Is obesity really a disease?

A few years ago, while I was teaching in the hospital, a medical student presented the case of a man with coronary artery disease, diabetes, hypertension, and hyperlipidemia. When we entered the man’s room I was surprised that the student had omitted a certain fact from his presentation: the man weighed well over 400 pounds.

No one argues that diabetes and blocked coronary arteries are diseases. And nobody argues that obesity, at least in part, causes these diseases — or that losing weight helps improve or even reverse them. But the question of whether obesity itself is a disease has been controversial.

The American Medical Association, the nation’s leading organization of physicians, has announced its stand on the question: obesity is a disease.

Some might wonder why this announcement is news, why the issue is controversial at all. I think it has to do with our ambivalence about conditions that have a behavioral component. In the last few years the question of whether certain behaviors are diseases or disorders — drug use and alcoholism, as well as hoarding, gambling, and Internet overuse (which the American Psychiatric Association now lists as disorders or potential disorders) — has come up repeatedly.

We tend to like to think we can control our behaviors, and everyone knows someone who — by sheer effort and willpower — has given up certain self-destructive behaviors. No doubt, many will see the AMA’s designation of obesity as a disease as an encouragement of “victim mentality” — an absolving of personal responsibility.

But the causes of obesity are complex, and include genetics, stress, the food supply, medications, and other factors. One could argue that if self-discipline alone cured obesity, people like Oprah Winfrey, Gov. Chris Christie, and millions of the rest of us who exhibit this quality in so many other aspects of our lives wouldn’t have a problem with weight. I can’t tell you how often someone who holds down two jobs, volunteers, and takes care of their parents and kids tells me they can’t lose weight because they’re “lazy.”

Another objection to classifying obesity as a disease will be that it’s so common. Do one-third of adults and one-fifth of children in America have a disease? By 2020, when, as is projected, 75% percent or more of us are obese, will most of us be “sick?” Does the word “disease” have any meaning if it affects a majority of people? If it’s the new normal?

The AMA has no specific authority to designate obesity as a disease, but it’s decided to use its considerable influence to effect a cultural shift. The hope is, that if obesity is thought of as a disease, insurance companies will be more supportive of obese people, researchers will pursue the problem more aggressively, public health efforts to curb obesity will be strengthened, and individual clinicians–like that medical student I mentioned above–will be better trained to address obesity with their patients.

study last year showed that only about half of primary care doctors felt competent to deal with their patients’ obesity. Among doctors who were obese themselves, the percentage was much lower.

Suzanne Koven is an internal medicine physician and a Boston Globe columnist.  She blogs at In Practice at Boston.com, where this article originally appeared. She is the author of Say Hello To A Better Body: Weight Loss and Fitness For Women Over 50

No Such Thing As Type 2 Diabetes? Why Old Notions Of 'Disease' Need …

Obesity was a status symbol in Renaissance cul...

Obesity was a status symbol in Renaissance culture: “The Tuscan General Alessandro del Borro”. It is now generally regarded as a disease. (Photo credit: Wikipedia)

As medicine advances, thanks to expanding research and sophisticating technologies, it’s always got the task of shedding its past and redefining itself. Part of this is to rid itself of conventions that are determined to be useless, or worse, erroneous. In a smart new editorial in The Lancet, researcher Edwin Gale of the University of Bristol argues that there’s a major problem with the way we think about disease today, in particular the ones that are not so clear cut, like type 2 diabetes, which itself affects millions across the globe, and now includes a growing new subset: children. But slapping the “type 2 diabetes” label on a wide constellation of symptoms (and, perhaps, causes) that has no simple treatment is a major “category error,” argues Gale. And this error can lead us – researchers and patients alike – down the wrong path when it comes to solutions.

Here’s Gale’s central argument. He says that medicine, unfortunately, still has the tendency to look for a unique cause and/or symptom to define a “disease.” As it happened in the case of diabetes, over a century ago, a researcher decided that blood sugar was the way to define the disease, and this convention has, very sadly, stuck. Even today, committees of experts sitting around a table deciding what defines normal and abnormal blood sugar is considered an acceptable method. But, argues Gale, it’s not acceptable at all, and we need a better way: “a problem that cannot be defined in scientific terms cannot have a scientific solution.”

