Fractures and Surgery:
Non-steroidal anti-inflammatory drugs are a large class of compounds that inhibit cyclo-oxygenase and thus the formation of prostaglandins, which are involved in bone metabolism. However, the effect of these drugs on bone metabolism is often overlooked. They inhibit osteoblasts at the endosteal bone surface and also reduce both the immune response and the inflammatory response. PGs have been shown to elicit and participate in inflammatory responses, increase osteoclast activity and subsequent bone resorption, and increase osteoblast activity and new bone formation. This apparent integral role for PGs in the process of bone healing, coupled with the knowledge that NSAIDs act by inhibiting the production of PGs, results in an understanding of the likely mechanism through which NSAIDs impart their deleterious effects on bone healing. By inhibiting the COX enzymes and the subsequent production of PGs, NSAIDs not only achieve their desired anti-inflammatory effects but also inhibit the increased production of PGs that is necessary for bone healing to occur.
On studies strong argues, the harmful effects of NSAIDs on bone: 'Despite animal studies which have highlighted the harmful effects of these drugs on the healing of fractures and spinal fusion, they continue to be used commonly for the relief of postoperative pain in the absence of well designed human trials. A random survey of the type of analgesia received by patients undergoing hip arthroplasties on our elective orthopaedic ward showed that 95% (18/19) were being treated with these drugs.' Based on this site ibuprofen has been shown to have an irreversible effect on the healing of fractures. Also the inhibitory effect of these drugs on fracture healing is greater the longer the duration of use.
Hip Surgery:
Another site argues that NSAIDs are good after hip surgery due to prevention of abnormal bone formation. 'Abnormal bone formation in the muscles around the hip occurs after about one third of all hip replacements. Use of an NSAID (apart from low dose aspirin) around the time of surgery reduces the risk of such bone developing by between one half and two thirds with little risk of side effects from treatment. Prevention of abnormal bone formation is likely to reduce the risk of long-term pain, stiffness and disability after hip replacement. However, the effects of treatment on these outcomes needs to be proved in a large-scale trial.'
It seems that NSAIDs have the ability to inhibit bone formation. This could be a good thing after hip surgery or a bad thing after a fracture or spinal fusion. However, more studies are needed.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1113091
http://www.cochrane.org/reviews/en/ab001160.html
30 November 2008
Exercise: Anti-inflammatory
We have discussed in almost every class the importance of a balanced diet and exercise. It seems fit to discuss how exercise acts as an anti-inflammatory. Regular exercise offers protection against chronic, low-grade systemic inflammation. We have talked about many different types of chronic inflammatory diseases; obesity/type II diabetes, stroke, inflammatory bowel diseases, arthritis, and neurodegenerative diseases.
Chronic, low-grade systemic inflammation has been introduced as a term for conditions in which there is typically a two to threefold increase in the systemic concentrations of TNF-α, IL-1, IL-6, IL-1ra, sTNF-R, and CRP is reflected.
Typically, IL-6 is the first cytokine present in the circulation during exercise. Plasma-IL-6 increases in an exponential fashion with exercise and is related to exercise intensity, duration, the mass of muscle recruited, and endurance. It has been demonstrated that the IL-6 protein is expressed in contracting muscle fibers, and that IL-6 is released from skeletal muscle during exercise.
The anti-inflammatory effects of IL-6 are demonstrated by stimulating the production of anti-inflammatory cytokines and cytokine inhibitors such as IL-1ra and IL-10 and
TNF-R. Furthermore, IL-6 stimulates the release of soluble TNF-α receptors, but not IL-1β or TNF-α.
Chronic, low-grade systemic inflammation has been introduced as a term for conditions in which there is typically a two to threefold increase in the systemic concentrations of TNF-α, IL-1, IL-6, IL-1ra, sTNF-R, and CRP is reflected.
Typically, IL-6 is the first cytokine present in the circulation during exercise. Plasma-IL-6 increases in an exponential fashion with exercise and is related to exercise intensity, duration, the mass of muscle recruited, and endurance. It has been demonstrated that the IL-6 protein is expressed in contracting muscle fibers, and that IL-6 is released from skeletal muscle during exercise.
The anti-inflammatory effects of IL-6 are demonstrated by stimulating the production of anti-inflammatory cytokines and cytokine inhibitors such as IL-1ra and IL-10 and
TNF-R. Furthermore, IL-6 stimulates the release of soluble TNF-α receptors, but not IL-1β or TNF-α.
Figure 1: A marked increase in IL-6, which is followed by IL-1ra, TNF-R, and IL-10.
IL-10 acts as an anti-inflammatory by inhibiting the synthesis of pro-inflammatory cytokines like IL-1β, IL-1-α, and TNF-α along with the production of chemokines, all of which play a critical role in the activation of granulocytes, monocytes/macrophages, natural killer cells, and T and B cells and, in their recruitment to the sites of inflammation.
http://jap.physiology.org/cgi/reprint/98/4/1154
As I researched, I found many different websites that demonstrated how exercise can prove beneficial to those suffering from inflammatory diseases.
