Coronary Heart Disease

Coronary artery and its branches provide the myocardium whit needed oxygen and nutrients,specially glucose,otherwise the heart muscle will suffer of ischemia(local anemia),and the risk of developing ischemia heart disease.

Causesof Myocardial ischemia:
-diminished blood flow in coronary artery
-diminished flow of oxygenated blood to myocardium
-increased oxygen requirement of myocardium

Risk factors:
Coronary atherosclerosis is the main cause of coronary heart disease and others.
classification of risk factors:
-unmodified factors:personal factors of age,gender,genetic and inheritance(family history).
-modified factors:potential factors that can be changed whit treatment.

Major factors:
-hyperlipidamia(serum cholesterol level)
-cigarette smoking
-hypertention
-diabetesor impaired glucose tolerance
Contributing factors:
-physical inactivity,lack of exercise
-heavy consumption of alcohol
-obesity
-personality type,mental stress and worry
-oral contraception
-socioeconomic circumstances

Characteristics:
In case of asymptomatic type the obstruction of blood flow in the coronaries is light at the beginning of disease and gives no symptoms.
In case of angina pectoris the obstraction and impaired blood flow are progressing,causing hypoxia of glucose,myocardium.
Types of angina:
-Classical angina:anginal pain appears on physical exertion and may be provoked by excitement,psychological upset and unger,exposure to cold or after heavy meals.
The attack is transient,for few minutes and disappears on rest.
-Nonclassical angina:this type arises under certain circumstances other then exertion,for exemple nocturnal angina due to coronary spasm during sleep,angina at rest,without any obvious provoking factors.
Acute myocardial infarction may arise from complete obstruction of involved vessels.

Prevention of coronary heart disease is based on prevention and control of determined risk factors:
1.Diet control:
-no excess of calories,fat and common salt
-dietary carbohydrates must be largely of the complex form: from grain and their products
-no excess of rafined sugar
-consumption of vegetable oil,rather then animal fat and margarine
-restriction of solid fats.
Marine fat oils(omega 3 tryglycerides)contain large amount of two highly unsaturated fatty acids and have potenital role in prevention of coronary heart coronary.

Red Sea Tourists and Life Medical Assistance

Is time for vacation and as an exotic place with oriental look and charm,Red Sea attracts during the whole year the interest of a large number of tourists from all over the world.A special place for diving,boat trips,swimming and other activities,an envirounment favourable to so many ways to spend free time,can bring risk of accidents.
Life Medical Assistance is next to you in vacation!In case of injuries or a minor suffering,L.M.A has special prices for Red Sea tourists and offers a big discount for insurance companies too.
Life Medical Assistance provides 24/7 emergency system,availability for any type of treatment,brilliant technology,laboratory service,surgery and hospitalization.
Our services are safety and affortable!

Cancer of Female Genitalia

Cancer and other malignant tumours may involve the female genital system.This form includes around 6% of total female malignancy.The frequency is:
-the cervix comes first:more than half of cases
-the ovary,vagina,endometrium,vulva and myometrium.

CERVIX CANCER:
Cervical cancer is the commonest cancer of female genital system.Peak is found around the age of 50 years.
The causes cannot be given.
Cervical cancer control:the case to be early finding and management.
-females must be aware of any vaginal discharge,or abnormal uterine bleeding,to seek medical consultation at time
-periodic health appraisal of at risk females over 40 years:clinical examinatio for visible cervical lesions(swelling,ulceration),taking cervical smear,to be examinated for positive cytology,so as to screen suspected cases.Diagnosis can be confirmed by biopsy.

ENDOMETRIAL CANCER:
Cancer of endometrium is a common cancer of female genital tract that comes next to cancer cervix.
A good percent of cases may occur before menopause and the majority after 50 years,with peak incidence in women aged 60-70 years.

Risk factors:
-hormonal-administration of hormones or hormonal disorders.
-giving synthetic estrogens(uncontrolled administration,before or around menopause to relieve menopausal symptoms)
-hormonal disorders as estrogenic disturbance,disturbance of hypothalamic,polycystic ovaries with prelonged anovulation.
-metabolic disorders,including impaired glucose tolerance and diabetes
-obesity(specially when is combinated with diabetes)
-nulliparity(radiation to induce menopause,did not prove to be a risk factor)

Females must be aware of gynecologic disorders(menstrual disorders including abnormal bleeding,and postmenopausal bleeding) and seek medical care,becouse are women that apparently have normal health condition and a medical examination is necessary to detect malignant disease early enough in the microscopic asymptomatic phase.

