Friday, March 26, 2010

Plastic Surgery for Men QT: I am going to the beach for spring break..What exercises can I do to get ready?


This routine tests your willpower, says C.J. Murphy, M.F.S., a strength coach Everett, Mass. Start with 3 sets of the clean and press. Then do the next three moves in succession, with one twist: Don't count reps. Instead, do as many reps of each as you can in 30 seconds. Rest 30 seconds between exercises, and repeat the three-move sequence once or twice.


1. Dumbbell clean and press 
Holding dumbbells in front of your thighs, bend your knees. Jump up in one explosive movement as you shrug your shoulders and pull the weights up. Catch the weights at your shoulders and then press them overhead. Lower to the starting position. Do 6 reps total.

















2. Cable squat with row
Attach an EZ-curl bar to the low pulley at a cable station. Grab the handles with your arms extended. Bend to lower your body until your thighs are parallel to the floor. Stand up and draw the handles to your rib cage, and then straighten your arms back out in front of your chest.
















3. Dumbbell burpee
Stand holding light dumbbells at your sides. Bend down until the weights touch the floor, then kick your feet behind you into a push position resting your hands on the weights. Do a pushup, then bring your feet back underneath you and jump up. Land softly and move into your next repetition.
4. Dumbbell floor sweeper
Lie faceup holding dumbbells above your chest. Lift your legs up and out to the left, keeping them straight. Then return to center and repeat to the right. Return to center, lower your legs, and do a situp, keeping your arms straight above you.



resource: http://health.msn.com/fitness/mens-fitness/articlepage.aspx?cp-documentid=100256274

Thursday, March 25, 2010

Plastic Surgery for Men QT: Which Foods Make You Fart?


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Farts stink, they certainly do,
the more that you smell em', the worser for you,
the more you release em', the better you feel,
so be sure to fart after every meal.

Here's our Top 10 list of the worst fart producing foods on the planet.



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10. French Food


Sure the French gave us the Statue of Liberty, but that doesn't mean they don't secretly hate America.

All those sauces on the plate may end up sauces in your pants.

Cheesy French onion soup, steak and fries, mushrooms, frog legs, fatty duck, goose liver, butter snails, tripe a la mode...Never take a date to a French restaurant unless they really like your ass.

Literally.


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9. Smoked Oysters In A Can


First of all, these are canned in cottonseed oil, an industrially produced food type product valued for its cheapness that can also be found in mayonnaise and crisco.

In many cases, the oysters are farm raised, which sounds nice, but is ugly when it comes to the amount of oyster shit they're swimming in. Welcome to fart city.


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8. Collard Greens With Ham Hocks and Bacon

This one is delicious, but deadly. Collards are a bitter, fiber-intense super green that have a very distinkt smell when you cook them.

Add on some fatty meats and you've got the recipe for building your own fartopolis.



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7. Biscuits and Gravy

Some say that gravy originated in ancient Egypt. What do you think Tut's revenge was when they opened his tomb? A 3,000 year old fart.

Gravy is something like a thickened, semi-liquid version of everything that causes farts in the first place, concentrated, and lumpy.

Sop it up.




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6. Brazilian Rodizio or Churrascaria

These all you can eat meat fests include items like steak wrapped in bacon, turkey wrapped in bacon, and maybe even bacon wrapped in bacon.

Servers magically appear tableside whenever you run out of food and restock your plate. They cut the meat directly off a giant skewer.

Eating more than your fill is encouraged and sides like salad, rice and beans, pineapple, and cooked bananas keep everything moving.

On the way home, drive with the windows down. The burps and farts from a night out like this may be with you for days.




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5. Curry

Some people think "curry" is an actual substitute term for flatulence, like, "Dude, I just curried loud as shit," or "Damn, what the hell did you eat? Curry ass motherfucker."

It comes in many different styles, flavors, and combinations all over the world, but the end result everywhere is always the same.





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4. Stuffed Boiled Cabbage

This one actually kind of smells like fart while it's cooking, except the fart version is very much worse.

Multiply that times the fartocity of whatever you stuff it with and you've got a recipe for disasster.


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3. Smoked Fish

Want to ostracize yourself, piss off your family, make an entire busload of people uncomfortable, ruin an elevator ride, or make sure nobody ever sits next to you?

Eat a full week's worth of smoked fish three times a day.



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2. Greenbean Casserole

Good thing your grandma Betty is sort of deaf. At least she doesn't hear you laughing every time she thinks she's getting away with ripping one of her classic 30 second fartathons.

Wait, she does think she's getting away with it right?



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1. Pickled Eggs from the Gas Station

There is a reason they sell these at gas stations, it's because they turn you into one.

Especially deadly when combined with the pickled sausages they are usually sold next to.

There's no telling how long they've been sitting there, where they came from, or if they've just been reusing the jar to make their own for less.

One thing is certain, and you already know what it is, so enjoy, but be careful.

And finally, always keep in mind the story of Jack Brown, he's the dude that's now departed, took a shit and thought he farted.
resource: http://blogs.miaminewtimes.com/shortorder/2010/03/top_10_worst_fart_producing_fo.php?page=1

Wednesday, March 24, 2010

Permanent Hair Removal

Permanent hair removal procedures verses other methods….what is permanent when it comes to hair removal?  Well, when it comes to advertising, permanent hair removal doesn’t mean it lasts forever.  Other products that tote that they are permanent are a permanent wave and a permanent magic marker. But are they?  Assessing new hair removal systems or procedures that manufacturers claim to be permanent it is very unlikely they will stop hair from returning over time.  Look at the advertising campaigns such as one manufacturer that claims their permanent hair removal results last 9 weeks…thats just 9 weeks, other alternative methods like waxing can last that long.  What is hairfacts definition of permanent when we look at hair removal treatments?  Without having to use another treatment or another product your hair should not return for a year.  Now this doesn’t seem like it is long enough to be defined as true permanence, but most people are satisfied with one procedure a year.  The only method that is clinically proven to permanently remove hair is electrolysis as some lasers or flash lamp achieve only permanent hair reduction.  Because of all the different distinctions of permanent hair removal I have divided them into three different categories; long-term hair removal, semi-permanent hair removal and hair reduction.

Long-term hair removal as defined is at least 6 months from the final treatment without using another method or product.  Semi-permanent hair removal which usually describes a laser treatment results lasts a few weeks.  As permanent hair removal destroys the hair follicle’s ability to regenerate and grow, hair reduction by lasers reduce the size of hairs especially coarse dark hair and lighten their color, the reduction appears to be permanent. 

If you are seeking permanent hair removal and want to spare the surrounding tissue from damage (which is hard to do) electrolysis will destroy the follicles by inserting a thin metal probe into the hair follicle. Proper insertion will not puncture the skin and should be done by a qualified practitioner as self-treatment is not recommended. If done wrong can be very painful, partial or full regrowth of hair and infections, Electrolysis has over 125 years of clinically proven safety and effectiveness. Up to 10% of the people treated were not satisfied with the results.  Treatment can be expensive, but can be 100% permanent.  

Lasers use a light at a specified wavelength that causes thermal or mechanical damage to a hair follicle while sparing the surrounding tissue.  Some customers experience long-lasting hair removal or permanent hair reduction.  If hair returns it can come back finer in texture and/or lighter in color. Best used on dark hair, generally not as effective on gray, red or blonde hair.  Not recommended on darker skin tones or those that tan.    It is generally safe to perform, but if improperly performed can cause burns, lesions, skin discoloration that lasts several months and patchy regrowth.  Can be expensive and more than one treatment may be recommended.  Treatments vary since each individual's hair growth occurs at different rates. On the average, treatments are usually spaced about 4-6 weeks for facial areas, 6-8 weeks for back and bikini areas, and 10-12 weeks for legs.

