Manage stress through troubleshooting

By Mayo Clinic staff

To alleviate a stressful situation, put your problem solving skills to use: 1. identify what is causing stress in specific terms. 2. Clarify what would make the problem go away. 3. Brainstorm potential ways you might solve your problem. 4. Select the option that feels the most realistic and satisfying. 5. Implement the solution. 6. reflect on the outcome and if the solution worked.

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Drinking Red Wine Is Good for Gut Bacteria

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Moderate Intake of Some Red Wines May Improve Health, Study Shows

By Cari Nierenberg
WebMD Health News

Reviewed by Louise Chang, MD

May 25, 2012 -- Drinking a daily glass of red wine not only tastes good to many people, but it's also good for the bacteria lining your large intestine.

A new Spanish study suggests that sipping about 9 ounces of Merlot or a low-alcohol red wine changed the mix of good and bad bacteria typically found in the colon in ways that can benefit your health.

Bacteria may sound like a bad thing to have in your intestinal tract, but having a balanced mix of them actually helps to digest food, regulate immune function, and produce vitamin K (which plays a key role in helping the blood clot).

Since the study results showed that Merlot and low-alcohol red wine had similar positive effects on intestinal bacteria, researchers suspect it's not due to the alcohol but to the polyphenol compounds found in the wine.

Polyphenols are helpful plant-based compounds found in a variety of foods and beverages. Besides red grapes, many other fruits and vegetables are rich sources of polyphenols, as are coffee, tea, chocolate, and some nuts.

Previous research has looked at whether polyphenols in the diet can influence the balance of intestinal bacteria. This study sought to explore whether drinking red wine can have a similar prebiotic effect. Prebiotics are substances you eat that help promote the growth of good gut bacteria.

In this small study, which appears in the American Journal of Clinical Nutrition, researchers followed 10 healthy middle-aged men. For the first 15 days of the study, the men had no wine or other alcohol. This was followed by three 20-day periods in which the men were given one of three beverages to drink each day: They received either 9 ounces of Merlot, 9 ounces of low-alcohol-content red wine, or about 3 ounces of gin.

Unlike the red wines, gin contains no polyphenols, so it served as a comparison.

Throughout the study, volunteers were asked not to change their diets or exercise habits. They were also told not to drink any additional alcohol. Blood, urine, and stool samples were collected from each man during all four study periods. And their weights and blood pressures were monitored.

The findings showed that the balance of intestinal bacteria shifted in the men in a similar way whether they drank the Merlot or low-alcohol red wine. In both cases, they had a larger percent of certain beneficial gut bacteria.

After drinking the polyphenol-rich beverages, the men also had lower blood pressure. It also decreased triglyceride levels, HDL cholesterol (the so-called good cholesterol), and C-reactive protein (CRP) levels, a measure of inflammation.

"This study was the first to show that regular, moderate consumption of red wine could have a noteworthy effect on the growth of select gut microbiota," the researchers conclude.

SOURCES: Queipo-Ortuno, M. American Journal of Clinical Nutrition, published online May 2, 2012.News release, American Journal of Clinical Nutrition.USDA Agricultural Research Service web site: "Phytonutrient FAQs."

©2012 WebMD, LLC. All Rights Reserved.

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Fringe — Episode 21 (Season 4): “Brave New World, Part 1 of 2”

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Better late than never. The Fringe team has their final confrontation with David Robert Jones and learns the identity of the real mastermind in an entertaining, albeit fairly cluttered, episode.

The Plot: The Fringe Team is called in to evaluate a cluster of cases of spontaneous combustion at a nearby convention center. Walter initially suspects a viral infection, but when he realizes the infection was caught from the handrail on the escalator and locates the source, he determines the victims have actually been infected with nanites. Video surveillance shows that David Robert Jones planted the nanites in the escalator, but after looking over the nanites, Walter recognizes them as the work of William Bell.

