at all during pregnancy.
The findings, published in the Journal of Epidemiology and Community Health, suggest the chances of premature birth increased.
The NHS recommends people avoid alcohol during pregnancy or when trying to conceive.
But says if people choose to drink, then they should not have more than two units of alcohol (about one pint) twice a week.
Heavy drinking in pregnancy is known to be damaging as it can affect the baby's development. But there is far more debate about drinking at the upper limit of the NHS guidelines.
Around seven in every 100 births in the UK is premature.
The study on 1,264 women in Leeds showed drinking more than the two units limit doubled the risk of premature birth, but even drinking at the limit increased the risk.
Camilla Nykjaer, one of the researchers at the University of Leeds, told the BBC: "This is a very sensitive issue, we don't want women who are pregnant now to panic, the individual risk is actually low.
"They shouldn't drink, they should stop drinking if they have been drinking during the pregnancy."

However, a study of more than 11,000 five-year-olds, conducted by University College London, showed drinking one or two units of alcohol a week during pregnancy did not raise the risk of developmental problems in the child.
Prof Yvonne Kelly who conducted that research told the BBC: "Heavy drinking is really very, very bad, but at low levels, in the work we've done we haven't found any negative effects in childhood.
"It's a massively charged area, getting the tone of this right is quite difficult.
"The guidelines are there, women are sentient beings and can choose - it's hugely politically charged all of this, I guess people will make their own judgements."
Dr Patrick O'Brien, a spokesperson for the Royal College of Obstetricians and Gynaecologists, said: "While the safest approach would be to choose not to drink at all, small amounts of alcohol, not more than one to two units once or twice a week, have not been shown to be harmful after 12 weeks of pregnancy.
"Pregnant women should always consult their midwives or doctors if they have any concerns about their alcohol intake."
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Serious Motorbike Accident Survival on Reconstruct 3D printed parts.

A survivor of a serious motorbike accident has had pioneering surgery to reconstruct his face using a series of 3D printed parts.

Stephen Power from Cardiff is thought to be one of the first trauma patients in the world to have 3D printing used at every stage of the procedure.
Doctors at Morriston Hospital, Swansea, had to break his cheekbones again before rebuilding his face.
Mr Power said the operation had been "life changing".
The UK has become one of the world's pioneers in using 3D technology in surgery, with advances also being made by teams in London and Newcastle.

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I can't remember the accident - I remember five minutes before and then waking up in the hospital a few months later”

Stephen Power

While printed implants have previously been used to help correct congenital conditions, this operation used custom printed models, guides, plates and implants to repair impact injuries months after they were sustained.

Despite wearing a crash helmet Mr Power, 29, suffered multiple trauma injuries in an accident in 2012, which left him in hospital for four months.
"I broke both cheek bones, top jaw, my nose and fractured my skull," he said.
"I can't remember the accident - I remember five minutes before and then waking up in the hospital a few months later."

Stephen Power was photographed before the operation, left, and afterwards, right

Two views of Stephen Power's skull after the operation with temporary staples

A skull model and implants produced using 3D printing

In order to try and restore the symmetry of his face, the surgical team used CT scans to create and print a symmetrical 3D model of Mr Power's skull, followed by cutting guides and plates printed to match.
Maxillofacial surgeon Adrian Sugar says the 3D printing took away the guesswork that can be problematic in reconstructive work.
"I think it's incomparable - the results are in a different league from anything we've done before," he said.
"What this does it allows us to be much more precise. Everybody now is starting to think in this way - guesswork is not good enough."
The procedure took eight hours to complete, with the team first having to re-fracture the cheek bones with the cutting guides before remodelling the face.
'Life changing' A medical-grade titanium implant, printed in Belgium, was then used to hold the bones in their new shape.
Looking at the results of the surgery, Mr Power says he feels transformed - with his face now much closer in shape to how it was before the accident.
"It is totally life changing," he said.
"I could see the difference straight away the day I woke up from the surgery."
Having used a hat and glasses to mask his injuries before the operation, Mr Power has said he already feels more confident.
"I'm hoping I won't have to disguise myself - I won't have to hide away," he said.

The procedure took eight hours to complete

"I'll be able to do day-to-day things, go and see people, walk in the street, even go to any public areas."
The project was the work of the Centre of Applied Reconstructive Technologies in Surgery (Cartis), which is a collaboration between the team in Swansea and scientists at Cardiff Metropolitan University.
Design engineer Sean Peel has said the latest advance should encourage greater use of 3D printing within the NHS.
"It tends to be used for individual really complicated cases as it stands - in quite a convoluted, long-winded design process," he said.
"The next victory will be to get this process and technique used more widely as the costs fall and as the design tools improve."
Mr Power's operation is currently being featured in an exhibition at the Science Museum in London, called 3D Printing: The Future.

