MEDICAL REVOLUTION

Hospital acquired infections

danielwitanto@gmail.com (Daniel Witanto) — Mon, 09 Nov 2009 14:56:00 +0000

When someone develops an infection at a hospital or other patient care facility that they did not have prior to treatment, this is referred to as a healthcare-associated (sometimes hospital-acquired) infection (HAI).

Healthcare-associated infections (HAIs) are a global crisis affecting both patients and healthcare workers.

According to the World Health Organization (WHO), at any point in time, 1.4 million people worldwide suffer from infections acquired in hospitals.

A Centers for Disease Control (CDC) report published in March-April 2007 estimated the number of U.S. deaths from healthcare asociated infections in 2002 at 98,987.

The risk of acquiring healthcare-associated infections in developing countries is 2-20 times higher than in developed countries.

Afflicting thousands of patients every year, HAI often leads to lengthening hospitalization, increasing the likelihood of readmission, and adding sizably to the cost of care per patient.

Financially, HAIs represent an estimated annual impact of $6.7 billion to healthcare facilities, but the human cost is even higher.

Until recently, a lack of HAI reporting requirements for healthcare facilities has contributed to less-than-optimal emphasis being placed on eliminating the sources of healthcare associated infections. However, growing public anxiety regarding the issue and resulting legislation on state and local levels demanding accountability is serving to accelerate initiatives to combat HAIs.

To learn more about the impact of healthcare-associated infections for both medical professionals and patients, please visit www.haiwatch.com.

Grabbed from:

http://haiwatchnews.com/

Swine Flu Pandemic (H1N1) 2009 WHO

danielwitanto@gmail.com (Daniel Witanto) — Thu, 16 Jul 2009 12:42:00 +0000

Viruses resistant to oseltamivir (Tamiflu) identified

8 JULY 2009 | GENEVA -- WHO has been informed by health authorities in Denmark, Japan and the Special Administrative Region of Hong Kong, China of the appearance of H1N1 viruses which are resistant to the antiviral drug oseltamivir (known as Tamiflu) based on laboratory testing.

These viruses were found in three patients who did not have severe disease and all have recovered. Investigations have not found the resistant virus in the close contacts of these three people. The viruses, while resistant to oseltamivir, remain sensitive to zanamivir.

Therefore, based on current information, these instances of drug resistance appear to represent sporadic cases of resistance. At this time, there is no evidence to indicate the development of widespread antiviral resistance among pandemic H1N1 viruses. Based on this risk assessment, there are no changes in WHO's clinical treatment guidance. Antiviral drugs remain a key component of the public health response when used as recommended.

WHO Recommendations

13 JULY 2009 | GENEVA -- On 7 July 2009, the Strategic Advisory Group of Experts (SAGE) on Immunization held an extraordinary meeting in Geneva to discuss issues and make recommendations related to vaccine for the pandemic (H1N1) 2009.

SAGE reviewed the current pandemic situation, the current status of seasonal vaccine production and potential A(H1N1) vaccine production capacity, and considered potential options for vaccine use.

The experts identified three different objectives that countries could adopt as part of their pandemic vaccination strategy:

protect the integrity of the health-care system and the country's critical infrastructure;
reduce morbidity and mortality; and
reduce transmission of the pandemic virus within communities.

Countries could use a variety of vaccine deployment strategies to reach these objectives but any strategy should reflect the country’s epidemiological situation, resources and ability to access vaccine, to implement vaccination campaigns in the targeted groups, and to use other non-vaccine mitigation measures.

Although the severity of the pandemic is currently considered to be moderate with most patients experiencing uncomplicated, self-limited illness, some groups such as pregnant women and persons with asthma and other chronic conditions such as morbid obesity appear to be at increased risk for severe disease and death from infection.

Since the spread of the pandemic virus is considered unstoppable, vaccine will be needed in all countries. SAGE emphasized the importance of striving to achieve equity among countries to access vaccines developed in response to the pandemic (H1N1) 2009

The following recommendations were provided to the WHO Director-General:

All countries should immunize their health-care workers as a first priority to protect the essential health infrastructure. As vaccines available initially will not be sufficient, a step-wise approach to vaccinate particular groups may be considered. SAGE suggested the following groups for consideration, noting that countries need to determine their order of priority based on country-specific conditions: pregnant women; those aged above 6 months with one of several chronic medical conditions; healthy young adults of 15 to 49 years of age; healthy children; healthy adults of 50 to 64 years of age; and healthy adults of 65 years of age and above.
Since new technologies are involved in the production of some pandemic vaccines, which have not yet been extensively evaluated for their safety in certain population groups, it is very important to implement post-marketing surveillance of the highest possible quality. In addition, rapid sharing of the results of immunogenicity and post-marketing safety and effectiveness studies among the international community will be essential for allowing countries to make necessary adjustments to their vaccination policies.
In view of the anticipated limited vaccine availability at global level and the potential need to protect against "drifted" strains of virus, SAGE recommended that promoting production and use of vaccines such as those that are formulated with oil-in-water adjuvants and live attenuated influenza vaccines was important.
As most of the production of the seasonal vaccine for the 2009-2010 influenza season in the northern hemisphere is almost complete and is therefore unlikely to affect production of pandemic vaccine, SAGE did not consider that there was a need to recommend a "switch" from seasonal to pandemic vaccine production.

WHO Director-General Dr Margaret Chan endorsed the above recommendations on 11 July 2009, recognizing that they were well adapted to the current pandemic situation. She also noted that the recommendations will need to be changed if and when new evidence become available.