In this universe, William Bell died in a car crash seven years before, but Walter is insistent that Bell must still be alive and tells the rest of the team that William visited him at St. Claire’s Hospital after he was supposed to be dead. A visit to the hospital shows no evidence of Bell visiting, but Walter keeps the sign-in log for good measure.

The viewers quickly realize that Walter is right and William Bell is still alive, and the Jones is working for him. After some clumsy metaphors about chess, Bell tells Jones that it is time to take out the Bishop. Soon, a bright powerful beam of light comes down from the sky, burning everything in its path. Walter and Peter realize that it is caused by satellites reflecting the sun’s rays and Walter is able to track down the source of the transmission controlling the satellite. Peter and Olivia head off to the transmission sight – antennas on two nearby buildings. They each climb to the roof of one building and shut down the transmitters, but Peter is jumped by Jones. Olivia is able to use her Cortexiphan abilities to take control of Peter’s body and beat Jones senseless. Jones then disintegrates into powder, remarking that he was the Bishop being taken off the board.

Back in his lab, Walter, with help from Astrid, cow’s brains, and an EZ Bake oven, determine that Bell did visit the asylum, leaving behind a trace of his favorite snack – almonds – on the sign-in log. Walter and Astrid head off to the almond warehouse in an attempt to track down Bell. They succeed too well – finding both Bell and some armed goons – and Astrid receives a gut shot as the episode ends.

1. Flame On!
Not quite classic spontaneous combustion. In this case, only their cheeks and respiratory system (or maybe GI system) burnt up – they didn’t all spontaneously burst in to flame.

2. Forget Minute Rice, Try Our Minute Cultures!
That’s way too short an amount of time to declare an area free of airborne germs. Well, unless you’re using a tricorder. Mabey Nimoy brought one with him.

3. Must Be Empty, And Very Understaffed
St. Claire’s hasn’t reassigned the room, or at least cleaned the desk, in the four years since Walter left?

4. And Lets Not Forget the Foreshadowing: Almonds = Cyanide
If William didn’t sign the page of the ledger, then why is his almond-residue on it? And why is only his snack on there? Surely someone else had eaten before touching the ledger.

5. My Get Rich Quick Plan Continues
Tonight’s episode is just more proof that the best way to make money in the Fringe universe is to own empty warehouses.

6. Don’t Try This At Home Kids
It’s not that easy to relocate a shoulder — in fact, I doubt Peter would have the strength to do it the way shown — especially with a posterior dislocation like Peter suffered. (Now if Peter has suffered multiple posterior dislocations before, his shoulder could pop in and out of socket easier than normal, though with all the fights he’s been in, you’d think we’d have seen that before.)

7. Have A Bigger Party, There’s More Than Enough XP To Go Around
It never occurs to Peter and Olivia they might need back up? They have access to an entire FBI division, after all.

8. Loaves and Fishes Lemon Cake and Pigs Brains
Cortexiphan now has regenerative properties? Hasn’t seemed to do much for Olivia in the past, though it does completely restore that tissue lemon cake really easily. Forget telekinesis, Walter has solved the world’s hunger problem.

A good episode, but there was enough here to spread it out over another episode. The Fringe Doomsday Clock remains at 11:54.

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Does treatment of SDB in children improve cardiovascular outcome?