Flashlamp like laser therapy uses a full spectrum (non-coherent) light and low-range infrared radiation is filtered to allow a specified range of wavelengths to destroy hair follicles with long-lasting hair removal or permanent hair reduction results.  Result data is the same as laser results.


Other lasting hair inhibitions that require continued use are oral prescription medications and topical preparation, Vaniqa. Vaniqa (pronounced “VAN-i-ka”) is a brand name prescription cream applied to the skin for the reduction of unwanted facial hair in women ages 12 and older. Your health insurance may not cover Vaniqa.  In clinical trials 58% of the women that used it had improvement, while 42% had no improvement. This medication is not a depilatory but acts as a hair retardant.  You may have to shave and/or pluck while you take Vaniqa, as full results take up to two months. If you stop taking Vaniqa your hair may grow back within two months.  Vaniqa should not be used by men as it has not been tested on males, by women that are pregnant or nursing, females under the age of 12, if you have acne or broken skin or by eyes, nose, mouth or vagina.


Restricted methods include x-ray which is banned in the United States and photodynamic therapy which is experimental.  Other methods that get rid of hair but are not permanent are; electric tweezers, transdermal electrolysis, transcutaneous hair removal, photoepilators, microwaves, dietary supplements and nonprescription topical preparations.  

Exercise’s Benefits for Type 2 Diabetes

You can easily manage diabetes if you engage in an exercise program for it. This is because exercise has a great effect for the glucose levels of those who are suffering from Type 2 diabetes. Take for example, energy that is found in your muscles are channeled when you exercise and converts it into glucose. This glucose is then expended. At the start, the body only utilizes the glucose (which is converted through the muscles’ glycogen). This glucose is traced from one’s blood stream. As soon as you engage in a long term exercise routine, your body will adjust and prevent your glucose levels from dipping too low. 

Aside from this, there are also some additional hormones as well as glucagon that gets released. These all work in order to break down all of the stored fat located in your liver, thereby converting it into more glucose. Make it a point to exercise all the time, because then your body will improve a lot and get more sensitive to your insulin. Aside from this, you will also attain a much better sense of control on your glycemic index.

As previously explained, the exercise will have a great effect on your glucose levels. This is actually quite important especially for patients of type 2 diabetes. There are a lot of studies that indicate a better control of one’s glycemic index in diabetes patients, but only if they engage in regular exercise. Those who fail to establish a regular routine for exercise have results which are not as good. Thanks to exercise, you get to improve on your insulin sensitivity. This means you need to use less medicines and attain adequate control over their blood sugar levels.

There are times when type 2 diabetes sufferers are prone to hypoglycemia, which is a condition that can develop out of exercise. This is both after as well as during the exercise routine itself. But at the same time, patients who exercise poor management of their diabetic condition may also be high risk when it comes to hyperglycemia.

Many experts recommend around two hours and thirty minutes of exercise three days each week for moderate aerobic activity. You could also do ninety minutes of vigorous aerobic exercise.
Truthfully, the different types of exercise are not the issue as the length of time one spends exercising. Studies show that engaging in both aerobic exercise and weight training gives you more benefits in the end.
 If you are high risk for cardiac arrest or engage in too stressful exercise, you should get cautioned and adapt to it slowly.

About the Author - Su Rollins writes for reactive hypoglycemia diet, her personal hobby blog focused on tips to prevent and cure hypoglycemia using the right diet and nutrition.

Tuesday, March 23, 2010

Plastic Surgery for Men: Stem-Cell Therapy My Illegal Heart

Stem-Cell Therapy : Men’s Health – My Illegal Heart
March 22, 2010 at 5:04 pm

Stem-Cell Therapy

My Illegal Heart

Facing death inspires desperate measures. Like having your stem cells drawn in Florida, sent to Israel for processing, and shot into your ailing heart in the Dominican Republic. How far would you go to save your own life?

By: Mark Cohen, Photographs by: Mauricio Alejo 4 Comments | 12 Recommended

Ron O’Leary, 36, has never felt so exposed. Naked from the waist down, the 6′2″, 210-pound man is lying atop an x-ray table, shivering in the air-conditioned chill. His blue eyes are fixed on the flexible 4-foot catheter about to be threaded through his femoral artery to his heart. He’s flown 1,000 miles from his home in Florida to the Dominican Republic because parts of his heart are dead.

Now, an ECG broadcasts the plodding clunk-clunk of his scarred heart, which is pumping at 30 percent of its normal capacity. The nurses begin slathering his privates with a dark-brown antiseptic solution. Thoughts flit through his mind.

Boy, is that cold . . .
Is this going to hurt? . . .
I just want my heart back . . .

It’s 2 p.m. in the dimly lit fourth-floor cardiovascular department at Centro de Otorrino, a private hospital in downtown Santo Domingo. O’Leary suffers from idiopathic dilated cardiomyopathy, a condition in which the heart muscle has stretched and then becomes weak and starts dying off. His heart is so damaged that it struggles to pump blood to his lungs, leaving the former restaurant owner unable to work and barely able to walk 40 yards without wheezing. His doctors in Florida counseled him that he needed to adjust to this new reality and prepare himself for a heart transplant in a few years if his condition deteriorated. Faced with this dramatic decline in his quality of life, O’Leary, who had been in good health 11 months prior, has flown to one of the poorest countries in the Caribbean for a new type of cardiac therapy. Doctors are going to use O’Leary’s own stem cells to repair his heart. There’s only un problemita. It’s not legal, at least in the United States, because the U.S. Food and Drug Administration classifies the adult stem cell as a high-risk biologic product, and requires a rigorous review of its safety and effectiveness before it can be marketed. Prior to leaving home, O’Leary had signed 12 pages of waivers exempting the doctors who would be inserting the catheter from any kind of malpractice suit.

As a nurse places a sheet over O’Leary’s groin, Dominican cardiologist Roberto Fernandez de Castro, M.D., picks up a polypropylene syringe from a stainless-steel surgical tray and gives it a slight shake. Inside, suspended in a yellow slurry of plasma, are 95 million of O’Leary’s stem cells. They were grown from his own blood, which was extracted a week earlier at the offices of Regenocyte, the Naples, Florida-based company overseeing this procedure.

Next, Dr. Fernandez screws this small syringe into the opening of a foot-long black plastic syringe. It’s then attached to the specially designed catheter that his partner, Hector Rosario, M.D., has begun feeding through a spot on O’Leary’s upper-right thigh, up into the lower-left chamber of his heart. On the black-and-white fluoroscopy monitor, the catheter snakes into view. Its tip flicking in and out in response to Dr. Rosario’s touch, the needle probes for a fertile site on the interior wall of O’Leary’s left ventricle. Dr. Rosario turns a dial at the end of the syringe to lengthen the tip, and with the help of a plunger, implants the stem cells directly into O’Leary’s heart.

“Ouch . . . pain, definitely a little pain there,” says O’Leary.

On the ECG, O’Leary’s rhythm spikes into a pattern of rapid squiggles. Dr. Fernandez mutters under his breath in Spanish, and Dr. Rosario adjusts his grip on the needle. “That’s actually a good sign,” says Dr. Rosario. In his broken English, he explains that the pain shows there’s enough healthy tissue in the heart muscle to react to being jabbed, which should help the stem cells take root and start growing new blood vessels. Then he maneuvers the needle to a second spot on the ventricle wall and fires off another 3 million cells.

