Wednesday, September 14, 2011

Women health - Urinary Tract Infection

Urinary Tract Infection is defined as a condition of is a bacterial infection of any part of the urinary tract. Women are at 10 times higher risk of develop the disease than men, according to the statistic and at least 50% of women will develop at least one urinary tract infection in their life time.

Symptoms
1. Pain and burning sensation in urination
2. Abnormal vaginal discharge
3. Abnormal pain
4. Blood in the urine
5. Strong smelling urine
6. Painful sexual intercourse
7. Nausea, vomiting
8. Frequent urge to urinate
9. Etc.

Causes and risk factors
1. Multiple sex partner
Women who are sexual active with multiple partners are at higher risk of urinary tract infection as a result of sexual transmitting disease and bacteria invasion, according to the study of 468 women using the University of Michigan Health Service because of urinary symptoms, completed questionnaires regarding medical history, stress, clothing, diet, sexual activity, and birth control method during the previous 4 weeks. 1484 potential Health Service controls without urinary symptoms were selected as well as 115 student-population -based controls, conducted by University of Michigan School of Public Health, posted in PubMed, researchers found that UTIs significantly increased with the frequency of sexual intercourse.

2. Diabetes and aging
According to the study of "Urinary tract infections" by Litza JA, Brill JR., posted in PubMed, researchers indicated that Urinary tract infection (UTI) is the most common urologic disorder and one of the most common conditions for which physicians are consulted. Patients at increased risk for UTI include women; diabetics; the immunocompromised; and those with anatomic abnormalities, impaired mobility, incontinence, advanced age, and instrumentation

3. Pregnancy
It is said the women who are pregnant are at the increased risk of urinary tract infection in the between of 6 to 26 weeks, but according to the study of "Managing urinary tract infections" by
Saadeh SA, Mattoo TK., posted in PubMed, researchers wrote that patients with acute pyelonephritis are at risk of renal scarring and subsequent complications such as hypertension, proteinuria with and without FSGS, pregnancy-related complications and even end-stage renal failure.

4. Bacterial infections
Bacteria is the main cause of all kinds of infection, including Urinary tract infection. In a study of "Urinary tract infections in women.Valiquette L, posted in PubMed, researcher indicated that
The predominant pathogen in both complicated and uncomplicated UTI remains pathogenic Escherichia coli, although Klebsiella sp. and Proteus appear with increased frequency in complicated UTI. Most often, bacteria cause UTIs by ascending means through the urethra into the bladder. Bacteria must possess virulence factors to cause UTI.

5. Contraceptive method
Believe or nor using contraceptive methods such as lubricated condom, a spermicidal cream or gel with an unlubricated condom increase the risk of urinary track infection by two-eightfolds in women. In a study of in a case-control study of sexually active college women ages 18-39 years. Cases (N = 144) were women with first urinary tract infection that was confirmed by culture recruited at the student health service, conducted by School of Public Health, University of Michigan, posted in PubMed, researchers found that using unlubricated condoms compared with using no birth control method strongly increased the risk of first urinary tract infection (odds ratio = 29.1; 95% confidence interval = 3.1-1,335). Using a lubricated condom (with or without spermicide in the lubricant) or a spermicidal cream or gel with an unlubricated condom was associated with two- to eightfold risk of first urinary tract infection. Unlubricated condom use was strongly associated with risk of first urinary tract infection, but this effect was largely neutralized by using a spermicidal cream or gel with the unlubricated condom or by using a lubricated condom.

6. Oral Contraceptions
Oral contraceptive method can cause hormone and glucose fluctuation that can lead urinary tract infection in some women. According to the study of In a cohort study, 200 women who chose DMPA for contraception were compared with 200 women who used the withdrawal method for urinary infection and urological symptoms after 3 months of consumption, conducted by Tarbiat Modarres University, posted in PubMed, researchers found that The rate of urinary infection and urological symptoms in the study group were higher than in the control group (p = 0.018, p < 0.0001, respectively). The most common microorganism that caused urinary infection was Escherichia coli. Among the 10 cases who suffered UTI in the case group, there were six women who had UTI in the previous pregnancy as well and concluded that We do not recommended administering depot-medroxyprogesterone acetate for contraception in women with a history of urinary tract infection in a previous pregnancy.

7. Tumors
Tumors and abnormal cell mass can cause UTs obstruction such as bladder and kidneys that can lead to urinary tract infection, in a study of "Occurrence of urinary tract infection in children with significant upper urinary tract obstruction" by Roth CC, Hubanks JM, Bright BC, Heinlen JE, Donovan BO, Kropp BP, Frimberger D., posted in PubMed, researchers found that Our results have demonstrated a low occurrence of UTI in antenatally diagnosed patients not maintained on antibiotics. We have concluded that antibiotic prophylaxis is unlikely to benefit most children with grade 3 or 4 hydronephrosis secondary to upper tract obstruction.

8. Medical history
Women who have a previous urinary tract infection are at higher risk to have it gain. According to the study of " Risk factors for urinary tract infection" by Remis RS, Gurwith MJ, Gurwith D, Hargrett-Bean NT, Layde PM., posted in PubMed, researchers wrote that the history of previous urinary tract infection was significantly greater in cases than in either of the control groups.

9. Weakened immune system
Immune system protect our body in fighting against the foreign invasion, including bacteria and virus. according to the study of " The innate immune response to uropathogenic Escherichia coli involves IL-17A in a murine model of urinary tract infection" by Sivick KE, Schaller MA, Smith SN, Mobley HL , posted by PubMed, researchers concluded that transcript expression of IL-17A in the bladders of infected mice correlated with a role in the innate immune response to UTI, and gammadelta cells seem to be a key source of IL-17A production. Although IL-17A seems to be dispensable for the generation of a protective response to uropathogenic E. coli, its importance in innate immunity is demonstrated by a defect in acute clearance of uropathogenic E. coli in IL-17A(-/-) mice. This clearance defect is likely a result of deficient cytokine and chemokine transcripts and impaired macrophage and neutrophil influx during infection. These results show that IL-17A is a key mediator for the innate immune response to UTIs.

10. Antibiotics
Antibiotics are used to treat bacteria infection can also suppress the immune system and cause mutation of the bacteria that can increase the risk of urinary tract and other infections. According to the study of 349 transplant recipients, 77% received induction therapy with low-dose rabbit antithymocyte globulin (rATG) and the others were treated with basiliximab. All patients received triple immunosuppression with tacrolimus, mycophenolic acid, and prednisone, conducted by Buffalo General Hospital, Buffalo, posted in PubMed, researchers found that Seven patients (2%) developed wound infections. Wound infections were more common in obese and older patients. All wound infections were superficial and responded well to wound drainage and outpatient antibiotic therapy. Six patients (1.7%) experienced a urinary tract infection (UTI) within the first postoperative month. UTIs were more common in the patient with ureteral stent compared to nonstented patients (11.4% vs 0.3%, P<.001). No patient or graft was lost due to perioperative bacterial infections (PBI).

11. Renal insufficiency
Reduced kidney function can increase the riak of urinary tract infection. According to the study of "The interaction of urinary tract infection and renal insufficiency" by Fünfstück R, Ott U, Naber KG., posted in PubMed, reasearchers found that Defence factors (Tamm-Horsfall protein, defensin, phagocytic activity of granulocytes) and underlying anatomical lesions as well as pre-existing renal disease determine the severity of UTI and the prognosis of renal insufficiency.

12. Etc.

Types of Urinary tract infection
Depending to the symptoms and location of organs affected, UTIs can be classified into the following
1. Infection of the bladder: cystitis
2. Infection of the Kidneys: pyelonephritis
3. Infection of Ureters: infection of the tubes that take urine from each kidney to the urinary bladder
4. Infection of Urethra: infection of the tube that empties urine from the bladder or urethritis

Diagnosis
If you are experience urinary tract infection, after recording the family history and carefully physical examination, test of urine sample may be the first that your doctor order to detect any presence of bacteria for any low risk of complications, depending to the symptoms. In order to prevnr nay contamination, sample of urine is taken in the midstream
1. Urinalysis
Urinalysis is also known as also known as R&M (Routine and Microscopy) performed by using urine test strips or light microscopy of urine samples to detect the cause of infection.
According to the study of`Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis`by Nicolle LE., posted in PubMed, researchers indicated that Urinary tract infections (UTIs) are the most common bacterial infections treated in the outpatient setting and range in severity from minimally symptomatic cystitis to severe septic shock in a wide array of patients. Diagnosis of uncomplicated cystitis can be inferred from history and physical, and confirmed by urinalysis

2. Urine Culture
If the urinalysis is negative, but the symptoms are indicated the UTIs, your doctor may order the test of Urine Culture. A urine culture is a test to identify bacteria that cause a urinary tract infection (UTI), depending to the presence and numbers of the bacteria. no bactreia growth in 24 or 48 hours is an indication of no infection.