Williams Gynecology Free ebook

danielwitanto@gmail.com (Daniel Witanto) — Fri, 10 Jul 2009 15:05:00 +0000

Share for all respectfull: residents, OBSGYN specialist, doctors and medical students

Williams Gynecology

Download link:

Click Here

Obstetrics and Gynecology Secrets, Updated Edition, 3rd edition

Mosby

Download Link

Click Here

Embryology ebook free

danielwitanto@gmail.com (Daniel Witanto) — Fri, 10 Jul 2009 14:31:00 +0000

Langman's Medical Embryology, 9th edition

Lippincott Williams & Wilkins

Download Link:

Click Here

208 pages

Publisher: Lippincott Williams & Wilkins; Third Edition edition (July 1, 2006)

Download link :

Part1

Part2

Fitzpatrick's Dermatology ebook free

danielwitanto@gmail.com (Daniel Witanto) — Sat, 27 Jun 2009 10:02:00 +0000

Finally after a long search for the reliable link of this favourite dermatology book, we present:

Fitzpatrick's Dermatology

in General Medicine

Download link:

Part 1

Part2

Part3

Part4

Part5

Part6

Part7

Special thank you for: www.Rapidshare.com and www.Linkbucks.com

Plastic Surgery Free ebooks

danielwitanto@gmail.com (Daniel Witanto) — Wed, 24 Jun 2009 13:18:00 +0000

Grabb and Smith's Platic Surgery 6th Edition

Click Download link

Plastic and Hand Surgery in Clinical Practice- Springer

Click Download link

Handbook of Plastic Surgery

Click Download Link

Reconstructive Surgery

Click Download Link

Toronto Notes 2008 Plastic Surgery

Click Download Link

2009 Swine Flu Pandemic

danielwitanto@gmail.com (Daniel Witanto) — Tue, 16 Jun 2009 16:11:00 +0000

Here is the original text:

Dr Margaret Chan, the Director-General of the World Health Organization:

Ladies and gentlemen,
In late April, WHO announced the emergence of a novel influenza A virus.
This particular H1N1 strain has not circulated previously in humans. The virus is entirely new.

The virus is contagious, spreading easily from one person to another, and from one country to another. As of today, nearly 30,000 confirmed cases have been reported in 74 countries.

This is only part of the picture. With few exceptions, countries with large numbers of cases are those with good surveillance and testing procedures in place.

Spread in several countries can no longer be traced to clearly-defined chains of human-to-human transmission. Further spread is considered inevitable.

I have conferred with leading influenza experts, virologists, and public health officials. In line with procedures set out in the International Health Regulations, I have sought guidance and advice from an Emergency Committee established for this purpose.

On the basis of available evidence, and these expert assessments of the evidence, the scientific criteria for an influenza pandemic have been met.

I have therefore decided to raise the level of influenza pandemic alert from phase 5 to phase 6.

The world is now at the start of the 2009 influenza pandemic.

We are in the earliest days of the pandemic. The virus is spreading under a close and careful watch.

No previous pandemic has been detected so early or watched so closely, in real-time, right at the very beginning. The world can now reap the benefits of investments, over the last five years, in pandemic preparedness.

We have a head start. This places us in a strong position. But it also creates a demand for advice and reassurance in the midst of limited data and considerable scientific uncertainty.

Thanks to close monitoring, thorough investigations, and frank reporting from countries, we have some early snapshots depicting spread of the virus and the range of illness it can cause.

We know, too, that this early, patchy picture can change very quickly. The virus writes the rules and this one, like all influenza viruses, can change the rules, without rhyme or reason, at any time.

Globally, we have good reason to believe that this pandemic, at least in its early days, will be of moderate severity. As we know from experience, severity can vary, depending on many factors, from one country to another.

On present evidence, the overwhelming majority of patients experience mild symptoms and make a rapid and full recovery, often in the absence of any form of medical treatment.

Worldwide, the number of deaths is small. Each and every one of these deaths is tragic, and we have to brace ourselves to see more. However, we do not expect to see a sudden and dramatic jump in the number of severe or fatal infections.

We know that the novel H1N1 virus preferentially infects younger people. In nearly all areas with large and sustained outbreaks, the majority of cases have occurred in people under the age of 25 years.

In some of these countries, around 2% of cases have developed severe illness, often with very rapid progression to life-threatening pneumonia.

Most cases of severe and fatal infections have been in adults between the ages of 30 and 50 years.

This pattern is significantly different from that seen during epidemics of seasonal influenza, when most deaths occur in frail elderly people.

Many, though not all, severe cases have occurred in people with underlying chronic conditions. Based on limited, preliminary data, conditions most frequently seen include respiratory diseases, notably asthma, cardiovascular disease, diabetes, autoimmune disorders, and obesity.

At the same time, it is important to note that around one third to half of the severe and fatal infections are occurring in previously healthy young and middle-aged people.

Without question, pregnant women are at increased risk of complications. This heightened risk takes on added importance for a virus, like this one, that preferentially infects younger age groups.

Finally, and perhaps of greatest concern, we do not know how this virus will behave under conditions typically found in the developing world. To date, the vast majority of cases have been detected and investigated in comparatively well-off countries.

Let me underscore two of many reasons for this concern. First, more than 99% of maternal deaths, which are a marker of poor quality care during pregnancy and childbirth, occurs in the developing world.

Second, around 85% of the burden of chronic diseases is concentrated in low- and middle-income countries.

Although the pandemic appears to have moderate severity in comparatively well-off countries, it is prudent to anticipate a bleaker picture as the virus spreads to areas with limited resources, poor health care, and a high prevalence of underlying medical problems.

Ladies and gentlemen,

A characteristic feature of pandemics is their rapid spread to all parts of the world. In the previous century, this spread has typically taken around 6 to 9 months, even during times when most international travel was by ship or rail.

Countries should prepare to see cases, or the further spread of cases, in the near future. Countries where outbreaks appear to have peaked should prepare for a second wave of infection.

Guidance on specific protective and precautionary measures has been sent to ministries of health in all countries. Countries with no or only a few cases should remain vigilant.

