A trip to the dentist can sometimes give you more than you bargained for: In some cases, it's a dentist who may be the first to discover that a nagging sore or odd-looking white patch is not merely an annoyance, but an early form of oral cancer.
Dentists are the very best when it comes to finding early lesions in the mouth that could eventually wind up being cancerous. Studies show that dental hygienists and dentists are the most thoroughly trained and the most sensitive to early, subtle changes in the mouth that could signal trouble later on. In other words, they may be able to spot problems that other primary care providers may miss.
And when it comes to oral cancer, the earlier it's discovered and treated, the better the chances of making a full recovery.
Oral cancers make up only a small fraction of the number of new cancers every year, but they are some of the deadliest. Currently, about half of all oral cancers are first detected after they have already had opportunity to take root and spread. At that point, they are difficult to cure. The American Cancer Society estimates that only about half the people diagnosed with oral cancer will survive longer than five years.
New treatments are desperately needed. A variety of agents that range from anti-angiogenesis drugs such as endostatin, to natural products like extracts from freeze dried black raspberries are being investigated to see if they may be able to suppress the conversion of precancerous to cancerous cells. Recently a clinical trial was approved to see if the black raspberry extracts can block the progression of precancerous oral lesions in humans.
Since the risk of oral cancer increases with age, clinicians are expecting an increasing number of cases in the coming years because large numbers of baby boomers are just beginning to enter their most vulnerable, cancer-prone decades.
This is a time when increased attention to periodic screening is so important.
While oral cancer is still more prevalent among men, dentists are seeing an increasing incidence among women, probably because more women are choosing to smoke. People at higher risk of developing oral tumors include anyone who uses tobacco products in any form and who drinks alcohol on a regular basis.
Catching oral cancer in its earliest phase is critical, as shown by the success of screening in reducing deaths from other types of cancer.
What has happened with cervical cancer in recent years is a good example. In many, less developed countries, cervical cancer still takes a terrible toll among women. But here in the United States, where there is about a 75-80 percent compliance with regular and routine screening, the incidence of cervical cancer has dropped significantly, and deaths have declined dramatically.
About 90 percent of oral malignancies are squamous cell carcinomas, meaning they originate in the lining of the mouth or tongue. And some sites in the mouth - particularly where pooling of saliva may occur - are more vulnerable than others. These areas, including the sides and undersurface of the tongue, the floor of the mouth, the soft palate at the back of the mouth and the tonsils, are the most common cancer sites, representing about half of all cases.
Cancer in its earliest stages can make the lining of the mouth or the tongue look just a little bit different - maybe red or white, or with little bumps.
Patients need to be on the lookout for any of the following signs or symptoms:
- A sore that bleeds easily or does not heal
- A change in the color or texture of any part of the mouth or tongue
- Pain or numbness in any part of the oral cavity
- A white or velvety red patch that does not wear off
It is tragic that so many people develop oral cancer when it's so easy to spot during a checkup. One may not be able to catch or cure every single case, but regular screenings would help us be much more effective in controlling this terrible disease.
CRO Akwa Wellness
Sources and References:
Hussain QA, Awan KH. Role of Dental Profession in Oral Cancer Prevention and Diagnosis. J Contemp Dent Pract 2016;17(12):963-964.
Chaturvedi P. Oral cancer: premalignant conditions and screening – an update. J Cancer Res Ther 2012;8(6):57-66.
Kohn WG. Guidelines for infection control in dental healthcare settings. National Center for Chronic Disease Prevention and Health Promotion 2003 Dec;52(RR17):1-61.
Carpenter WM, Silverman S Jr. Oral cancer: the role of the dentist in prevention and early detection. Dent Today. 2001 May;20(5):92-7.
American Dental Association
Oral Health Foundation
Oral Cancer Foundation
Are dental x-rays really necessary?
Many diseases, lesions and conditions can only be detected with the use of dental radiographs. It is impossible to see directly between the teeth or under the gums or bone without the use of a dental radiograph. Many times the patient has no signs or symptoms of disease. Without the use of dental radiographs, the dentist is limited to detect only the disease which is visible in the mouth. Dental x-rays can detect disease much sooner than the clinical examination alone. This enables the dental practitioner to identify problems early so that pain and extensive, costly treatment can be avoided.
How often should I have dental x-rays?
Dental x-rays are prescribed based on the needs of the individual. The dentist must weigh the benefits of disease detection against the risk of radiation exposure. There are guidelines published by the American Dental Association that are used to aid the dentist in prescribing the number, type, and frequency of dental radiographs. However, the dentist knows each patient’s health history and susceptibility to oral disease and is in the best position to make this professional judgment in the interest of each patient. For example, a patient with a high decay rate will need x-rays more frequently than a patient without such disease.
How often should children have dental x-rays?
There is no set time interval between x-ray exposures. The radiographic exam should be based on the needs of the individual child. For example, children with decay will need x-rays more frequently than children without decay.
Can I refuse x-rays and be treated without them?