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{Challenges} Side Effects of Metakelfin on skin colour

Normal skin color for Mr Hafidh Masokola

Skin Color for Mr Hafidh after genetic Mutation caused by Metakelfin

This was reported in Tanzania that Mr Halfidh Masokola who previously exposed to Metakelfin for Malaria treatment, he became albino from normal colour of his skin hence open more room for scientists geneticists to study more on side effects of  Metakelfin on gene mutations:

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This is how food allergies may results into eosinophilic esophagitis:

"Two to 4 years later, they come back with a different allergy," said Jonathan Spergel, MD, chief of the allergy section of The Children's Hospital of Philadelphia in Pennsylvania. "Initially, they are getting anaphylactic shock to this food. Now they are getting a swollen esophagus."
Dr. Spergel presented the study results here at the American Academy of Allergy, Asthma & Immunology 2014.
Eosinophilic esophagitis is characterized by the presence of a large number of white blood cells, called eosinophils, in the tissue of the esophagus, which causes inflammation or swelling. Symptoms include abdominal pain, difficulty swallowing, and vomiting. Swelling can become severe enough to cause food impaction.
Recent research has suggested that the mechanism of disease of eosinophilic esophagitis is independent of immunoglobulin E, a key mediator of typical food allergies.
To measure the frequency of food allergy in patients with eosinophilic esophagitis, Dr. Spergel and his team studied 1025 children treated for the condition.

Just because you now tolerate a food doesn't mean you're absolutely clear.

A specific food was identified as the culprit in 425 of those children. A food was considered to cause eosinophilic esophagitis if removing it from the diet stopped symptoms or if reintroducing it into the diet caused symptoms to reoccur.
For these 425 children, the most common triggers were milk, egg, wheat, and soy.
A total of 17 patients developed an eosinophilic esophagitis reaction to a food after they outgrew an allergy to that same food. Milk, egg, wheat, and soy were still the most common esophagitis triggers in this subgroup, and 94% of the patients had atopic disease.
The investigators noted that 2 children had normal biopsies of the esophagus when they had a food allergy. After they outgrew that food allergy, they developed an esophagitis reaction to the same food when that food was reintroduced into their diet.
This study focused on patients who naturally outgrew their food allergies, but about 10% to 15% of patients who undergo oral immunotherapy for their food allergies also develop esophagitis, noted Wesley Burks, MD, physician in chief at North Carolina Children's Hospital in Chapel Hill.
Clinicians should be aware of the symptoms of eosinophilic esophagitis in patients with a history of food allergies, said Dr. Spergel. "When patients outgrow milk or peanut allergies, you need to worry if they come back 2 or 6 months later with abdominal pains and flu-like symptoms. You need to go back and look at whether the food they couldn't eat a few years ago is causing these new symptoms."
"I think Dr. Spergel has a very good point that just because you now tolerate a food doesn't mean you're absolutely clear," said Hugh Sampson, MD, professor of pediatrics, allergy, and immunology at the Mount Sinai Hospital in New York City.
Dr. Sampson speculated that patients with typical food allergies might start out susceptible to esophagitis, but be unaware of the condition because they are avoiding the food.
Patients who outgrow their allergies to foods then develop esophagitis in reaction to these foods must once again avoid them, said Dr. Spergel.
The most common treatments for the condition are to swallow small doses of corticosteroids or to inhale corticosteroid asthma medications, he noted.
Dr. Spergel reported financial relationships with Dannone, DBV Technologies, and MEI Pharma. Dr. Burks has disclosed no relevant financial relationships. Dr. Sampson reports relationships with Dannone, ThermoFisher Scientific, Allertein Therapeutics, Regeneron, Novartis, and UpToDate, among others.
FROM:  American Academy of Allergy, Asthma & Immunology (AAAAI) 2014: Abstract 990. Presented March 2, 2014.

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Anesthesia and surgery increase the risk for dementia