Countries with widespread transmission should focus on the appropriate management of patients. The testing and investigation of patients should be limited, as such measures are resource intensive and can very quickly strain capacities.

WHO has been in close dialogue with influenza vaccine manufacturers. I understand that production of vaccines for seasonal influenza will be completed soon, and that full capacity will be available to ensure the largest possible supply of pandemic vaccine in the months to come.

Pending the availability of vaccines, several non-pharmaceutical interventions can confer some protection.

WHO continues to recommend no restrictions on travel and no border closures.

Influenza pandemics, whether moderate or severe, are remarkable events because of the almost universal susceptibility of the world’s population to infection.

We are all in this together, and we will all get through this, together.

Thank you.

Article taken completely from:

http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html

Medical ebooks 2

danielwitanto@gmail.com (Daniel Witanto) — Mon, 18 May 2009 14:25:00 +0000

Infectious Disease, Emergency Department Diagnosis & Management

Download Link

Nelson Textbook of Pediatrics, download Link : Part1 ,Part2 , Part 3

Source: www. Rapidshare.com

Swine Flu Update (WHO report)

danielwitanto@gmail.com (Daniel Witanto) — Tue, 05 May 2009 06:06:00 +0000

WHO 4 May 2009, 21 countries have officially reported 1085 cases of influenza A (H1N1) infection.

Mexico has reported 590 laboratory confirmed human cases of infection, including 25 deaths. The United States has reported 286 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (101), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Colombia (1), Denmark (1), El Salvador (2), France (4), Germany (8), Ireland (1), Israel (4), Italy (2), Netherlands (1), New Zealand (6), Portugal (1), Republic of Korea (1), Spain (54), Switzerland (1) and the United Kingdom (18).

It is considered prudent for people who are ill to delay international travel and for people developing symptoms following international travel to seek medical attention, in line with guidance from national authorities. Individuals are advised to wash hands thoroughly with soap and water on a regular basis and should seek medical attention if they develop any symptoms of influenza-like illness.

WHO advises no restriction of regular travel or closure of borders.

There is no risk of infection from this virus from consumption of well-cooked pork and pork products.

Source:

http://www.who.int/csr/don/2009_05_04a/en/index.html

http://www.scientificamerican.com/media/inline/worry-about-swine-flu_1.jpg

Swine flu Outbreak (Influenza A H1N1)

danielwitanto@gmail.com (Daniel Witanto) — Sun, 03 May 2009 14:45:00 +0000

2009 new emerging disease outbreak in Mexico and toward around the globe, this is happen when human's imune system seem so weak, so vulnerable against this tiny creature.

Influenza A virus subtype H1N1, also known as A(H1N1), is a subtype of influenzavirus A and the most common cause of influenza (flu) in humans. Some strains of H1N1 are endemic in humans, including the strain(s) responsible for the 1918 flu pandemic which killed 50–100 million people worldwide. Less virulent H1N1 strains still exist in the wild today, worldwide, causing a small fraction of all influenza-like illness and a large fraction of all seasonal influenza. H1N1 strains caused roughly half of all flu infections in 2006. Other strains of H1N1 are endemic in pigs and in birds.

In March and April 2009, hundreds of laboratory-confirmed infections and a number of deaths were caused by an outbreak of a new strain of H1N1.

2 May 2009. The situation continues to evolve. As of 18:00 GMT+1, 2 May 2009, 16 countries have officially reported 658 cases of influenza A(H1N1) infection. Mexico has reported 397 confirmed human cases of infection, including 16 deaths. The higher number of cases from Mexico in the past 48 hours reflects ongoing testing of previously collected specimens. The United States Government has reported 160 laboratory confirmed human cases, including one death.

The following countries have reported laboratory confirmed cases with no deaths - Austria (1), Canada (51), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Denmark (1), France (2), Germany (6), Israel (3), Netherlands (1), New Zealand (4), Republic of Korea (1), Spain (13), Switzerland (1) and the United Kingdom (15). Influenza viruses are not known to be spread by eating food items.

Influenza viruses are spread through inhalation or through touching contaminated surfaces and then touching the mouth, nose, or eyes.

According to the U.S. Centers for Disease Control and Prevention, two important ways to reduce the chance of contracting 2009 H1N1 flu virus are appropriate hand washing and avoidance of touching the mouth, nose, or eyes

Source:
http://en.wikipedia.org/wiki/Influenza_A_virus_subtype_H1N1
http://en.wikipedia.org/wiki/File:AntigenicShift_HiRes.png
http://www.cdc.gov/h1n1flu/images.htm
http://www.fda.gov/oc/opacom/hottopics/H1N1Flu/faq_food.html
http://www.who.int/csr/don/2009_05_02a/en/index.html

More Medical ebooks

danielwitanto@gmail.com (Daniel Witanto) — Tue, 21 Apr 2009 15:05:00 +0000

More Medical ebooks free in this blog, we are welcome all of your suggestion, request and even critic

Dorland's Electronic Medical Dictionary download: part 1, part2, part3

Gray's Anatomy for Students download: part1, part2

Color Atlas of ENT diagnosis download

Free Medical ebooks

danielwitanto@gmail.com (Daniel Witanto) — Tue, 21 Apr 2009 13:24:00 +0000

Dear reader,

As sharing knowledge is a very good thing, for the improvement of this blog and make it more useful and reliable, from now on we try provide links of medical ebooks for your reference and we will gradually update the content. You can download from the links and it's completely free. We are waiting for your feedback and suggestion.

pdb format (Open with isilo ebook reader)

links:
Current medical diagnosis and treatment

Link:

Current Critical Care

Link:

Liver atlas

Plastic and Orbital Surgery

For PDB File, open it with iSilo PDB reader, download here: iSilo Reader

Source: Rapid Share, 4Shared

BOTOX® Injections

danielwitanto@gmail.com (Daniel Witanto) — Thu, 26 Mar 2009 02:11:00 +0000

The cosmetic form of botulinum toxin, often referred to by its product name BOTOX®, is a popular non-surgical injection that temporarily reduces or eliminates frown lines, forehead creases, crows feet near the eyes and thick bands in the neck. The toxin blocks the nerve impulses, temporarily paralyzing the muscles that cause wrinkles while giving the skin a smoother, more refreshed appearance. Studies have also suggested that BOTOX is effective in relieving migraine headaches, excessive sweating and muscle spasms in the neck and eyes.