Heart Disease/Stroke:
- increase strength of heart muscle
- decrease blood pressure
- increase HDL
- decrease LDL
- improve blood flow
Obesity/Type II Diabetes:
- decrease body fat
- increase muscle mass
- increase body’s ability to use calories
Rheumatoid Arthritis/Osteoarthritis:
- increase muscle strength
- decrease pain and fatigue
- increase grip strength
- replenishment of lubrication to joint
- promotion of bone formation
- prevention of bone loss with aging
Crohn’s Disease (mild only)
- improved symptoms
- increased ratings of quality of life
Multiple Sclerosis:
- improved bowel and bladder function
- increased coordination
- increased ratings of quality of life
- decreased risk of CAD
- increased endurance
Parkinson’s Disease:
- decreased incidence of muscle cramps, rigidity of joints
- decreased aches/pains associated with staying still
- maintained control of gross movement (not tremors)
- heighten sense of achievement kept stress and anxiety levels low
In conclusion, regular exercise protects against diseases associated with chronic low-grade systemic inflammation.
http://www.medicinenet.com/benefits_of_exercise/article.htm
http://www.heuga.org/articles/benefits_of_exercise_for_people_with_ms
http://www.ccfa.org/reuters/excercise
http://www.worldwidehealth.com/health-article-The-Benefits-of-Exercise-for-People-Who-Suffer-From-Parkinsons-Disease.html
http://www.nutristrategy.com/health.htm
http://www.hopkins-arthritis.org/patient-corner/disease-management/exercise.html
Top 10 Anti-Inflammatory Foods
Hope everyone's Thanksgiving was wonderful!! Now that everyone ate a bunch of food, let's see if anyone got in their anti-inflammatories. Here are the Top 10 Anti-inflammatory Foods in no particular order...according to dlife.com.
Cold Water Fish and Grass Fed Animals.
This includes Salmon, Free-Range Chicken, and Grass Fed Beef. The thing that all three have in common is the super healthy fats, omega-3s. Although your cold water fish like salmon is going to give the most omega-3s, Grass Fed Cows and Chickens are going to have way more than grain fed, which have next to none. Grass fed beef may be a little tougher though so cook it ground or slow!!
Olive Oil
Olive oil is another great source of an anti-inflammatory fat. This one is called oleic acid. According to the American College of Nutrition, those who consume more oleic acid have better insulin function and lower blood sugar. Extra Virgin is the least processed so it is better for you. Other "cold-pressed" or "expeller-pressed" can be good for you too!
Salads
Dark green lettuce, spinach, tomatoes, and other salad veggies that are rich in vitamin C are anti-inflammatories. They are also rich in anti-oxidants and nutrients that also dampen inflammation. Use olive oil and vinegar for the dressing for even more anti-inflammatory action!!
Cruciferous Vegetables
What are they? Vegetables like broccoli, cauliflower, brussel sprouts, and kale. These veggies contain anti-oxidants as well as sulfur which which allows the body to make another much needed, high powered anti-oxidant, glutathione.
Cherries
According to the Journal of Nutrition, cherries are once again packed with anti-oxidants and if eaten daily, significantly reduce inflammation. Not in season? Frozen are just as good.
Blueberries
Not only do they have natural compound that reduce inflammation, they may also protect the brain from the effects of aging (Alzheimer's?). Again, frozen are just as good as fresh, and maybe a little cheaper.
Tumeric
A revisited spice. According to Biochemical Pharmacology, it is a powerful, natural anti-inflammatory. Pan fry curry seasoned, free range chicken in some extra virgin olive oil...very anti-inflammatory!!
Ginger
Here is another East Asian flavor that has anti-inflammatory benefits. Studies have shown that ginger can be used to help control blood sugar.
Garlic
The jury is still out on this one, there has been inconsistent research. But garlic might have anti-inflammatory effects and glucose-regulating benefits. Also, it might help the body fight off infections.
Green Tea
Green Tea is like fruits and vegetables where it contains natural, anti-inflammatory compounds. Also, it may reduce the risk of heart disease and cancer. It is suggested to drink a cup a day.
So did you have a Free-Range turkey on Turkey Day?
Cold Water Fish and Grass Fed Animals.
This includes Salmon, Free-Range Chicken, and Grass Fed Beef. The thing that all three have in common is the super healthy fats, omega-3s. Although your cold water fish like salmon is going to give the most omega-3s, Grass Fed Cows and Chickens are going to have way more than grain fed, which have next to none. Grass fed beef may be a little tougher though so cook it ground or slow!!
Olive Oil
Olive oil is another great source of an anti-inflammatory fat. This one is called oleic acid. According to the American College of Nutrition, those who consume more oleic acid have better insulin function and lower blood sugar. Extra Virgin is the least processed so it is better for you. Other "cold-pressed" or "expeller-pressed" can be good for you too!
Salads
Dark green lettuce, spinach, tomatoes, and other salad veggies that are rich in vitamin C are anti-inflammatories. They are also rich in anti-oxidants and nutrients that also dampen inflammation. Use olive oil and vinegar for the dressing for even more anti-inflammatory action!!