What we’ve learned in the last 50 or 60 years is that diseases like type 2 diabetes are actually multifactorial, and they’re “defined by their attributes and consequences rather than by their causal mechanisms, which remain unknown.” In the case of type 2 diabetes, after all, we don’t really know what causes it: We know that the body doesn’t use insulin correctly, and that there’s a laundry list of associated risk factors – overweight and obesity, being sedentary, high levels of blood fats, etc. – but we don’t really know what’s happening in the body to lead to the condition (or group of conditions). And as numerous the causes, so can be symptoms, which often vary widely from person to person.

Therefore, Gale says, “assuming standard causal mechanisms and universal treatment pathways” is our fatal flaw, and it leads to major problems in the solutions for the “disease.” He adds that our outdated notion of type 2 diabetes has led to decades of wasted research that could have been better spent in other avenues.

As Gale told the Lancet TV, “If you give something a name, you imply an entity; you imply that this thing actually exists. In practice, when somebody like myself talks about Type 2 diabetes, I’m saying ‘a form of diabetes for which I can find no other cause’. In other words, it’s a diagnosis of exclusion…There are various conditions, spectrums, and severities of diseases, all wrapped into this one definition.”

So what’s the solution, should “type 2 diabetes” be scribbled out of the medical texts? The answer, in a manner of speaking, is yes. Gale suggests that we have to realize that our current thinking has gotten us nowhere and to seriously readjust how we approach disease. “When a century of scientific endeavour brings us round to the conclusion that we cannot define what we are talking about, it might be time to consider adjusting our minds.”

He proposes we scrap the term “type 2 diabetes” and replace it with “idiopathic hyperglycemia,” at least for the time being. He realizes that changing our thinking will be a long process, since there’s a lot of money and power tied up in the old ways – but new thought leaders will emerge and help shift things in a better direction. “Ruling paradigms become entrenched around the sources of money and influence, and new thinking must wait for the present generation of power brokers to move into the rose garden. The ghostly entity of type 2 diabetes is likely to haunt us for years to come, although we might for the interim avoid a terminological loop by referring to it as idiopathic hyperglycaemia.”

Different disciplines have to collaborate, he says, since the “disease” is multifactorial – so should the effort be toward understanding it. “Present thinking examines glucose or lipids; future thinking will abandon the sectarian boundaries of academic specialties to achieve a more integrated view of phenotypic development. Idiopathic hyperglycaemia will no longer be considered as a disease in its own right, but as an outcome of networked processes contributing to the affluent phenotype of adiposity, hypertension, hyperglycaemia, hyperlipidaemia, and cancer.”

Science is undergoing a lot of changes and unrest right now (not that it’s ever not). Definitions of mental health disorders are being called into serious question. Major organizations are at odds over recommendations for when women should begin having mammograms. And years later, we’re still living with the specter of the flawed autism-vaccine study that was formally retracted, but which many still take as gospel. Things will change, we hope, though it may be slow.

So how long does it take science to shrug off old notions and definitions? Decades, or perhaps years, if we’re lucky. While researchers debate the fate of “the disease formerly known as diabetes,” please weigh in below on how science can best evolve, and how we should conceptualize these conditions that don’t have a clear cause or cure.

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Wellcome Trust and MRC invest £24 million in Cambridge obesity …

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29 May 2013


The Wellcome Trust and Medical Research Council (MRC) are to invest £24 million into obesity research led by the Wellcome Trust-MRC Institute of Metabolic Science.

The Institute of Metabolic Science (IMS), based on the Cambridge Biomedical Campus, will investigate the causes and health consequences of obesity and develop new approaches to prevent and treat metabolic diseases, such as diabetes.

The IMS is a joint venture between the MRC, the Wellcome Trust, the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust. Co-directed by Professors Stephen O’Rahilly and Nick Wareham, it provides a unique environment linking basic and applied science in metabolic diseases.

The IMS houses not only state-of-the-art facilities for laboratory science and clinical and population research, but also purpose-built clinics providing outpatient care for children and adults with metabolic and endocrine disorders.