3. Ultrasound
Ultrasound allows your doctor to visualize the Urinary Tract and around structures and obstructions of the flow of urine that cause the infection as well as looking for any abnormal cells growth mass, including tumor and cancer.

4. Voiding Cystourethrogram
Voiding Cystourethrogram is an X rays of the bladder and urethra with the injection of dye into the urethra and passed through the bladder to check for any abnormality of the bladder and urethra.

5. Intravenous pyelogram (IVP)
Intravenous pyelogram is a X ray of kidney, ureters and urinary bladder with the use of iodinated contrast material injected into veins to check for any obstruction in the urinary tract.

6. 6. In case of obstruction caused by tumor and cancer, further tests may be needed
a. CT Scan (computerized tomography)
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes. CT scan can only review the existence of cancer, but can not tell it is a primary or secondary cancer.

b. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the lung and surrounding areas.

7. Etc

Preventions
A. How to prevent
1. Void high amount of sugar
Process sugar can decrease the immune system by delaying the immune white blood cells's function for up to 5 hours. According to the quote of "Role of sugars in human neutrophilic phagocytosis" and posted in Dangers of Sugar Intake. Suppressing the immune system over prolonged period of time increases the risk of infection, including urinary tract infection.

2. Avoid excessive intake of Coffee
Can coffee promotes the risk of infection?, according to the study of in 15 men and women, showed that the responses to PHA and Con A were about one-third lower during coffee drinking compared to a period of abstinence from coffee (117335, 99856 and 181236, 153315, P less than 0.004, 0.009 respectively)., conducted by Department of Pediatrics, Rokach Hospital, posted in PubMed, researchers indicated that chemotaxis was higher in the coffee period at all concentrations. This exploratory study suggests that coffee intake modifies various measures of the immune function.

3. Avoid excessive intake of Caffeine
According to the article of How caffeine affects the immune system, posted in Caffeine addiction affect, the author wrote that The stimulating effects of caffeine are very much similar to body’s own response under stress and chronic stress weakens our immune system.

4. Avoid excessive alcohol drinking
Moderate alcohol consumption are beneficial to the immune system compared to alcohol abuse or abstinence, but excessive drinking can cause damage to the liver and can directly suppress a wide range of immune responses. According to the abstract of study of "Moderate alcohol consumption and the immune system: a review" by Romeo J, Wärnberg J, Nova E, Díaz LE, Gómez-Martinez S, Marcos A., posted in PubMed.

5. Don't hold it when you need to urinate
It is common sense, if you hold your urine, when you needs to, you can damage the auto response of the bladder muscles and increase the risk of bladder infection as urinary is also help to flush up the bacteria presented in your urinary tract.

6. Drinking equated amount of water
Water can help to flush out the bacteria presented any where in your urinary tract and dehydration, frequently, and incompletely empty the bladder increase the risk of urinary infection. According to the study of "Mild dehydration: a risk factor of urinary tract infection?" by Beetz R., posted in PubMed.

7. Shower instead of bath can be helpful
As the water goes down, it washes always the bacteria, instead holding them in the water.

8. Wipe your bottom front to back
It is avoid the bacteria from anus from entering the vaginal.

9. Douching
Douching increases the risk of irritation and can lead to urinary tract infection as a result of imbalance of good and bad bacteria as well as reducing the state of acidity to prevent bacteria and yeast invasion.

10. Avoid sexual transmitting diseases
By limiting numbers of sexual partners and known their medical history. No anal sex.

11. Etc.

B. Diet
Diet is important to enhance immune system in fighting against forming of free radicals and invasion of bacteria and virus.
1. Foods contain high amount of antioxidant scavenger
Vitamin A, C, E are classified as antioxidant can be found abundantly in fruits and vegetable. they not only promte the immune function in free radicals scavenging but also protect our body against infection and inflammation. For more information visit Antioxidants

2. Cranberry
According to the study of "Cranberry and urinary tract infections" by Guay DR , posted in PubMed, researcher indicated that the findings of the Cochrane Collaboration support the potential use of cranberry products in the prophylaxis of recurrent UTIs in young and middle-aged women. However, in light of the heterogeneity of clinical study designs and the lack of consensus regarding the dosage regimen and formulation to use, cranberry products cannot be recommended for the prophylaxis of recurrent UTIs at this time. For other health benefits of foods, visit 100+ Healthy Foods Classification

3. Probiotics
probiotics enhance the balance of good and bad bacteria in the digestive tract and other related organs such as vagina. According to the study of "Role of probiotics in urogenital healthcare" by Waigankar SS, Patel V., posted in PubMed, researchers found that the value of a probiotics cannot be taken at face value. Probiotics must not be considered a panacea for treating urogenital infections. However, the available data promises that it will be a strong option in improving and maintaining urogenital health.

4. Moderate alcohol consumption
In a study conducted by Department of Metabolism and Nutrition, Consejo Superior de Investigaciones Cientificas (CSIC), posted in PubMed, researchers wrote that moderate alcohol consumption seems to have a beneficial impact on the immune system compared to alcohol abuse or abstinence. Therefore, the link between alcohol consumption, immune response, as well as infectious and inflammatory processes remains not completely understood.

5. Water Consumption and UTIs
According to the study of "Mild dehydration: a risk factor of urinary tract infection?" by Beetz R., posted in PubMed., researchers found that the combination of the behaviourally determined aspects of host defence and not simply increasing fluid intake is important in therapy and prophylaxis of UTI.

6. Etc.

C. Nutritional supplements
1. Vitamin A, E, C, D
a. Vitamin A
Vitamin A occurs in the form retinol and is best known for its function in maintaining the health of cell membrane, hair, skin, bone, teeth and eyes. It also plays an important role as an antioxidant as it scavenges free radicals in the lining of the mouth and lungs; prevents its depletion in fighting the increased free radicals activity by radiation; boosts immune system in controlling of free radicals; prevents oxidation of LDL and enhances the productions of insulin pancreas.

b. Vitamin C
Vitamin C beside plays an important role in formation and maintenance of body tissues, it as an antioxidant and water soluble vitamin, vitamin C can be easily carry in blood, operate in much of the part of body. By restoring vitamin E, it helps to fight against forming of free radicals. By enhancing the immune system, it promotes against the microbial and viral and irregular cell growth causes of infection and inflammation.
Vitamin C also is a scavenger in inhibiting pollution cause of oxidation.

c. Vitamin E
Vitamin E is used to refer to a group of fat-soluble compounds that include both tocopherols and tocotrienols discovered by researchers Herbert Evans and Katherine Bishop. It beside is important in protecting muscle weakness, repair damage tissues, lower blood pressure and inducing blood clotting in healing wound, etc, it also is one of powerful antioxidant, by moving into the fatty medium to prevent lipid peroxidation, resulting in lessening the risk of chain reactions by curtailing them before they can starts.

d. Vitamin D
Reseacher found that vitamin D, a group of fat-soluble secosteroids is also a membrane antioxidant, with the ability to inhibit iron-dependent lipid peroxidation in liposomes compared to cholesterol.

2. Carotenoids
Carotenoids are organic pigments, occurring in the chloroplasts and chromoplasts of plants and some other photosynthetic organisms like algae, some bacteria.
a. Beta-carotene
Beta-Carotene, an organic compound and classified as a terpenoid, a strongly-coloured red-orange pigment in plants and fruits.
a.1. It is not toxic and stored in liver for the production of vitamin A that inhibits cancer cell in experiment. Beta-carotene also neutralize singlet oxygen before giving rise of free radicals which can damage of DNA, leading to improper cell DNA replication, causing cancers.
a.2. Cell communication
Researcher found that beta-carotene enhances the communication between cell can reduce the risk of cancer by making cells division more reliable.
a.3. Immune system
Beta-carotene promotes the immune system in identifying the foreign invasion such as virus and bacteria by increasing the quality of MHC2 protein in maintaining optimal function of white cells.
a.4. Polyunsaturated fat
Researchers found that beta-carotene also inhibits the oxidation of polyunsaturated fat and lipoprotein in the blood that reduce the risk of plaques build up onto the arterial walls, causing heart diseases and stroke.
a.5. There are more benefits of beta-carotene.