BOTOX® is a therapeutic muscle-relaxing agent that works at motor nerve endings (nerves that lead to muscles). It is in a class of drugs called neurotoxins. BOTOX® has been granted FDA approval for use on "crow's feet," between brows, forehead, and upper lip area.

Botulinum toxin injection therapy is also used to treat dystonia—a neuromuscular disorder that produces involuntary muscle contractions, or spasm—that affects muscles that control movement in the eyes, neck, face, limbs, voice box, or the smooth muscle in the bladder. The goal of the therapy is to reduce muscle spasm and pain.

What is Botox?
BOTOX® is the commercial tradename for Botulinum Toxin Type A. Botulinum Toxin is derived from the bacterium Clostridium Botulinum.There are seven known types of C. botulinum toxin, but only types A; (BOTOX® Cosmetic) and B (Myobloc®) are used as medical treatments. When injected into muscles, Botulinum Toxin has a local effect. It blocks transmission between the nerve endings and muscle fibres around the injection site to cause weakness of the nearby muscle.

What is Botox used for?
Botox is a non-surgical cosmetic treatment for moderate to severe frown lines. It is typically used in people aged 18 to 65. Botox works by blocking nerve transmission to temporarily reduce the contractions of the facial muscles that cause frown lines.

It has been proven to be a safe and effective treatment for wrinkles, and botox injections are becoming increasingly popular.

Botulinum toxin has proven to be useful in the treatment of many forms of dystonia, including the following:
* blepharospasm–forceful involuntary closure of the eyelids
* strabismus–misalignment of the eyes
* hemifacial spasm–sudden contraction of the muscles on one side of the face
* spasmodic torticollis, or cervical dystonia–muscle spasm in the neck that causes the head to turn to one side, and sometimes forward or backward
* oromandibular dystonia–continuous spasms of the face, jaw, neck, tongue, larynx, and in severe cases, the respiratory system
* urinary retention–severe inability to urinate that requires catheterization
* spasmodic dysphonia–spasm of the vocal cords that causes sudden disruption of speech
* stuttering–repetitions of parts of words and whole words, long pauses, elongated sounds
* voice tremor–quavering vocalization
* limb spasticity (e.g., following stroke)

Is Botox safe?
BOTOX Cosmetic™ is very safe. It has been used since the 1970’s for the treatment of lazy eye muscles. Since the 2000 it has been used on millions of people yearly and in fact is the number one cosmetic procedure performed in the United States. Its side effects are local and may include:
* Slight bruising
* Short-term headache
* Tenderness at the injection site
* Temporary ptosis or drooping of the eyelid or the brows

Who can have Botox treatment?
Your doctor will decide if you can have cosmetic treatment with botox. Before starting treatment, tell your doctor if you have any disorders that affect your nerves and muscles, if you are breastfeeding, or if you are planning to become pregnant soon.

The Botox injection procedure
Your doctor will administer several tiny injections of botox directly into the muscles of your face. Prior to injection, your doctor will determine where to administer the injections by examining your ability to move certain muscles in your brow area. The entire botox injection procedure takes approximately 10 minutes and does not require anaesthesia. Discomfort is usually minimal and brief.

Doctors should avoid injection near the levator palpebrae superioris, particularly in patients with larger brow-depressor complexes. Medial corrugator injections should be placed at least 1 cm above the bony supraorbital ridge.

After the injection
You should notice an improvement in your frown lines within 3 to 7 days, the effects of which can last up to 4 months. However, results may vary. After a period of time, your frown lines will begin to reappear as the effects of botox wear off.

How often can Botox injections be given?
You can receive botox injections every 4 months. With repeated treatments, thinning of the muscles occurs, which produces longer lasting results.

How much does Botox treatment cost?
Each treatment costs around £200.

Possible side-effects of Botox
- headache
- flu-like symptoms
- temporary eyelid droop (ptosis)
- nausea
- squint/double vision
- twitching of the eye
- facial pain
- redness at the injection site
- muscle weakness

Cautions/contra-indications
Do not have botox treatment if you:
- have an infection where botox will be injected
- are allergic to any of the ingredients
- are pregnant or think you might be pregnant
- have a neurological disorder (eg. Myasthenia Gravis)

There are also a number of medicines that may interact with botox (eg. quinidine, some antibiotics). It is important to tell your doctor if you are taking any medication.

Source:
http://www.neurologychannel.com/botulinum/index.shtml
http://www.medic8.com/healthguide/articles/botox.html
http://www.plasticsurgery.org/Patients_and_Consumers/Procedures/Cosmetic_Procedures/Botox.html
http://www.beautifulself.com/botox.htm
http://science.nationalgeographic.com/science/enlarge/botox-injection.html
http://icondenver.com/botox.html
http://www.acclaimimages.com/_gallery/_pages/0072-0603-1620-4054.html
http://img.dailymail.co.uk/i/pix/2007/11_03/beforeAfterGPX2011_468x459.jpg
http://www.fda.gov/fdac/graphics/2002graphics/botoxZ.jpg

Why Hair Goes Gray

danielwitanto@gmail.com (Daniel Witanto) — Mon, 02 Mar 2009 09:54:00 +0000

Why our hair turns gray? Human degeneration will always be medical concern, and every research is meaningful. Senile graying of human hair has been the subject of intense research since ancient times.