This close link to patients ensures that advances in basic science can be applied rapidly to improve patient care and disease prevention. The IMS is also close to the largest concentration of biotechnology companies in Europe, creating excellent opportunities for industrial collaboration.

Funding from the MRC will establish a new MRC Metabolic Diseases Unit at the IMS, under the direction of Professor O’Rahilly, as well as new programmes of research at the existing MRC Epidemiology Unit and MRC Human Nutrition Research. The Wellcome Trust investment will create an enhanced Clinical Research Facility dedicated to metabolic studies, as well as providing funding for major core laboratory equipment and studies in animal models.

Stephen O’Rahilly, Co-Director of the Wellcome Trust-MRC IMS and Director of the MRC Metabolic Diseases Unit, University of Cambridge, said: “This joint initiative from the MRC and Wellcome Trust will provide exciting new opportunities to better understand the fundamental causes of disease such as obesity and diabetes and translate that knowledge into improved therapies.”

Professor Sir John Savill, Chief Executive of the MRC, said: “Obesity is one of the biggest challenges facing the future health of the developed world and understanding the causes and consequences of this condition is a major research priority. The MRC is very happy to be partnering with the Wellcome Trust and University of Cambridge in an ambitious joint venture that will unite experts in basic science, population science and experimental medicine to create a world-leading centre for metabolic research.”

Dr Ted Bianco, Acting Director of the Wellcome Trust, said: “With obesity rates soaring across the globe, the need to understand the biological, behavioural and environmental factors that influence metabolic diseases has never been greater. This additional investment from us and the MRC reflects the quality of research that is being undertaken at Cambridge and lays the foundations for taking basic scientific discoveries right through to clinical advances.”

Professor Sir Leszek Borysiewicz, Vice-Chancellor of the University of Cambridge, said: “Obesity has become an urgent public health issue as research continues to reveal its detrimental effects. With obesity doubling between 1980 and 2008 – a span of less than 30 years – investing in obesity research has never been more critical, and the University is delighted with the support of the MRC and the Wellcome Trust.”

The £24m joint investment will be broken down as follows:

  • £10.8m from the MRC to establish a new university unit: the MRC Metabolic Diseases Unit, University of Cambridge (Directed by Professor Stephen O’Rahilly and located at the Wellcome Trust-MRC IMS)
  • £10.1m from the Wellcome Trust for basic science infrastructure and new clinical research facilities at the IMS, and to support joint working with the Wellcome Trust Sanger Institute.
  • £2.5m from the MRC for research into biomarkers for diabetes at the MRC Epidemiology Unit, University of Cambridge (Directed by Professor Nick Wareham and located at the Wellcome Trust-MRC IMS).
  • £1m from the MRC for a collaborative programme to investigate human fat metabolism, led by MRC Human Nutrition Research (Directed by Professor Ann Prentice and based at the Elsie Widdowson Laboratory in Cambridge).

Image: Clinical research into obesity and diabetes. Credit: Wellcome Library

Contacts

Jen Middleton
Senior Media Officer, Wellcome Trust
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020 7611 7262
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j.middleton@wellcome.ac.uk

Hannah Isom
MRC press office
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020 7295 2345
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press.office@headoffice.mrc.ac.uk

Notes to editors

The Institute of Metabolic Science (IMS) was established by the University of Cambridge in 2008, in partnership with the MRC and Cambridge University Hospitals NHS Foundation Trust. The IMS focuses on understanding the causes and adverse consequences of obesity, and approaches to prevent and treat metabolic disease. In recognition of the current significant investments and of the substantial support for metabolic disease research provided by the Wellcome Trust and MRC in Cambridge over more than 20 years, the IMS is to be renamed the Wellcome Trust-MRC Institute of Metabolic Science.

The Wellcome Trust has invested over £60m in the past decade on basic and translational research in obesity and related metabolic diseases at the University of Cambridge Metabolic Research Laboratories and the Clinical School. The new investment supports a number of individuals who are in receipt of prestigious personal funding from the Trust and will continue to support the PhD Programme hosted at this site, alongside other members of the IMS.