3. Flavonoids
Flavonoids also known as Vitamin P and citrin are a yellow pigments having a structure similar to that of flavones occurred in varies plants. it has been in human history for over thousands of years and discovered by A. S. Szent-Gyorgi in 1930. As he used vitamin C and flavonoids to heal the breakage of capillaries, which caused swelling and obstruction of blood flow. Most plants have more than one group or type act as predominate.
Flavonoids process a property as antioxidants. it helps to neutralize many of reactive oxygen species (ROS), including singlet oxygen, hydroxyl and superoxide radicals.
Although nitric oxide is considered a free radical produced by immune system to destroy bacteria and cancerous cells, but when it is over produced, it causes the production peroxynitrite which may attack protein, lipid and DNA, Flavonoids inhibit NO production of peroxynitrite due to reduction of enzyme expression.
a. Quercetin
Quercetin is a plant-derived flavonoid found in fruits, vegetables, leaves and grains and studies show that quercetin may have anti-inflammatory and antioxidant properties as a antioxidant, quercetin scavenges free radicals, which damage cell membranes, cause mutation of cells with tampering DNA.

b. Rutin
Rutin is a citrus flavonoid glycoside found in buckwheat and glycoside of the flavonoid quercetin. It inhibits platelet aggregation, decreases the capillary permeability, makes blood thinner and improves circulation. As an antioxidant, it can reduce the cytotoxicity of oxidized LDL cholesterol caused by free radical that lowers the risk of heart diseases.

c. Catechin
Catechin is a natural phenol antioxidant plant and natural anti-bacterial substance. Study showed catechin as good free radical scavenging power inhibits ROS production, thus it can be useful to the development of alimentary strategies to prevent OTA-induced cytotoxicity in human.

4. Copper
Copper, an essential trace element is essential for the absorption and utilization of iron and distributed widely in the body and occurs in liver, muscle and bone. Deficiency of copper can often cause the anemia-like symptoms. However, ingesting too much of it can lead to generator of free radicals that can damage DNA .
a. Antimicrobial and viral Copper enhances the immune function in fighting against foreign invasion, such as bacteria and virus, thus reducing the risk of infection and inflammation by utilizing the absorption of oxygen and production of energy within cells.

b. Antioxidant enzyme Superoxide dismutase (SOD)
Copper is vital for the making of antioxidant enzyme, superoxide dismutase, an important antioxidant defense in nearly all cells exposed to oxygen by protecting the cell membranes from free radicals. In fact, it outcompetes damaging reactions of superoxide, thus protecting the cell from superoxide toxicity. Research found in experiment, Mice lacking SOD1(Superoxide dismutase [Cu-Zn]) develop a wide range of pathologies, including hepatocellular carcinoma, an acceleration of age-related muscle mass loss,an earlier incidence of cataracts and a reduced lifespan. Mice lacking SOD3(Extracellular superoxide dismutase [Cu-Zn] ) do not show any obvious defects and exhibit a normal lifespan, though they are more sensitive to hyperoxic injury and mice lacking SOD2 (Superoxide dismutase 2, mitochondrial) die before birth. The above result enhances the importance of the presence of copper in improving life span and living health in human as well.

5. Glutathione (GSH)
Glutathione (GSH), a polypeptide of glycine, cysteine, and glutamic acid that occurs widely in plant and animal tissues beside is best known for its role in enhancing the immune system in protect our body from bacteria and virus, it also is an antioxidant that helps to prevent damage caused by oxidation of cellular components such as free radicals and peroxides by converting to its oxidized form glutathione disulfide (GSSG), leading to generation of antioxidant enzymes, glutathione peroxidases and peroxiredoxins of which reduces the risk of oxidative DNA damage and subsequently the individual’s risk of cancer susceptibility.

6. Manganese
Manganese is an essential trace nutrient in all forms of life. It is well known for its role in helping the body to maintain healthy skin and bone structure, but also acts as cofactors for a number of enzymes in higher organisms, where they are essential in detoxification of superoxide (O2−, with one unpaired electron) free radicals.
Although superoxide is biologically quite toxic and is deployed by the immune system to kill invading microorganisms by utilizing the enzyme NADPH oxidase. Any Mutations in the gene coding for the NADPH oxidase cause an immunodeficiency syndrome.

7. Selenium
Selenium , a trace mineral plays an important and indirect role as an antioxidant by fulfilling its function as a necessary constituent of glutathione peroxidase and in production of glutathione, that inhibits the damage caused by oxidation of free radical hydrogen peroxide, leading to aging effects.
a. Immune system
Selenium enhances the immune function that fighting off the attack of AID virus by promoting the function of interleukin 2 and T-cells.

b. Cancer
Study showed that levels pf selenium in blood test is associated with high rate of cancer, including skin cancer.

8. Etc.

Treatments
I. In conventional medicine
A. Uncomplicated Urinary tract infection
Uncomplicated urinary tract infection can be recovered quickly and is generally treated with Oral antibiotics, such as rimethoprim, cephalosporins. According to the study of "Uncomplicated urinary tract infection in adults including uncomplicated pyelonephritis" by Nicolle LE., posted in PuBMed, researchers indicated that Acute uncomplicated urinary tract infection and acute pyelonephritis are very common infections affecting many women throughout their lives. The determinants of infection have been well described and current strategies to prevent recurrent infections are highly effective. While antimicrobial management is straightforward for most episodes, the evolution of antimicrobial susceptibility of E. coli in community-acquired infection requires continuing re-evaluation of appropriate empiric therapy.
B. Pyelonephritis
Pyelonephritis can be a serious case of kidney infection and treated more aggressively than a simple bladder infection with either a longer course of oral antibiotics or intravenous antibiotics. IV antibiotics can be performed in hospital as outpatient.
According to the study of `Advances in non-surgical treatments for urinary tract infections in children`by Yang SS, Chiang IN, Lin CD, Chang SJ., posted in PubMed, researchers filed the result that he proposed non-surgical management of pediatric UTI included behavioral modification (timed voiding and adequate fluids intake), topical steroid for phimosis, nutrient supplements (breast milk, cranberry, probiotics, and vitamin A), biofeedback training for dysfunctional voiding, anticholinergics for reducing intravesical pressure, alpha-blockers in dysfunctional voiding and neurogenic bladder, and intermittent catheterization for children with large PVR.

C. In case of infection caused by kidney stones
1. Laser treatment (Lithotripsy)
Lithotripsy is medical producer of physical destruction of kidney stones into smaller parts so they can passed through the ureter and expelled in the urine with the use of laser under anesthesia, if possible, as not all patient are right candidate for the procedure due to locations and size of the kidney stone.

2. Surgical treatment
In case of kidney stone can not be treated by laser lithotripsy, surgery is another option. In the removal of kidney stone surgery, after an incision is made in the abdomen, the kidney is carefully cut, during the surgical procedure, ice is essential and used to keep the kidneys cool to prevent irritation, then the stone is removed and any blockage is corrected to make sure that the kidneys can begin to function properly, before the incision is stitched up. During the surgery and after the kidney completely heal, a catheter is inserted into the kidney to ensure that urine can pass out of the body.

D. In case of infection caused by tumor and cancer
1. In case of cancer found in the bladder, visit Bladder Cancer
2. in case of cancer found in the kidney, visit Kidney Cancer (Renal Cell Carcinoma)

II. Herbs
A. For urinary tract infection caused by tumor and cancer, visit
1. Bladder cancer
2. Kidney cancer
B. Other causes of urinary tract infection
1. Cranberry
Herbalist view cranberry as primary herbs for diuretic and in preventing and treating urinary tract infection by by inhibiting bacterial attachment to the urinary tract lining of the bladder and urethra, according to the article of "How Cranberry Juice Can Prevent Urinary Tract Infections" post in Science daily, writer wrote that Cranberry juice had no discernible effect on E. coli bacteria without fimbriae, suggesting that compounds in the juice may act directly on the molecular structure of the fimbriae themselves.