Cruciferous Vegetables
What are they? Vegetables like broccoli, cauliflower, brussel sprouts, and kale. These veggies contain anti-oxidants as well as sulfur which which allows the body to make another much needed, high powered anti-oxidant, glutathione.
Cherries
According to the Journal of Nutrition, cherries are once again packed with anti-oxidants and if eaten daily, significantly reduce inflammation. Not in season? Frozen are just as good.
Blueberries
Not only do they have natural compound that reduce inflammation, they may also protect the brain from the effects of aging (Alzheimer's?). Again, frozen are just as good as fresh, and maybe a little cheaper.
Tumeric
A revisited spice. According to Biochemical Pharmacology, it is a powerful, natural anti-inflammatory. Pan fry curry seasoned, free range chicken in some extra virgin olive oil...very anti-inflammatory!!
Ginger
Here is another East Asian flavor that has anti-inflammatory benefits. Studies have shown that ginger can be used to help control blood sugar.
Garlic
The jury is still out on this one, there has been inconsistent research. But garlic might have anti-inflammatory effects and glucose-regulating benefits. Also, it might help the body fight off infections.
Green Tea
Green Tea is like fruits and vegetables where it contains natural, anti-inflammatory compounds. Also, it may reduce the risk of heart disease and cancer. It is suggested to drink a cup a day.
So did you have a Free-Range turkey on Turkey Day?
Turmeric and Inflammation
Is there a correlation between the Eastern Indian diet and cancer?
Compared to the United States, India has a significantly lower incidence of reported cancer cases. This is true for both men and women. There have been many studies performed in this area, all of which report that an Indian diet plays a major role in the health.
Turmeric is a spice used in Indian dishes, such as curry, that acts as an anti-inflammatory and an antioxidant. Turmeric is one of the 700 Ayurvic medications prescribed to promote good health and well-being. Ayurveda is traditional medicine native to India, which is practiced as a form of alternative medicine. Turmeric has been used for centuries in India to treat various diseases including cancer. The spice has been found to suppress and destroy blood cancer cell lines in humans.
Lastly, Indians may also have a decreased risk of cancer due to their vegetarian diets, which rely on legumes (beans, chickpeas, and lentils) as protein. Studies have shown that legumes are associated with a reduction in cancer.
Bottom line: Eat your veggies and curry!
Dealcoholized Red and White Wines Decrease Oxidative Stress Associated with Inflammation in Rats
When I read this article the first time (I ended up reading it 3 times!) I was very lost and so I thought it would be a good idea to do my blog this week on the article itself. Hopefully this sum up of the information will help you better understand the article.
This article looked at the antioxidant and anti-inflammatory affects of dealcoholized red and white wine. Both of theses affects are due to the polyphenols that are present in wine.
In the study they had three groups of rats, a control group that was fed standard food, a group that was fed food containing dealcoholized red wine (DRW), and a group that was fed food containing dealcoholized white wine (DWW). After 15 days the authors induced a granuloma with carrageenan (a component of red seaweed) in all the rats from all three groups. After 24 hours blood from the heart and exudate from the granuloma was taken from all the rats.
In the blood and exudate total phenols was measured. TBARS, or thiobarbituric acid-reactive substances were measured. This shows the amount of malondialdehyde in the blood plasma and the exudate which demonstrates the amount of lipid peroxidation. Lipid peroxidation is the break down of lipids via free radicals (see figure below courtesy of Wikipedia). They also measured the amount of NO in the plasma and exudate and the ratio of L-citrulline vs L-arginine. This ratio can be used as an indication of iNOS activity.
The authors also removed polymorphonuclear (PMN) leukocytes from each of the three groups of rats. When these cells are activated they cause the release of superoxide anion (O2-) which is generated by NADPH oxidase and xanthine oxidase. PMN cells also release NO, which is generated by iNOS activity. Once released O2- will cause damage while the effects of NO release depends on the amount released, the location of their release, and what other reactive species are present. With these removed cells, the authors could then measure O2- and NO production by the cells and the level of COX-2 activation. For the amount of NO they looked at both nitrites and nitrates, as well as the amount of L-citrulline formed from L-arginine which shows the iNOS activity as previously stated. To measure the amount of COX-2 activation the authors looked at the amount of PGE2 produced, which is a prostaglandin released due to COX-2 activation.
From all of these measurements the authors found that DRW had more polyphenolic compounds than DWW, which explained the slightly increased antioxidant abilities of DRW in comparison to DWW. They also found that with both DRW and DWW there was a decrease in the number of cells in the exudate, which they said was due to the fact that O2- will recruit leukocytes while NO inhibits this. Since there was a decrease in O2- and an increase in NO in the exudate for both of the wine groups then a decrease in cell number in the exudate was expected. One unexpected finding was that there was actually an increase in PGE2 in the DRW. The authors said that this might be due to something else in the wine that is interacting with the polyphenolic compounds. This was an important point in the paper, that though they see that polyphenolic compounds are the substances that are the most important in their rat model, in the human body the interactions of all the substances within metabolism make it hard to directly apply the results of the study to humans.
Hopefully this helps you with the reading the article, it sure helped me!