Despite all the billion-dollar research, medical advances, and new life-extending recommendations of the past 50 years, there still isn’t much you can do for a damaged heart. If you suffer a severe heart attack or an enlarged heart like O’Leary’s, your choices are limited: Downshift your daily life so that watering the garden ranks as your most strenuous activity, or get in line with the other 3,000 Americans waiting for one of the 2,200 donor hearts available annually. The human heart may be one of our most mechanically sophisticated organs, but it’s just not a good healer. With its own electrical system and unique muscle tissue beating 100,000 times a day, the heart is just too complex and too busy to repair itself significantly. Deprive critical cardiac tissue of oxygen, even for just a few minutes, and it dies. Weaken a single chamber or a single valve, and pumping efficiency plummets. Allow the damaged parts to dip below a certain baseline level of functioning, and they only become worse, never better.

Which is why stem-cell therapy is so intriguing — and potentially so lucrative. Of the 17 million adults in the United States who have suffered heart attacks or other major cardiac malfunctions, 5.7 million have started on the inexorable slide toward heart failure. And more than 3 million of them are men. If science could harness the regenerative powers of the patients’ own stem cells to reverse that slide, the savings in terms of lives and dollars would be enormous. It’s nothing short of the groundbreaking first step on the path toward growing your own replacement heart. “Stem-cell therapy shifts the whole paradigm for treating heart disease, whether it’s caused by heart attack, arrhythmia, or cardiomyopathy,” says Joshua Hare, M.D., a cardiologist and the director of the University of Miami’s interdisciplinary stem-cell institute. “My prediction is that in 10 to 15 years, thanks to this new ability to repair damage, heart disease will no longer be the number one killer in the country.”

Dr. Hare is overseeing four of the 21 phase 1 and phase 2 cardiac stem-cell-therapy clinical trials now under way at 43 research institutions around the country. While scientists race to win approval from the FDA, they’re playing by the rules — they’re following the systematic, government-regulated route of testing experimental medical treatments to make sure they’re safe before they can become standard practice. Researchers estimate the cost of a three-phase stem-cell trial will be upward of $50 million, with a 10-year time table. Regenocyte and the nearly two dozen other for-profit off shore stem-cell clinics are taking a shortcut, but at whose expense?

Since Regenocyte began offering treatments in the Dominican Republic in February 2008, its doctors have performed 75 of what it calls myocardial cellular regeneration procedures, at a cost of $64,500 a pop — not a penny of which is covered by insurance. The process kicks off in Naples, Florida, with a blood draw; the blood is then immediately whisked by courier to the lab of Regenocyte’s affiliate, TheraVitae, in Tel Aviv, Israel, for centrifuging and culturing. After a 5-day incubation period, which increases the stem cells’ numbers a thousandfold, a TheraVitae representative boards a flight with the stem cells in a temperature-controlled tissue container, and arrives in Santo Domingo on the morning of the procedure. Shuttling cells back and forth across six time zones and performing the procedure outside the United States allows the company to operate without interference from U.S. authorities. The FDA’s jurisdiction extends only to products manufactured within the United States; as it is, the only step of the process the company carries out on American soil is a needle stick to the arm.

“It’s a questionable practice,” says Emerson Perin, M.D., Ph.D., the director of clinical research for cardiovascular medicine at the Texas Heart Institute, who’s supervising five of the clinical trials. “They’re charging big bucks for an experimental procedure that will require years of rigorous research before we know if it will benefit patients. It’s a total gunslinger mentality, and that’s coming from someone in Texas.” Concerned about the rise in “stem-cell tourism,” the nonprofit International Society for Stem Cell Research recently cardiac-produced a handbook for patients who are considering experimental therapies. It outlines the risks, which are physical, financial, and psychological.

The greatest danger in adult stem-cell cardiac treatments derives from the fragility of patients with terminal heart disease. “They can die if they sneeze the wrong way,” says Amit Patel, M.D., the director of clinical regenerative medicine in cardiac surgery at the University of Utah, who is overseeing a phase 2 clinical trial using stem cells to treat dilated cardiomyopathy. If a patient’s weak condition causes some other medical problem, many smaller clinics simply don’t have the resources to provide emergency help, he says. A further concern for patients is the cost of that emergency care and the burden of additional fees.

That said, the technique and cells Regenocyte’s doctors are using are low risk. “This modified catheterization approach has had few complications,” says Dr. Patel. However, as with any heart catheterization, there is roughly a 1 percent chance of perforation of the heart, which would likely result in death, he says. Dr. Patel also notes that although adult stem cells have been used in phase 1 and phase 2 clinical trials, long-term concerns about safety and efficacy remain, because there is no long-term data yet.

Even when patients understand and accept these risks, they still need to ask the next question: Does the treatment actually work as advertised? A peer-reviewed clinical trial is the gold standard for verifying efficacy. The consensus in the medical establishment is clear, as Clyde Yancy, M.D., president of the American Heart Association and medical director of the Baylor University heart and vascular institute in Dallas, explains: “We do not encourage patients to pursue any therapy that has not met the standards of evidence-based medicine or is not a part of an established study.” If the treatment doesn’t work, patients find themselves both out of money and out of options, which can be psychologically devastating.

There is also a concern that what companies like Regenocyte are doing creates a dangerous precedent that could lead to patients rolling the dice with other stem-cell therapies that have less scientific merit. “There’s no way you can let stem cells go unregulated,” says Doris Taylor, Ph.D., the director of the cardiovascular repair center at the University of Minnesota stem-cell institute. And yet, perhaps because Taylor is so familiar with stem cells’ potential, she also makes an interesting concession for a scientist at an elite research institution. Asked if she might advise someone she loved who was dying of heart failure to book a flight to the Dominican Republic, she replies, “You know, I’m not sure. But I would discuss it first with my colleagues.”

Adult stem cells usually aren’t associated with controversy. Embryonic stem cells, the kind grown from cryo-frozen fertilized eggs stored in liquid nitrogen in fertility clinics, are the ones that have been at the flash point of moral agonizing. The use of these cells to find cures for Parkinson’s and Alzheimer’s has been hotly debated in presidential elections, taken up by celebrity advocates like Michael J. Fox, and recently restarted by President Obama with the approval of the first cell lines available for research using federal funding. But something curious happened while the ethics debates raged: The cardiac research community’s enthusiasm for embryonic stem cells waned. “Many of us found the whole embryonic-cell debate to be overstated,” says Dr. Hare. “The cells are unpredictable and have the tendency to turn cancerous. They’re almost too powerful.”

So doctors began shifting their research to a more reliable and readily available type of stem cell. Like days-after-conception stem cells, adult stem cells can morph into virtually any other kind of cell, but they’re found in the blood, bone marrow, and many organs of every living human. “Ten years ago, we didn’t even think organs like the heart had stem cells or were capable of regeneration,” says Dr. Hare. “We now realize that the body has a much greater capacity for rejuvenation. It just needs some help.”

Dr. Hare’s office is on the eighth floor of a glass tower near downtown Miami. From there it’s a 3-hour drive west through the Everglades to Regenocyte’s Naples headquarters. On a monthly basis, Dr. Hare finds himself competing for prospective trial participants who have heard the Regenocyte pitch on organ-transplant blogs or on the radio ads the company airs. “What I find frustrating is that they’re preying on people’s desperation. Stem cell therapy has great potential, but there’s so much about it we’re still figuring out.”