A large population-based study conducted by investigators at the Neurological Institute in Taipei Veterans General Hospital, in Taipei City, Republic of China, showed that the risk of developing dementia nearly doubled within 3 to 7 years of anesthesia and surgery. In addition, the average time to dementia diagnosis was shorter in patients who had anesthesia and surgery compared with their counterparts who did not undergo these procedures.
The study adds to "growing concerns that anesthetic agents may have neurodegenerative complications," study investigator Jong-Ling Fuh, MD, of the Neurological Institute, told Medscape Medical News.
"In vitro and animal studies showed that inhaled anesthetic drugs can promote amyloid beta oligomerization and impair memory. However, it remains controversial whether anesthesia and surgery contribute to the development of dementia in human studies," she said.
"This population-based study provides statistically sound evidence for the association of dementia with anesthesia and surgery. Our findings support the view that patients who undergo anesthesia and surgery may be at increased risk of dementia."
"Although we do not know how to mitigate the risk of dementia after anesthesia and surgery at this point, physicians and surgeons should be more vigilant about the possible development of long-term cognitive decline postoperatively in patients who have undergone anesthesia and surgery," Dr. Fuh added.
The study was published in the March issue of the British Journal of Psychiatry.
Need for More Research
Using the Taiwan National Health Insurance Research Database, Dr. Fuh and colleagues extracted the records of 24,901 patients aged 50 years and older who underwent anesthesia for surgery between 2004 and 2007, and a control group of 110,972 randomly selected individuals matched for age and sex. They excluded anyone with a history of cancer, dementia, Parkinsonism, stroke, or brain operations.
During 3 to 7 years of follow-up, 661 patients in the anesthesia group (2.65%) and 1539 in the control group (1.39%) were diagnosed with dementia. Alzheimer's disease accounted for the majority of these cases.
Dementia occurred sooner in the anesthesia group (mean 907 days) than in the control group (mean, 1104 days; P < .0001).
After adjusting for hypertension, hyperlipidemia, depression, and Charlson index, patients who underwent anesthesia and surgery had an estimated 1.99-fold increased risk of developing dementia (95% confidence interval [CI], 1.81 - 2.17; P < .001). The risk for dementia after anesthesia was increased similarly in men and women.
The risk was greatest with regional anesthesia (adjusted hazard ratio [HR], 1.80; 95% CI, 1.57 - 2.07), followed by intravenous/intramuscular anesthesia (HR, 1.60; 95% CI, 1.11 - 2.30) and general anesthesia (HR, 1.46; 95% CI, 1.28 - 1.68).
Of the 8 types of surgery, 5 were associated with an increased risk for dementia (dermatologic, musculoskeletal, genitourinary, digestive, and eye surgery). Ear, nose, and throat (ENT), respiratory, and cardiovascular surgery was not associated with increased dementia risk.
Dr. Fuh said "caution must be exercised in asserting causality between development of dementia and anesthesia-associated neurotoxicity. More clinical studies are needed to investigate the association and causality between anesthesia with surgery and subsequent dementia."
Red Flags and Caveats
Commenting on the findings for Medscape Medical News, Roderic G. Eckenhoff, MD, professor and vice-chair of research, Department of Anesthesia and Critical Care, University of Pennsylvania in Philadelphia, who was not involved in the study, said that sometimes surgery is necessary, but in cases of elective surgery, patients may want to think twice.
However, he cautioned that the study has some "big red flags" and said this "is an area in need of further clarification."
"If it's surgery, is it the actual surgery, or the anesthesia, or is it the stress of being in the hospital? It's probably all those things combined, but it's probably the surgical procedure itself that causes the largest risk, at least that's what we believe," Dr. Eckenhoff said.
"This is a good additional study, and its real strength is its size," Dr. Eckenhoff said.
"Even when corrected for comorbidity, they found a significant effect of having had surgery in the past and risk for dementia. The level of risk is about consistent with some of the other studies performed," he noted.
What's "very concerning," he said, is that the demographics and comorbidity are "significantly different" in the surgery group and the control group, "although they did try to correct for that."
Still, "a big red flag and qualifier with this study is that the patients needing surgery are in fact different than the patients who don't need surgery. It may be those differences and not the fact that they had surgery itself that account for the difference in propensity for getting dementia," Dr. Eckenhoff said.
"I think in the end we are going to find that there are small populations of people that are more vulnerable to another insult like surgery and who go downhill more quickly afterwards. The challenge is to figure out who those people are, and that's going to require really good biomarkers," said Dr. Eckenhoff.
The study was supported by Taipei Veterans General Hospital and other noncommercial entities. The authors have disclosed no relevant financial relationships.
SOURCES: http://www.medscape.com/viewarticle/821770?src=rss

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4 Tips To Boost your Memory

Oscar Wilde once said, “Memory is the diary that we all carry about with us.” Well, what about those days when we’re lucky that our heads are attached to our bodies because we might forget those, too? There are many theories and schools of thought as to why we forget. Some have to do with genetics, others with age. However, this isn’t a dead end for developing a better memory. There are ways to help improve your memory. No, it doesn’t entail tying a string around your finger or writing on your forearm. Take a look below at four proven scientific ways for boosting your memory.

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Management of Drug Overdoses:

• Overdoses account for 15% of acute medical emergencies.
• 65% of drugs involved belong to the patient, a relative, or friend.
• 30% of self-poisonings involve multiple drugs.
• 50% of patients will have taken alcohol as well.
• The history may be unreliable. Question any witnesses or family about where a patient was found and any possible access to drugs. Examination may reveal clues as to the likely poison (e.g. pinpoint pupils with opiates) and signs of solvent or ethanol abuse and iv drug use should be noted

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