This article looked at the antioxidant and anti-inflammatory affects of dealcoholized red and white wine. Both of theses affects are due to the polyphenols that are present in wine.
In the study they had three groups of rats, a control group that was fed standard food, a group that was fed food containing dealcoholized red wine (DRW), and a group that was fed food containing dealcoholized white wine (DWW). After 15 days the authors induced a granuloma with carrageenan (a component of red seaweed) in all the rats from all three groups. After 24 hours blood from the heart and exudate from the granuloma was taken from all the rats.
In the blood and exudate total phenols was measured. TBARS, or thiobarbituric acid-reactive substances were measured. This shows the amount of malondialdehyde in the blood plasma and the exudate which demonstrates the amount of lipid peroxidation. Lipid peroxidation is the break down of lipids via free radicals (see figure below courtesy of Wikipedia). They also measured the amount of NO in the plasma and exudate and the ratio of L-citrulline vs L-arginine. This ratio can be used as an indication of iNOS activity.
The authors also removed polymorphonuclear (PMN) leukocytes from each of the three groups of rats. When these cells are activated they cause the release of superoxide anion (O2-) which is generated by NADPH oxidase and xanthine oxidase. PMN cells also release NO, which is generated by iNOS activity. Once released O2- will cause damage while the effects of NO release depends on the amount released, the location of their release, and what other reactive species are present. With these removed cells, the authors could then measure O2- and NO production by the cells and the level of COX-2 activation. For the amount of NO they looked at both nitrites and nitrates, as well as the amount of L-citrulline formed from L-arginine which shows the iNOS activity as previously stated. To measure the amount of COX-2 activation the authors looked at the amount of PGE2 produced, which is a prostaglandin released due to COX-2 activation.
From all of these measurements the authors found that DRW had more polyphenolic compounds than DWW, which explained the slightly increased antioxidant abilities of DRW in comparison to DWW. They also found that with both DRW and DWW there was a decrease in the number of cells in the exudate, which they said was due to the fact that O2- will recruit leukocytes while NO inhibits this. Since there was a decrease in O2- and an increase in NO in the exudate for both of the wine groups then a decrease in cell number in the exudate was expected. One unexpected finding was that there was actually an increase in PGE2 in the DRW. The authors said that this might be due to something else in the wine that is interacting with the polyphenolic compounds. This was an important point in the paper, that though they see that polyphenolic compounds are the substances that are the most important in their rat model, in the human body the interactions of all the substances within metabolism make it hard to directly apply the results of the study to humans.
Hopefully this helps you with the reading the article, it sure helped me!
29 November 2008
Inflammation, Alzheimer's and polypharmacy
Hi everyone:
The last couple of topics have covered some areas of research that I help with at UA, so I thought it would be interesting to blog about them.
For awhile we were studying the respiratory muscle functions of a man with Parkinson's Disease (PD) that was being treated for it using a deep-brain stimulator. We were able to turn off his stimulator for the trials, and the difference in symptom manifestation was remarkable. His tremors literally would start and stop like a switch was being flipped. He said that the therapy had changed his life, though it wasn’t perfect. He was willing to trade infrequent nausea for the ability to eat a bowl of cereal on his own or to tie his shoes without help.
http://restless-legs-syndrome.emedtv.com/requip/requip-side-effects.html
http://www.ninds.nih.gov/disorders/deep_brain_stimulation/deep_brain_stimulation.htm
25 November 2008
Probiotics and Clinical Disease
A few weeks ago, I went to an interesting lecture entitled, “Bacterial Colonization, Probiotics, and Clinical Disease” given by Allan Walker. The lecture focused on the hygiene hypothesis and the colonization of gut bacteria in children. Dr. Walker pointed that the colonization of bacteria in a person’s body occurs in four steps after leaving the germ-free in utero environment. The first exposure to bacteria is from a person’s mother while leaving the birth canal, the second round of exposure arises from oral feeding, the third from weaning, and the fourth phase is complete around the age of 2 years when the baby has complete adult colonization. Breast feeding and normal vaginal birth both help promote this bacterial colonization and can help against abnormal colonization that may lead to increased susceptibility to pathogens and immune mediated disease. It is apparent that a disruption in any of these steps may lead to a disruption in bacterial exposure during childhood development.
He highlighted many previous studies that have demonstrated the relationship between bacterial colonization and clinical disease. For example a study in Japan demonstrated that antibiotic use during infancy promotes a shift in the Th1/Th2 balance towards a Th2 dominant immunity in mice[1]. He also highlighted the importance of breast milk in promoting a normal pH and presence of normal intestinal flora. He argued that bacterial colonization helps promote a health host defense and that imbalances in T helper cells may lead to disease.
Through his description of countless studies that have examined the relationship of innate immunity and the presence of old friends, I was most interested in his research in probiotic treatment for clinical disease. He discussed that it may be possible to address the hygiene hypothesis by using probiotics as a surrogate for initial colonization and therapy for prevention and treatment of microbial-induced disease. I did not have much knowledge about probiotics but a simple google search yielded over two million matches, so it seems that they are certainly a hot topic. Probiotics are viable microbial dietary supplements used in fermented foods like yogurt and they claim to enhance natural defenses and prevent disease. You can by these in capsules in the supplement aisle and there are many dairy products that tout their probiotic qualities (such as Activia). Studies have shown that oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants[2]. However, clinical recommendations for probiotics are very much in the early stages, and Walker’s final conclusions stated that although probiotics may be a useful tool, many additional studies should be conducted to understand the specific function in clinical treatment.