2. Bearberry
Bearberry also best known as Uva Ursi, has diuretic, astringent and antiseptic properties. and been used as tea in herbal medicine to treat urinary tract infection. In a study of "Natural approaches to prevention and treatment of infections of the lower urinary tract" by Head KA., posted in PubMed, researchers indicated that botanicals that can be effective at the first sign of an infection and for short-term prophylaxis include berberine and uva ursi. Estriol cream and vitamins A and C have also been shown to prevent UTIs, while potassium salts can alkalinize the urine and reduce dysuria.

3. Golden-seal
Gloden-seal is said contains antimicrobial properties of which can be used to treated urinary tract infection, according to the article of "Golden-seal" posted in University of Maryland Medical Center, the author wrote that It (Golden-seal root) is commonly used to treat several skin, eye, and mucous membrane inflammatory and infectious conditions (such as sinusitis, conjunctivitis, and urinary tract infections). It is also available in mouthwashes for sore throats and canker sores.

4. Aloe Vera
Aloe Vera contains high amount of mannose which can be used to prevent and treat urinary tract infection according to the study of "Intervening with urinary tract infections using anti-adhesives based on the crystal structure of the FimH-oligomannose-3 complex" by
Wellens A, Garofalo C, Nguyen H, Van Gerven N, Slättegård R, Hernalsteens JP, Wyns L, Oscarson S, De Greve H, Hultgren S, Bouckaert J., posted in PubMed, researchers indicated that
The potential of ligand-based design of antagonists of urinary tract infections is ruled by the structural mimicry of natural epitopes and extends into blocking of bacterial invasion, intracellular growth and capacity to fluxing and of recurrence of the infection.

5.
Bilberry
Bilberry is best known in herbal medicine in treating eye related diseases, it laso contain high amount of antioxidants which not promote immune system in fighting against forming of free radicals and guarding our body against foreign invasion such as bacteria and virus. In a study of "Bioactive compounds from northern plants' by Hohtola A., posted in PubMed, researcher wrote that Bilberry (Vaccinium myrtillus) is a characteristic field layer species in boreal forests. Bilberry and other northern Vaccinium species, berries and leaves, contain high amounts of phenolic compounds. Bilberries are known for its exceptionally high amounts of anthocyanins with powerful antioxidant capacity.

6. Green tea
According to the study of "Selective microbiologic effects of tea extract on certain antibiotics against Escherichia coli in vitro" by Neyestani TR, Khalaji N, Gharavi A., posted in PubMed, researchers found that the microbiologic effects of both black tea and green tea extracts on certain antibiotics against E. coli may vary, depending on the type of the tea extract (i.e., black vs. green), the amount of the extract, and the antibiotic being used.

7. Etc.

III. Traditional Chinese medicine
A. For urinary tract infection caused by tumor and cancer, vist
1. Bladder cancer in TCM Perspective
2. Kidney (Renal) cancer

B. Other cause of urinary tract infection
B.1. Traditional Chinese medicine view urinary tract infection as a result of the of damp heat accumulation that lead to symptoms of
a frequent urination, burning sensation, painful duirng sexual intercourse; cloudy or yellow-milky urine, etc.
1. Long dan cao (Gentian)
Besides it is used to treat liver heat caused by dampness accumulation due to spleen' inability in materials absorption, It also enhances the liver and the gallbladder function in draining damp heat in the body through kidney urinary secretion.

2. Huang qin (Scullcap)
Huang qin is important to enhance the lung function by moistening the qi, thus reducing the risk of fever, irritability, thirst, cough. It also improves the stomach function in absorbing vital vitamins and minerals by clearing the heat caused extreme dampness that causes diarrhea and thirst with no desire to drink.

3. Zhi zi (Gardenia)
It improves the circulatory function by clearing the liver heat due to constrained liver and heat caused by infection or inflammation as a result of fluids accumulated in body for a prolong period of time.

4. Mu tong (Akebia)
Mu tong besides increases the kidney in clearing dampness through urinary secretion, it also enhances the blood function by draining the blood heat caused by blood stagnation.

5. Che qian cao (Plaintain root)
Che qian cao has a vital function by eliminating the toxin accumulated in the body and promoting damp heat expelling through urinary secretion.

6. Chai hu (Buplerum)
Chai hu enhances the spleen and stomach in qi and materials digestion, thereby reducing damp heat in the abdominal region caused by liver blood stagnation, resulting in lessening the menstrual cramps and pain and pain caused lung qi stagnation due to spleen abnormal function in qi transportation.

7. Gan cao (licorice root)
Gan cao reduces damp heat accumulated in the body in many different ways
a) It moistens the lung, thus reducing the lung dryness causing symptoms of coughing and promoting the smooth qi movement.
b) It reduces the heat caused by toxins in the body by eliminating them through urinary secretion.
c) It enhances the heart in regulating the movement of blood by strengthening the blood that stop the irregular pulse.
d) It increases the liver function in regulating the abdominal muscles, thus reducing the menstrual cramps and pain.

B.2. Spleen and kidney deficiency
Spleen is considered as the prenatal organ in traditional Chinese medicine. It means what you have is what you get. depletion of kidney Jing can have a serious effect in your health. Spleen is the organ responsible for distribution of Qi and nutrition to the body organ, including kidney and lung. Deficiency of kidney and spleen may result in the symptoms of urinary tract infection, including
dribbling urination; frequent urination during the night; dull pain during urination; sporadic urination, recurrence of infection, lower back pain, etc.
1. Wu Bi Shan Yao Wan (Incomparable Dioscorea Pill)
The pill has been been used in TCM to treat urinary tract infection by nourishing the Yin enhancing the Yang and the Qi and Strengthens the Kidneys. It is one of the patent formula in a collection of 355 efficient valuable and most famous prescriptions among Chinese patent drugs. according to Chinese Patent Medicines (English Edition) Editor-in-Chief: Chen Keji, MD. Editors: Chen Kai MD, Zhang Qunhao MD, Wang Wei MD, Lin Yuxiong MD, Hsia I-Szu Ph.D. Published by Hunan Science & Technology Press, 1997
2. Ingredients
a. Shan Yao
Main uses; Tonifies Qi Kidney Yin and Spleen,nourishes the Stomach Yin.
b. Rou Cong Rong
Main uses; Tonifies the Kidneys, strengthens the Yang, benefits Kidney Jing and bone marrow
c. Wu Wei Zi
main uses; Tonifies the Kidneys, benefits Jing
d. Du Zhong
Main sues; Tonifies Yang, Kidneys and Liver
e. Niu Xi
main uses; Invigorates the Blood, nourishes the Liver and Kidney Yin
f. Sheng Di Huang
Main uses; Clears Heat, cools Blood, nourishes Yin and generates fluids
g. Ze Xie
Mian uses; Promotes urination, drains Kidney Fire and Dampness
h. Shan Zhu Yu
Main uses; Tonifies Liver and Kidney Yin, benefits Kidney Yang
k. Ba Ji Tian
Main sues; Tonifies Kidneys and strengthens Yang.
l. Chi Shi Zhi
Mian uses; Enhances the Intestines functions and stops diarrhea.
m. Tu Si Zi
main uses; Tonifies the Kidneys and Spleen, strengthens Yang, enhances Yin
n. Fu Shen
Main uses; Nourishes the Heart and calms the Shen

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Women's Health - Hormone Estrogen

Estrogen is a female sex hormone is defined as a group of compounds for its function in regulating in the estrous cycle of women after puberty.

A. Reproductive Organs
1. Promote female reproductive system
Estrogen promotes female reproductive system beginning in the puberty by increasing pulsatile secretion of the hypothalamic gonadotropin releasing hormone (GnRH), which stimulates the release of gonadotropins and in turn gonadal activity, leading to the growth of breasts and other female characteristics. In a study of "Inducing puberty" by Delemarre EM, Felius B, Delemarre-van de Waal HA., posted in PubMed, researchers indicated that sex steroids will induce development of the secondary sex characteristics alone, while combined administration of gonadotropins and GnRH may induce gonadal development including fertility.