About the Wellcome Trust
The

Wellcome Trust is a global charitable foundation dedicated to achieving extraordinary improvements in human and animal health. It supports the brightest minds in biomedical research and the medical humanities. The Trust’s breadth of support includes public engagement, education and the application of research to improve health. It is independent of both political and commercial interests.

About the Medical Research Council
Over the past century, the

Medical Research Council has been at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Twenty-nine MRC-funded researchers have won Nobel Prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms.

The

MRC Centenary Timeline chronicles 100 years of life-changing discoveries and shows how our research has had a lasting influence on healthcare and wellbeing in the UK and globally, right up to the present day.

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Doctors Detect Obesity Bug on Breath: Scientific American



Certain microbes that line the intestines, detectable on the breath may contribute to excessive weight gain, researchers find.
Image: Flickr/Tony Alter

Obesity has its obvious manifestations; it’s a disease that is difficult to conceal. And now, doctors say they can even smell it on your breath.

Doctors from Cedars-Sinai Medical Center in Los Angeles say certain gas-emitting microbes living in the human gut might determine one’s propensity for packing on too many pounds; and the presence of methane and hydrogen on one’s breath from these microbes is closely related to excess body weight and body fat.

These doctors concede that overeating and a lack of activity are the primary causes of obesity. Yet other factors — namely, the abundance or reduction of certain microbes that line the intestines, detectable on the breath — also may contribute to excessive weight gain.

Their work will appear online March 28 in the Journal of Clinical Endocrinology Metabolism.

Hungry microbes
The concept that gut microbes are linked to obesity is not new. Dozens of papers have been written on the topic in the last few years alone. Scientists don’t understand, however, which microbes are the chief culprits. [Why We’re Fat: 8 Surprising Causes of Obesity]

Doctors led by Ruchi Mathur, director of the Cedars-Sinai Diabetes Outpatient Treatment and Education Center, focused on a methane-producing microbe called Methanobrevibacter smithii. The theory is that M. smithii eats the hydrogen produced by other microorganisms in the gut. Lower hydrogen levels, in turn, increase fermentation in the gut, allowing the body to absorb more nutrients and more energy, or calories, from food.

“Usually, the microorganisms living in the digestive tract benefit us by helping convert food into energy,” said Mathur. “However, when this particular organism, M. smithii, becomes overabundant, it may alter this balance in a way that causes someone to be more likely to gain weight.”

Mathur’s previous study on rats, published last year, seemed to indicate that M. smithii promoted weight gain. An abundance of M. smithii could leave detectable levels of methane on the breath of obese human subjects as smoking-gun evidence of this microbe’s role in obesity, Mathur said.

Breath test
So, Mathur’s group analyzed the breath of 792 people. They found that the subjects either had normal breath content, higher concentrations of methane, higher levels of hydrogen, or higher levels of both gases. Those who tested positive for high concentrations of both gases had significantly higher body mass indexes and higher percentages of body fat.

But the presence of hydrogen with methane on the breath of obese subjects may indicate that more than the methane-producing M. smithii is to blame. Or, at a minimum, the picture is complex.

Indeed, French researchers publishing a study in June 2012 in the International Journal of Obesity found that the gut microbe Lactobacillus reuteri was most associated with obese subjects in conjunction with lower, not higher, levels of M. smithii. An earlier study by some of these same French researchers, published in the journal PLOS ONE in 2009, found excess M. smithii associated with anorexia.

Mathur’s group also could not ascertain cause and effect: Is obesity caused by a certain imbalance of microbes, or does a diet associated with obesity — for example, highly processed foods rich in calories and low in nutrients — change the gut microbe flora in such a way that promotes obesity. That is, the obesity bug is not something one catches randomly like the flu. The microbes most recently associated with obesity are in all human guts, along with trillions of other microbes.


Thylane Lena-Rose blondeau: Vogue's 10-year-old model causes public outrage

With the increase in the ‘nanny state’ approach to society and the continued stepping up of extreme security measures at airports, on the internet and in general everyday policing, it’s incredible that Vogue magazine have managed to slip a sexed up 10-year-old model through the net and in doing so rouse complete contempt in the public eye, added further anxiety to the minds of those with eating disorders while fuelling paedophilic fantasies of the more depraved social elements in one fell swoop.