[1] J Allergy Clin Immunol. 2001; 107(1):153-9
[2] Pediatrics 2005; 115; 1-4
For those of you interested in background of Probiotics
http://www.mayoclinic.com/health/probiotics/AN00389
http://www.msnbc.msn.com/id/27454348/ (mainstream article on MSNBC on probiotics in the news)
http://en.wikipedia.org/wiki/Probiotic (I know this is wiki, but it had an interesting history of their use, take it as a wiki source)
I addition I have the biliography from the lecture. If you are interested, let me know and I can scan/e-mail to you.
He highlighted many previous studies that have demonstrated the relationship between bacterial colonization and clinical disease. For example a study in Japan demonstrated that antibiotic use during infancy promotes a shift in the Th1/Th2 balance towards a Th2 dominant immunity in mice[1]. He also highlighted the importance of breast milk in promoting a normal pH and presence of normal intestinal flora. He argued that bacterial colonization helps promote a health host defense and that imbalances in T helper cells may lead to disease.
Through his description of countless studies that have examined the relationship of innate immunity and the presence of old friends, I was most interested in his research in probiotic treatment for clinical disease. He discussed that it may be possible to address the hygiene hypothesis by using probiotics as a surrogate for initial colonization and therapy for prevention and treatment of microbial-induced disease. I did not have much knowledge about probiotics but a simple google search yielded over two million matches, so it seems that they are certainly a hot topic. Probiotics are viable microbial dietary supplements used in fermented foods like yogurt and they claim to enhance natural defenses and prevent disease. You can by these in capsules in the supplement aisle and there are many dairy products that tout their probiotic qualities (such as Activia). Studies have shown that oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants[2]. However, clinical recommendations for probiotics are very much in the early stages, and Walker’s final conclusions stated that although probiotics may be a useful tool, many additional studies should be conducted to understand the specific function in clinical treatment.
[1] J Allergy Clin Immunol. 2001; 107(1):153-9
[2] Pediatrics 2005; 115; 1-4
For those of you interested in background of Probiotics
http://www.mayoclinic.com/health/probiotics/AN00389
http://www.msnbc.msn.com/id/27454348/ (mainstream article on MSNBC on probiotics in the news)
http://en.wikipedia.org/wiki/Probiotic (I know this is wiki, but it had an interesting history of their use, take it as a wiki source)
I addition I have the biliography from the lecture. If you are interested, let me know and I can scan/e-mail to you.
24 November 2008
Acupuncture
I read the article titled The Neuroimmune Basis of Anti-inflammatory Acupuncture. I thought it would be helpful to blog about acupuncture and some of the theories behind its effects on the body.
HISTORY
Acupuncture originated in China and can be traced back to the Stone Age. At this time instead of needles sharp stones were used. As mentioned in the article the 5000-year-old mummy, Otzi, found in the Alps is thought to be further evidence of the use of acupuncture in ancient times. On his body there are over 50 tattoos that mark the locations of acupuncture points on his body.
Despite these ancient roots in Chinese history, acupuncture and other folk medicine declined during the Revolution of China in 1911. Yet during the Long March many of the soldiers used acupuncture to maintain the health of the People's Liberation Army. With the success of acupuncture in this situation, Mao Zedong, the leader of the Chinese Communist Party, became an advocate for the use of acupuncture on a larger scale. This seems very opposite of the rest of the party who criticized the use of folk medicine as a step backwards.
From this support, Traditional Chinese Medicine was born. Traditional Chinese Medicine is the formalized system of folk medicine that was taught in medical schools throughout China. It is still an important part of Chinese medical curriculum today.
Acupuncture was first brought over to the US in the 1970s. Travelers to China were fascinated by the use of acupuncture as the only anesthesia for patients during surgery. The National Acupuncture Association (NAA) was started during this time. The NAA hosted a number of seminars and research presentations around the US in order to increase acupuncture's popularity. It succeeded and in 1972 the first acupuncture clinic was opened in Washington, D.C.
METHODS
The basis of acupuncture is rooted in the belief that there is a substance within our bodies called Qi. This vital energy runs freely through our body along meridians. When an imbalance, or blockage of our Qi occurs, that is when acupuncture needs to be done. Acupuncture allows for drainage of excess Qi from certain areas, clearing of blockages, and promoting flow where stagnation has occurred.
When acupuncture is done, it is done along the meridians in the body. The twelve primary meridians in the body, or mai, correspond to the systems of function. These primary meridians are: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, San Jiao (not really associated with a specific body part, it is for the control of temperature), Gall Bladder, and Liver. There are also Eight Extraordinary Pathways, the Luo Vessels, the Divergents, and the Sinew Channels that are also used, just not as commonly.
