Archive for July, 2011

Top Quality Embryos Go With The Flow

Ever since the first so-called “test-tube” babies were born, fertility experts have been searching for the best way to culture fertilized eggs outside a woman’s womb.

A new device that mimics the movements inside the womb may help produce better quality embryos.

Normally, nutrient-rich fluid washes over the embryo through muscle contractions within the fallopian tubes.

To copy that in the laboratory, University of Michigan researchers created a culture system that moves pins up and down to send pulses of medium washing over an embryo.

The researchers tested the new system versus standard, static embryo culturing using 315 embryos from 25 women undergoing in vitro fertilization (IVF).

They found the new system slightly boosted the number of embryos graded as top-quality and greatly improved the chances of embryos becoming good quality, reported Michigan’s Gary Smith, Ph.D, Professor, of Obstetrics and Gynecology, at the European Society of Human Reproduction and Embryology annual meeting in Stockholm, Sweden, this month.

He expects the new system to translate into better pregnancy rates, and is tracking that now.

Another important approach to improve the success rate of IVF is to optimize the laboratory conditions for early embryos.

At Weill-Cornell, Zev Rosenwaks, MD and colleagues have developed a method to co-culture embryos with certain helper cells to enhance the development of fertilized eggs and improve embryo quality.

“Endometrial co-culture is a laboratory method that utilizes the mother’s own uterine lining cells to enhance embryo quality,” says Dr. Rosenwaks.

Simply stated, in a separate menstrual cycle 1 to 2 months before undergoing an IVF procedure, the woman undergoes a biopsy of her endometrial lining 7 to 10 days after ovulation.

The cells are separated, grown in the laboratory, and frozen, later to be thawed during the subsequent IVF cycle.

After her eggs are fertilized through IVF, the embryos are grown on top of the mother’s extracted cells.

“This provides a better environment for the embryos, especially for couples who have exhibited poor embryo quality in previous IVF cycles,” he says.

Co-culture is usually reserved for use in “poor prognosis” patients, particularly when other cycles have failed because of slow growth of the embryo.

“This method is not a cure for age-related IVF failures, but in properly selected couples, it has significantly improved embryo quality,” says Dr. Rosenwaks.

Swimming, the Near-Perfect Exercise – Except for the Shoulders

I can’t think of a better way to beat the heat of a hot summer day than a dip in a pool or the ocean.

I even deigned to dive through the waves at Atlantic Beach in East Hampton last Saturday.

The water was warm enough and I was hot enough.

A cool way to stay cool.

Swimming is probably the most nearly perfect form of exercise.

And you don’t have to put in thousands of hours in the pool like Olympic champion Michael Phelps to get a good workout.

• It’s non-weight-bearing and so imposes no stress on the bones and joints.

Even people with bad backs can exercise in the water without fear of injury.

• It exercises and strengthens the upper and lower body.

• It’s an exercise in which it’s easy to reach your training range (which exercises your heart) and maintain it.

• It’s an effective weight-control exercise.

An hour of vigorous swimming burns about as many calories as running 6 miles in an hour.

• It’s a form of meditation.

It calms your nerves in addition to providing a good workout.

• It’s a good exercise for people with exercise-induced bronchospasm.

People with this condition are unable to warm and moisten the air to the lungs when they breathe hard.

Although swimming isn’t considered a sport that leads to injuries, serious swimmers often have problems with their shoulders.

The most common injury is referred to as “swimmer’s shoulder” and can affect up to 70% of competitive swimmers.

Swimmer’s shoulder is basically a rotator cuff sports injury.

The rotator cuff muscles, which hold the head of the shoulder in the joint, are not meant to be overstressed with the arm at an angle above parallel to the ground.

All swimming strokes (except the breaststroke) place the arm in this over-the-head position and stress these muscles as the arm is pulled through the water.

The small rotator cuff muscles become stretched, allowing the head to slip around in the shallow socket.

As it slips, it catches the bicep tendons, pinching them and causing pain.

If you feel shoulder pain after swimming, rest for several weeks and then modify your training program by using a kickboard or doing the breaststroke to maintain conditioning.

Combine this with a shoulder-strengthening program using light weights.

Here are some more tips on how to minimize the risk of a shoulder injury from John Cavanaugh, PT, a physical therapist at Hospital for Special Surgery in New York City:

• Do not attempt to swim if you are too tired, too cold, or overheated.

• Make sure to warm up properly.

• Focus on swimming technique. Poor technique can leave you more prone to injury.

• Engage in a general exercise program on land to develop muscle strength, endurance, balance, and flexibility. This includes strengthening the core abdominal muscles.

• Do not swim vigorously if you have a fever, upper respiratory infection, or ear infection.