2. Accelerate metabolism
Estrogen enhances metabolism to allow the body of the women to grow, reproduce, maintain the structures and survival of the human species, adapt to the change of environments to sustain living, etc.. According to the study of "Differential roles of estrogen receptors α and β in control of B-cell maturation and selection" by Hill L, Jeganathan V, Chinnasamy P, Grimaldi C, Diamond B., posted in PubMed, researchers found that engagement of either estrogen receptor α or β can alter B-cell maturation, but only engagement of estrogen receptor α is a trigger for autoimmunity. Thus, maturation and selection are regulated differentially by estrogen. These observations have therapeutic implications.

3. Muscle mass, Abnormal fat distribution
According to the study of 64-week prospective cohort trial evaluated the effects of 20-mg oestradiol implants, replaced every 4 months, in healthy postmenopausal women aged 45-65 years. Of 20 implant and 14 control subjects who remained in the trial at 32 weeks, 13 implant and seven controls continued to 64 weeks, conducted by University of Sydney Royal North Shore Hospital, posted in PubMed, researchers concluded that The abdominal fat-to-lean soft tissue ratio decreased by 18% in implant subjects ( p<0.001), but did not change in controls ( p<0.05 implants versus controls). Neither group displayed significant changes in weight, fat or appendicular skeletal muscle mass. The 32-week data were consistent with these results. Hence, oestradiol implant therapy can reduce abdominal adiposity and could lower the risk of obesity-related metabolic disorders.

4. Increase bone density
Deficiency or reduced estrogen levels in post menopause women can lead to bone density loss.
According to the study of "A protective effect of Curcuma comosa Roxb. on bone loss in estrogen deficient mice" by Weerachayaphorn J, Chuncharunee A, Mahagita C, Lewchalermwongse B, Suksamrarn A, Piyachaturawat P., posted in PubMed, researchers suugested that suggest that C. comosa prevents bone loss induced by estrogen deficiency. Therefore, C. comosa would be a potential alternative treatment for prevention of postmenopausal osteoporosis.

5. Endometrial growth
Women's endomyrium undergoes certain change after puberty to adapt to the estrous cycle and pregnancy. According to the study conducted by Research laboratory at Kansai Medical University of 16 patients undergoing hysterectomy for benign reasons, in vitro, posted in PubMed, researchers found that the E(2) or OHT stimulates VEGF production and concurrently attenuates sVEGFR-1 production in ESCs. This consequential increase in VEGF:sVEGFR-1 ratio might enhance the biological effects of VEGF on the angiogenic environment in human endometrium.

6. Uterine growth
In the stage of estrous cycle, women uterus undergoes marked morphological, physiological and functional changes as a result of the levels of estrogen produced by the body. According to the study of "Characterisation of mouse interferon-induced transmembrane protein-1 gene expression in the mouse uterus during the oestrous cycle and pregnancy" by Park HJ, Kuk IS, Kim JH, Kim JH, Song SJ, Choi BC, Kim B, Kim NH, Song H., posted in PubMed, researchers concluded that Expression of Ifitm1 mRNA was higher in response to PMSG than other hormones investigated. These results suggest that Ifitm1 may be involved in uteri physiology, although the mechanisms involved in the regulation of this gene expression and function in the uterus remain unknown.

7. Vaginal lubrication
Vaginal lubrication is one of characteristic of hormone estrogen for women in per-manopause stage to moistens the vagina and to protect it especial during sexual intercourse. Insufficient lubrication or vaginal dryness in women can cause painful sexual intercourse disorder. According to the sudy of "Treatment options for female sexual arousal disorder: part II" by Feldhaus-Dahir M., posted in PubMed, researcher wrote that Female sexual arousal disorder (FSAD) occurs when a woman experiences distress due to the inability to attain or maintain adequate vaginal lubrication. Many treatments are still under investigation, and at this time, there are no FDA-approved medications available for the treatment of FSAD. Treatment options include "off-label" medications, vaginal estrogen, compounded preparations, and over-the-counter products.

8. Thicken the vaginal wall
As a result of level of estrogen, the vaginal wall is thickened to provide favorable condition for conception by moisturizing the vaginal and protecting the vaginal during sexual intercourse, In a study of The study included 89 patients undergoing vaginal surgery for urogynecological conditions, conducted by Mainz University Hospital, Dept. of Obstetrics and Gynecology,posted in PubMed, researchers found that menopausal women showed a higher amount of PR expression in vaginal tissue than premenopausal women. Women with no endocrine treatment showed a lower amount of ER β expression in vaginal tissue.

9. Etc.

B. Maintenance of vessels and skin
It is easy to understand that estrogen maintain the healthy and vessels and skin for pre-menopause women, as ageing is considered as a progressive reduction in function and reserve capacity of skin and vessel tissue. According to the study of "The effect of menopause on the skin and other connective tissues", by Calleja-Agius J, Brincat M., posted in PubMed, researchers wrote that oestrogen has profound effects on connective tissue turnover, no matter the site. It has been shown that menopause has similar effects on the connective tissue of the carotid artery media, intervertebral discs and bones.

C. Protein synthesis
Protein is also known as polypeptides, they are are organic compounds made of amino acids and can be found in meat, beans, milk, eggs or any source of food which provides our body the raw materials to build its own protein. Since our body can not store protein, we require to take them regularly. Researchers found that intake of plant base protein is more healthy than animal base protein, because it helps to prevent high blood pressure, reduce cholesterol, heart diseases and strokes, if taking together with complex carbohydrate.

Protein synthesis is defined as a complicate process of cells building or manufacturing proteins. You can view the step of protein synthesis from this link. According to the study of "Estrogen stimulates postsynaptic density-95 rapid protein synthesis via the Akt/protein kinase B pathway" by Akama KT, McEwen BS., posted in PubMed, researchers found that These results demonstrate an essential role for Akt in estrogen-stimulated dendritic spine protein expression, describe for the first time a signal transduction pathway in PSD-95 expression, and delineate a novel, molecular mechanism by which ovarian hormones might translationally regulate synaptogenesis via activating protein synthesis for dendritic function.

D. Coagulation
Coagulation is defined as a complicate process of forming blood clots to reduce the risk of bleeding that can cause blood vessels damage and health of the patient. In a study of in 27 postmenopausal women at baseline and after 2 and 12 weeks of treatment. Oral and transdermal estradiol induced similar increases in serum free estradiol concentrations in measuring the measures of coagulation, fibrinolysis, inflammation and serum lipids and lipoproteins, conducted by University of Helsinki, Finland, posted in PubMed, researchers found that oral estradiol increased markers of fibrinolytic activity, decreased serum soluble E-selectin levels and induced potentially antiatherogenic changes in lipids and lipoproteins. In contrast to these beneficial effects, oral estradiol changed markers of coagulation towards hypercoagulability, and increased serum CRP concentrations.

E. Lipid
Lipid is defined as fat in the blood, including HDL(high density lipoproteins), triglyceride, LDL(low density lipoproteins), etc. levels of estrogen really affect the levels of fat in the blood as one can easily see through the levels of estrogen and lipid in a woman menstrual cycle. According to the study of "Variations in lipid levels according to menstrual cycle phase: clinical implications. Mumford SL, Dasharathy S, Pollack AZ, Schisterman EF., posted in PubMed, researchers wrote that Overall, lipoprotein cholesterol levels were observed to vary in response to changing estrogen levels. Taken together, the evidence suggests that total cholesterol and LDL-C tend to be highest during the follicular phase and to decline during the luteal phase, with HDL C highest around ovulation. Based on these findings, the menstrual cycle phase should be taken into account when evaluating lipoprotein cholesterol levels among reproductive-aged women. Measuring cholesterol levels during menses is recommended for consistent comparisons as this phase can be more reliably identified than other phases, although women within National Cholesterol Education Program acceptable ranges, but near the boundaries when tested during menses, should undergo additional tests.

F. Fluid balancing
Estrogen plays an important role in balancing the fluid in the body. According to the study of "Estrogen and the central control of body fluid balance" by Curtis KS., posted in PubMed, researchers indicated that Taken together, the body of evidence amassed from more than 40 years of investigations suggests that the central actions of estrogen influence body fluid regulation and, more specifically, compensatory responses to perturbations of osmotic or volume balance in two interrelated ways.