In clinical practice a disposable stainless steel needle is usually used. The needle has a diameter between .18mm to .51 mm depending on the location. The ends of the needle is wrapped with wire or covered in plastic to stiffen the needle and allow it to be easily grasped by the acupuncturist. The length of the needle, and the depth it is inserted, depends on the style that the acupuncturist is using as well as what he is trying to alleviate.
With acupuncture heat or electricity can be applied to the area in order to further the affects of the needle. When heat is applied is usually done via moxibustion, which is the burning of herbs (usually mugwort). Moxibustion can be done several different ways. One way involves attaching the herbs to the exposed end of the needle and lighting it on fire. Another technique is holding a light stick of mugwort near the acupuncture needle. Another is applying an ointment to the area of the skin and then lighting the mugwort directly on the skin before inserting the acupuncture needle.
THEORIES
The two theories that are mentioned in the article that I felt weren't really explained clearly are the Gate-Control Theory and the DNIC theory. I wanted to share the information I found when I looked them up. This helped me out so I thought it might be helpful to others.
Gate-Control Theory
The Gate-Control Theory of Pain was proposed by Ronald Melzack and Patrick Wall in 1962 and in 1965. The theory states that pain is not just determined by the action of nociceptors. Nociceptors are receptors that take in a stimulus and cause us to perceive pain due to this stimulus. Yet Melzack and Wall state that there are other fibers that can affect this transmission of stimulus into pain. They state there are other nonnociceptive fibers that interact with the nociceptor fibers. Thus if these other fibers are stimulated they can actually counter the pain signal of the nociceptors.
This can be applied to acupuncture very easily. When applied to acupuncture this theory is saying that the insertion of the needle is actually activating nonnociceptive fibers in that area. This activation then causes a signal to be sent, which interferes with the nociceptors and the pain that is perceived is lessened.
DNIC
This stands for Diffuse Noxious Inhibitory Control. This theory seemed pretty complicated to me, so my explanation is only what I got from the information I found. I kind of simplified it down so I could easily understand it.
This idea is very similar to that of the Gate-Control Theory of Pain. It states that if you have a stimulus that is perceived as pain in a certain area, you can inhibit this by administering a painful stimulus in a distal area. This is like the general idea that if your head hurts and someone stands on your foot you won't head won't hurt anymore.
LINKS
Here is a link to an interactive map of the acupuncture points and meridians:
http://www.yinyanghouse.com/acupuncturepoints/locations_theory_and_clinical_applications
Here is a link to the NIH Conference statement that is mentioned in the article:
http://consensus.nih.gov/1997/1997Acupuncture107html.htm
Here is where I got some of the information about DNIC:
http://www.clas.ufl.edu/jur/200611/papers/paper_lovell.html
HISTORY
Acupuncture originated in China and can be traced back to the Stone Age. At this time instead of needles sharp stones were used. As mentioned in the article the 5000-year-old mummy, Otzi, found in the Alps is thought to be further evidence of the use of acupuncture in ancient times. On his body there are over 50 tattoos that mark the locations of acupuncture points on his body.
Despite these ancient roots in Chinese history, acupuncture and other folk medicine declined during the Revolution of China in 1911. Yet during the Long March many of the soldiers used acupuncture to maintain the health of the People's Liberation Army. With the success of acupuncture in this situation, Mao Zedong, the leader of the Chinese Communist Party, became an advocate for the use of acupuncture on a larger scale. This seems very opposite of the rest of the party who criticized the use of folk medicine as a step backwards.
From this support, Traditional Chinese Medicine was born. Traditional Chinese Medicine is the formalized system of folk medicine that was taught in medical schools throughout China. It is still an important part of Chinese medical curriculum today.
Acupuncture was first brought over to the US in the 1970s. Travelers to China were fascinated by the use of acupuncture as the only anesthesia for patients during surgery. The National Acupuncture Association (NAA) was started during this time. The NAA hosted a number of seminars and research presentations around the US in order to increase acupuncture's popularity. It succeeded and in 1972 the first acupuncture clinic was opened in Washington, D.C.
METHODS
The basis of acupuncture is rooted in the belief that there is a substance within our bodies called Qi. This vital energy runs freely through our body along meridians. When an imbalance, or blockage of our Qi occurs, that is when acupuncture needs to be done. Acupuncture allows for drainage of excess Qi from certain areas, clearing of blockages, and promoting flow where stagnation has occurred.
When acupuncture is done, it is done along the meridians in the body. The twelve primary meridians in the body, or mai, correspond to the systems of function. These primary meridians are: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Pericardium, San Jiao (not really associated with a specific body part, it is for the control of temperature), Gall Bladder, and Liver. There are also Eight Extraordinary Pathways, the Luo Vessels, the Divergents, and the Sinew Channels that are also used, just not as commonly.
In clinical practice a disposable stainless steel needle is usually used. The needle has a diameter between .18mm to .51 mm depending on the location. The ends of the needle is wrapped with wire or covered in plastic to stiffen the needle and allow it to be easily grasped by the acupuncturist. The length of the needle, and the depth it is inserted, depends on the style that the acupuncturist is using as well as what he is trying to alleviate.