• If you are training for a triathlon, note that the swim is completely different from pool swimming.

Generally, in open water, you can’t see where you’re going and there are people all around you.

Be aware of the bodies and avoid them as much as you can.

Newly Designed Molecule Blocks Chlamydia Infections

A newly designed molecule may block the damaging effects of Chlamydia, the bacteria responsible for the largest number of sexually transmitted infections in the United States.

About 3 million cases of Chlamydia trachomatis are reported each year among Americans.

If left untreated, the infection can scar a man’s sperm-carrying tubes and permanently damage a woman’s egg-transporting fallopian tubes.

The end result can be male infertility or female infertility if the infection is not treated properly with antibiotics.

Now a team of Duke University researchers may have come up with a new way to fight off a chlamydial infection, they report in the July 21 print edition of Cell Host and Microbe.

They have designed a molecule that takes away the bacteria’s self-defense mechanisms.

Instead of directly killing the bacteria with antibiotics, they disarm a central weapon of Chlamydia, and let the body take care of the rest.

By blocking a specific enzyme with this molecule, the enzyme no longer could degrade the proteins in the cell that would normally mount an immune response to the infection.

When the enzyme is inhibited, the infected human cells effectively “commit suicide,” says lead researcher Raphael Valdivia, Ph.D., an associate professor in the Duke Department of Molecular Genetics and Microbiology.

“When the infected human cell dies, so does Chlamydia, and this ends the infection.”

Up to 25% of men infected with Chlamydia have no symptoms at all.

What’s more, almost two-thirds of men have not one but two genital infections, usually with gonorrhea, putting a double whammy of their reproductive tracts.

In women, the symptoms of pelvic inflammatory disease, often caused by a chlamydial infection, may also be silent.

Most often, when a fertility evaluation finds a woman’s fallopian tubes are closed, she was not aware that she had previously had a pelvic infection.

Sometimes a man does not feel any symptoms either, and he may unwittingly pass the infection back and forth with his female partner.

If the Duke approach pans out, it could be a welcome addition to help fight off chlamydial infections.

“Klingon Cloaking Device” May Be Key to Male Infertility

The lack of a protein that normally coats sperm may be the reason why some sperm don’t reach the egg to fertilize it.

This protein acts as a “Klingon cloaking device” to allow sperm to swim through cervical mucus and avoid the immune system on its long journey to the egg, says Gary Cherr, a professor at the UC Davis Bodega Marine Laboratory and Center for Health and Environment.

The protein DEFB126 is generated by a specific gene, and men with two copies of the defective gene do not produce the protein, the researchers reported in a study published online on July 20 in the journal Science Translational Medicine.

Some 70% of men have infertility that can’t be explained based on their sperm count and quality, say the researchers.

This discovery may help explain a significant portion of this infertility.

In tests of men worldwide, they found about half of all men carry 1 defective copy.

One quarter have 2 defective copies and therefore make sperm that are poor at swimming through cervical mucus.

In studying about 500 couples in China who were trying to become pregnant, they found that men with 2 copies of the abnormal gene were 30% less likely to father a child over about a 2-year period.

And it took nearly 2 months longer for the couples to have a baby if the man had 2 copies of the abnormal gene.

The researchers are now looking to develop a test for the mutation.

If a couple found that the man has a double mutation, they could go directly to single-sperm injection with intracytoplasmic sperm injection, or ICSI, to inseminate the woman’s egg.

Choosing a healthy sperm becomes crucial to ICSI success.

In a natural conception, only the fittest and healthiest sperm makes the arduous journey to the egg.

ICSI bypasses this natural selection barrier, so the chances of a genetically abnormal sperm fertilizing an egg are higher.

A new test for sperm DNA damage could help select the best sperm for a single-sperm injection.

Strengthening Exercises Boost Bone Density in Osteoporosis

Weight-bearing exercises are essential to prevent and limit the bone-wasting disease osteoporosis as women age.

That’s the bottom-line result of a new update of clinical studies just published by the Cochrane Collaboration, an international organization that evaluates medical research.

When you have osteoporosis, old bone breaks down faster than new bone can replace it.

As this happens, bones lose minerals (such as calcium).

This makes bones weaker and more likely to break even after a minor injury, like a little bump or fall, according to the Cochrane Review.

The new review confirms that strengthening exercises boost bone density in postmenopausal women with osteoporosis compared to staying sedentary.

The review of 43 studies and more than 4,300 women shows that for postmenopausal women

– Exercise will improve bone mineral density slightly.

– Exercise will reduce the chances of having a fracture slightly.

All types of exercises, including aerobics, strength training, walking, and Tai Chi, improved bone mineral density and slightly reduced the risk of fracture in postmenopausal women.