With so much controversy surrounding the Vatican last year amid rumours and accusations of child abuse and paedophilia, and the recent scandal surrounding Rupert Murdoch and his phone tapping exploits at the News of the World, you might think that society deserves a break from underhanded, exploitative media.

Pre-teen model Thylane Lena-Rose BlondeauCue 10-year-old Thylane Lena-Rose Blondeau, daughter of former French footballer Patrick Blondeau and French TV presenter Veronika Loubry, who is one of the hottest properties in fashion modelling currently.

Thylane has modelled in Vogue Enfants for a number of years but in January this year, Vogue took a step too far by publishing images of the child dressed in high heels, a plunging dress and full make up, aiming to give her the appearance of someone twice her age but actually making her look like a child prostitute.

[adsense]The implications associated with such material are massive; dressing a child as a woman is denying her the opportunity to be a child and one only has to look at other child stars such as Michael Jackson, Drew Barrymore and Gary Coleman to see where that can lead.

Furthermore, with the dramatic rise of paedophilia in the last two decades, images like these will only add fuel to the fire and could lead to even greater desensitising among the public. Violent films, video games and certain musical styles have already lowered the threshold and we live in a world filled with violent and pornographic images which pass us by almost unnoticed, such is the extent to which things have decayed.

The ugly face of paedophilia

Christopher Paul Neil tops Interpol’s paedophile hitlist

As of yet neither Tom Ford, who edited the January edition, or Vogue have made no apologies or excuses for that publication.

Publishing such pictures could have a massive psychological effect on women with eating disorders, who, in many cases already aspire to have the body of a teenager, and the anxiety of seeing even younger models with formless bodies may well exacerbate their bodily issues.

One also has to question the motives and thoughts of Thylane’s parents. Both have made plenty of money through their own careers so if they’re using their daughter as a form of cash calf then greed truly has overridden their sense of taste, decency and core parental instincts – to protect.

They need to understand the ramifications of exposing their pre-teen child to a world which harbours dangerous, twisted minds who will see her as an opportunity or a use her visage as a fantasy enacted upon another hapless victim.

Ultimately, Patrick Blondeau, Veronika Loubry, Vogue and agents alike need to ensure that children are protected from paedophiles, human traffickers and the porn industry by not allowing images of 10-year-olds dressed as 30-year-olds to be taken, let alone publicised, thus negating the risk of a rising epidemic and new wave of child abuse.

Please share your thoughts on Vogue using under age models and the impact it might have on society by leaving a comment.

Read about other models who courted controversy like Ana Carolina Reston, Crystal Renn, Stephanie Seymour and Kate Moss.

images: ABCnews; theoriginalgreenwichdiva.com, news.sky.com, carregwenimages.com

Dyslexia – Causes, Symptoms and Treatment

The term dyslexia is derived from the Greek language and broadly means difficulty with words. It is a very common type of learning difficulty that is associated with problems reading and spelling words. The severity of symptoms vary from very mild to severe. Most people are diagnosed during childhood, when problems reading and writing become apparent despite adequate intellectual ability and teaching.

What causes it?

There are various different theories on what causes dyslexia, but most agree that it is a genetic condition, which changes the way the brain processes information and is passed down through families. If you suffer from dyslexia, the likelihood of your child inheriting it is 40-60%. This theory is further supported by the fact that identical twins are usually both affected by it.

People with dyslexia often feel overwhelmed by words

The phonological processing impairment theory explains how dyslexia affects reading and writing. In speech, humans have the natural ability to distinguish between phonemes (the smallest units of sound that make up words) and reassemble them together so they make sense. With reading a writing, it is a little different. These skills require the ability to recognise the letters in a word, then using those to identify the appropriate phonemes and then assembling them to make a word. This is known as phonological processing. It is believed that people with dyslexia find this process more difficult than others.

It is also thought that the reason why people with dyslexia find phonological processing more difficult than others is that some parts of their brain function in a different way. MRI scans have revealed that activity levels in the left hemisphere of the brain are lower in people with dyslexia when they are reading.

It is important to emphasise that dyslexia has nothing to do with intellect and that sufferers show a normal range of intelligence.

[adsense]What are the symptoms?