For the past 5 years, Dr. Hare and his colleagues have been struggling to answer a host of important questions: What’s the correct dosing, the optimal delivery method, the ideal wait time between heart attack and treatment? Another pressing area of exploration: Which of the hundreds of types of stem cells will prove the most practical and effective for cardiac repair? Dr. Hare and Dr. Patel have been focusing on one especially promising type of bone-marrow-derived stem cell. Another group at the University of Pittsburgh is investigating the stem cells found in fat tissue, which may lead them down the mind-bendingly circular road of one day curing patients’ heart conditions with a by-product of their own liposuction procedures.

Exactly how stem cells work their biological magic is still not fully understood. “We think the cells might send out signals to other cells to migrate to the area to help with the repair,” says Dr. Hare. “Or they might awaken the stem cells in the heart itself.” Another thing researchers need to determine before the FDA can approve stem cell therapy for general consumption is how well they work.

A landmark study published in the December 2009 Journal of the American College of Cardiology showed definitively for the first time that treating a patient with adult stem cells after a heart attack can repair — not just manage — damaged heart tissue. The double-blind, placebo-controlled study, part of a phase 1 clinical trial led by Dr. Hare, found that the patients had significant improvement in heart and lung function and experienced lower rates of side effects, such as cardiac arrhythmia. For instance, the patients averaged a 6.7 percent gain in their heart’s pumping function. Called “ejection fraction,” this common measure of heart function records the percentage of blood flowing into the left ventricle that’s pumped out with each heartbeat. A healthy heart should expel 55 percent to 70 percent of the blood that flows into it. The heart-attack victims in the study averaged an ejection fraction of 50.4 prior to treatment. So a 6.7-point bump puts them back into the normal category.

Another recent study, a multicenter phase 2 trial of 167 heart-attack patients presented at the meeting of the American Heart Association, found that those treated with stem cells added 120 seconds to the length of time they could walk briskly on a treadmill. Each 60 seconds of treadmill improvement is thought to equal about 15 minutes of normal activity, says lead researcher Douglas Losordo, M.D., a professor of cardiology at Northwestern University. That 120 seconds was just an average (one outlier saw a nearly 10-minute gain), but is not insignificant when it extends your range from the distance between bed and bathroom to a stroll around the block.

The typical adult-stem-cell trial is divided into three equal groups: patients who receive the optimal dose, those who receive a reduced dose, and the placebo group. That means if you’re a study participant, the chances of your damaged heart receiving a cutting-edge application of sugar water is 33 percent. It usually takes 12 to 18 months to even find out which group you’re in. “Most people are okay with that,” says Dr. Hare. “They understand that when you walk into a pharmacy and put an FDA-approved pill in your mouth that you’re 99 percent sure is safe and effective, it’s because generations of people before you went along with this approach. But I do hear some who say, ‘I understand, doc, but I don’t want to take my chances. I just want the cells.’ “

Like many of the estimated 300,000 American men under 55 suffering from some kind of cardiomyopathy, Ron O’Leary had next to no warning of the illness that would turn his high-functioning heart into a swollen lump of scar tissue. With his outgoing personality, mop of blond hair, and nose bent from an old football injury, he reminded people of a stocky Owen Wilson. Suddenly, in September 2007, he noticed his energy level dropping and had difficulty catching his breath during his long shifts at the restaurant. After several days, O’Leary went to a hospital emergency room, was told he had pneumonia, and left the ER clutching a prescription for an antibiotic. A week later he was coughing up blood and went to an ER at a second hospital. Doctors there ran an ECG and admitted him for additional tests.

The diagnosis: idiopathic dilated cardiomyopathy. The doctors couldn’t even be sure what had caused O’Leary’s heart condition, because it didn’t run in his family. The most likely culprit was a viral infection. One doctor told O’Leary his was the weakest heart he’d ever seen. It was emptying just 8 percent of the blood that flowed into it before his doctors loaded him up with diuretics, beta-blockers, and ACE inhibitors, which boosted his ejection fraction to 30 percent.

“Numb. Just floored,” O’Leary recalls of his reaction. “I mean, I’d never even really been sick before. The only medical professional I saw on a regular basis was my dental hygienist. My cardiologist put in a defibrillator, kept me on the medication, ordered regular tests, and told me I might eventually need a transplant.”

And under most circumstances, that would have been that. But O’Leary lives in Sarasota, close to the burgeoning South Florida stem-cell belt. After an article about his plight appeared in a local newspaper, O’Leary received an unsolicited call from a satisfied Regenocyte customer. Two months later he attended his first informational seminar and was, as he describes it, just blown away by the patient testimonials. (See “5 Stay-Safe Rules for the Desperate Patient.”)

Regenocyte’s founder, 44-year-old Zannos Grekos, M.D., is an experienced interventional cardiologist who estimates he has performed more than 10,000 angioplasties, angiograms, and pacemaker implants. Early in his career, Dr. Grekos and the hospital he worked in were sued for malpractice after one of his patients died. The woman’s family claimed he waited too long to refer her for a coronary bypass after it should have been apparent that a cardiac catheterization he’d performed hadn’t worked. Dr. Grekos’s insurance company settled the case out of court for $600,000 in 2001. It’s not uncommon for interventional cardiologists to face such suits, because these procedures are high risk. But the incident left the young physician cynical about the legal and regulatory aspects of his business. “It can make you question whether you want to be in a profession where you do everything you can to help a patient, work 100 hours a week, and end up having lawyers still question what you do,” he says.

Four years ago, Dr. Grekos was working at his cardiology practice in Naples, Florida, when a longtime patient, a prominent local businessman, phoned to tell him that he’d scheduled to have stem cells injected into his heart. In Bangkok. “I said, ‘You scheduled what? ‘ ” says Dr. Grekos. But he checked into the company — TheraVitae, which had state-of-the- art facilities in Bangkok and Israel — and decided it looked legit. “So I told him, ‘I’ll go over with you, but if anything doesn’t look quite right, you’re taking the next plane home.’ Then I met the doctors and realized it was the most fantastic development I’d ever seen. I also realized that there were things about it we could do better if we licensed the technology ourselves and performed the catheterizations closer to home, saving patients from sitting on a plane for 36 hours.”

Dr. Grekos studied pioneering research being done by Dr. Patel (then at the University of Pittsburgh), Dr. Perin at the Texas Heart Institute, and Dr. Losordo (then at Tufts), among others. Various pilot studies examining the safety and efficacy of injecting adult stem cells into the heart, either by surgery or through a modified angioplasty catheter, indicated that stem-cell treatments held promise. Dr. Grekos believed using a catheter that allowed him to implant the cells directly into the heart wall might work better. He found a Florida-based company called Bioheart that had created the MyoCath, a catheter with a retractable needle tip to implant stem cells, and trained to use it at the University of Florida in 2008. (A phase 2 clinical trial treating patients with heart failure using the MyoCath and delivering stem cells derived from thigh muscle is under way at the Duke University heart center.) Based on what he learned in Thailand and from other research, Dr. Grekos decided to use the MyoCath with stem cells cultured by TheraVitae. He teamed with Dominican cardiologists and trained them to use the MyoCath.

How does Dr. Grekos respond to those who say he is exploiting desperate patients and who question his ethics for charging for an experimental treatment? “I’m just trying to help my patients,” says Dr. Grekos. “In our experience, we see a 21-point ejection fraction gain. I actually think it would be more unethical to administer a placebo.” However, until Dr. Grekos publishes the data in a peer-review forum, there is no way for anyone to really know if these numbers are accurate.

In the one pilot study that Dr. Grekos has made public, he presented data about 20 ischemic cardiomyopathy patients at the New Cardiovascular Horizons conference in 2008. The group’s baseline average ejection fraction was 28 percent (range 14 percent to 42 percent) at the start. After treatment and 6 months, it was 49 percent (range 38 percent to 56 percent). He says he’s compiling more data and that he’s waiting until he has the results from 100 patients, including follow-up stats after a year, before publishing it. But on average, he says, he’s still seeing a 21-point gain.