New research shows that hair turns gray as a result of a chemical chain reaction that causes hair to bleach itself from the inside out.

The process starts when there is a dip in levels of an enzyme called catalase. That catalase shortfall means that the hydrogen peroxide that naturally occurs in hair can't be broken down.

Research demonstrate almost absent catalase and methionine sulfoxide reductase A and B protein expression via immunofluorescence and Western blot in association with a functional loss of methionine sulfoxide repair in the entire gray hair follicle. Here can be concluded that H2O2-mediated oxidative stress affects human hair color by blunting methionine sulfoxide repair

As the research summary, concept of H2O2-induced oxidative damage in the entire human hair follicle, inclusive of the hair shaft, as a key element in senile hair graying, which does not exclusively affect follicle melanocytes. This new insight could open new strategies for intervention and reversal of the hair graying process.

J. M. Wood, H. Decker, H. Hartmann, B. Chavan, H. Rokos, J. D. Spencer, S. Hasse, M. J. Thornton, M. Shalbaf, R. Paus, and K. U. Schallreuter

SOURCES:

http://www.fasebj.org/cgi/content/abstract/fj.08-125435v1

http://www.webmd.com/skin-problems-and-treatments/news/20090225/why-hair-goes-gray

Liposuction, Beauty & Risk

danielwitanto@gmail.com (Daniel Witanto) — Wed, 11 Feb 2009 05:10:00 +0000

Globally, the World Health Organization estimated that in 2005, 400 million people were obese. Currently, 78 million Americans are classified as obese. This number is projected to increase to 700 million world-wide by the year 2015.

Liposuction is defined as the removal of fat from deposits beneath the skin using a hollow stainless steel tube (called a cannula) with the assistance of a powerful vacuum. Liposuction can be accomplished either with the use of general anesthesia, or with heavy IV sedation, or totally by local anesthesia.

1. Tumescent Technique – A saline solution is injected through slit incision in the skin, and then allowed to diffuse (percolate) through the fatty tissue. Best for in-office surgery, since agents in the solution reduce bleeding. This technique is the safest and it allows for a faster recovery, but it’s also the most expensive. Percolating can take up to 60 minutes, which means an extra hour of operating-room costs.

2. Ultrasound-assisted Lipoplasty (UAL): An ultrasonic vibrating probe “liquefies” the fat before it is suctioned. It can be done externally, through a hand-held device applied to the skin, or internally, through a vibrating canule. UAL is the preferred method in clinics.

Modified Tumescent Liposuction
Modified tumescent liposuction refers to a combination of tumescent local anesthesia plus some form of systemic anesthesia (general anesthesia or heavy IV sedation), they must be administered by an anesthesiologist.

The Different Liposuction Techniques
There are many ways to do liposuction, for example liposuction can be accomplished painlessly either totally by local anesthesia or with general anesthesia. In the realm of liposuction, maximum speed and maximum volume of aspirate are not criteria for excellence. Ultimately, excellence is measured in terms of patient happiness which is a function of safety, patient comfort, finesse, and quality of results.

Liposuction Complications
Liposuction complications are often the direct result of lack of caution, poor judgment, over confidence, ignorance about pharmacology, or adherence to faulty dogma.

The "Art of Liposuction"
Liposuction is a medium of artistic expression that displays itself in (1) a practical application of scientific knowledge, (2) the production of what is beautiful, (3) a perfection of workmanship, (4) a perpetual quest for improvement in technique, and (5) a skill attained through clinical experience, and above all (6) making people feel happy about what they see in the mirror.

Artistry and Safety are Related
In order to master an artistic liposuction technique, the surgeon must have the skill and intelligence to avoid exposing patients to unnecessary dangers. The true artist provides better results, and uses the safest technique and never forgets the duty to "first, do no harm." . It is not artistry to take unnecessary risks or push liposuction to the limits of safety.

Risks of Liposuction
As with any surgery, liposuction carries some risks. These include:

Infection
The formation of fat clots or blood clots, which can loosen and move to the lungs (a potentially fatal condition called pulmonary embolism)
Too much fluid loss, leading to shock and potentially death
Fluid accumulation
Nerve damage that causes numbness or changes in sensation
Swelling that lasts for several weeks or months after the procedure
Skin death (necrosis), in which the skin above the liposuction site sloughs off and dies and/or becomes infected
Burns from the ultrasound probe
Punctures to the organs (For example, the intestines may be punctured during abdominal liposuction.)
Drug reactions, including reactions to the lidocaine fluid that is injected in the tumescent and super-wet techniques
Rippling or indentation under the skin if the doctor removes too much fat
Scarring (although doctors make every attempt to keep the scars small and hidden)

Tumescent Technique is Safest
The tumescent technique for liposuction is unquestionably the safest form of liposuction. When tumescent liposuction is done correctly (not excessively), it is a very safe procedure, there have been no reported deaths associated with tumescent liposuction totally by local anesthesia. The dilute epinephrine contained in the tumescent anesthetic solution profoundly shrinks capillaries and thus virtually eliminates surgical blood loss.

Smoother Cosmetic Results
The tumescent technique permits the use of microcannulas which in turn yields smoother cosmetic results. Traditional liposuction cannulas (stainless steel tubes) have a relatively large diameter and remove fat rather quickly. However, with the use of large cannulas (diameter greater than 3 millimeters) there is an increased risk of irregularities and depressions in the skin. Microcannulas with a diameter less than 3 millimeters, allow fat to be removed in a smoother and more uniform fashion. Some surgeons prefer larger cannulas because it allows liposuction to be done more quickly.