G. Estrogen and Cortisol
Cortisol is a glucocorticoid produced by the adrenal gland. It is one the hormone that work together with melatonin to regulate the pattern of sleep and awake. Estrogenhas a very close relationshion ship with the increase of levels of cortisol in the reproductive years. According to the stdy of "Cortisol, Estradiol-17{beta} and Progesterone Secretion within the First Hour after Awakening in Women with Regular Menstrual Cycles" by Ahn RS, Choi JH, Choi BC, Kim JH, Lee SH, Sung SS., posted in PubMed, researchers found that The areas under curves showing the E2 and P4 levels from the time immediately after awakening to 60 min after awakening (i.e., E2auc and P4auc) in women with regular menstrual cycles were greater than those in postmenopausal women.

H. Estrogen and Sex Hormone Binding Globulin
SHBG is a glycoprotein, produced by the liver to bind to sex hormones testosterone and estradiol. In an abstract of the study of "The ability of hydroxylated estrogens (2-OH-E2 and 4-OH-E2) to increase of SHBG gene, protein expression and intracellular levels in MCF-7 cells line" by Gregoraszczuk EL, Ptak A, Wrobel A., posted in PubMed, researchers filed the result that 4-OH-E2 in high doses and 2-OH-E2 in the highest dose, while 17β-estradiol in all doses used increased intracellular but not extracellular SHBG levels. Both metabolites increased SHBG mRNA expression, the rank order of potency being E2 > 4-OH-E2 > 2-OH-E2. Both E2 and its metabolites increased SHBG protein expression.

I. Gastrointestinal tract
Gastrointestinal tract forms a part of digestive system and refers to the stomach and intestine or digestive system of all the structures from the mouth to the anus. According to the researcher of the study of "Estrogen, progesterone and the gastrointestinal tract" by Eliakim R, Abulafia O, Sherer DM., posted in PubMed, researchers indicated that This review provides an abundance of data supporting that estrogen and progesterone have both beneficial and detrimental effects on the esophagus, stomach, gallbladder, and small and large intestine.

J. Melanin
Melanin is a is a pigment that gives the human skin and hair color. It is easlily to understand the relattionship of estrogen and melanin, as thw women age, the reduction of levels of estrogen cause the hair color to turn gray. According to the study of Estrogen increases hair pigmentation in female recessive yellow mice" by Hirobe T, Kiuchi M, Wakamatsu K, Ito S., posted in PubMed, researchers concluded that suggest that estrogen is the main factor in determining the higher content of eumelanin and pheomelanin in female hair of Mc1r(e)/Mc1r(e) mice.

K. Estrogen and the Lung
Believe it or not, estrogen plays an important role in protect the women lung against diseases. According to the study of Estrogen Rescues Pre-existing Severe Pulmonary Hypertension in Rats" by Umar S, Iorga A, Matori H, Nadadur RD, Li J, Maltese F, van der Laarse A, Eghbali M., posted in PubMed, researchers concluded that estrogen rescues pre-existing severe PH in rats by restoring lung and RV structure and function that is maintained even after removal of estrogen. Estrogen-induced rescue of PH is associated with stimulation of cardiopulmonary neoangiogenesis, suppression of inflammation, fibrosis and RV-hypertrophy. Furthermore, estrogen-rescue is likely mediated through estrogen receptor-b.

L. Estrogen and Fetal development
Believe or not, estrogen Estrogen turns play a central role in maintaining pregnancy and fetal development In the abstract of the study of "Estrogen regulation of placental angiogenesis and fetal ovarian development during primate pregnancy" by Albrecht ED, Pepe GJ., posted in PubMed, researchers wrote that this review will describe the developmental processes required for placental vascularization and fetal follicular maturation and recent studies which show that estrogen has an important role in regulating these events.

M. Etc.


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Women' health: Obesity and Neural Tube Birth Defects

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Neural Tube Birth Defects
is a type of birth defect and defined as a medical condition of the spinal cord or brain that occurs very early in the development stage of the fetus, including spina bifida (the spinal cord and spine does not close properly) and anencephaly (much of the brain does not develop). Approximately, according to the statistic of the Public Health Agency of Canada, the birth prevalence of NTDs in Canada has been declining gradually. In 1989, the rate was 1.1 per 1,000 total births compared with 0.77 per 1,000 total births in 1996.

D. How Obesity associates with Neural Tube Birth Defects
1. In a study of 64 SNPs in 34 genes for association with spina bifida in up to 558 case families (520 cases, 507 mothers, 457 fathers) and 994 controls in Ireland of " Evaluation of 64 candidate single nucleotide polymorphisms as risk factors for neural tube defects in a large Irish study population" by Carter TC, Pangilinan F, Troendle JF, Molloy AM, VanderMeer J, Mitchell A, Kirke PN, Conley MR, Shane B, Scott JM, Brody LC, Mills JL., conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, posted in PubMed, researchers found that The associations between LEPR SNPs and spina bifida suggest a possible mechanism for the finding that obesity is a NTD risk factor. The association between a variant in COMT and spina bifida implicates methylation and epigenetics in NTDs.

2. According to the study of "Prepregnancy obesity: a complex risk factor for selected birth defects" by Carmichael SL, Rasmussen SA, Shaw GM, posted in PubMed, researchers indicated that This article briefly reviews existing literature on the association between maternal obesity and birth defects, discusses potential underlying mechanisms, and suggests research needed to improve our understanding of this important association.

3. In a study conducted by the National Birth Defects Prevention Study who had index pregnancies between October 1, 1997, and December 31, 2002 with an aim to To describe the relation between maternal obesity, overweight and underweight status, and 16 categories of structural birth defects, Posted in PubMed, researchers filed the result that Mothers of offspring with spina bifida, heart defects, anorectal atresia, hypospadias, limb reduction defects, diaphragmatic hernia, and omphalocele were significantly more likely to be obese than mothers of controls, with odds ratios ranging between 1.33 and 2.10. Mothers of offspring with gastroschisis were significantly less likely to be obese than mothers of controls.

4. According to the abstract of the study of "Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta-analysis" by Stothard KJ, Tennant PW, Bell R, Rankin J., posted in PubMed, researchers filed the result that Pooled ORs for overweight and obesity were calculated for 16 and 15 anomaly groups or subtypes, respectively. Compared with mothers of recommended BMI, obese mothers were at increased odds of pregnancies affected by neural tube defects (OR, 1.87; 95% confidence interval [CI], 1.62-2.15), spina bifida (OR, 2.24; 95% CI, 1.86-2.69), cardiovascular anomalies (OR, 1.30; 95% CI, 1.12-1.51), septal anomalies (OR, 1.20; 95% CI, 1.09-1.31), cleft palate (OR, 1.23; 95% CI, 1.03-1.47), cleft lip and palate (OR, 1.20; 95% CI, 1.03-1.40), anorectal atresia (OR, 1.48; 95% CI, 1.12-1.97), hydrocephaly (OR, 1.68; 95% CI, 1.19-2.36), and limb reduction anomalies (OR, 1.34; 95% CI, 1.03-1.73). The risk of gastroschisis among obese mothers was significantly reduced (OR, 0.17; 95% CI, 0.10-0.30).

5. In a case-control study of fetuses and liveborn infants among California births, July 1999 and June 2004. Of those eligible, 80% of case mothers (n = 659) and 77% of control mothers (n = 700) were interviewed. Cases were 147 infants with anencephaly, 191 with spina bifida, 142 with d-transposition of great arteries, and 181 with tetralogy of Fallot. Maternal body mass index (BMI) was based on prepregnant weight and height, conducted by the Children's Hospital Oakland Research Institute, posted in PubMed, researchers indicated in the result that the odds ratios of birth defects with obesity (BMI > or =30 relative to normal BMI) were 1.6 for anencephaly (95% confidence intervals = 1.0-2.6); 1.4 for spina bifida (0.8-2.2); 0.7 for d-transposition of great arteries (0.4-1.4); and 0.8 for tetralogy of Fallot (0.4-1.4). Modestly elevated odds ratios were observed with obesity among women who reported weight gain in their waist before pregnancy-for anencephaly, 2.4 (1.2-5.1) and for spina bifida, 1.8 (0.9-3.6)

6. In a study of 499 mothers of offspring with neural tube defects, 337 mothers of offspring with other major birth defects, and 534 mothers of offspring without birth defects, conducted by California Department of Health Services, posted in PubMed, researchers concluded that our data suggest that offspring of obese women (but not underweight women) are at an increased risk of neural tube defects and several other malformations.