A combination of exercises led to the least bone mineral loss in the spine compared to controls who did not exercise.

Strength training was the most effective for limiting bone mineral loss at the hip compared to controls.

“There’s the perception that resistance training is really just for young athletes.

That’s just not true.

There’s a role that resistance training plays for everyone,” C. David Geier, Jr., MD, an assistant professor of orthopedic surgery and director of the sports medicine program at the Medical University of South Carolina, told the Health Behavior News Service.

Deepen Your Breath with Tai Chi

A Tai Chi joke:

Student: “Master, what is the secret of a long life?”

Master: “Keep breathing as long as you can!”

Strong lungs and efficient breathing are central to overall health and well-being and living a long life.

In fact, on average, we breathe more than 20,000 times per day, so it naturally follows that efficient, mindful, and freer breathing patterns have the potential to enhance and sustain your health.

Part of the reason breathing so centrally impacts health may be because how we breathe is regulated and intertwined with nearly all core physiological systems, including the musculoskeletal, nervous, cardiovascular, and endocrine systems.

The slow, deep, mindful and rhythmic breathing developed in Tai Chi potentially impacts the efficiency of breathing and lung health.

It also impacts other multiple physiological systems that control cardiovascular processes (such as blood pressure), nervous system processes (such as involuntary control of blood flow to organs or muscle contraction in the intestines), perception and tolerance of pain, and mood and stress, says Peter Wayne, PhD, Director of Tai Chi and Mind-Body Research Programs, Harvard Medical School’s Osher Research Center.

Breathing in Tai Chi serves more than the function of bringing oxygen into and expelling carbon dioxide out of the body.

“Breathing provides as an internal massage, serves as a tool for sensory awareness and focus, balances the nervous system and emotions, and regulates and enhances the flow of qi,” says Wayne.

“More efficient posture and increased inner awareness and flexibility with Tai Chi exercises deepen breathing in a natural way.”

Muscles, including the diaphragm and intercostals, play big roles in mechanically expanding and contracting the lungs, and thus drawing in and expelling air.

The diaphragm is the primary muscle of healthy breathing.

When the diaphragm is relaxed, it assumes a domed, upward shape.

When it contracts, it pushes downward.

Along with some help from the intercostal muscles (which pull the ribs upward), the downward movement of the diaphragm opens the rib cage, decreases pressure on the lungs, and creates a vacuum (negative pressure) that draws outside air in all the way to the bottom of the lungs.

As you exhale, the diaphragm returns to its relaxed, upward domed shape, compressing the lungs and squeezing air out.

When you adopt this breathing method, inhaling makes your diaphragm expand outward as well as downwards to the abdomen, which can give your lungs more space.

During Tai Chi the air that is breathed in and out should have a fine, continuous flow.

The idea is to attain a level of natural breathe that flows regularly, lightly, slowly, and deeply.

As the Tai Chi classics say, “Let the body breathe you.”

Tai Chi Classes As Part of Cardiac Rehab

The flowing, circular movements of Tai Chi, balancing on one leg, always breathing deeply, has been shown to help heart patients feel better.

The co-author of a recent study of Tai Chi for heart failure, Dr. Gloria Yeh of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, says,

“We know that chronic heart failure is this progressive chronic syndrome.

There is no cure.

And patients often suffer over time with their symptoms:

a decrease in exercise tolerance;

a shortness of breath;

and a decrease in quality of life because of this.

And so, if we can make patients feel better overall and increase their well-being, this is a significant impact.”

This new podcast tells of how at the Mayo Clinic’s cardiac rehab unit in Minnesota, Dr. Mary Jurisson leads Tai Chi classes for patients and staff.

Some join in to recover from a heart attack or surgery, while others practice because it makes them feel better, for example, the relaxation helps with aches and pains.

Dr. Jurisson says Tai Chi brings opposites into balance and restores energy.

Balance is found through meditation and movement.

“What you are learning to do is to maintain that central equilibrium, that center of gravity, that sense of yourself in the world and your environment,” she says.

Tai Chi can lower blood pressure, the heart rate, and anxiety.

Plus as Dr. Jurisson says, Tai Chi may help boost your immune system, and almost anyone can practice it.

An Accurate Way to Predict Miscarriage

Miscarriages occur more often than you think.

For younger women under age 34, about 10% of all pregnancies result in miscarriage.

In women age 45 and up, 50-60% of pregnancies are lost.

If you have had 3 or more consecutive miscarriages, it’s likely there’s a medical or genetic cause.

Now British fertility researchers say they have a way to predict if a pregnancy will end in a miscarriage.