Available online 29 May 2012

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The Ritchie Centre, Monash Institute of Medical Research, Monash University, Melbourne, AustraliaReceived 9 December 2011. Revised 20 April 2012. Accepted 20 April 2012. Available online 29 May 2012.View full text Sleep disordered breathing (SDB) is a common disorder in both adults and children and is caused by the obstruction of the upper airway during sleep. Unlike adults, most cases of paediatric SDB are due to the presence of enlarged tonsils and adenoids, thus the main treatment option is adenotonsillectomy (T&A). It is well known that obstructive sleep apnoea in adults increases the risk for hypertension, coronary artery disease and stroke, and there is now mounting evidence that SDB also has a significant impact on the cardiovascular system in children with reports of elevated blood pressure, endothelial dysfunction and altered autonomic cardiovascular control. As there is now substantial evidence that elevated blood pressure in childhood is carried on to adulthood it is important to know if treatment of SDB improves cardiovascular outcomes. Studies in adults have shown that treatment of SDB leads to improvements in cardiovascular function, including a reduction in pulmonary artery pressure, systemic blood pressure and endothelial dysfunction. However, studies exploring the outcomes of treatment of SDB in children on the cardiovascular system are limited and varied in their methodology and outcome measures. As a number of cardiovascular disturbances are sequelae of SDB, early detection and management could result in the reduction of elevated blood pressure in children, and consequently a reduction in cardiovascular morbidity in adulthood. The aim of this review is to summarise the findings of studies to date which have investigated the cardiovascular outcomes in children treated for SDB and to make recommendations for future management of this very common disease.

prs.rt("abs_end");Adenotonsillectomy; Blood pressure; Cardiovascular; Children; Hypoxaemia; Inflammation; Obstructive sleep apnoea; Sleep disordered breathing; Treatment

Figures and tables from this article:

Fig. 1. The effects of treatment on the cardiovascular consequences of obstructive sleep apnoea in children. The tick indicates studies that show improvement in the cardiovascular outcome with treatment, the question mark indicates study results are conflicting or that the treatment effects are unknown. OSA indicates obstructive sleep apnoea; RV, right ventricle; BP, blood pressure. Adapted from Bhattacharjee et al., 2009.49

View Within ArticleTable 1. Summary of studies investigating the effect of treatment on cardiovascular outcomes in children treated for SDB.

AHI – apnoea hypopnoea index; ApoB – apolipoprotein B; BP – blood pressure; BNP – brain natriuretic peptide; CRP – c-reactive protein; DBP – diastolic blood pressure; ET-1 – endothelin-1; HR – heart rate; IL-6 – interleukin 6; IL-10 – interleukin 10; LV – left ventricular; mo – month; N/A – not available; NIPPV – non-invasive positive ventilation; NOB – non-obese group; NT-proBNP – N-terminal pro-B-type natriuretic peptide; OB – obese group; ODI – oxygen desaturation index; OSA – obstructive sleep apnoea; P – prospective; PR – pulse rate; PRV – pulse rate variability; PS – primary snoring; R – retrospective; RV – right ventricular; S – primary snoring; SBP – systolic blood pressure; SD – standard deviation; SDP – sleep disordered breathing; T&A – adenotonsillectomy; w – week; y – year.

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Chronic renal failure

By Mayo Clinic staff

Chronic kidney failure, also known as chronic renal disease, describes the gradual loss of kidney function. The kidneys filter waste products and excess fluid from your blood, which are then excreted in the urine. When the chronic renal failure reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic renal failure, you may have a few signs or symptoms. Chronic renal failure may not become evident until the renal function is significantly reduced.