Breast Cancer

Breast cancer affects females and rarely males.
The causes of breast cancer in females are not definitely known,but certain risk factors,precancerous conditions and host variable are known to inluence susceptibility to incidence of breast cancer.
Risk Factors:
1.Hormonal disturbance:endogenous and exogenous.Increased estrogen,progesterone or prolactin.
2.Contaceptive pill:proper use is safe(not precancerous,ot risky).Under certain circumstances,however,oral contraception may be potentially risky for development of breast cancer:
-continued,not interrupted,oral contraception for long time,years undefined,may be more than four.
-practice of oral contraception over 35 years of age,may be also risky.
3.Parity:
-multiparas are exposed to more incidence of breast cancer,that usually appears in 40-60 years,specially when regular breast feeding in not fallowed
-practice of breast feeding:mothers not or irregularly practising breast feeding are exposed to milk retention,with more risk of breast cancer
-nulliparous women
-delayed childbearing:women having their first full-term pregnancy at older age,specially after 35,may show somewhat higher incidence of breast cancer.
4.Menstruatio Pattern:
-early menarche(under 12) and late natural menopause(after 50) are associated with little increased incidence
-late menarche at early menopause are associated with lower incidence.
5.Morbidity:
-cancer of one breast increases susceptibility to involvement of the other breast
-cases of cancer body uters show more incidence of breast cancer and cases of breast cancer show increased endometrial cancer.
6.Family history of breast cancer:families having cases of breast cancer show higher incidence of disease.the more intimate the degree of relation,more is the risk.
Prevention:
Primary prevention cannot be precisely given,since cause is not known.Prevention is based on:
-avoiding exposure to risk factors
-early detection and management of precancerous conditions.
Hormonal preparation has to be used only on medical prescription,and under supervision.
For those who use oral pill:
-select the proper pill and dosage
-don't have a continued use,not more than 4 years
-the women over 35 have to not use the pill and use an other method.For womens that use oral contraception,change to some other method after 4 years and then you can come back to pill after some time if is recomandated.

Role of Antioxidants

The antioxidants are vitamin A,C,E and selenium.They are valuable for diminished morbility in general,lowered incidence of cancer and cotributing to increased life expectancy.
They have synergistic effect.When dietary supply may be deficient,supplemention by suitable preparation can be given.
Beta-carotene-Vitamin A:are needed to maintain stability of biological membranes(protect the cells against oxidats).
Vitamin E:many tocopherols have vitamin E value and the alpha is particularly important.Vitamin E contributes to maintaining stability of the protective biological membranes.Vitamin E also protects polyunsaturated fatty acids against oxidation.
Vitamin C:ascorbic acid is a powerful reducing agent,prevents atherosclerosis and cancer.
Selenium:cofactor of the enzyme glutathione peroxidase that protects membranes from the oxidative damage of oxidants.the enzyme destroys peroxides derived from unsaturated fatty acids.deficiency may affect the liver and skeletal muscles.
Adequate Diet:
Must be considered:
-energy:just needed calories
-low fat,specially that saturated,or restricted fat
-low cholesterol cotent of diet
-adequate complex content of diet
-adequate fiber content,no excess
-limited salt intake,no excess
-limited sugar
-sufficient vegetable,fruits and whole grain cereals.

Osteoporosis

Osteoporosis is the commonest metabolic disease of bone and is characterised by:
-segnificantly reduced bone density(low bone mass,diminised amount of bone)
-increased bone fragility,with the risk of collapse of vertebral bodies and fractures of vertebre and bones.
Mass and bone density increase with age to attain optimal level between age of 30.The growth and development of bone are influenced by:genetic factors,adequate nutrition and growth steroids,significantly increased during puberty.
The bone is continually exposed to two process,bone formation and resorption,the first must gain the upper hand,as to prevent loss of bone.
As about the causes of osteoporosis some of them can be only occasionally and multiple causes are related the inability to reach the peak of optimal bone density before the age of 30 years and loss of bone substance,when resorption goes at higher rate than formation.
Predisposing and Risk factors:
I.Personal factors:
-Age:bone mass begins to decline around the age of 40 years and progress with age.At risk age factores is 50-75 years for type I,and over 70 for type II osteoporosis.
-Sex:women are signifcantly more ate risk that men due to:lower bone mass in women and much increased postmenopausal loss of bone.
-Slender body built(low body weight is a risk factor)
-Delaued puberty in males and menarche in females(sice increased growth steroids during puberty are a determinant of peak bone density).