Rapid Healing
After tumescent liposuction, there is a certain amount of blood-tinged local anesthetic solution that remains under the skin. This excess fluid is either slowly absorbed over several weeks into the blood stream, or it can be rapidly removed by drainage through skin incisions and absorbed by special absorptive pads (HK Pads).

Source:
How Liposuction Works. Stephanie Watson. http://static.howstuffworks.com
Liposuction. http://www.peacemotivate.com/2007/09/09/liposuction/
IAPAM's 7 Top Anti-Aging Trends for 2009. Jeff Russell. http://www.prweb.com/releases/antiaging/trends/prweb1907894.htm
Liposuction Information. http://www.liposuction.com/lipoinfo/intro.php
Liposuction Facts. http://www.cosmeticsurgery.com/essential_facts/cosmetic-surgery
Liposuction: Facts and Myths . Diana Bocco. http://www.googobits.com/articles/1045-liposuction-facts-and-myths.html/Liposuction/

Air Pollution can Induce Appendicitis

danielwitanto@gmail.com (Daniel Witanto) — Sat, 06 Dec 2008 04:10:00 +0000

The newest research of Dr. Gilaad G. Kaplan from the University of Calgary and Environment Canada's National Air Pollution Surveylance (NAPS), has identified 5000 Appendicitis patient in 1999 until 2006. The result shows that this disease is induced by the ozone substances consentrate such as Nitrogen dioxide, Sulfur dioxide, Carbon monoxide, etc, that also polluting the air.

These air and ozone pollutants can induce inflamation of human being, and corelated with Appendicitis (Appendix bowel inflamation). Other research that compare ozone concentrate in different days show that there is 15% more amounts of patients in the lower ozone concentration.

To decrease this risk, we clearly have to increase the air quality make it clear from these horrible pollutant.

Source: Prevention magazine, page 16, December 2008

Picture from http://www.hipusa.com/webmd/encyclopedia/appendicitis

Melatonin research

danielwitanto@gmail.com (Daniel Witanto) — Wed, 17 Sep 2008 12:08:00 +0000

At the beginning of this blog i wrote an article about melatonin, the hormones that is produced by the Pineal gland in located in the human brain, the mid section between the Cerebrum and the Cerebellum. I wrote this article based on the mini experimental study and only conclude that melatonin lengthening the reaction time.

There is many theory and hypothesis about melatonin, the most popular said that melatonin is the key for human long life, is it true?

I become very interested about this thing when I read the experiment done by American professor to the mice, there are two mice, one is old and dying, the other is young, fit and healthy. Then their pineal gland is switch one another. The result is, the old and dying mouse becomes healthy, fit and look much younger, and contrary the young mouse becomes sick, dying and die young.

There is many study about melatonin, I believe, and I hope there is many people interested to prove this, for it may be..., just may be the recipe to make human forever young, and aged over than 100 years

MSG Induces Pain , is it true?

danielwitanto@gmail.com (Daniel Witanto) — Mon, 08 Sep 2008 04:37:00 +0000

MSG (Monosodium Glutamate) commonly known as "Vetsin" is used widely among Indonesian people, and may also all over the country, it is used commonly in cooking, to add a good taste in food, especially various Chinese food, so that we often hear about Chinese restaurant syndrome, where we can find people having headache, flashing, sweating, numbness or burning around the mouth, sense of facial pressure or swelling, rapid heart rate, even decreased air entry into the lungs. Some media even called it the poison in the pantry. There is finding lately that MSG can induce pain.

There is evidence that elevated tissue concentrations of glutamate may contribute to pain and sensitivity in certain musculoskeletal pain conditions. In the present study, the food additive monosodium glutamate (MSG) was injected intravenously into rats to determine whether it could significantly elevate interstitial concentrations of glutamate in the masseter muscle and whether MSG administration could excite and/or sensitize slowly conducting masseter afferent fibers through N-methyl-d-aspartate (NMDA) receptor activation.

The present results indicate that a 2- to 3-fold elevation in interstitial glutamate levels in the masseter muscle is sufficient to excite and induce afferent mechanical sensitization through NMDA receptor activation. These findings suggest that modest elevations of interstitial glutamate concentration could alter musculoskeletal pain sensitivity in human.

So if you experience unexplainable reason of muscle pain, remember what have you eat lately, is it contain MSG?

Related Article and Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/001126.htm
http://findarticles.com/p/articles/mi_m0876/is_n49/ai_7648519
Picture Source
http://www.naturalcondition.com/2008/03/08/monosodium-glutamate-yumami/

Global Warming

danielwitanto@gmail.com (Daniel Witanto) — Tue, 15 Jul 2008 15:32:00 +0000

On this opportunity let me discuss about warm topic recently, it's about global warming, of course we have heard it. Can you imagine that this earth is melting because of us? what has been done by our ancestor maybe bad and destructive, but right now we should stop blaming whoever, let's start from ourself, let's do our best to save this earth where we life and grow together.

Have you seen the documentary movie "Earth", if you haven't please go to the dvd rental now and watch this film, and hope this film can open our eyes and our heart, how sad is our mother earth, how the polar bear die because of human, how the whale become extinct because there is no enough krills to eat, the polar ice is melting widely, the sea level surface is increasing, storm , earthquake and tsunami everywhere.. it's disaster, what have we done?

Our God trusts us to reserve this land, make it bloom, green, flowery, beautiful, for everyone's sake, for you and for me and the entire human being (remember mike's song: Heal the world), but human is just a human with passion, and greed, with it's proud with the technology, industrial revolution, born of machine In one side it has a huge advantages for human, but in other side it makes human easier to exploit this earth greedily for their own wealth ignoring the ecosystem balance and try to make this screaming earth silence with the pollution, the waste?.. but this earth is more powerful than we expect it struggling against human, the destructor, until it's end.. and maybe..maybe this is near end, the end of the world?.. our earth is dying..