Some cardiologists, such as Dr. Patel, who is conducting a stem-cell cardiomyopathy trial, believes the treatment could be that successful. “Most heart-attack patients have very little change in their ejection fraction, but these heart-failure patients have 10 percent to 30 percent,” says Dr. Patel. “When you start with patients with more-advanced heart failure, such as cardiomyopathy, there’s a lot more room for improvement. Regenocyte could be seeing gains that high.”

To the researchers who say Regenocyte’s $64,500 fee is double what the procedure should cost, Dr. Grekos counters, “How do they know what our expenses are? The cell culturing and couriering back and forth to Israel alone costs $20,000. I’m just glad we’re making some profit on it, because if not, the treatment wouldn’t be available.” He also notes that Regenocyte has an impeccable safety record and that no patients have died during the procedures.

Dr. Grekos even tries to turn the tables on the FDA by invoking “the practice of medicine,” the long-held precedent granting physicians wide latitude in applying established procedures in new combinations. He says his treatments are little different from those of a physician who orders a special formulation from a compounding pharmacy or prescribes the off-label use of a drug approved for one condition to treat another. “It’s the same way in vitro fertilization developed in this country. It was never ‘approved’ by the FDA. It developed as the field established its own standards and governed itself under the practice of medicine. I don’t see how adult stem cells, which are a patient’s own cells and not even mixed with someone else’s, should be treated any differently than IVF was treated.”

This sounds reasonable, but from the FDA’s perspective, it flies in the face of logic. “Cellular therapies that are more than minimally manipulated, even if they’re used in the same person they come from, are regulated under the Public Health Services Act and require premarket approval,” says FDA spokeswoman Karen Riley. As soon as you start taking cells from one part of the body, adding things to them to make them grow, and putting them in the heart, you’re doing more than minimal manipulation in the eyes of the FDA. Doctors are in essence functioning as drug manufacturers when they prepare and use these stem-cell treatments, so they are subject to federal regulations.

The FDA is making the same argument against Regenerative Sciences, a for-profit stem-cell company (in the relatively low-risk arena of joint and disc repair) that treats its patients within U.S. borders. When in July 2008 the FDA informed the Denver-based clinic that it couldn’t promote its stem-cell treatment like a drug treatment, Regenerative responded by filing a suit saying that what it was doing was out of the agency’s jurisdiction. The case is now in early pretrial proceedings in U.S. District Court in Colorado.

Dr. Grekos says he has already begun planning for the day when stem-cell therapy becomes available in the United States, and he is working on a two-pronged strategy: moving treatment for any approved uses to his cardiology practice in Naples, and continuing to use unapproved treatments off shore. He says he just gained approval to treat patients in Freeport, in the Bahamas.

Recognizing that little can be done to stop the off shore clinics, and in an effort to review those clinics’ claims, a group of scientists and doctors recently teamed up to create the International Cellular Medicine Society (ICMS). At this online registry, off shore clinics have patient results tracked and verified by an objective third-party source. But of 20 off-shore clinics contacted for a survey, only 11 responded, and only one met the criteria used by the ICMS to ascertain safety: TheraVitae. The report concluded that the most troubling aspect about the stem-cell clinics was a lack of transparency: “Nearly all the evaluated clinics refused to answer all questions posed.”

Regenocyte did not participate because the survey was only for companies that process their own stem cells. But Regenocyte is not sharing its results with the ICMS. “When I first talked to Dr. Grekos last summer, he seemed interested,” says Christopher Centeno, M.D., the Denver pain-management specialist and ICMS member who founded Regenerative Sciences. “Then he had me talk to his business manager, who later got back to me and said they’d decided not to participate. The way he put it to me was, he just didn’t see what’s in it for them.” By joining such a registry, Regenocyte would be opening up its treatments to the same statistical metrics used by clinical trials. Patients who failed to respond as favorably would be lumped in with the star performers who achieved 10-minute gains in their treadmill times. The focus of prospective patients could start to shift from the anecdotal evidence that now dominates the company’s marketing to the law-of-averages bottom line.

Ron O’Leary answers the phone. He sounds out of breath. “Hey . . . How are you doing?” he says, his voice ragged and halting. “Sorry,” he goes on. “I just got in from a bike ride.” It’s been 6 months since his stem-cell procedure and O’Leary, now 37, sounds to be settling back into his old routine. That is, his old old routine, the one he had before a freak-of-nature heart malady reduced him to puttering around like a geriatric.

A few weeks earlier, O’Leary traveled to Naples for his 6-month follow-up. His ejection fraction had increased to 44, which was 14 points above where it was before the doctors repaired parts of his heart. He didn’t experience the 21-point jump that Dr. Grekos says is typical, but 14 points is a significant improvement.

For O’Leary, though, the most telling test may have been one he administered to himself a week before his office visit. He’d ventured out onto a local bike trail for a 20-mile ride with two friends. “It’s not like I was racing Lance Armstrong; these guys are in their 50s,” he says. “On the way back I took off for a stretch. I left them behind. That’s when I knew. I feel like there’s nothing I can’t do.”

5 stay-safe rules for the desperate patient
If conventional medicine fails, use these guidelines to find an alternative — whether it’s an off shore therapy, a clinical trial, or a holistic approach.

1 Seek a second opinion
Discuss with your primary-care physician any unsanctioned treatment you’re considering. He or she knows the full history of your condition, says Sam Moon, M.D., M.P.H., a Duke integrative-medicine clinician. And unlike the doctor administering an unsanctioned treatment, your doctor can help you weigh the pros and cons.

2 Disregard patient testimonials
“Patients’ stories are not objective,” says Heather Rooke, Ph.D., science director for the International Society for Stem Cell Research. Even when improvement does occur, it may be independent of the treatment or exaggerated, she says. Ask how the clinic measures improvement and if an independent committee has reviewed the treatment.

3 Investigate your treatment
Surf the WHO Registry Network (who.int/trialsearch), or the NIH clinical trials registry (clinicaltrials.gov) for human clinical research on the treatment. For disease-specific therapies, check the trial’s inclusion criteria — participants should share your age, diagnosis, and treatment history, says Jeffrey Karp, Ph.D., a stem-cell researcher at Harvard’s medical school.

4 Check beyond credentials
The title “doctor” is vague, says Zhaoming Chen, M.D., Ph.D., executive board chairman of the American Association of Integrative Medicine. Contact your state medical board — or if abroad, the department of health — to confirm a physician’s credentials, licensure, and specialty. Ask how many times the doctor has performed the procedure: You don’t want to be among first 50 guinea pigs.

5 Be prepared for the worst
No procedure is risk-free. The key: “Balance hope for long-term gains against the risks of treatment,” says Dr. Moon. Make sure your patient consent form clearly outlines the care and potential side effects, and allows you to withdraw from treatment. Check the clinic’s capacity for emergency care and find out what follow-up is provided.
laura roberson

How stem cells can repair your heart
To find out which of the stem-cell therapies being tested are the most promising, we surveyed key researchers. Here are their predictions.