Treatment without the necessary radiographs is considered negligence. If a patient refuses to have necessary dental x-rays taken then the dentist must refuse to provide patient care.
Can the dentist use my x-rays from my previous dentist?
Yes. If the x-rays are of good diagnostic quality and are recent enough then the dentist may use them for the oral radiographic examination. Some additional radiographs may still be necessary depending on the needs of the individual.
How are x-rays measured?
Just like there are ways of measuring distance in miles or kilometers and weight in pounds or kilograms, there are ways to measure x-ray exposure. The roentgen is a way of measuring radiation exposure. The amount of energy absorbed by tissue is termed the rad or radiation absorbed dose.
How much radiation will I receive from dental x-rays?
We are exposed to radiation every day from various sources such as; airplane travel, high altitudes, radon gases and home appliances.
*A millisievert (mSV) is a unit of measure that allows for some comparison between radiation sources that expose the entire body (such as natural background radiation) and those that only expose a portion of the body (such as radiographs).
Why do the dental radiographer use a lead apron?
It is important that we do everything that we can to reduce the amount of radiation exposure when a patient has dental x-rays taken. The lead in the lead apron with the lead thyroid collar actually prevents the radiation from reaching the radiosensitive organs, such as, reproductive, blood forming and thyroid tissues from scatter radiation.
Should dental x-rays be taken during pregnancy?
The accepted cumulative dose of ionizing radiation during pregnancy is 5 rad (.05 Sv). According to the American Academy of Family Physicians, you would need 50,000 dental x-ray examinations to reach the 5-rad cumulative dose to the fetus. The decision to order films during pregnancy is a personal one. Because of the relatively low dose, it is not expected that there will be any harm to the fetus. However, many dentists elect to postpone the radiographic exposures to those needed to treat the patient during the pregnancy (symptomatic teeth or active decay).
Why does the dental radiographer leave the room when x-rays are used?
Dental x-rays should only be used when the benefit of disease detection far outweighs the risk of any dental x-ray exposure. The dental radiographer will not benefit from the exposure to the x-rays so the best protective measure is to maintain adequate distance and shielding.
Can’t my dental office use one large extraoral panoramic radiograph instead of several of the smaller intraoral radiographs?
No. A panoramic radiograph cannot be used as a substitute for a complete series of intraoral radiographs. The panoramic radiograph gives an overall view of the teeth and jaws, however it does not show as much detail as the intraoral radiograph.
Who owns my dental radiographs?
The dental record, including all of the dental radiographs belong to the dentist, however, the patient is entitled to a copy of the dental radiographs.
CRO Akwa Wellness
Sources and References:
Iannucci, JM, Howerton, LJ: Patient Education and the Dental Radiographer. In Dental Radiography Principles and Techniques,Third Edition, St. Louis, 2006, Saunders, pp. 151-153.
Frederiksen NL. X-Rays: What is the Risk? Texas Dental Journal. 1995;112(2):68-72.
Most back pain can be treated without surgery.
Most patients with back pain recover without residual functional loss. Patients should contact a doctor if there is not a noticeable reduction in pain and inflammation after 72 hours of self-care.
Ice and Heat: Although ice and heat (the use of cold and hot compresses) have never been scientifically proven to quickly resolve back injury, compresses may help reduce pain and inflammation and allow greater mobility for some individuals. As soon as possible following trauma, patients should apply a cold pack or a cold compress (such as a bag of ice or bag of frozen vegetables wrapped in a towel) to the tender spot several times a day for up to 20 minutes. After 2 to 3 days of cold treatment, they should then apply heat (such as a heating lamp or hot pad) for brief periods to relax muscles and increase blood flow. Warm baths may also help relax muscles. Patients should avoid sleeping on a heating pad, which can cause burns and lead to additional tissue damage.
Bed rest: 1–2 days at most. A 1996 Finnish study found that persons who continued their activities without bed rest following onset of back pain appeared to have better back flexibility than those who rested in bed for a week. Other studies suggest that bed rest alone may make back pain worse and can lead to secondary complications such as depression, decreased muscle tone, and blood clots in the legs. Patients should resume activities as soon as possible. At night or during rest, patients should lie on one side, with a pillow between the knees (some doctors suggest resting on the back and putting a pillow beneath the knees).
Exercise: Exercise may be the most effective way to speed recovery from low back pain and help strengthen back and abdominal muscles. Maintaining and building muscle strength is particularly important for persons with skeletal irregularities. Doctors and physical therapists can provide a list of gentle exercises that help keep muscles moving and speed the recovery process. A routine of back-healthy activities may include stretching exercises, swimming, walking, and movement therapy to improve coordination and develop proper posture and muscle balance. Yoga is another way to gently stretch muscles and ease pain. Any mild discomfort felt at the start of these exercises should disappear as muscles become stronger. But if pain is more than mild and lasts more than 15 minutes during exercise, patients should stop exercising and contact a doctor.