Dyslexia often becomes apparent in early childhood with problems putting together sequences, for instance, such as numbers or coloured beads. Some toddlers may mix up their words, have problems with rhyming, clapping rhythms or show a lack of interest in reading and writing and delayed speech development. Over the cours of growing up, these symptoms can seriously affect the child’s self-esteem.

How is it treated?

While there is no cure for dyslexia, there are treatments available to manage the condition. It is important to have dyslexia diagnosed by a psychologist or a dyslexia specialist to figure out the best treatment. Teaching methods can be tailored appropriately to help the child learn better and instruction on phonemic, fluency and comprehension provided. Using colour overlays, mind maps (diagrams using images and keywords to create visual representation) and voice-recognition software among many other things can also help in later life.

Click here to read about Magic johnson and his battle with dyslexia and ADD and how Tom Cruise believes ADD is a myth.

Images: pinkcotton and denverjeffrey on Flikr

Bacterial Vaginosis (BV)

Bacterial Vaginosis, also known as BV, is one of the most common causes of bacterial infection in the female reproductive system and is brought on by an imbalance in the usual bacteria found in the vagina. It mostly affects women of childbearing age and those who are pregnant.

What causes BV?

The exact cause of BV is not fully understood, according to CDC, but it is associated with the imbalance of bacteria.

Some types of bacteria are always present in the vagina to keep it healthy. It should contain lactobacilli (lactic acid bacteria). The lactobacilli produce lactic acid, making the organ slightly acidic, thus preventing other bacteria from growing there.

BV causes the sufferer to have less lactobacilli, meaning the vagina is not as acidic as it should me. This allows other types of bacteria to grow.

Women who are sexually active are more likely to get BV. Risk, according to the NHS, can also be increased by:

  • Having a new or multiple sexual partners
  • Using soap or deodorant on the vagina
  • Washing underwear with strong detergent
  • Smoking
  • Using an intrauterine device (IUD) as a contraceptive

What are the symptoms?

BV usually causes an abnormal vaginal discharge, accompanied by an unpleasant fish-like odour (especially after intercourse), white or grey discharge, itchiness and burning during urination.

How is it treated?

It is important to see a doctor if you suspect you have BV, as it needs to be correctly diagnosed and distinguished from other possible vaginal conditions and sexually transmitted diseases.

BV is usually treated with a course of antibiotics, which are 85-90% effective in combating the infection.

There is currently no evidence that probiotics, such as those found in live yoghurt, are of any benefit for treating or preventing BV.

If, after treatment, the symptoms have vanished, there is no need to take any further action. More tests are needed if symptoms persist.

[adsense]Could there be any complications?

BV is not usually accompanied by complications. However, it can increase certain risks, according to CDC:

  • Having BV can increase a woman’s susceptibility to HIV if she is exposed to the virus.
  • Having BV has been associated with an increase in the development of an infection following surgical procedures such as a hysterectomy or an abortion
  • Having BV during pregnancy can put a woman at increased risk of complications, such as premature delivery or the baby being born weighing less than normal
  • Having BV can increase a woman’s susceptibility to other STDs, such as genital herpes, chlamydia and gonorrhea

The bacteria that cause BV can sometimes infect the uterus (womb) and fallopian tubes (tubes that carry eggs from the ovaries to the uterus). This type of infection is called pelvic inflammatory disease (PID) and can cause infertility or damage the fallopian tubes enough to increase the future risk of ectopic pregnancy and infertility.

Click here to read more about candida yeast infections in women and in men.

Images: Wikimedia Commons and Wikipedia

What happens during a miscarriage?

A miscarriage is a pregnancy that ends before 24 weeks, which is before most developing babies can survive outside the womb.

The majority of miscarriages happen during the first 12 weeks of pregnancy, which is often referred to as the first trimester and are much more common that people realise. Many women who miscarry do not like talking about.

An estimated 20% of pregnancies end in miscarriage, according to the NHS, but many cases go unreported because a woman often loses the baby before she even realises she’s pregnant.

What causes a miscarriage?

About half of all early miscarriages happen when a problem in the way chromosomes from the egg and sperm combine during the fertilization process, according to Bupa, leading to problems with the foetus. Many couples never find out why this has happened, and it is often put down to chance rather than another underlying cause.