If you suffer dilated cardiomyopathy
Amit Patel, M.D., a researcher at the University of Utah, is overseeing a clinical trial that he expects will enter its final phase in July 2010. Patients have 200 million of their own cultured bone-marrow stem cells injected into their heart muscle through a catheter. The stem cells may secrete growth factors, and then other cells in the heart help out by remodeling scar tissue, growing new blood vessels, and boosting heart-muscle function.
Estimated time to FDA approval: 2 years

If you survive a heart attack
Jay Traverse, M.D., a cardiologist at the Minneapolis Heart Institute, is using bone-marrow-derived stem cells to treat people within 3 to 7 days of a heart attack. In his phase 1 and phase 2 clinical trials, doctors infuse 150 million stem cells into patients’ hearts using a modified catheter. The stem cells may improve the efficiency of their hearts by growing new blood vessels.
Estimated time to FDA approval: 5 years

If you have heart failure
Joshua Hare, M.D., director of the interdisciplinary stem-cell institute at the University of Miami, is leading a phase 2 trial to treat heart- failure patients. The patients have 20 million to 200 million bone-marrow stem cells, either theirs or ones derived from a donor, put into their hearts through a catheter. The benefits are due to a combination of blood-vessel regeneration, new cardiac-tissue growth, and scar-tissue reduction.
Estimated time to FDA approval: 4 to 5 years

If you have heart disease
Douglas Losordo, M.D., director of cardiovascular regenerative medicine at Northwestern University, recently completed a phase 2 trial of patients suffering from chronic chest pain due to blocked arteries. Stem cells har vested from the patients’ blood are injected into their hearts and arteries through a catheter. The stem cells improve bloodflow by stimulating the growth of new blood vessels and expanding the diameter of coronary arteries.
Estimated time to FDA approval: at least 5 years

If you need a heart transplant
Doris Taylor, Ph.D., director of the cardiovascular repair center at the University of Minnesota stem-cell institute, is using human heart stem cells to grow live hearts on cadaver scaffolds. The cadaver heart is stripped of cells and then stem and progenitor cells are introduced. A beating heart develops in about a week. She’s working on animal studies and expects the first human implant trial to start in a few years.
Estimated time to FDA approval: 10 years
repairstemcell.wordpress.com

Sunday, March 21, 2010

Plastic Surgery for Men QT: Is There Yoga for Male Libido Enhancement and Sexual Health?

This article at Hubpages has great information and Yoga Poses for men...
Yoga for Male Libido Enhancement and Sexual Health

 

 

 

Yoga for Men - Yoga Pose and Techniques for Men

Yoga 
for Men Through Yoga, particularly Meditation, men can look deeper into themselves, listen to their inner voice, and develop a more positive view on life, thus, enhancing their relations with other people.

Since men are more into sports and other physical activities, practicing Asanas will help offset any physical irregularities that they may acquire from such tasks. Like in sports such as golf or tennis, there is a tendency that some muscles are used more than their respective symmetrical counterparts (i.e. right and left arms, legs, etc.) Asanas help by loosening tightness in the muscles, bringing the body back into its natural alignment.

While Weight Training isn’t bad, combining it with Yoga can produce even better results. Asanas will allow for more flexibility and will relax the muscles. Pranayama keeps the health vibrant and can also improve response from the nervous system. Meditation will help keep one’s focus and concentration and will clear one’s mind, reducing the stress resulting from the repetitive actions of weight lifting.

The overall practice of Yoga can help combat age-related diseases like impotence, prostate conditions, osteoporosis, and heart problems. That, plus reasons mentioned above, is why the practice of Yoga is highly recommended to all men. resource:  http://www.abc-of-yoga.com/yoga-and-health/yoga-for-men.asp

Sunday, March 14, 2010

Men's Fashion: New Looks for Men Spring Summer 2010

Zara-and-clothing
Since some months ago, Zara is making public (through its website) some new looks and items  that are renovated in a monthly basis. Of course, those items and looks also include clothing pieces for men. Let’s check some recent updates of the Zara masculine collection.

red-jacket
There is a wide range of colors including strong contrasts and some very eye-catching colors. For example, this red jacket which can be combined with a striped navy blue jersey. This way, a navy touch is added and that is starting to be a trend slightly incorporated in masculine collections, not only by Zara but also by other clothing brands. Anyway, the navy style is not for everyone, especially regarding men’s clothes.
daring-look-striped-T-shirt
For those who are looking for a more daring style, Zara opted for this look which is a little less “conventional”. Here, the more intense colors and the classic touch of a one-button jacket are combined to result in a carefully planned look. Even, the trendy sunglasses are matching white jeans. Definitively, this is a great and fashionable option to look good.
bicolored-scarf
Another remarkable thing in this “update” of the Zara collection for men is the inclusion of some interesting bicolored scarves. They are really original and attractive.
khaki-pants
In general terms, and as we stated in a previous post about the Zara Spring-Summer 2010 collection for men, most pants will be available in khaki shades, including these ankle-length pants (as seen in the picture) that appears combined with worn-out shoes. It’s a very interesting look with a vintage touch!
denim-shirt
And, to conclude, this update also takes in consideration the star product of the Spring-Summer 2010 season: Denim shirt. Here, you can see a light beige denim shirt worn with dark pants and some ripped details.
Gallery (click on the images to enlarge them):
young-jackets-2010spring-suit-2010new-looks-Zaramen-fashion-2010foulards-scarves-fashionzara-spring-summer-2010-collection
Zara – Official website

Plastic Surgery for Men QT: I would like a really close shave ..got any tips?

Razor burn, ingrown hair, and cuts are daily realities for most men who shave. The face is a delicate area and it only takes a little irritation to leave you feeling frustrated. For men, shaving is a ritual they do before presenting themselves to the world every day. If you put a little extra effort into your daily shave, you can have a clean looking and well cared for appearance.



The first thing you should do is go out and buy a good moisturizer for yourself. Most men think moisturizer is only for women. This simply isn't true. Shaving with a blade can take up to two layers of skin off each time you shave. Your face loses essential moisture that keeps your skin in its best condition. There are a variety of moisturizers available. Try and choose something with natural soothers such as aloe or vitamin E.


Typically men shave in the morning. The very best time to do so is right after a hot shower. The hot water from your shower will open your pores, and causes the hair shaft to swell. If you aren't going to shower before you shave, use a washcloth dunked in hot water. Lay it across the area you are going to shave for two minutes. This will have the same effect as the hot shower. This also helps to stimulate the oil glands in your skin, giving it some extra protection during shaving. Don't forget to exfoliate. This removes the dead skin cells from your face, allowing a closer shave.


The next thing you will do is apply your shaving cream. Try to find a brand that contains aloe. Aloe will help sooth your skin while shaving. Apply cream with a good shaving cream brush or with your fingertips. Rub onto face in a circular motion. Be sure to cover all areas well and let the cream set on your face for two minutes. This will also help the hair shaft draw in more moisture. Keep in mind that moist hair is 70 percent easier to cut than dry hair.


Make sure you have a sharp blade. If your blade is dull you may press harder while shaving, causing unnecessary damage to your skin. Dull blades also tend to be full of nicks, which scrap and pinch your skin as you shave.


Don't shave against the hair growth. Shave in the same direction as hair grows. Shaving against the hair growth tends to cause painful in-grown hairs. When you shave against the hair growth, you tend to use more force, causing more nicks and overall skin irritation. Remember to rinse your razor often, and take your time.

Start on the sides of your face, near you sideburns and your cheek area. Save the mustache and lower chin area for last. The hair in this area tends to be thicker. By doing it last, you give it a little extra time to absorb moisture from your shaving cream.


For shaving the underside of your chin and your neck, pull the skin taunt as you go. This will give you a closer shave. Remember to be extra gentle in these areas; the skin is looser and more apt to get nicked by your razor blade.


When you are finished, wipe away excess cream gently and splash your face with cold water. This helps close your pores and it refreshes your skin. If you use an after-shave, avoid products containing menthol or alcohol type ingredients. Though they feel refreshing, they will dry out your skin. Try to find an aftershave that moisturizes and has a disinfectant ingredient.