Medications are often used to treat acute and chronic low back pain. Effective pain relief may involve a combination of prescription drugs and over-the-counter remedies. Patients should always check with a doctor before taking drugs for pain relief. Certain medicines, even those sold over the counter, are unsafe during pregnancy, may conflict with other medications, may cause side effects including drowsiness, or may lead to liver damage.
Over-the-counter analgesics: including nonsteroidal anti-inflammatory drugs (“NSAIDs”, such as aspirin, naproxen, and ibuprofen), are taken orally to reduce stiffness, swelling, and inflammation and to ease mild to moderate low back pain. Counter-irritants applied topically to the skin as a cream or spray stimulate the nerve endings in the skin to provide feelings of warmth or cold and dull the sense of pain. Topical analgesics can also reduce inflammation and stimulate blood flow. Many of these compounds contain salicylates, the same ingredient found in oral pain medications containing aspirin.
Anticonvulsants: drugs primarily used to treat seizures, may be useful in treating certain types of nerve pain and may also be prescribed with analgesics.
Some antidepressants: particularly tricyclic antidepressants such as amitriptyline and desipramine, have been shown to relieve pain (independent of their effect on depression) and assist with sleep. Antidepressants alter levels of brain chemicals to elevate mood and dull pain signals. Many of the new antidepressants, such as the selective serotonin reuptake inhibitors, are being studied for their effectiveness in pain relief.
Opioids: such as codeine, oxycodone, hydrocodone, and morphine are often prescribed to manage severe acute and chronic back pain but should be used only for a short period of time and under a physician’s supervision. Side effects can include drowsiness, decreased reaction time, impaired judgment, and potential for addiction. Many specialists are convinced that chronic use of these drugs is detrimental to the back pain patient, adding to depression and even increasing pain.
When back pain does not respond to more conventional approaches, patients may consider the following options:
Spinal manipulation: Spinal manipulation is literally a "hands-on" approach in which professionally licensed specialists use leverage and a series of exercises to adjust spinal structures and restore back mobility.
Acupuncture: Acupuncture involves the insertion of needles the width of a human hair along precise points throughout the body. Practitioners believe this process triggers the release of naturally occurring painkilling molecules called peptides and keeps the body’s normal flow of energy unblocked. Clinical studies are measuring the effectiveness of acupuncture in comparison to more conventional procedures in the treatment of acute low back pain.
Biofeedback: Biofeedback is used to treat many acute pain problems, most notably back pain and headache. Using a special electronic machine, the patient is trained to become aware of, to follow, and to gain control over certain bodily functions, including muscle tension, heart rate, and skin temperature (by controlling local blood flow patterns). The patient can then learn to effect a change in his or her response to pain, for example, by using relaxation techniques. Biofeedback is often used in combination with other treatment methods, generally without side effects.
Interventional therapy: Interventional therapy can ease chronic pain by blocking nerve conduction between specific areas of the body and the brain. Approaches range from injections of local anesthetics, steroids, or narcotics into affected soft tissues, joints, or nerve roots to more complex nerve blocks and spinal cord stimulation. When extreme pain is involved, low doses of drugs may be administered by catheter directly onto the spinal cord. Chronic use of steroid injections may lead to increased functional impairment.
Traction: Traction involves the use of weights to apply constant or intermittent force to gradually “pull” the skeletal structure into better alignment. Traction is not recommended for treating acute low back symptoms.
Transcutaneous electrical nerve stimulation (TENS): TENS is administered by a battery-powered device that sends mild electric pulses along nerve fibers to block pain signals to the brain. Small electrodes placed on the skin at or near the site of pain generate nerve impulses that block incoming pain signals from the peripheral nerves. TENS may also help stimulate the brain’s production of endorphins (chemicals that have pain-relieving properties).
Ultrasound: Ultrasound is a noninvasive therapy used to warm the body’s internal tissues, which causes muscles to relax. Sound waves pass through the skin and into the injured muscles and other soft tissues.
Infrared Sauna: Using the infrared sauna as your main heat source, you should be able to feel your muscles loosening when they become warmed up. This is made possible with the dilation of blood vessels around the lumbar spine. With the heat penetrating the body and opening up the vessels, the nutrients and oxygen coursing through are able to flow better to the muscles. This begins a healing process for the damaged tissue, as well as eases the transmission of pain signals to the brain.
Massage therapy: This therapy can provide substantial healing and pain relief for people suffering from low back pain caused by muscle tension and strain, if the correct muscles are targeted.
CRO Akwa Wellness
Sources and References:
Morrisette D, Cholewicki J, Logan S, Seif G, McGowan S. A randomized clinical trial comparing extensible and inextensible lumbosacral orthoses and standard care alone in the management of low back pain. Spine (Phila Pa 1976). 2014 October 1; 39(21):1733-42.
Furlan A, Tazdi F, Tsertsvadze A, et al. Complementary and Alternative Therapies for Back Pain II. Evidence Report/Technology Assessment No. 194. AHRQ Publication No. 10(11) E007. Rockville, MD; Agency for Healthcare Research and Quality. October 2010.
