This document discusses lifestyle factors and their impact on health and aging. It suggests that lifestyle modifications through practices like exercise, nutrition, stress management and social support can help maintain health and prevent disease by affecting aging at the cellular level. Specifically, it discusses how telomeres and telomerase are markers of biological aging and how lifestyle interventions may help preserve telomere length and telomerase activity to slow cellular aging. Overall, the document advocates that lifestyle medicine which focuses on prevention through lifestyle changes may be more effective than medical treatments alone.
1) The document discusses the history of hormone treatments for menopausal women from ancient times to modern developments.
2) It notes that while hormone treatments helped relieve symptoms, long term use revealed risks like increased chances of endometrial and breast cancer as well as vascular diseases.
3) The document argues that today's focus should be on women's overall health, disease prevention, and treatment options that consider quality of life - not just debating long term hormone use but finding the best approach.
- Ms. P is a 64-year-old woman diagnosed with fibromyalgia who experiences widespread muscle pain and fatigue. Her pain is aggravated by touch and relieved by rest and heat.
- She has tried numerous medications for fibromyalgia but most resulted in adverse effects. Her current treatment includes acupuncture, pregabalin, hydrocodone, and cyclobenzaprine.
- Fibromyalgia is characterized by widespread pain and is often accompanied by fatigue, memory problems, and sleep disturbances. It affects 2-8% of the population and is considered a centralized pain state involving central nervous system pain amplification.
1) Hormone replacement therapy (HRT) is a misnomer and should be called postmenopause hormone treatment (PMHT) as it is not replacing anything physiological.
2) PMHT refers to the use of estrogens and other hormones when indicated along with non-hormonal treatments and lifestyle changes to maintain health and prevent diseases associated with menopause.
3) It is important not to view HRT/PMHT as obligatory or the only option for postmenopausal women. Treatments must be individualized based on risk factors and health needs.
The document discusses the experience and lessons learned by the author, a medical doctor specializing in women's health, in treating menopausal women over the course of his career. Some key points made include:
- Looking after menopausal women is a fascinating, gratifying, and complex experience for physicians due to the holistic factors involved.
- Recent large studies like WHI have been misinterpreted by medical professionals and caused unnecessary fear, when properly interpreted they show hormone therapy is generally safe and effective for relieving menopausal symptoms.
- Younger women may receive heart protection from estrogen therapy, and risks of conditions like breast cancer return to normal after stopping therapy.
- Occult breast cancers are actually
The document discusses the argument that medicine may be the leading cause of illness rather than the cure. It provides several examples and studies that suggest focusing on lifestyle changes like diet, exercise, and stress reduction through methods like yoga, herbalism, and other natural remedies can be more effective treatments than conventional medicine which often does more harm than good through toxic drugs and medical errors. The document advocates for adopting a holistic and natural approach to healthcare rather than relying on the current medical system.
Deterioro en el estado general y pérdida de pesoIntegrarsalud
1) Unintentional weight loss of 10% or more in 6-12 months is defined as involuntary weight loss.
2) Common causes include cancer, gastrointestinal disorders, endocrine diseases, and psychological factors.
3) Involuntary weight loss is associated with increased mortality, hospital complications, disability, and reduced quality of life.
The Interface of Loneliness, Hospitalization and Illness | Crimson PublishersCrimsonpublishersPPrs
This article reviews the experience of loneliness and how it is influenced, and influences, the ill person and the hospitalized individual. Social ties enhance the immune system and help individuals cope with stress and illness. Loneliness has physical, emotional, and cognitive negative effects. Loneliness, which can involve both excruciating physical and mental suffering, is an ancient nemesis. Loneliness is implicated in numerous somatic, psychosomatic, and psychiatric diseases [1]. It is a mundane yet arcane human affliction that is often hazardous to health and hostile to happiness [2]. In this article, I review the experience of loneliness as it affects us when we are not doing well, such as when we are ill or hospitalized.
Cancer affects quality of life through physical, psychological, social, and spiritual impacts. Physically, cancer and its treatments can cause pain, fatigue, sleep issues, nutritional problems, and sexual dysfunction. Psychologically, common issues include cognitive impairment, stress, anxiety, depression, and the need for coping strategies and hope. Cancer also has social impacts by changing social roles and lifestyle. Overall quality of life is reduced by the disease but can be improved by addressing these multifaceted issues.
1) The document discusses the history of hormone treatments for menopausal women from ancient times to modern developments.
2) It notes that while hormone treatments helped relieve symptoms, long term use revealed risks like increased chances of endometrial and breast cancer as well as vascular diseases.
3) The document argues that today's focus should be on women's overall health, disease prevention, and treatment options that consider quality of life - not just debating long term hormone use but finding the best approach.
- Ms. P is a 64-year-old woman diagnosed with fibromyalgia who experiences widespread muscle pain and fatigue. Her pain is aggravated by touch and relieved by rest and heat.
- She has tried numerous medications for fibromyalgia but most resulted in adverse effects. Her current treatment includes acupuncture, pregabalin, hydrocodone, and cyclobenzaprine.
- Fibromyalgia is characterized by widespread pain and is often accompanied by fatigue, memory problems, and sleep disturbances. It affects 2-8% of the population and is considered a centralized pain state involving central nervous system pain amplification.