Clean your shaving equipment when you are finished. Hang the razor to air dry.

This process should leave you with a nice close shave and soft healthy skin.
resource:  http://www.essortment.com/lifestyle/mensgroomingti_sjgb.htm

Friday, March 12, 2010

Plastic Surgery for Men QT: Can You Get Plastic Surgery If You Have HIV?

What If I Have to Have Surgery? Surgery and HIV Disease
Resource: http://www.aegis.com/pubs/bala/2001/BA011201.html

The "buffalo hump" on the back of your neck is now too large to ignore anymore; it's time to get something done. And you sure aren't about to discontinue the HAART cocktail that has brought your T-cells up, your viral load down, and you-well-back to life again! So you talk it over with your doctor, and decide that a plastic surgeon may be able to help this unsightly fat mass ("lipodystrophy" is a fancy word for lumps and fat pads developing where you don't want them).

But what will you have to look forward to? You've been told "nothing to eat or drink eight hours before the surgery". What about your meds? You may have heard that the anesthesia may make you nauseated, or even cause some vomiting after surgery. What about your meds? Will the stress of the surgery cause your viral load to climb? Do surgery and all the anesthesia drugs cause HIV disease to get worse? Do any of the drugs used during surgery interact with your antiretroviral drugs? These and many other questions may arise for you if you must undergo a surgical procedure.

Why is it that people who are having surgery must have nothing to eat or drink for several hours before? Because general anesthesia makes you unconscious. An unconscious person cannot swallow or cough up secretions in their throat, and such stuff may wind up in the lungs, causing serious pneumonia, which is avoided by having an empty stomach. However, important medications (those which can be taken on an empty stomach without causing problems) can be taken with water the morning of surgery without increasing this risk, so consult with your doctor and/or anesthetist about taking morning doses the day of surgery. This will not apply to medications that must be taken with food, and if taking a medication on an empty stomach makes you nauseated, discuss with your doctor the advisability of skipping the dose!

What about the issue of postoperative nausea and vomiting? Occasionally the anesthetic agents or narcotic pain relieving drugs can cause stomach upsets. This usually resolves within 24 hours, and you can be reasonably assured that missing your regular medication doses for 24 hours will not cause an increase in viral load or disease progression. One principle to remember is: if you discontinue one med, you should discontinue them all until you can resume your regular medication schedule in order to prevent the possible development of resistant viral strains. In other words, if your cocktail of antiretrovirals includes meds you take with food as well as meds you take on an empty stomach, you should probably skip all your meds for that dose on the morning of surgery. Be sure to confer with your doctor before discontinuing your meds.

Your care providers can give you anti-nausea drugs, which you should request if you have had postoperative nausea in the past. Also, if you need to stay on oral pain medications for a few days, here are some tips to help prevent stomach upsets common with these drugs (examples: Tylenol (also known as acetominophen) with codeine, oxycodone (Vicodin), hydrocodone (Percocet)): move very slowly; no sudden leaps out of bed; stick to "gentle" foods like crackers and soups; and drink lots of clear liquids like water, apple juice, and sodas. Ice chips can also help, and some of these meds can be very constipating.

Does the stress of anesthesia and surgery cause the viral load to climb and disease to progress? Review of the literature on this topic, and consultation with physicians in the specialty of HIV care, have shown that there are no deleterious effects of surgical intervention on HIV disease progression. There may be a temporary or transient increase, also called a blip, in viral load. And what if you do have a slight increase in viral load following surgery? It's been shown that, in people who have virologic suppression (that is, the viral load is less than 50 copies), blips are a frequent occurrence and are not associated with a sustained increase in viral load. Bottom line is that, if you have some problem that is amenable to surgery (some common examples in the HIV-infected population include: chronic sinus infections; genital warts; anal fissures or lesions; cervical lesions; increasingly, plastic surgery for lipodystrophy; and soon, even liver and kidney transplant surgery), then you should seek consultation with the appropriate surgeon and get the surgical repair done.

Do anesthetic drugs interact with HIV medications? The prescribing literature for all of the currently approved protease inhibitors -- saquinavir (Fortovase, or Invirase), ritonavir (Norvir), indinavir (Crixivan) and nelfinavir (Viracept) -- prohibits the concurrent administration of midazolam (Versed) and, with Norvir, meperidine (Demerol) as well). Versed is the most commonly used sedative drug in anesthesia and Demerol is a commonly used pain medication. The theoretical concern is that the action of these drugs may be enhanced and prolonged because they are metabolized by the same enzymes in the liver as the PIs. However, it has been the experience of many anesthesia providers that intravenous Versed as commonly used for sedative purposes causes no problems in patients on PIs. As for the rest of the anesthetic and sedative drugs commonly used, there are no documented theoretical or observed interactions with the antiretroviral drugs.

However, remember that when you are going to have surgery, the doctors and nurses who will be caring for your surgical and anesthesia needs will most likely not have an in-depth knowledge of HIV disease or the drugs you are taking. Therefore, be prepared to patiently and thoroughly go over the entire regimen of HIV care, and refer the surgeon to your HIV doctor if questions arise that the doctor needs to address. If you have complicated conditions or are on multiple drugs, write all the information down on a list that you should keep with you at all times. On this list, it would be helpful to note all known drug interactions (your HIV care practitioner can give you this information). Take it into the preoperative area with you to help get all the important information to your surgical team. Include your latest laboratory results (especially if you have been anemic or have other abnormalities) as well, in case your team needs to see them.

Likewise, if the surgical team gives you instructions or information that you are not comfortable with, call or see your HIV doctor about this. For example, explain how important it is to never miss a dose of antiretroviral medication. Explain food and dietary requirements of the drugs you are taking. Think ahead to the recovery room, bring in your medications with you and have your next dose of medication available (if you are able to take it) to avoid missing any doses if possible. You can ask your anesthetist for a dose of antinausea medication to help assure you can take your medications when you awaken from anesthesia.

With careful, complete and patient communication with the surgical and anesthesia team, you can deal with the surgical experience successfully while continuing to care for your HIV disease as well.

What Is Lipodystrophy?

Lipodystrophy means abnormal fat changes. It is used to describe a number of unwanted changes in body fat that are experienced by many HIV+ people. Lipodystrophy can also include changes in fat and sugar levels in the blood of HIV+ people.



Although there is no official definition of lipodystrophy in HIV, it is generally broken down into two categories:

* Body shape changes – Includes fat loss (lipoatrophy) and fat gain (lipohypertrophy) or redistribution in particular areas of the body
* Metabolic complications – Includes increases in fats and sugars in the blood

HIV+ people can experience both body shape changes and metabolic complications. This is sometimes called lipodystrophy syndrome.

Body Shape Changes

Changes in the way your body looks are caused by fat loss or build up.



Fat loss may happen in the:

* Arms and legs (fat loss may cause bulging veins in the arms and legs)
* Buttocks
* Face (sunken cheeks)

Fat build up may happen in the:

* Stomach
* Breasts
* Back of the neck (“buffalo hump”)
* Round lumps of fat may appear under the skin (lipomas)

Some studies show that lipodystrophy affects men and women differently. Women are more likely to see fat gain in their breasts and stomachs while men are more likely to see fat loss in their legs, arms, buttocks, or faces. However, many men and women suffer from both symptoms. It is not clear why there might be differences based on sex. It might have something to do with hormones or with how men and women burn fat differently.