Nordin M, Campello M. Physical therapy: exercises and the modalities: when,
what, and why? Neurol Clin. 1999;17:75-89.
Cherkin DC, Deyo RA, Battié M, Street J, Barlow W. A comparison of
physical therapy, chiropractic manipulation, and provision of an educational
booklet for the treatment of patients with low back pain. N Engl J Med. 1998;
Bronfort G, Goldsmith CH, Nelson CF, Boline PD, Anderson AV. Trunk
exercise combined with spinal manipulative or NSAID therapy for chronic low
back pain: a randomized, observer-blinded clinical trial. J Manipulative Physiol
The statistics are staggering. About 80-90% experience lower back pain at some point in their lives. Many people with chronic lower back pain are working, and lose productivity on the job as a direct result. In fact, it is estimated by national statistics that back pain costs billions of € a year in lost earnings, and lower back pain is the Number 1 cause of visits to physicians.
Types of Back Pain
The most common types of back pain are:
Lumbar, or lower back pain, is typically located at and above the waist in the middle of the back or spine. The pain can be directly linked to prolonged stretches or sitting, standing, or lifting.
Sciatica is a sharp, stabbing pain that starts in the buttock and travels down the leg. It can often include numbness, "pins and needles", and/or even weakness of the leg. Sciatica is one of the most common forms of pain caused by compression of the spinal nerves, and the leg pain often feels much worse than the back pain. Sciatica is actually a symptom and not a diagnosis. While the most common cause of sciatica is a herniated (or "slipped") disc, many other conditions can cause this type of pain.
Relieving the Pain
If you or a loved one suffers chronic back pain, there are options to relieve the pain in the form of:
Visiting a Spine Specialist
Through careful evaluation and diagnostic tests, a spine specialist can determine the correct method of treatment including:
Don't Delay Treatment
Regardless of what type of back pain you suffer from, one aspect remains constant: If untreated, chronic aches and back pain can continue to follow you throughout your life. If mundane household chores or tasks at work lead to recurring pain on a daily basis, it's important for you to know that options are available.
The vast majority of lower back pain conditions will get better with time and can be addressed with conservative treatments. However, it is important to note that there are some diagnoses that indicate the need for surgery to enable relief from pain and better enjoyment of day-to-day activities.
CRO Akwa Wellness
April 7th 2018
Sources and References:
Burke GL (2008). "Chapter 5: The Differential Diagnosis of a Nuclear Lesion.". Backache: From Occiput to Coccyx. Vancouver, BC: MacDonald Publishing.
Lavelle, W. F., Kitab, S. A., Ramakrishnan, R., & Benzel, E. C. (2017). Anatomy of Nerve Root Compression, Nerve Root Tethering, and Spinal Instability. In Benzel's Spine Surgery (4th ed., pp. 200-205).
Bogduk, N. (Ed.). (2004). Practice guidelines for spinal diagnostic and treatment procedures. San Francisco: International Spine Intervention Society.
Indahl, A., Indahl, A., Velund, L., & Reikerås, O. (1995). Good prognosis for low back pain when left untampered. Spine, 20, 473–477.
Chou R, Baisden J, Carragee EJ, Resnick DK, Shaffer WO, Loeser JD (May 2009). "Surgery for low back pain: a review of the evidence for an American Pain Society Clinical Practice Guideline". Spine. 34 (10): 1094–109.
Heart disease kills. Cardiovascular disease kills more men and more women each year than any other cause of death. Numbers of heart attacks and strokes, as well as episodes of congestive heart failure, are escalating to epidemic proportions. Prevention is the key to saving lives.
Cardiovascular disease prevention focuses on risk factors. Risk factors are divided into two categories: Modifiable and Unmodifiable.
Unmodifiable risk factors can't be changed. These include:
Gender. Men develop heart disease earlier than women. It is commonly thought that women lag behind in the development of heart disease by about ten years. However, more women are developing heart disease at an earlier age that ever before and often have more severe disease and symptoms that are very atypical.
Family history of heart disease is a key predictor. This includes a close (parents or siblings) male relative having heart disease or a heart attack before the age of 55, and/or a female relative before the age of 65.
Modifiable risk factors depend on you. These are things that you can change. If you have unmodifiable risk factors, it is very important that you minimize your risk of cardiovascular disease by modifying the factors listed below.
High blood pressure, or hypertension, causes the heart to work harder. Like any pump- the heart has to overcome the pressure against it. Because of this, the heart muscle can enlarge. High blood pressure can also damage the lining of the artery walls, which encourages plaque build-up. High blood pressure is defined by a blood pressure reading of 130/80 or greater. A healthy blood pressure is 120/80 or less. If you have other risk factors, even a blood pressure of 130/80 may be too high.
High cholesterol. There are two types of cholesterol in the body: LDL and HDL. LDL - or "bad" - cholesterol sticks to the inside of an artery's walls, causing plaque to build up. HDL - or "good" - cholesterol circulates through the arteries and decreases the risk of plaque build-up. Cholesterol is found only in foods derived from animals, such as milk, cheese and meat.