These 6 factors have the greatest impact on miscarriage risk, they say:

History of subfertility

Levels of progesterone

Levels of the pregnancy hormone human chorionic gonadotrophin (hCG)

Fetus length

Extent of bleeding

Baby’s gestational age

The British researchers combined two factors — bleeding and hCG levels — to create a Pregnancy Viability Index (PVI), they reported this week at the European Society for Human Reproduction in Stockholm.

The PVI was able to predict accurately the pregnancy outcome in 94% of women who had ongoing pregnancies, and also predicted the outcome in 77% of women whose pregnancy ended in miscarriage, said lead author Kaltum Adam of Britain’s St Mary’s Hospital in Manchester, England.

“This research has, for the first time, offered us a robust tool to begin to attempt to rescue pregnancies threatening to miscarry when currently all we can do is fold our hands and hope for the best,” Adams told Reuters.

This new tool will allow doctors to focus on risky pregnancies that are likely to go on to miscarry.

It will also help women who are not at high risk to avoid unnecessary treatment, such as repeat blood tests and ultrasound scans during pregnancy, hospital admissions for bed rest, sexual abstinence, low dose aspirin, and progesterone supplementation.

If you have had more than 2 miscarriages, fertility experts recommend that you undergo a recurrent pregnancy loss evaluation.

Miscarriages can be caused by medical conditions, endocrine or anatomic problems, as well as by genetic defects or environmental factors.

Top 10 Fitness and Nutrition Tips For Older Adults

Tai Chi has been shown to be very safe for elderly, frail, and de-conditioned people.

That makes Tai Chi an excellent response to the U.S. Surgeon General’s recent call for novel exercise programs for women with low bone density, which includes 34 million American women over age 50.

In fact, the Surgeon General’s report specifically recommends Tai Chi as a good exercise for fall prevention.

With the number of Americans 65+ expected to reach 20% of the U.S. population by 2050, exercise and diet is more important than ever.

Here’s a list of Top 10 tips to help older adults enhance overall wellness into their later years, compiled by Peggy Buchanan, coordinator of vitality/wellness programming for Front Porch, a not-for-profit provider of retirement living communities in Southern California.

1. Fight afternoon fatigue – Fatigue is a common problem among older adults, especially after lunch.

Having a glass of water and a high-antioxidant food like a prune can revitalize the body and stimulate the mind.

2. Exercise from the neck up – Keeping the brain active and fit is imperative to the health of older adults.

Not only does it stave off memory-loss illnesses like Alzheimer’s and dementia, but it also fosters executive function.

Try word games and recall exercises.

For example, find five red objects during a walk in the neighborhood and recall them when back home.

3. Pole walk – Walking poles allow for more balanced mobility than walkers or canes.

Walking with poles engages the muscles of the upper torso, which increases upper-body strength and cardiovascular endurance.

Consult a physician before making the switch to poles.

4. Dine in duos – Those who share meals with others eat less than those who eat alone.

This is an easy weight-loss tactic and one that fosters social interaction and engagement.

While this is easy for those aging in community, older adults aging at home can plan to have meals with family or friends at least several times a week.

5. Break routine – Routine limits brain stimulation.

Introduce new foods or new ways of eating the same food.

For example, replace canned peaches with freshly sliced ones.

Also, try taking a different route to the grocery store or shopping center.

6. Sole Support – As people age, the fat pads on the bottom of their feet compress, creating fatigue and pain.

Consider wearing supportive shoes or inserting foot pads for better stability and comfort or socks that have extra padding and a wicking agent to keep feet dry and comfortable.

7. Fats: Out with the bad, in with the good – Older adults with an increased genetic risk for dementia can reduce the risk by increasing the amount of Omega-3 fatty acids in their diet.

These fatty acids, found in fish, nuts, olive oil and green leafy vegetables, can reduce brain inflammation, a possible cause of Alzheimer’s disease.

8. Decrease salt and increase your salsa – High blood pressure, which can lead to strokes and a significant decline in cognitive function, often increases with age.

As adults get older, the sense of taste also fades, leading to a desire for more salt on food to enhance flavor.

Decreasing salt intake by putting down the shaker – and increasing exercise habits by shaking to a salsa beat – will enhance cardio and cognitive health.

9. Balancing act – In addition to exercises that build strength and improve flexibility and cardiovascular endurance, make sure to add balance activities to the daily routine.

Good balance requires maintaining a center of gravity over the base of support.

Tai chi, yoga, walking on challenging surfaces and water exercises all enhance overall balance.

10. Dance like there’s no tomorrow – Older adults getting regular physical exercise are 60% less likely to get dementia.

Exercise increases oxygen to the brain and releases a protein that strengthens cells and neurons.

Dance involves all of the above plus the cerebral activity present in learning and memory.