While these chromosome problems often happen by chance, there are some known risk factors, which increase the chances of these issues occurring in the first 3 months of pregnancy (first trimester):

  • Age – women under 25 are at lowest risk with 9%, whereas those over 45 have a 75% chance of miscarrying, the NHS states.
  • Obesity
  • Smoking
  • Drug use
  • Alcohol and caffeine consumption – drinking more than one cup of coffee a day and 2 small glasses of wine a week increases risk.

Second trimester miscarriages can often be caused by:

  • Underlying health conditions such as diabetes, lupus, kidney disease or thyroid problems
  • Infections such as rubella or bacterial vaginosis (BV)
  • A higher than usual level of the antibody called antiphospholipid (aPL) in the blood
  • A weakened cervix
  • Polycystic ovary syndrome

The NHS dispels myths by stating that miscarriage risks ARE NOT linked to:

  • The mother’s emotional state during pregnancy
  • Being shocked or having a fright
  • Exercising during pregnancy (the most appropriate type of exercise should be discussed with a doctor)
  • Lifting or straining
  • Working during pregnancy or having sex

What are the symptoms of miscarriage?

The most common symptom of a miscarriage is vaginal bleeding. This can vary from light to very heavy, including blood clots and brown discharge. There may also be:

  • Cramping and pain in the pelvis and back
  • Usual pregnancy symptoms such as sickness and breast tenderness suddenly stopping

[adsense]You should contact your doctor or midwife immediately if you start experiencing bleeding during your pregnancy. A gynaecologist can diagnose a miscarriage through an ultrasound scan and blood tests.

How is a miscarriage treated?

Treatment depends on whether or not the miscarriage is complete or incomplete. In cases of a complete miscarriage, no further medical treatment is needed. If the latter occurs, however, the foetal tissue needs to be removed otherwise it may become infective. This can be done in three ways:

  • Surgical treatment where minor surgery is used to remove the tissue,
  • Medical treatment – where medication is used to remove the tissue, or
  • Expectant treatment – where you wait for the tissue to pass naturally out of your womb.

If you are experiencing recurring miscarriages, it is important to talk to your doctor about what treatments are available to maximise the chance of having a successful pregnancy.

Celebrities who have previously had miscarriages include screen siren Sharon Stone and songstress Lily Allen. Also read about Kym Marsh’s agony over giving birth to a premature baby and how Chris Evans’ wife nearly died during an ectopic pregnancy.

Images: Wikimedia Commons

What is Tuberculosis?

Tuberculosis (TB) is a bacterial infection, spread by inhaling tiny droplets of saliva released through the cough or sneeze of an infected person. It affects the lungs primarily, but can spread to almost any part of the body. Before antibiotics, TB was a major problem and resulted in many deaths.

What causes it?

Tuberculosis is caused by a strain of bacteria called mycobacterium tuberculosis. It is spread when someone with an active infection in their lungs coughs or sneezes and another person inhales droplets of the saliva.

However, despite the fact that it is spread in the same way as Influenza (flu), TB is not as contagious, according to the NHS, and a person would usually need to spend a considerable amount of time in close contact with the patient before contracting it themselves.

It is therefore often spread between family members and others who live together. It is unlikely to get TB from sitting next to someone who is infected on the bus or train. The very young, elderly and those with pre-existing health conditions affecting their immune system (such as HIV/AIDS) are more likely to contract TB. The risk is also heightened for those who live in a community or have received visitors from a part of the world where TB is still commons.

What are the symptoms?

There are three types of TB and three ways in which the body could react to the infection. The NHS outlines these:

  • Your immune system kills the bacteria, and you experience no further symptoms. This is what happens in the majority of cases.
  • Your immune system cannot kill the bacteria, but manages to build a defensive barrier around the infection. This means that you will not experience any symptoms, but the bacteria will remain in your body. This is known as latent TB but could develop into active TB at a later date if the immune system becomes weakened.
  • Your immune system fails to kill or contain the infection and it slowly spreads to your lungs. This is known as active TB.