What Will You Do For This Dying Earth?

Originally written by the Author

Supported by : http://transformer.myffi.biz

Breastfeeding is the Best

danielwitanto@gmail.com (Daniel Witanto) — Tue, 01 Jul 2008 14:48:00 +0000

Breastfeeding is advocated for good reasons. Breast milk contains the right balance of nutrients as well as antibodies. Studies have shown that breast milk strengthens a baby's immunity and protects against gut and respiratory infections. Babies will be less prone to coughd, colds, diarrhea and ear infections.

Breastfeeding is not only beneficial to the environment, there are big benefits for babies and mothers too:
1. The mother’s antibodies will protect the baby from illness.
2. Breastfed babies are less likely to have allergies.
3. Breastfeeding reduces the rates of breast cancer and ovarian cancer in mothers.
4. Breastfeeding saves time.
5. Mothers who breastfeed lose weight more quickly after giving birth.

If human breast milk came stamped with an ingredients label, it might read something like this: 4 percent fat, vitamins A, C, E and K, lactose, essential minerals, growth hormones, proteins, enzymes and antibodies. In a healthy woman, it contains 100 percent of virtually everything a baby needs to survive, plus a solid hedge of extras to help ward off a lifetime of diseases like diabetes and cancer. Breast milk helps disarm salmonella and E. coli. Its unique recipe of fatty acids boosts brain growth and results in babies with higher I.Q.'s than their formula-slurping counterparts. Nursing babies suffer from fewer infections, hospitalizations and cases of sudden infant death syndrome. For the mother, too, breast-feeding and its delicate plumbing of hormones afford protection against breast and ovarian cancers and stress. Despite exhaustion, the in-laws and dirty laundry, every time we nurse our babies, the love hormone oxytocin courses out of our pituitaries like a warm bath. Human milk is like ice cream, Valium and Ecstasy all wrapped up in two pretty packages.

Source:
Reader's Digest. june2008. RDHealth.p134. Breast is Best
http://ecostreet.com/blog/eco-friendly-parenting/2007/08/01/
http://www.mindfully.org/Health/2005/Toxic-Breast-Milk9jan05.htm

Metabolic syndrome increase Brain attack

danielwitanto@gmail.com (Daniel Witanto) — Thu, 05 Jun 2008 16:12:00 +0000

Eventough metabolic syndrome has been linked with the increasing risk of stroke, but the relation between this disorder with the subclinical ischemic lession has not been figured clearly. Dr. Hirokazu bokura and friends from Shimura University, Japan, doing the cross sectional study about MRI scan on 1.151 generally healthy volunteer.

After considering many variable such as age, sex, and smoking habit, the researcher found there is significant connection between some of symptoms of the metabolic syndrome with the arising silent brain infarct. It is reported that the patients that have one component of metabolic syndrome have 1,49 times higher risk to suffer this silent brain infarct, meanwhile the subject with four components of metabolic syndrome have 4,71 times higher risk.

If the components of this metabolic syndrome are seen individually, then hypertension is seen correlated with the increasing risk of periventricular hyperintensity lession and subcortical white substance lession (substantia alba). The abnormal metabolism of glucose increase the risk for them both, meanwhile dislipidemia increasing the risk of subcortical substantia alba lession 1,40 times, but did not increase the risk of periventricular hyperintensity significantly.

The researcher conclude that there is a positive connection between the metabolic syndrome with the arising silent brain lession, and this can be used as the diagnostic to predict and prevent stroke in the future.

Source: Medical update medicine, may08, p.20. (Stroke,2008,doi:10.1161/STROKEAHA.107.508630).
Picture taken from abcnews.go.com/Health/wireStory?id=4204233 &www.biij.org/2006/2/e16

Smoking and Lung Cancer

danielwitanto@gmail.com (Daniel Witanto) — Wed, 21 May 2008 15:11:00 +0000

Tobacco smoke is a complex mixture of more than 3,000 different substances, including the addictive stimulant nicotine, benzene, ammonia, hydrogen cyanide, carbon monoxide, and tar. The burning tar elements in the smoke are known to be strongly cancer-causing (carcinogenic). The risk of developing lung cancer increases with the number of cigarettes smoked per day, thair tar content, the number of years that a person has smoked, and the depth of inhalation into the lungs. Another risk factor is regular exposure to other people's cigarette smoke, whish is known as passive smoking.

Tar is just one of thousands of chemicals in tobacco smoke. In smokers, healthy lung tissue becomes dotted with deposits of tar.

The process:
1. In healthy airway lining, the columnar cells topped by tiny, hairlike cilia line healthy airways (bronchi). Basal cells constantly divide to replace naturally damaged columnar cells.
2. Initial damage: Over time, columnar cells damaged by smoking become squamous cells, which gradually lose their cilia. The mucus-secreting goblet cells die
3 .Cancer begins: to replace the damaged cells, basal cells start to multiply at an increased rate. Some of these new basal cells develop into cancerous cells.
4. Cancer spreads: the cancerous cells replace healthy cells. If these cells break through the basement membrane, they can enter blood vessels to travel elsewhere

Source:
The Human body book, Steve Parker, Robert Winston, DK.p143
http://health.nytimes.com/health/guides/disease

What is stroke?

danielwitanto@gmail.com (Daniel Witanto) — Sun, 11 May 2008 10:22:00 +0000

Definition
Definition of stroke, devised by the World Health Organization in the 1970s, is a "neurological deficit of cerebrovascular cause that persists beyond 24 hours or is interrupted by death within 24 hours". This definition was supposed to reflect the reversibility of tissue damage and was devised for the purpose, with the time frame of 24 hours being chosen arbitrarily. The 24-hour limit divides stroke from transient ischemic attack, which is a related syndrome of stroke symptoms that resolve completely within 24 hours.

A stroke is a medical emergency. Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted.