7. Etc.

E. Treatment of Obesity and Neural Tube Birth Defects
1. According to the study of "Risks and management of obesity in pregnancy: current controversies" by Wax JR., posted in PubMed, researchers found that Limiting maternal weight gain in obese women to less than 15 lb may favorably attenuate perinatal risk (macrosomia, cesarean delivery, preeclampsia) but increase risk for small-for-gestational-age newborns. Obese women are at significantly increased risk for offspring to develop open neural tube defects and congenital heart disease as well as other anomalies and concluded that obesity and its surgical treatment are associated with lifelong health implications for the mother as well as her offspring. An appreciation of these obesity-related reproductive issues is critical for optimal care of this growing segment of the female population.

2. In a study of "Maternal obesity and risk of neural tube defects" by Koren G., posted in PubMed, researchers found that Experience with olanzapine is relatively slight, but available prospective data do not show increased teratogenic risk. Adiposity, on the other hand, is associated with increased risk of neural tube defects. Only some of this risk can be reduced by folate supplementation.

3. Etc.

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Women' health: Obesity and Policystc Ovary Syndrome (PCOs)

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Policystc Ovary Syndrome (PCOs) is defined as endocrinologic diseases caused by undeveloped follicles clumping on the ovaries that interferes with the function of the normal ovaries as resulting of enlarged ovaries, leading to hormone imbalance( excessive androgen), resulting in male pattern hair development, acne,irregular period or absence of period, weight gain and effecting fertility. It effects over 5% of women population or 1 in 20 women.

D. How Obesity associates with Policystc Ovary Syndrome (PCOs)
1. In a study of 453 women who fulfilled diagnostic criteria for PCOS were classified by age into two groups: Group A (20-29 years old, n= 294) and Group B (30-40 years old, n= 159). Group A had significantly higher total testosterone levels than Group B. Group B had higher fasting insulin and glucose levels, triglycerides, body mass index and waist measurements and a higher incidence of obesity than Group A, conducted by Taipei Medical University, posted in PubMed, researchers found that increased age is accompanied by a decrease in the prevalence of both clinical and biochemical hyperandrogenism in women. Hyperandrogenism is the important factor for young women with PCOS; however, abdominal obesity and certain metabolic disturbances became major concerns for older women with PCOS.

2. In a study of "[Exploration of the classification of polycystic ovarian syndrome]" [Article in Chinese], by Lin JF, Li X, Zhu MW., posted in PubMed, researchers filed the conclusion that The classification according to the revised 2003 consensus on diagnosis reflects the basic characteristics of PCOS; while the classification based on obesity shows the severity of hyperandrogenism and degree of IR, and thus has substantial significance for evaluation of metabolic complications.

3. According to the study of "Common Genetic Aspects between Polycystic Ovary Syndrome and Diabetes Mellitus" by Mendoza N., posted in PubMed, researchers found that So, the interest of the diagnosis of the PCOS is, not only improve fertility but to prevent possible future medical complications like the diabetes mellitus and the obesity. Due to the classical definition of PCOS as functional hyperandrogenism, the race to discover genetic alterations that could lead to the development of PCOS started with the androgen metabolism genes. However, the list of candidates was later expanded to other genes outside this hormonal pathway, and it now includes genes involved in carbohydrate and lipid metabolism as well as those involved in inflammatory processes.

4. In the study of "Homocysteine metabolism in polycystic ovary syndrome" by Grodnitskaya EE, Kurtser MA., posted in PubMed, researchers wrote that women with PCOS are more likely to develop components of the metabolic syndrome such as disturbances of carbohydrate metabolism, obesity, hypertension and dyslipidemia, which in turn are risk factors for cardiovascular disease. A number of studies confirmed the presence of increased serum homocysteine concentration in PCOS patients and the possible determinants of this observation are still debated. PCOS treatment options can influence homocysteine levels.

5. According to the study of 136 adolescent girls from a cohort of 301 girls between 15 and 17 years of age with confirmed menstrual irregularity, with or without ultrasound diagnosed polycystic ovaries, were assessed in detail after a gap of 2 years, conducted by Child Development Centre, Medical College, Thiruvananthapuram, posted in PubMed, showed that The results of this study support screening for menstrual irregularity, obesity and signs of clinical hyperandrogenism for early diagnosis of PCOS in an effort to improve the reproductive health of adolescent girls.

6. Etc.

E. treatments of Obesity and Policystc Ovary Syndrome (PCOs)
1. According to the study of "Current approaches to the diagnosis and treatment of polycystic ovarian syndrome in youth" by Harwood K, Vuguin P, DiMartino-Nardi J., posted in PubMed, researchers indicated that Antiandrogens are usually required for a substantial improvement in hirsutism score. Insulin sensitizers such as metformin are a new class of drugs utilized in treatment of PCOS. By improving insulin sensitivity and decreasing insulin levels, they improve the unfavorable metabolic profile of patients with PCOS. Metformin also helps to increase SHBG, decrease androgen levels and induce ovulation. Despite all the available medications, life-style changes are the mainstay of therapy as weight loss and exercise improve all parameters of PCOS without the potential side effects of medication.

2. In the study of "Polycystic ovary syndrome" by Goudas VT, Dumesic DA., posted in PubMed, researchers wrote that . A careful history and physical examination guide the extent of diagnostic testing. Slowly progressive hirsutism with anovulation of peripubertal onset usually reflects hyperandrogenic anovulation. This type of clinical presentation requires an evaluation to rule out other endocrinopathies (e.g., virilizing tumors, adult-onset CAH, hyperprolactinemia, and Cushing's syndrome). Virilization or severe rapidly progressive hirsutism requires immediate investigation to rule out a possible virilizing tumor. The ultimate goals of therapy for hyperandrogenic anovulatory women are to normalize the endometrium, antagonize androgen action at target tissues, reduce insulin resistance, and correct anovulation, if necessary.

3. In the abstract of study conducted by The University of Chicago Pritzker School of Medicine with the title of "What every physician should know about polycystic ovary syndrome", posted in PubMed, researcher concluded that Ultrasonography helps in the differential diagnosis and may demonstrate the polycystic ovaries that have recently been vetted as an alternative to oligo-anovulation as a diagnostic criterion. Management of PCOS is determined by symptomatology. For those women not desiring pregnancy, the most common therapies are oral contraceptive pills, antiandrogens (contraindicated in the absence of adequate contraception), and insulin-lowering treatments (which have little effect on hirsutism).

4. According to the study of "Polycystic ovary syndrome" by Goudas VT, Dumesic DA., posted in PubMed, researshers indicated that Virilization or severe rapidly progressive hirsutism requires immediate investigation to rule out a possible virilizing tumor. The ultimate goals of therapy for hyperandrogenic anovulatory women are to normalize the endometrium, antagonize androgen action at target tissues, reduce insulin resistance, and correct anovulation, if necessary.

5. Etc.

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Women's health: Obesity and Female Sexual Dysfunction

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Female Sexual Dysfunction is defined as a condition of lacking interest in sex. There are many reason for low libido, including obesity, hormone imbalance, pain during intercourse, history of menstrual regulation, mental stress, etc. According to the study of A consecutive series of 107 obese BED (Binge eating disorder) and 110 obese non-BED patients referring for the first time to the Clinic for Obesity of the University of Florence, together with a control group of 92 normal weight subjects, posted in PubMed, researchers found that BED and obese non-BED probands reported a lower sexual activity compared to controls, in terms of absence of sexual intercourse rate, and sexual intercourse frequency.

D. How Obesity associates with female sexual dysfunction
1. According to the study of Obesity and sexual quality of life of 1) 500 participants in an intensive residential program for weight loss and lifestyle modification (BMI = 41.3 kg/m2), 2) 372 patients evaluated for gastric bypass surgery (BMI = 47.1 kg/m2), and 3) 286 obese control subjects not seeking weight loss treatment (BMI = 43.6 kg/m2), conducted by Obesity and Quality of Life Consulting, posted in PubMed, researchers filed the result that Obesity is associated with lack of enjoyment of sexual activity, lack of sexual desire, difficulties with sexual performance, and avoidance of sexual encounters. Sexual quality of life is most impaired for women, individuals with Class III obesity, and patients seeking gastric bypass surgery.

2. According to the abstract of the study of "Factors associated with sexual dysfunction in Jordanian women and their sexual attitudes" by Abu Ali RM, Al Hajeri RM, Khader YS, Ajlouni KM., posted in PubMed, researchers found that Older age was associated with a decreased total FSD index and its domain scores. Women with obesity were more likely to have impaired arousability and impaired capability of reaching orgasm.