If you have an HDL cholesterol level of 60 or higher, your risk of heart disease does not increase, and may even be below average. This is true even if your total cholesterol levels are also high (greater than 200.) It's important to have both your total cholesterol and your cholesterol profile checked and evaluated in terms of your personal cardiovascular risk.
The general goals for cholesterol levels are as follows:
Diabetes: Diabetes increases the rate at which heart disease develops and progresses. It is very important to get screened for diabetes. If you have diabetes, it is important to control your blood sugars well, exercise, and avoid any other risk factors. People with diabetes are at very high risk for cardiovascular disease and are often treated as if they have cardiovascular disease. If you have diabetes, it is imperative that you follow regularly with your doctor and report any symptoms that you may be having, such as chest pain or shortness of breath.
Stress puts excess demand on the heart muscle. During stressful situations, the body releases adrenaline, a hormone that increases heart rate and narrows blood vessels. This in turn increases blood pressure, and the heart works even harder. Stress does not need to be eliminated from life, but it can be reduced and controlled through stress management techniques and exercise.
Obesity is one of the fastest growing health problems in the United States - for children and for adults. Regular physical activity and following a heart-healthy diet are a key prescription in the prevention and treatment of obesity and heart disease.
Warding off heart disease on your own.Keeping your blood sugar levels under control, increasing your level of "good" cholesterol with regular exercise, maintaining a normal weight and, if you have it, controlling your high blood pressure are all good ways to help prevent heart disease.
Also, aerobic exercise most if not all days of the week can help you to control the modifiable risk factors for heart disease. Before beginning any new exercise program, consult your physician and get screened for any risk factors for heart disease. By being aware of any risk factors, you and your physician can be proactive in your health care and reduce risks for heart disease.
Be aware - it's your heart!
Take the American Heart Association's quiz to see if you are at risk for a heart attack.
CRO Akwa Wellness
Sources and References:
Swerdlow, Daniel I.; Humphries, Steve E. (2017-02-01). "Genetics of CHD in 2016: Common and rare genetic variants and risk of CHD". Nature Reviews Cardiology. 14 (2): 73–74.
Ronksley, Paul E.; Brien, Susan E.; Turner, Barbara J.; Mukamal, Kenneth J.; Ghali, William A. (2011-02-22). "Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis". BMJ. 342: d671.
Ignarro, LJ; Balestrieri, ML; Napoli, C (Jan 15, 2007). "Nutrition, physical activity, and cardiovascular disease: an update". Cardiovascular Research. 73 (2): 326–40.
Bhupathiraju, SN; Tucker, KL (Aug 17, 2011). "Coronary heart disease prevention: nutrients, foods, and dietary patterns". Clinica Chimica Acta. 412 (17–18): 1493–514.
Vanhecke TE, Miller WM, Franklin BA, Weber JE, McCullough PA (Oct 2006). "Awareness, knowledge, and perception of heart disease among adolescents". Eur J Cardiovasc Prev Rehabil. 13 (5): 718–23.
World Health Organization (2008). Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health : Commission on Social Determinants of Health Final Report. World Health Organization.
Berneis K, Rizzo M. "LDL size: does it matter?" Swiss Med Wkly 2004;134:720-724.
Blood pressure is the pressure created by the heart as it pumps blood through the arteries and the circulatory system.
What blood pressure numbers mean
What High Blood Pressure Does to the Body
High blood pressure puts you at a higher risk for the following:
Symptoms of High Blood Pressure
High blood pressure usually has NO SYMPTOMS!! Because of this it is sometimes referred to as "The Silent Killer".
How to tell if you might have high blood pressure:
Causes of High Blood Pressure
Blood pressure develops when certain nerve impulses cause arteries to become larger (dilate) or smaller (contract). If vessels are wide open blood flows easily. If vessels narrow pressure inside increases causing hypertension. The cause of vessels narrowing is unknown in 90 to 95% of cases. This is called Primary Hypertension. In 5 to 10% of cases, the cause of vessel narrowing comes from another condition. This is called Secondary Hypertension. Some common conditions that can cause secondary hypertension are:
Risk Factors of High Blood Pressure
Risk Factors You Can't Control
Uncontrollable risk factors are inherent to you and cannot be changed. They include:
Controllable risk factors are lifestyle choices that increase the risk of high blood pressure. They include:
Women and High Bood Pressure
Women are particularly at risk for hypertension due to the following:
What You Can Do to Reduce the Risk of Hypertension
High blood pressure is a lifelong disease. It can be controlled, but not cured. Controlling blood pressure will reduce the risk of stroke, heart attack, heart failure and kidney disease. The following lifestyle changes will help you reduce your risk:
The Ten Commandments for Blood Pressure Control
Medication for High Blood Pressure
Blood Pressure Measurement
Blood pressure is measured using a sphygmomanometer. There are two numbers in a bood pressure reading.