Treatment for chronic renal failure is focused on slowing down the progression of kidney damage, usually by controlling the underlying cause. Chronic renal failure can progress to end-stage renal disease, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Refers to Goldman L, et al, Cecil medicine. 24 ed. Philadelphia, PA: Saunders Elsevier;. 2012. http://www.mdconsult.com/das/book/body/191371208-2/0/1492/0.html#. Accessed April 2, 2012. clinical Adviser Irons FF. 2012 irons: 5 books in 1. Philadelphia, PA: Mosby Elsevier;. 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3 ...Competition-0-38601-8--Top & ISBN = 978-0-323-05611-3 & 291436269-101 uniqId =. Accessed on 2 April, 2012. Marx JA, Rosen's emergency medicine: concepts et al. and clinical practice. 7th ed. Philadelphia, PA: Mosby Elsevier;. 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0 ...X0001-1--Top & ISBN = 978-0-323-05472-0 230100505 =-& uniqId 57. The 2 April 2012. Bope ET, Conn's current therapy et al. Philadelphia, PA: Saunders Elsevier;. 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0986-5 ...Competition-0-9-38984-Top-978-& ISBN = 1-4377-0986-5 & about = true & = 236797353-5 uniqId. Accessed on April 3, chronic kidney disease About 2012: a guide for patients and their families. National Kidney Foundation. http://www.Kidney.org/Atoz/content/aboutckd.cfm. Accessed on April 3, 2012. Coping effectively: a guide to living well with kidney failure. National Kidney Foundation. http://www.Kidney.org/Atoz/PDF/coping.pdf. Accessed on April 3, 2012. Kidney Failure: the choice of a treatment that is right for you. Kidney and urologic diseases information & National Clearinghouse. http://kidney.niddk.nih.gov/KUDiseases/pubs/choosingtreatment/index.aspx. Accessed on 2 April, at 2012. Chronic kidney disease 5: nutrition guidelines. Health nutrition manual. American Dietetic Association. http://nutritioncaremanual.org/index.cfm. Accessed on April 3, 2012 The kidneys and how they work. Kidney and urologic diseases information & National Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/. The 4 April, 2012. El Zoghby ZM (expert opinion). Mayo Clinic, Rochester, 1 may 2012, Minnesota Anderson CF (expert opinion). Mayo Clinic, 24 April, Rochester, Minnesota 2012. Rethinking drinking: alcohol and your health. National Institute on alcoholism and alcohol abuse. http://pubs.NIAAA.nih.gov/publications/RethinkingDrinking/Rethinking_Drinking.pdf. Access 2012. Dietary Guidelines for Americans, May 8, 2010. U.S. Department of health and human services. http://www.CNPP.USDA.gov/DGAs2010-PolicyDocument.htm. Accessed may 8, 2012. Post R (expert opinion). U.s. Department of Agriculture, Alexandria, VA. August 8, 2011.

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Sleep in special needs children: The challenge

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Sleep-dependent memory consolidation in patients with sleep disorders

Sleep can improve the off-line memory consolidation of new items of declarative and non-declarative information in healthy subjects, whereas acute sleep loss, as well as sleep restriction and fragmentation, impair consolidation. This suggests that, by modifying the amount and/or architecture of sleep, chronic sleep disorders may also lead to a lower gain in off-line consolidation, which in turn may be responsible for the varying levels of impaired performance at memory tasks usually observed in sleep-disordered patients.

The experimental studies conducted to date have shown specific impairments of sleep-dependent consolidation overall for verbal and visual declarative information in patients with primary insomnia, for verbal declarative information in patients with obstructive sleep apnoeas, and for visual procedural skills in patients with narcolepsy-cataplexy.

These findings corroborate the hypothesis that impaired consolidation is a consequence of the chronically altered organization of sleep. Moreover, they raise several novel questions as to: a) the reversibility of consolidation impairment in the case of effective treatment, b) the possible negative influence of altered prior sleep also on the encoding of new information, and c) the relationships between altered sleep and memory impairment in patients with other (medical, psychiatric or neurological) diseases associated with quantitative and/or qualitative changes of sleep architecture.

Table 1. Methodological characteristics and results of the experimental studies on memory consolidation during sleep in patients with chronic sleep disorders.

Abbreviations: DM = declarative memory; NC = narcolepsy with cataplexy; NDM = non declarative memory; OSA = obstructive sleep apnoea; PI = primary insomnia; REM = rapid eye movement (sleep); REMD = REM density; SE = sleep efficiency; SWS = slow wave sleep; SPT = sleep period time; SFI = sleep fragmentation index; SOA= stimulus onset asynchrony; TST = total sleep time; WASO = wake after sleep onset.

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Copyright © 2012 Elsevier Ltd. All rights reserved.

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