3. In the study of "Body mass index, urinary incontinence, and female sexual dysfunction: how they affect female postmenopausal health" by Pace G, Silvestri V, Gualá L, Vicentini C., posted in PubMed, researchers concluded that Increased BMI early in menopause represents a risk both for UI and for sexual dysfunction. Weight control has an essential role in postmenopause and should be considered early in perimenopause to safeguard female quality of life as well as to prevent or improve UI and female sexual dysfunction symptoms.

4. Accorsing to the study of 45 obese and overweight and 30 age-matched voluntary healthy women serving as a control group were evaluated by a detailed medical and sexual history, including the FSFI questionnaire, conducted by Faculty of Medicine, Pamukkale University,, posted in PubMed, researchers wrote that a significant negative correlation between BMI and orgasm (P=0.007, r=-0.413). Satisfaction was also negatively correlated with BMI (P=0.05, r=-0.305) and weight (P=0.03, r=-0.326). Testosterone levels were negatively correlated with only satisfaction domain scores of FSFI (P=0.01, r=-0.385). We found that 86% of obese women and 83% of controls had sexual dysfunction. Although obesity does not seem to be a major contributor to sexual dysfunction, it affects several aspects of sexuality.

5. On the abstract of the study of "[Obesity and disturbance of sexual function]"
[Article in Japanese] by Sasaki Y, Arai T., posted in PubMed, researchers files the conclusion
that The conversion of androgens to estrone in the lipocytes evokes overproduction of estrone, which stimulates LH release and induces overproduction of androgens. Hyperandrogenemia is a cause of disturbance of the sexual function in obese women.

6. Etc.

E. Treatments of Obesity and female sexual dysfunction
1. In a study of obese men (n = 91) and women (n = 134) using the comprehensive validated Sexual Functioning Questionnaire, conducted by Duke University Medical Center, posted in PubMed, researchers filed in conclusion that Increasing body mass index was associated with decreasing sexual functioning only for arousal and behavior. Sexual functioning was also reduced on most subscales for individuals who reported sexual inactivity in the past month.

2. In the study of "Significant resolution of female sexual dysfunction after bariatric surgery" by Bond DS, Wing RR, Vithiananthan S, Sax HC, Roye GD, Ryder BA, Pohl D, Giovanni J., posted in PubMed, researchers found that FSD resolved in a large percentage of women after bariatric surgery. Sexual functioning in the entire sample improved to levels consistent with those of normative controls. This improvement in sexual function did not depend on surgery type or weight loss amount and appears to be an additional benefit for women undergoing bariatric surgery.

3. In a Cross-sectional associations of lifestyle factors with sexual inactivity and sexual dysfunctions were estimated by logistic regression-derived, confounder-adjusted odds ratios (ORs) study of 5,552 Danish men and women aged 16-97 years in 2005, conducted by Statens Serum Institut, Department of Epidemiology Research, posted in PubMed, researchers filed the conclusion that In both sexes, several unhealthy lifestyle factors were associated with sexual inactivity with a partner in the last year. Additionally, among sexually active participants, men with unhealthy lifestyles were significantly more likely to experience sexual dysfunctions. Considering the importance of a good sex life, our findings may be useful in attempts to promote healthier lifestyles.

4. Etc.

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nobody in China suffers from fatty liver or obesity

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Women's health: Obesity and Hirsutism

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Hirsutism is defined as a condition of excessive hair growth in the places where are considered minimal or not at all.

D. How obesity associates with Hirsutism
1. In a study of Endocrinology of hirsutism" by Kopera D, Wehr E, Obermayer-Pietsch B., conducted by Department of Dermatology, Internal Medicine, Medical University, posted in PubMed, researchers indicated that Obesity associated reproductive and metabolic dysfunctions may aggravate the symptoms of PCOS. PCOS might be underdiagnosed in non obese women because lean PCOS phenotypes might be underestimated for the syndrome. Effective medical treatment of PCOS and associated hirsutism depends on the endocrinological expertise and experience of the therapist in each individual case. An algorithm for the treatment has not been established yet.

2. According to the study of "Endocrinology of hirsutism" by Kopera D, Wehr E, Obermayer-Pietsch B., posted in PubMed, researcher wrote that Hirsutism represents a primary clinical indicator of androgen excess. The most common endocrine condition causing hirsutism is polycystic ovary syndrome (PCOS). Diagnosing PCOS is not easy as the signs and symptoms are heterogenous. The newest diagnostic guideline made by the Androgen Excess and PCOS Society in 2006, claims the presence of hyperandrogenism, and ovarian dysfunction. Obesity associated reproductive and metabolic dysfunctions may aggravate the symptoms of PCOS. PCOS might be underdiagnosed in non obese women because lean PCOS phenotypes might be underestimated for the syndrome.

3. In the study of "Comparison of clinical and laboratory characteristics of cases with polycystic ovarian syndrome based on Rotterdam's criteria and women whose only clinical signs are oligo/anovulation or hirsutism" by Hassa H, Tanir HM, Yildiz Z., posted in PubMed, researchers concluded that non-PCOS women with only sign or symptom of oligo/anovulation or hirsutism had a more favorable endocrine milieu. These cases should be followed in vigilance in an aim to confront the development of short- and long-term adverse effects of impending PCOS in the future. Furthermore, different phenotypes of PCOS cases were clinically or biochemically similar in characteristics.

4. According to the study of "Management of polycystic ovary syndrome in childhood and adolescence" by Ojaniemi M, Tapanainen P, Morin-Papunen L.,posted in PubMed, researchers indicated in the clinical feature that typical features in adolescence include irregular menstrual cycles, acne, hirsutism, obesity and signs of insulin resistance such as acanthosis nigricans. Biochemical hyperandrogenism and polycystic ovaries are often present. However, some adolescents have no evidence of clinical and biochemical hyperandrogenism despite dysfunctional polycystic ovaries.

5. In a study of "Polycystic ovary syndrome: challenges in adolescence" by Oliveira A, Sampaio B, Teixeira A, Castro-Correia C, Fontoura M, Luís Medina J., posted PubMed, researchers filed in abstract that polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age. PCOS typically develops during adolescence and is a heterogeneous syndrome classically characterized by features of anovulation combined with signs of androgen excess (hirsutism, acne). Increasing obesity in adolescents probably exacerbates signs of PCOS, contributing to its earlier recognition.

6. Etc.

E. Treatments of Obesity and Hirsutism
1. According to the study of Six studies were included with n=164 participants. Three studies compared physical activity to minimal dietary and behavioural advice or no advice. Three studies compared combined dietary, exercise and behavioural interventions to minimal intervention, conducted by School of Public Health and Preventive Medicine, Monash University, posted in PubMed, researchers concluded that Lifestyle intervention improves body composition, hyperandrogenism (high male hormones and clinical effects) and insulin resistance in women with PCOS. There was no evidence of effect for lifestyle intervention on improving glucose tolerance or lipid profiles and no literature assessing clinical reproductive outcomes, quality of life and treatment satisfaction.

2. In the study of 151 girls with various complete and incomplete forms of precocious puberty, 20 girls with congenital adrenal hyperplasia, 20 with hirsutism, 18 with obesity, and 133 age-matched normal girls, conducted by University of Bologna, Italy, posted in PubMed, researchers sttated that Ultrasound imaging allowed an easy distinction between true precocious puberty and premature thelarche or idiopathic premature adrenarche. It was also helpful in the diagnosis of transient sexual precocity, although in these cases the differential diagnosis of precocious puberty can be difficult. In postmenarcheal patients with congenital adrenal hyperplasia, ultrasound study showed a low uterine volume and, frequently, a macrocyst in the ovary. In hirsute girls and in a few obese patients, ovaries had an increased volume and a microcystic structure, similar to those in polycystic ovary syndrome. Pelvic ultrasonography can be useful not only in diagnosing disorders in sexual development but also for greater understanding of the pathogenesis of these and other disorders.

3. Etc.
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Chinese Secrets to Fatty Liver and Obesity Reversal
A groundbreaking e book about why almost
nobody in China suffers from fatty liver or obesity

For other health articles, please visit http://medicaladvisorjournals.blogspot.com/

If you like what you read, please follow me at http://twitter.com/kylejnorton