American Heart Association Recommended Blood Pressure Levels
Home Blood Pressure Monitoring
Drs. Christiaan Janssens MBA
CRO Akwa Wellness
Sources and References:
Rowan, Robert; Schrader, Constance, Control High Blood Pressure Without Drugs: A Complete Hypertension Handbook (2001).
James, Paul A.; Oparil, Suzanne; Carter, Barry L.; Cushman, William C.; Dennison-Himmelfarb, Cheryl; Handler, Joel; Lackland, Daniel T.; Lefevre, Michael L.; MacKenzie, Thomas D.; Ogedegbe, Olugbenga; Smith, Sidney C.; Svetkey, Laura P.; Taler, Sandra J.; Townsend, Raymond R.; Wright, Jackson T.; Narva, Andrew S.; Ortiz, Eduardo (18 December 2013). "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults". JAMA. 311 (5): 507–20.
Lackland, DT; Weber, MA (May 2015). "Global burden of cardiovascular disease and stroke: hypertension at the core". The Canadian journal of cardiology. 31 (5): 569–71.
Mendis, Shanthi; Puska, Pekka; Norrving, Bo (2011). Global atlas on cardiovascular disease prevention and control (PDF) (1st ed.). Geneva: World Health Organization in collaboration with the World Heart Federation and the World Stroke Organization. p. 38. ISBN 9789241564373.
Hernandorena, I; Duron, E; Vidal, JS; Hanon, O (July 2017). "Treatment options and considerations for hypertensive patients to prevent dementia". Expert Opinion on Pharmacotherapy (Review). 18 (10): 989–1000.
Poulter, NR; Prabhakaran, D; Caulfield, M (22 August 2015). "Hypertension". Lancet. 386 (9995): 801–12. doi:10.1016/s0140-6736(14)61468-9.
Carretero OA, Oparil S; Oparil (January 2000). "Essential hypertension. Part I: definition and etiology". Circulation. 101 (3): 329–35. doi:10.1161/01.CIR.101.3.329.
"How Is High Blood Pressure Treated?". National Heart, Lung, and Blood Institute. 10 September 2015.
Campbell, NR; Lackland, DT; Lisheng, L; Niebylski, ML; Nilsson, PM; Zhang, XH (March 2015). "Using the Global Burden of Disease study to assist development of nation-specific fact sheets to promote prevention and control of hypertension and reduction in dietary salt: a resource from the World Hypertension League". Journal of clinical hypertension (Greenwich, Conn.). 17 (3): 165–67.
Naish, Jeannette; Court, Denise Syndercombe (2014). Medical sciences (2 ed.). p. 562. ISBN 9780702052491.
Lau, DH; Nattel, S; Kalman, JM; Sanders, P (August 2017). "Modifiable Risk Factors and Atrial Fibrillation". Circulation (Review). 136 (6): 583–96.
James, PA.; Oparil, S.; Carter, BL.; Cushman, WC.; Dennison-Himmelfarb, C.; Handler, J.; Lackland, DT.; Lefevre, ML.; et al. (Dec 2013). "2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8)". JAMA. 311 (5): 507–20.
Musini, VM; Tejani, AM; Bassett, K; Wright, JM (7 October 2009). "Pharmacotherapy for hypertension in the elderly". The Cochrane Database of Systematic Reviews (4): CD000028.
Sundström, Johan; Arima, Hisatomi; Jackson, Rod; Turnbull, Fiona; Rahimi, Kazem; Chalmers, John; Woodward, Mark; Neal, Bruce (February 2015). "Effects of Blood Pressure Reduction in Mild Hypertension". Annals of Internal Medicine. 162: 184–91.
Xie, X; Atkins, E; Lv, J; Bennett, A; Neal, B; Ninomiya, T; Woodward, M; MacMahon, S; Turnbull, F; Hillis, GS; Chalmers, J; Mant, J; Salam, A; Rahimi, K; Perkovic, V; Rodgers, A (30 January 2016). "Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: updated systematic review and meta-analysis". Lancet. 387 (10017): 435–43
Diao, D; Wright, JM; Cundiff, DK; Gueyffier, F (Aug 15, 2012). "Pharmacotherapy for mild hypertension". The Cochrane Database of Systematic Reviews. 8: CD006742.
Garrison, SR; Kolber, MR; Korownyk, CS; McCracken, RK; Heran, BS; Allan, GM (8 August 2017). "Blood pressure targets for hypertension in older adults". The Cochrane Database of Systematic Reviews.
During warm and sunny weather we all love to do outdoor activities. But, we should take care to avoid heat-related injuries and illnesses. Heat illness is a common, yet preventable, problem for those who exercise, play sports, or spend time outdoors in the hot and humid months.
Use the following guidelines to decrease the risk of heat illness:
Those planning on exercising in hot and humid weather need to be accustomed gradually to this environmental stress. You should exercise at decreased intensity for at least a week. So the body becomes acclimatized to the heat. You can increase the exercise intensity gradually.
Water intake should be carefully monitored and encouraged for those exercising in the heat. Unlimited access to cold water should be available at all times. Fluid consumption should occur before, during, and after activity. During exercise, you have to plan frequent water breaks. Water is usually the best choice for fluid replacement. Try to avoid drinks with caffeine or alcohol.