Lipodystrophy can dramatically change your appearance. These changes can leave some people with feelings of poor self-image and low self-esteem. Some people may want to stop taking their HIV drugs. Others may put off treatment due to fear of experiencing lipodystrophy symptoms. You should talk to your health care provider if you are feeling this way.

Metabolic Complications

Changes in fat (lipids) and sugar (glucose) in your blood are called metabolic complications and include:

* Increased lipids in your blood such as cholesterol and triglycerides (hyperlipidemia)
* Increased glucose levels (hyperglycemia)
* Insulin resistance or diabetes
* Increased lactic acid in your blood (lactic acidosis)

Metabolic changes cannot be seen without lab tests, but can cause serious long-term health problems.

* Increased levels of cholesterol and triglycerides can put you at a higher risk of developing heart disease or having a heart attack or stroke.
* Increased glucose and insulin levels greatly increase the chance of developing diabetes, a disease that can cause vision and kidney problems and may be life threatening.
* Increased lactic acid can lead to a rare but dangerous condition called lactic acidosis. Symptoms include nausea, vomiting, or stomach pain; feeling very weak and tired; and shortness of breath.

Be sure your health care provider is ordering regular lab tests to monitor you for metabolic complications. Call your health care provider right away if you are experiencing symptoms of lactic acidosis.



See TWP sheets on hyperlipidemia, diabetes and lactic acidosis for more information.

What Causes Lipodystrophy?

Scientists have many theories about what causes lipodystrophy and research in this area is ongoing. However, the exact causes of lipodystrophy are still unknown. There may be different causes for different symptoms.

* Fat loss: Research shows that certain HIV drugs from the nucleoside reverse transcriptase inhibitor (NRTI) class are the main cause of fat loss. These drugs are Retrovir (zidovudine, AZT) and Zerit (stavudine, d4T)
* Fat gain: It is less clear what causes fat gain. Taking protease inhibitors (PIs), another class of HIV drug, may increase the risk of fat accumulation. Another theory is that insulin resistance and increased lipid levels play a role in fat gain
* Increased lipids: Some of the PIs are believed to increase lipid levels. It is still not clear which ones are most likely to do this, but Reyataz (atazanavir) seems to be the least likely to cause increased lipid levels
* Increased glucose levels, insulin resistance, and diabetes: Both PIs and NRTIs have been linked with insulin resistance and diabetes
* Lactic acidosis: Some of the NRTIs are associated with lactic acidosis, especially Zerit and Videx (didanosine, ddI).

Not everyone taking HIV drugs develops body shape changes or problems with fat or sugar levels in the blood. Researchers have been looking for other factors that may cause lipodystrophy. The following appear to be risk factors:

* Starting HIV treatment with lower CD4 cell counts
* Starting HIV treatment at an older age
* Being on an HIV drug regimen containing certain PIs and NRTIs (the longer the time on the regimen the higher the risk)
* HIV itself
* Cigarette smoking
* White race


Can Lipodystrophy Be Treated?

At this time, there is no simple treatment for lipodystrophy. However, there are a number of approaches that are being used to treat some of the symptoms.



Fat loss

* Switching or avoiding Zerit and Retrovir: People who have not developed fat loss should avoid taking the NRTIs Zerit or Retrovir to prevent the condition. People who have fat loss can switch these drugs for others in the same class (either Viread [tenofovir] or Ziagen [abacavir]). The results of switching drugs are uncertain and may take some time; you and your health care provider may decide that changing medications is not right for you. Be sure to talk with your health care provider before stopping or switching any medications.
* Injections, implants, and plastic surgery: Some people have procedures done to restore fullness in the face. Injections of fat or synthetic fat substitutes can fill out sunken cheeks, as can cosmetic cheek implants. However, many of these treatments are still being studied and have not been approved by the Food and Drug Administration (FDA) for HIV-related lipodystrophy. If you are considering plastic surgery, research the options carefully. Some treatments are short-term, can be very expensive, and don’t work for everyone. It is important to consult with a plastic surgeon or dermatologist experienced in treating HIV-related lipodystrophy. Also find out if your insurance company will cover plastic surgery.

Fat gain

* Human growth hormone (HGH): HGH may decrease excess fat build up in the stomach; however, it can also cause fat loss in the arms, legs, or face. Two drugs, a synthetic human growth hormone (Serostim) and a synthetic growth hormone releasing factor (tesamorelin), have shown the ability to reduce fat build up in studies, but are not FDA approved for use in HIV-related lipodystrophy.
* Liposuction: Liposuction is a plastic surgery procedure that can be used to remove fat from the back of the neck and around the breasts, but not usually in the stomach (since fat gain caused by lipodystrophy in this area is deep, internal fat). Liposuction tends to be a temporary solution and the unwanted fat frequently returns. It can also be painful and is generally not covered by health insurance plans, although some people have had some success getting reimbursed for this expensive procedure.



Increased lipids

* Switching HIV drugs: There are some HIV drugs that have less of an impact on cholesterol and triglycerides. These include Viramune (nevirapine), Intelence (etravirine), Isentress (raltegravir), and Selzentry (maraviroc). Reyataz and Prezista (darunavir) are also less likely to increase lipids, but both require use with Norvir (ritonavir), and Norvir does increase lipids.
* Lipid-lowering medications: There are drugs available to reduce lipid levels. Some lipid-lowering medications interact with HIV drugs, so have your health care provider review all your medications before prescribing anything.



Increased glucose levels, insulin resistance, and diabetes

* Switching HIV drugs: Switching to other HIV drugs may reduce glucose levels. Speak to your health care provider about this option before stopping any medications.
* Medications: There are some drugs that can be used to treat these conditions, such as Glucophage (metformin).



All symptoms of lipodystrophy

* Diet and exercise: Increasing exercise and improving your diet may help with all of the symptoms of lipodystrophy. Exercise can help reduce fat gain, build muscle, and reduce elevated lipid and glucose levels.

Lowering the amount of saturated fats (found in animal products) may help reduce cholesterol levels. Lowering the amount of fats and carbohydrates may help reduce triglyceride levels. Some health care providers recommend more fiber in the diet to help control insulin resistance and help decrease stomach fat.



While there is no definite proof that these methods will improve lipodystrophy, there is no down side to eating right and exercising. It is a good idea to speak with a nutritionist or dietician about the steps you can take to improve your diet and exercise habits.



See the TWP sheets on lipodystrophy treatments, nutrition, and exercise for more information.

Caring for Yourself

If you are experiencing lipodystrophy it is especially important to take care of your body. Keep all of your doctor’s appointments, get regular lab tests, and tell your doctor about any changes in the way you feel or in your body shape. Recording body measurements and weight on a regular basis, whether or not you are taking HIV medications, may give you valuable information down the road.


Some of these body shape changes and metabolic problems have been linked with heart disease and strokes in HIV+ people, so make sure you are monitored closely. Other factors also contribute to the risk of heart attacks and strokes, including high blood pressure. If you have high blood pressure, make sure it is treated. You can also support your body, and especially your heart, with a healthy diet, regular exercise, and giving up smoking.



Even though the physical changes of lipodystrophy can cause emotional distress, no researcher has suggested that people with lipodystrophy should stop taking their HIV medications. If you are concerned about your appearance, speak to your health care provider before making any changes to your HIV medication schedule that might jeopardize your health.

Information provided on this website is for educational purposes only. It is designed to support, not replace, personal medical care and should never be used as a substitute for personal medical attention, diagnosis, or hands-on treatment. We recommend all medical decisions be made in consultation with your personal health care provider.
resource: http://www.thewellproject.org/en_US/Diseases_and_Conditions/Treatment_Related_Conditions/Lipodystrophy.jsp