With acupuncture heat or electricity can be applied to the area in order to further the affects of the needle. When heat is applied is usually done via moxibustion, which is the burning of herbs (usually mugwort). Moxibustion can be done several different ways. One way involves attaching the herbs to the exposed end of the needle and lighting it on fire. Another technique is holding a light stick of mugwort near the acupuncture needle. Another is applying an ointment to the area of the skin and then lighting the mugwort directly on the skin before inserting the acupuncture needle.
THEORIES
The two theories that are mentioned in the article that I felt weren't really explained clearly are the Gate-Control Theory and the DNIC theory. I wanted to share the information I found when I looked them up. This helped me out so I thought it might be helpful to others.
Gate-Control Theory
The Gate-Control Theory of Pain was proposed by Ronald Melzack and Patrick Wall in 1962 and in 1965. The theory states that pain is not just determined by the action of nociceptors. Nociceptors are receptors that take in a stimulus and cause us to perceive pain due to this stimulus. Yet Melzack and Wall state that there are other fibers that can affect this transmission of stimulus into pain. They state there are other nonnociceptive fibers that interact with the nociceptor fibers. Thus if these other fibers are stimulated they can actually counter the pain signal of the nociceptors.
This can be applied to acupuncture very easily. When applied to acupuncture this theory is saying that the insertion of the needle is actually activating nonnociceptive fibers in that area. This activation then causes a signal to be sent, which interferes with the nociceptors and the pain that is perceived is lessened.
DNIC
This stands for Diffuse Noxious Inhibitory Control. This theory seemed pretty complicated to me, so my explanation is only what I got from the information I found. I kind of simplified it down so I could easily understand it.
This idea is very similar to that of the Gate-Control Theory of Pain. It states that if you have a stimulus that is perceived as pain in a certain area, you can inhibit this by administering a painful stimulus in a distal area. This is like the general idea that if your head hurts and someone stands on your foot you won't head won't hurt anymore.
LINKS
Here is a link to an interactive map of the acupuncture points and meridians:
http://www.yinyanghouse.com/acupuncturepoints/locations_theory_and_clinical_applications
Here is a link to the NIH Conference statement that is mentioned in the article:
http://consensus.nih.gov/1997/1997Acupuncture107html.htm
Here is where I got some of the information about DNIC:
http://www.clas.ufl.edu/jur/200611/papers/paper_lovell.html
Aspirin and Myocardial Infarctions
Everyone has seen the commerical where the man takes apsirin to stop his heart attack...well that got me thinking...is it true? How does it work?
In October 1997, the AHA reported in its journal, Circulation, that up to 10,000 more people would survive heart attacks if they would chew one 325 milligram aspirin tablet when they first had chest pain or other sign of a heart attack. Other studies have come to similar conclusions. One found that heart attack patients who took aspirin when their symptoms began, and then daily for one month, significantly lowered their risk of dying and of having another heart attack or stroke over the people in the study who were given the placebo. Now, just about all researchers agree that patients should be given aspirin during the first hour -- during pre-hospital transport or in the Emergency Room -- if a heart attack is suspected.
How it works: The Basics:
Basically, it interferes with the production of a series of chemicals in the body -- called prostaglandins -- that regulate many of the body’s vital functions. By blocking certain prostaglandins, aspirin lowers body temperature, relieves minor aches and pains, relieves inflammation and interferes with the role of blood platelets in forming clots. It is this last effect that appears to impact on risk for heart disease. Blood clots are formed by platelets grouping together. Aspirin interferes with this process by making the platelets less “sticky” -- and therefore less successful in grouping together -- by inhibiting the manufacture of prostaglandins. This same blood “thinning” action that makes aspirin effective in reducing a person’s risk for heart disease, but “you have to chew the aspirin, especially if you only have enteric-coated aspirin, because if you just pop one of those, you won’t see any action for hours.” Always call 911 first. Then, after chewing the aspirin, you can wash it down with water and get immediate medical attention.
Interesting Facts:
Aspirin was officially introduced 100 years ago and has been marketed in its current form for more than 80 years.
The origin of the drug can be traced back to Hippocrates. he advised his followers to chew the leaves of the willow tree to alleviate pain.
The Chinese have been using the bark of the same trees -- which contain salicin -- to control fever.
In the early 1800’s different derivatives of this bark were tested and one -- acetylsalicylic acid, the chemical name for aspirin -- was found to be tolerated better than the others.
http://www.yourfamilyshealth.com/cardiology/aspirin/
In October 1997, the AHA reported in its journal, Circulation, that up to 10,000 more people would survive heart attacks if they would chew one 325 milligram aspirin tablet when they first had chest pain or other sign of a heart attack. Other studies have come to similar conclusions. One found that heart attack patients who took aspirin when their symptoms began, and then daily for one month, significantly lowered their risk of dying and of having another heart attack or stroke over the people in the study who were given the placebo. Now, just about all researchers agree that patients should be given aspirin during the first hour -- during pre-hospital transport or in the Emergency Room -- if a heart attack is suspected.