Monitor Weight Loss
Check your body weight before and after each exercise session on hot and humid days. Most of the body weight lost during exercise in the heat is water weight. It should be replaced the next day through proper diet and fluid replacement. A loss of 3-5% of body weight can reduce blood volume and lead to a health threat.
Lightweight, loose-fitting, light colored clothing should be worn while exercising in the heat. Shorts and short-sleeved shirts should be worn. Avoid exercising in heat producing garments (sweatshirts, rubber suits, etc).
Monitor Temperature and Humidity
Check the environmental temperature and humidity (heat index) during exercise sessions or sporting events. If the heat index reaches dangerous levels, you need to modifie your activities. Try moving activities to early morning or late evening when the temperature and humidity are lower.
Heat illness is a serious health concern that can lead to permanent disability and, sometimes, death. Anyone is susceptible to heat illness; however, elderly, overweight, and unacclimatized individuals should be monitored closely. Any incident of heat related illness should be referred to a physician immediately.
Drs. Christiaan Janssens
CRO Akwa Wellness
For active people, participating in exercise or athletic events can often result in minor musculoskeletal injuries. The following is a list of things which should be done soon after an injury occurs. The guidelines are based on the acronym R.I.C.E., which stands for Rest, Ice Compression, and Elevation.
Rest - Rest is very important for allowing musculoskeletal injuries to heal. Immobilization of an injury allows the body's healing processes to occur without complication. This will help to ensure the most efficient recovery period.
Ice - Cold, primarily ice in different forms, is an excellent first aid agent. It helps to reduce swelling, decrease pain, and ease muscle spasm. Ice should be applied for approximately 20 minutes every hour or hour and a half following an injury. This protocol should be followed for 2-3 days or until pain and swelling subsides.
Compression - Compression is another effective tool for treatment of new injuries. Elastic wraps and tapes provide uniform compression to injured areas, helping to minimize inflammation. Compression should be maintained throughout the day, with intermittent cold applications.
Elevation - Elevation can also aid the healing process by reducing swelling and increasing venous return of injured cells. The injured area should be elevated above the level of the heart, especially during ice and compression applications.
Many injuries that, at first, seem too minor can sometimes become more involved. If pain, swelling and other symptoms are not improving, it is important to consult your physician. Any injury which results in severe pain, deformity, or joint instability, should be examined immediately by a health care professional.
Drs. Christiaan Janssens
CRO Akwa Wellness
If you’ve ever requested a vegetarian meal on an airplane, then you know that the airline gives you an entirely different meal than everyone else. While you're eating bean paste and sprouts without a cookie, you start salivating over the sandwich, grapes, and chips everyone else is eating. During my 15 years of vegetarianism, there is no question I get asked more frequently than, “What should I feed a vegetarian guest?” To answer the question, prepare whatever dish you normally would, with meat on the side.
Vegetarians are like everyone else, but we just don’t eat meat. I’ve been to many dinner parties where I was forced to choke down bland, poorly-cooked tofu while everyone else ate gourmet. Follow these simple guidelines to please any vegetarian guest. You’ll be surprised how easy it is.
In an effort to please vegetarian guests, many hosts have made simple mistakes that prevented a vegetarian from enjoying a dish that was intended for their enjoyment. For example, you’ve made your famous bean stew, thinking how high in protein it will be. Unfortunately, you forgot to skip the ham hock step in the directions. Maybe you’ve made a Caesar salad for your vegetarian guest, but you forgot that the dressing has tiny bits of anchovy in it. Other ways of tainting a veggie meal for your guest are adding bacon bits to a salad or putting meat that could be served on the side in the main dish. For example, if you’re serving chili, put the ground beef on the side. This is a win-win situation.
Don't make a fuss
Most vegetarians do not like having to eat something entirely different than everyone else because we feel left out. If you were planning on steaks for your dinner party and cooking a separate dish just for the vegetarian, reconsider. Go ahead and serve the steak, but try pasta primavera, salad, and dinner rolls on the side. A vegetarian guest can make the pasta his or her main dish, no problem. It is not necessary to do as the airlines do and make us a tofu cake with lentil sauce. We like the same food as everyone else!
With the wide array of fake meat available today, throw a meatless patty on the grill. It is sure to please your vegetarian guest. I recommend either fake beef or fake chicken patties. Grilled vegetables are also great on the grill. Be careful to make extras though. Your other guests are sure to see the grilled veggies and want to try some. If you’re doing shish kabobs, try either tofu with vegetables for your vegetarian guest. Tofu and fake meat can be purchased in the produce or frozen food section of your local grocery store.
Many holiday meals center around turkey or ham. No problem, any vegetarian already knows this. Don’t worry about offending a vegetarian guest because everyone else is having meat. As long as there are enough veggie side dishes, no one will go hungry. Having a “pot luck” holiday dinner is also a great way to please a vegetarian guest. No doubt the vegetarian will bring something he or she will enjoy.