II.Faulty Lifestyle:
-Diet(inadequate bone-forming and maintainig nutrients,excess protein cosumption for long time)
-Sedentary life:lack of physical activity and exercise(the exercises preserve bone mass)
-Smoking:increases loss of bone and may affect estrogen
-Alcohol consumption.

III.Morbidity:
-Endocrine disease:hyperparathyroidism,hypogonadism,diabetes.
-Rheumatoid arthritis
-Malignancy
-Others;chronic liver disease,chronic renal failure,anorexia nervosa.

Types of Osteoporosis:
Type I(including the menopausal)
Type II-of the elderly

Type I Osteoporosis;
Both men and women are involved,due to estrogen and androgen deficiency.
Mainly women are affected,commonly the postmenopausal middle-aged.Gives painful vertebral fractures.At risk age of fractures: 50-75 years.
Osteoporosis of Menopause:
Menopause osteoporosis is due to estrogen deficiency.In men causes of hypogonadism are at risk of osteoporosis type I.

Type II Osteoporosis;
It is osteoporosis of the elderly,due to changes of bone mass with age.Both men and women over 70 years are at risk,though may be more in women.
Causes:aging in associated with deficiency of calcium and vitamin D that are needed for maintenance of boe and prevention of bone loss.
Cases are exposed to fractures commonly of:hip(fracture neck femur) and vertebre(collapse of vertebral bodies)

Prevention of Osteoporosis:
Prevention is based on increasing bone density and preventing loss of bone.
1.Healthful lifestyle:adequate nutritio,physical activity and exercise and no smoking and alcohol.Balanced diet with special consideration of bone(calcium,vitamin D).
Supplementatio may be given when necessary on medical advice for calcium(oral),vitamin D(oral),fluoride(oral).
2.Hormonal Prophylaxis:
-estrogen:for postmenopausal women,specially during first 10 years
-antrogens for men
Don't take drugs without medical advice.

Food Additives and Food Cancer

Food additives are the substances added to different processed foods for some purposes.More then 3000 additives are widely used in food technology processes at present.
Food additives are used for:
-to make food more attractive to consumers,through providing appealing features:colour and flavour that gives smell and taste
-to preserve food(chemical preservatives are added)
-to keep food fresh,by adding sodium nitrate and vitamin C to uncooked fruits,to prevent becoming brownish
-to help processing and improve texture and consistency of food
to improve nutritive value(fortification of certain foods,like baby powder milk,margarine,common salt for iodine,refined flour.

Uncontrolled use of additives may be unsafe whit potential risk of toxicity to body organs,specially the liver and kidney and carcinogenicity,specially on regular long term consumption.

Marketing of processed food must be submitted to quality and safety assurance regulation and must have as objecties:
-prevention of all forms of adulteration
-regulation of additives for safety:allowing only additives that proved safe,on laboratory and experimental animal testing,specifying maximal allowable concentration,giving name and concentration of additives on food lebel,regular inspectation for quality,validity(manufacture and expiry date),used additives and presentation.

Studies are ongoing for correlation of food and cancer.They suggest that according to circumstances both protective value of diet(anticarcinogens containing and protective factors as antioxidants) and the role risk(may contain carcinogens).
To decrease the risk of cancer we have to take in consider:
-just the needed calories,and caloric restriction if is necessary
-get energy from complex carbohydrates mainly whit reduce fat and sugar
-regular checking of dietry control of weight
-the alcohol must be avoided,and salted and smoked foods.
Saccharin is an artificial nonsucrose sweetener that gives no calories.
Saccharin is used sweetener for many diet products on the market,as soft drinks,syrops and sweets to be labelled "Diet" and personal used at home,to sweeten drinks as tea and sweets.
Saccharin has been implicated as potential carcinogen,based on experimental studies on rats.
Carcinogenic role in man,however,has not been established.There was no difference in the incidence of cancer in a study group of saccharin users and a control group of nonusers.
A balanced diet must provide vegetable and fruits(the main source of vitamins and essential elements,provide antionxidants that protect the body cells against the effects of free radicals and oxidants) and suitable fiber,from vegetable and fruits and high fibre grain.It is valuable for gastrointestinal mobility and contributes to prevention of cancer colon.