TB does not usually cause any symptoms until it reaches the lungs. As the bacteria are slow moving, it may take months or even years for any symptoms to surface. When they do, they commonly include, according to the BBC:

  • A persistent cough, usually lasting longer than three weeks – it may be dry to start with but eventually bring up bloody mucus
  • Night sweats for weeks or months
  • Weight loss
  • Fatigue
  • High temperature
  • Breathlessness

In some cases, TB can spread from the lungs to other parts of the body (this is called extrapulmonary TB) causing a host of different symptoms:

  • Lymph nodes – this causes the nodes to swell up and, over time, begin releasing fluid
  • Genitourinary – this can cause groin pain and blood in the urine
  • Gastrointestinal – this can cause abdominal pain, diarrhoea and bleeding from the rectum
  • Skeletal – this leads to bone weakness and pain, loss of feeling and curving of the affected bone or joint
  • Central nervous system – this can lead to headaches, vomiting, blurred vision and seizures

[adsense]How is it treated?

It is important to seek immediate medical advice if you suspect that you may have TB. The illness takes a long time to leave the body and is usually treated through a course of different antibiotics over 6 months.

A vaccine is available and recommended to those who are more at risk of being exposed to the bacteria – by living with someone who has the illness, for example, or travelling to a country where TB is still common.

Click here to read about Nelson Mandela and his struggle following TB and the new hope of a cure for TB.

Images: Wikimedia Commons and EOL

Urinary Incontinence

What is urinary incontinence?

Urinary incontinence (UI) is the passing of urine unintentionally. It is a common condition which can affect all adults but is most prevalent in older people and more women than men are thought to be affected. According to the NHS, one in five women over the age of 40 suffers from UI.

The health expert highlights the two types of urinary incontinence:

  • Stress incontinence – when the pelvic muscles preventing the bladder from releasing urine until a suitable time become too weak
  • Urge incontinence – when incorrect signals are transmitted between the brain and the bladder. Normally, the bladder sends a signal to the brain when it is full, making the individual aware that they need to use the bathroom. The brain then sends a signal to the bladder to release the urine at the appropriate time. Urge incontinence occurs when this process has been disrupted.

Medicine Net points out a third type – overflow incontinence, which is the constant release of urine, causing the sufferer to go to the toilet frequently and in small amounts.

What causes it?

Stress incontinence is caused by the weakening of the pelvic muscles. So, any extra pressure on them, such as laughing or sneezing, can make urine leak out. Certain factors can weaken these muscles in women:

  • Pregnancy and childbirth can overstretch the muscles
  • Getting older usually means muscles become weaker
  • Obesity can create excess pressure
  • Menopause causes a fall in the level of oestrogen, which can weaken muscles
  • Having a hysterectomy can damage the muscles
  • Urinary infections such as cystitis can also have an effect

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UI is less common in men, but many still suffer from it, according to Medicine Net. Common causes for men and some women include:

  • Diabetes – those who have suffered from the condition for a number of years may develop nerve damage which affects their bladder control
  • Illnesses such as Parkinson’s, multiple sclerosis and stroke can all affect the way the brain interacts with the bladder
  • A spinal cord injury can also affect the process by interrupting nerve signals
  • Treatment for prostate cancer in men or an enlarged prostate gland, which can irritate the urethra

What are the symptoms?

The main symptom of UI is passing urine without intending to. Those suffering from stress incontinence sometimes find this happens during physical activity such as laughing, sneezing, coughing and exercise. Urge incontinence may cause you to pass a larger amount of urine after suddenly feeling the need to go to the toilet while overflow incontinence may give the sufferer the sensation that their bladder is never fully empty.

How can it be treated?

Treatments for UI vary depending on severity and type on incontinence. However, certain lifestyle changes have been known to reduce symptoms regardless. These include:

  • Losing weight
  • Drinking less caffeine
  • Reducing the amount of fluid intake if it is excessive
  • Doing pelvic floor exercises daily to strengthen muscles
  • Wearing incontinence underwear to increase confidence

If these prove to be ineffective, your doctor may recommend more intrusive treatment. There is a large number of surgical procedures available to minimise the effects of UI, as well as medication.

One celebrity who has suffered from urinary incontinence is actress Helena Bonham Carter.

Images: Wikimedia Commons