Health & Beauty Blogger
In an earlier post we talked about the importance of dietary fats in any (weight loss) diet plan. Not only do they supply energy to our body, they also play an important part in our nerve system, cell membranes, hormones and many other bodily functions.
In this article I’m going to talk about the 4 different kinds of dietary fats: saturated fat, polyunsaturated fat, monounsaturated fat and trans fatty acids. Some fats are good for you while others are dangerous and should be avoided.
One interesting fact often overlooked is that fat in food always comes in a mixture. Some foods have more of the good fats while others have more of the bad fats. But there will always be a combination of the two. It's your task to learn which food products have more of the healthy dietary fat and consequently, avoid the bad foods.
There are over 20 kinds of saturated fat present in nature. The main source of saturated fat are found in meat. But there are also exist plant based saturated fats such as palm oil and coconut oil. At room temperature saturated fat will be in a solidified form.
Saturated fat can be found in many food products:
When talking about the health benefits coming from saturated fat: there are none to very little. Saturated fat is usually related with an increase of cholesterol and should therefore be avoided as much as possible. It’s bad for your heart. A much better source of fat would be the unsaturated kind.
One side note though. Saturated fats come in different health risk gradations. The saturated fats that increase cholesterol the most are butter and other dairy products. But some sources of saturated fat are not so bad at all, like coconut fat and cacao butter. Saturated fat in meat is neither the worst nor the best kind of saturated fat.
Monounsaturated fat always comes in a liquid form and is very good for your health because it lowers the bad and increases the good cholesterol. The most popular source of monounsaturated fat is olive oil. When deciding what kind of baking fat to use, you should go for the olive oil and leave the regular baking fat on the shelves.
Good sources of monounsaturated fats are:
arachis oil (peanut oil)
Polyunsaturated fats contain the essential fats omega 3 and omega 6. It lowers our bad and raises our good cholesterol, just like the monounsaturated fat does. Omega fats should play a very important part in your diet, since your body can’t make these by itself.
It is important to know that your omega 3 and omega 6 fat intake must be well balanced. Most people eat to much omega 6 and to little omega 3. It is advised to increase the amount of omega 3 and decrease omega 6 fat intake. A good ratio would be 3:1. For every 10 grams of omega 3 you should eat 30 grams of omega 6. Most people eat these fats in a 10:1 or even higher ratio, which is way too much omega 6.
Omega 3 fats benefit the cell membranes in our whole body and especially those of our eyes, brains and sperm cells. Also the benefits to our hormones and our immune system have been proven substantial. But the most praises for the omega 3 fatty acids are derived from its benefits for our heart. The omega 3 fat stabilizes our heart rhythm and dramatically decreases the chance of a sudden congestive heart failure. Just in the United States over 200.000 people die of an acute heart failure a year.
Omega 6 fat sources
Saffloweroil oil (~ 70%)
sunflower oil (~ 60%)
walnut oil (~ 60%)
Omega 3 fat sources
Flaxseed oil (~ 50%)
Walnut oil (~ 20%)
Soybean oil (~ 7%)
Fish oils (20 - 30%) such as salmon oil, herring oil,...
Fatty fish (~ 2%)
Unstable nature and hydrogenation
One reason for the decline of omega 3 fatty acids in our diets is the fact that food industry takes it out of it's products. They harden or hydrogenate the polyunsaturated fats in our food, transforming these healthy fats into dangerous trans fatty acids (or trans fats).
The explanation for this malicious act is the short shelf date and unstable nature of polyunsaturated fats. When exposed to heat, light or air, polyunsaturated fats oxidize by which free radicals are released. As a result the fat will go rancid which will make the food taste bad, look bad and very unhealthy. What the food industry does is they harden the polyunsaturated fats, turning them into hydrogenated fats or trans fats. This way the products have a much longer shelf life. But the flipside of this deal is the unkind nature of trans fats to our health. They are the worst kinds of fat and should be avoided at all cost!
This is the biggest downside to polyunsaturated fats. Though they have huge health benefits, they are not very stable, making them possibly hazardous when not preserved right. It is important you keep your polyunsaturated oils in a cold, dark and air locked place. If you would use them to bake food, free radicals would be released. Free radicals attack your body and make you more vulnerable to cancer. It is important to remember that you should not avoid polyunsaturated fats for this reason. You should just be cautious.
The most abundant source of omega 3 fat is flaxseed oil. Though very beneficial, it's goes rancid pretty fast, it is very expensive and it tastes extremely bad. The best options are fatty fish, fish oil capsules, nuts or some other natural source of omega 3.
This fat was invented as a solution to preserve and transport liquid fats. Hydrogenation would harden oils, making them last longer and a lot easier to transport. The downside of this process is that it poses a huge threat to our health, damaging mainly the heart.
Trans fats can be found in candy, cookies, fried foods and many other cheap commercial products. They can be recognized in the ingredient list by looking for "[partially] hydrogenated [oils]".
Health & Beauty Blog