Strokes can be classified into two major categories: ischemic and hemorrhagic

Ischemic stroke
In an ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction and necrosis of the brain tissue in that area. There are four reasons why this might happen: thrombosis (obstruction of a blood vessel by a blood clot forming locally), embolism (idem due to a embolus from elsewhere in the body, see below), systemic hypoperfusion (general decrease in blood supply, e.g. in shock) and venous thrombosis. Stroke without an obvious explanation is termed "cryptogenic" (of unknown origin).

Hemorrhagic stroke
Intracranial hemorrhage is the accumulation of blood anywhere within the skull vault. A distinction is made between intra-axial hemorrhage (blood inside the brain) and extra-axial hemorrhage (blood inside the skull but outside the brain). Intra-axial hemorrhage is due to intraparenchymal hemorrhage or intraventricular hemorrhage (blood in the ventricular system). The main types of extra-axial hemorrhage are epidural hematoma (bleeding between the dura mater and the skull), subdural hematoma (in the subdural space) and subarachnoid hemorrhage (between the arachnoid mater and pia mater). Most of the hemorrhagic stroke syndromes have specific symptoms (e.g. headache, previous head injury).

Intracerebral hemorrhage (ICH) is bleeding directly into the brain tissue, forming a gradually enlarging hematoma (pooling of blood). It generally occurs in small arteries or arterioles and is commonly due to hypertension, trauma, bleeding disorders, amyloid angiopathy, illicit drug use (e.g. amphetamines or cocaine), and vascular malformations. The hematoma enlarges until pressure from surrounding tissue limits its growth, or until it decompresses by emptying into the ventricular system, CSF or the pial surface. A third of intracerebral bleed is into the brain's ventricles. ICH has a mortality rate of 44 percent after 30 days, higher than ischemic stroke or even the very deadly subarachnoid hemorrhage.

Stroke is occasionally treated with thrombolysis ("clot-buster"), but usually with supportive care (physiotherapy and occupational therapy) and secondary prevention with antiplatelet drugs (aspirin and often dipyridamole), blood pressure control, statins and anticoagulation (in selected patients)

Symptoms of stroke
* Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
* Sudden confusion, trouble speaking or understanding speech
* Sudden trouble seeing in one or both eyes
* Sudden trouble walking, dizziness, loss of balance or coordination
* Sudden severe headache with no known cause
If you have any of these symptoms, you must get to a hospital quickly to begin treatment.

Preventions
Because stroke may indicate underlying atherosclerosis, it is important to determine the patient's risk for other cardiovascular diseases such as coronary heart disease. Conversely, aspirin prevents against first stroke in patients who have suffered a myocardial infarction.

The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes, cigarette smoking (active and passive), heavy alcohol consumption and drug use, lack of physical activity, obesity and unhealthy diet. Alcohol use could predispose to ischemic stroke, and intracerebral and subarachnoid hemorrhage via multiple mechanisms (for example via hypertension, atrial fibrillation, rebound thrombocytosis and platelet aggregation and clotting disturbances). The drugs most commonly associated with stroke are cocaine, amphetamines causing hemorrhagic stroke, but also over-the-counter cough and cold drugs containing sympathomimetics.

Source:
National Institute of Neurological Disorders and Stroke (http://www.nlm.nih.gov/medlineplus/stroke.html)
Wikipedia encyclopedia (http://en.wikipedia.org/wiki/Stroke)

Testicle: Rich Source of Stem Cells

danielwitanto@gmail.com (Daniel Witanto) — Tue, 06 May 2008 08:53:00 +0000

Dr. Shahin Rafli from Weil Cornell Medical College, New York, claimed that someday, men's testicle organ can be use as the source of the Stem Cells. The amount is abundant and easy to get, to help this person against his disease or to regenerate the damaged organs.

The researcher has been succeeded to isolate this kind of cells on mice, and developed it to become heart cells, brain cells, and vascular tissue. This mice Stem Cells didn't need addition or gene manipulation to make them form into multipotent cells, and then produce many kind of this cells. Meanwhile the mature cells reprogramming in connecting tissue with another technique can produce multipotent stem cells, but can also increase the risk of malignancy.

SPC (Spermatogonial progenitor stem cells) in the testicle specialized to form the sperm precursor. These cells are very eficient and can keep a man fertile with the increasing age.

The researchers hope is to apply the same methode in producing this SPCs in these mice to a man on the future. It is said that this same method can be work on the female ovary, that also consists of productive cells, but this theory still need more experiment.

Source: Nature 2007,449:346-350;

Melatonin and sleep disorders

danielwitanto@gmail.com (Daniel Witanto) — Fri, 25 Apr 2008 08:28:00 +0000

Recently there are many people who have sleep disorders, and nowadays there are also many drugs in the markets that can trigger sleep and helping people with this disorders, but many kinds of these drugs can cause undesired side effects. Melatonin, as the natural hormone takes an important role in human sleep cycle, is expected to be the safest choice to solve this problem.

The writer have done an observation on purpose to know the effect of melatonin on the simple reaction time.

This little experiment involve 12 male students of the Maranatha Christian University Bandung-Indonesia as the subjects. The measurement of the simple reaction time was done to these 12 male students with variety of ages are 20-22 years old,towards red light, yellow light, green light, and blue light ten times each. This measurements was done before and after consuming 1 tablet of melatonin (3 mg), afterwards it was measured every five minutes until 50 minutes. The data was analyzed with paired t-test (alpha=0,05)

The average simple reaction time after consuming melatonin for the green light are 0.331 seconds, the blue 0.330 seconds, the yellow 0.319 seconds, and the red 0.337 seconds. This results shows that the simple reaction time are longer than before: the green light 0.223 seconds, blue light 0.225, yellow light 0.212, and the red light 0.215 (p<0.05).>

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