How it works: The Basics:
Basically, it interferes with the production of a series of chemicals in the body -- called prostaglandins -- that regulate many of the body’s vital functions. By blocking certain prostaglandins, aspirin lowers body temperature, relieves minor aches and pains, relieves inflammation and interferes with the role of blood platelets in forming clots. It is this last effect that appears to impact on risk for heart disease. Blood clots are formed by platelets grouping together. Aspirin interferes with this process by making the platelets less “sticky” -- and therefore less successful in grouping together -- by inhibiting the manufacture of prostaglandins. This same blood “thinning” action that makes aspirin effective in reducing a person’s risk for heart disease, but “you have to chew the aspirin, especially if you only have enteric-coated aspirin, because if you just pop one of those, you won’t see any action for hours.” Always call 911 first. Then, after chewing the aspirin, you can wash it down with water and get immediate medical attention.
Interesting Facts:
Aspirin was officially introduced 100 years ago and has been marketed in its current form for more than 80 years.
The origin of the drug can be traced back to Hippocrates. he advised his followers to chew the leaves of the willow tree to alleviate pain.
The Chinese have been using the bark of the same trees -- which contain salicin -- to control fever.
In the early 1800’s different derivatives of this bark were tested and one -- acetylsalicylic acid, the chemical name for aspirin -- was found to be tolerated better than the others.
http://www.yourfamilyshealth.com/cardiology/aspirin/
Alternative Medicine: Cupping
The review article, The Neuroimmune Basis of Anti–inflammatory Acupuncture, mentions the term “cupping”. As I had mentioned before in class, I grew up with Russian gymnastic coaches who brought their knowledge of Eastern Medicine to the West. I was lucky enough not to get stung by bees but had the enjoyment of having cupping done. Hope you find it as interesting as I did.
Illness is caused by an imbalanced, stagnated or weak Qi. Acupuncturists are trained to use cupping when Qi needs to be drawn to the surface of the body from deep within. The cups are applied to acupuncture points. Cupping is a technique in which glass cups are heated from the inside with fire to create a vacuum and then placed on the afflicted area of the body. The cup's suction pulls at the skin and is said to "suck out" the body's toxins.
Sources of these toxins include: air pollution, drugs, junk food, and smoking, waste products of metabolism, trauma/accidents, stress, anger, anxiety and depression. Toxins can slow down or block supply of blood that delivers much needed oxygen, nutrients, water, mineral electrolyte, vitamins, enzymes, hormones and immune system cells to cells, tissues and organs. This also prevents the removal of metabolic waste products and toxic substances which are excreted through our lungs, skin and urine. As a result, our cells, tissues, and organs become progressively weak, inefficient, and easily overcome. This can cause tissue/organ malfunction and infection to take place. This will cause symptoms of diseases such as aches and pain, numbness, fever, cough, stomach ache, constipation, diarrhea and headaches. If left untreated, further accumulation of toxic waste may lead to serious chronic diseases including hypertension, ulcers, diabetes, arthritis, Alzheimer disease, migraine, heart disease, stroke and cancer.
Illness is caused by an imbalanced, stagnated or weak Qi. Acupuncturists are trained to use cupping when Qi needs to be drawn to the surface of the body from deep within. The cups are applied to acupuncture points. Cupping is a technique in which glass cups are heated from the inside with fire to create a vacuum and then placed on the afflicted area of the body. The cup's suction pulls at the skin and is said to "suck out" the body's toxins.
Sources of these toxins include: air pollution, drugs, junk food, and smoking, waste products of metabolism, trauma/accidents, stress, anger, anxiety and depression. Toxins can slow down or block supply of blood that delivers much needed oxygen, nutrients, water, mineral electrolyte, vitamins, enzymes, hormones and immune system cells to cells, tissues and organs. This also prevents the removal of metabolic waste products and toxic substances which are excreted through our lungs, skin and urine. As a result, our cells, tissues, and organs become progressively weak, inefficient, and easily overcome. This can cause tissue/organ malfunction and infection to take place. This will cause symptoms of diseases such as aches and pain, numbness, fever, cough, stomach ache, constipation, diarrhea and headaches. If left untreated, further accumulation of toxic waste may lead to serious chronic diseases including hypertension, ulcers, diabetes, arthritis, Alzheimer disease, migraine, heart disease, stroke and cancer.
There are 3 different cupping techniques.
- Air Cupping: most common, no side effects, prevents and treats slight ailments
- Aggressive Cupping: used for serious chronic diseases, marks may remain up to 1 year
- Blood Cupping: cups applied to scratched skin, toxic blood is removed
Some diseases treated by Cupping Therapy
- cold/cough
- headaches/migraine
- asthma
- allergies
- hypertension/hypotension
- osteoarthritis
- rheumatoid arthritis
- diabetes
- kidney/liver problems
- Alzheimer’s disease
- stroke
- cancer
Interestingly, if the person is really healthy, the redness will dissipate very quickly with the skin returning to its normal color, usually within minutes or hours. However, if the person is in poor health, injured or experiencing Qi blockages, there will be some bruising and skin will not return to normal color for a couple of days rather than hours.
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