1) Hormone replacement therapy (HRT) is a misnomer and should be called postmenopause hormone treatment (PMHT) as it is not replacing anything physiological.
2) PMHT refers to the use of estrogens and other hormones when indicated along with non-hormonal treatments and lifestyle changes to maintain health and prevent diseases associated with menopause.
3) It is important not to view HRT/PMHT as obligatory or the only option for postmenopausal women. Treatments must be individualized based on risk factors and health needs.
The document discusses the experience and lessons learned by the author, a medical doctor specializing in women's health, in treating menopausal women over the course of his career. Some key points made include:
- Looking after menopausal women is a fascinating, gratifying, and complex experience for physicians due to the holistic factors involved.
- Recent large studies like WHI have been misinterpreted by medical professionals and caused unnecessary fear, when properly interpreted they show hormone therapy is generally safe and effective for relieving menopausal symptoms.
- Younger women may receive heart protection from estrogen therapy, and risks of conditions like breast cancer return to normal after stopping therapy.
- Occult breast cancers are actually
The document discusses the argument that medicine may be the leading cause of illness rather than the cure. It provides several examples and studies that suggest focusing on lifestyle changes like diet, exercise, and stress reduction through methods like yoga, herbalism, and other natural remedies can be more effective treatments than conventional medicine which often does more harm than good through toxic drugs and medical errors. The document advocates for adopting a holistic and natural approach to healthcare rather than relying on the current medical system.
Deterioro en el estado general y pérdida de pesoIntegrarsalud
1) Unintentional weight loss of 10% or more in 6-12 months is defined as involuntary weight loss.
2) Common causes include cancer, gastrointestinal disorders, endocrine diseases, and psychological factors.
3) Involuntary weight loss is associated with increased mortality, hospital complications, disability, and reduced quality of life.
The Interface of Loneliness, Hospitalization and Illness | Crimson PublishersCrimsonpublishersPPrs
This article reviews the experience of loneliness and how it is influenced, and influences, the ill person and the hospitalized individual. Social ties enhance the immune system and help individuals cope with stress and illness. Loneliness has physical, emotional, and cognitive negative effects. Loneliness, which can involve both excruciating physical and mental suffering, is an ancient nemesis. Loneliness is implicated in numerous somatic, psychosomatic, and psychiatric diseases [1]. It is a mundane yet arcane human affliction that is often hazardous to health and hostile to happiness [2]. In this article, I review the experience of loneliness as it affects us when we are not doing well, such as when we are ill or hospitalized.
Cancer affects quality of life through physical, psychological, social, and spiritual impacts. Physically, cancer and its treatments can cause pain, fatigue, sleep issues, nutritional problems, and sexual dysfunction. Psychologically, common issues include cognitive impairment, stress, anxiety, depression, and the need for coping strategies and hope. Cancer also has social impacts by changing social roles and lifestyle. Overall quality of life is reduced by the disease but can be improved by addressing these multifaceted issues.
This document discusses treatment options for climacteric (menopausal) women based on the experience and perspectives of Dr. Manuel Neves-e-Castro. It begins by introducing Dr. Castro and his background. It then discusses definitions and objectives related to treating climacteric women, including critical objectives like diagnosis, risk identification, and symptom/disease treatment. It also discusses specific objectives and targets related to conditions like cardiovascular disease, CNS issues, bones, reproductive organs, and more. The document provides examples of treatment options and projects for various objectives. It continues discussing controversies, lessons from studies like WHI, effects on heart disease and breast cancer risk, and considerations around hormone therapy.
This document outlines the evolution of concepts of health and illness through eight stages: empirical-sensory knowledge, humoral concept, mechanical-systemic concept, biomedical concept, ecological concept, psycho-social concept, holistic concept, and socio-medical concept. It then discusses definitions of health, indicators of health status, determinants of health, and the dimensions of health. Key concepts discussed include viewing health as a dynamic process influenced by various environmental, social, and individual factors.
Health exists on a spectrum, with death on one end and optimal well-being, as defined by the WHO, on the other. Along the spectrum are degrees of health from better to mild to severe sickness. An individual's health is dynamic and constantly changing, with what is considered maximum health one day potentially becoming minimum the next. There are varying levels of both health and illness.
HISTORY OF 3-STEP LADDER WHO
1980 – WHO establishes Cancer Control Programme
Cancer prevention
Early diagnosis with curative treatment
Pain relief and palliative care
1986 – ” Cancer Pain Relief “ published by WHO
Step Ladder WHO
Updated on 1996
Worldwide acceptance protocol
Today, worldwide consensus favouring its used for management of all pain associated with serious illness
The document summarizes research on cancer, stress, and personality. It finds that while stress may accelerate tumor growth in animal models, studies do not show stress causes cancer in humans. Childhood adversity is linked to increased risk behaviors but its relationship to cancer is unclear. Personality does not determine cancer risk but may impact progression. Psychotherapy improves mood in cancer patients but does not extend survival. It can reduce chemotherapy side effects through classical conditioning approaches.
Functional medicine is a patient-centered, science-based healthcare approach that focuses on identifying and addressing the root causes of disease rather than just treating symptoms. It involves comprehensively assessing factors like genetics, environment, and lifestyle that may be contributing to poor health, and developing individualized treatment plans, such as customized diet and supplement protocols, to restore balance and improve function. In contrast to conventional medicine which uses an algorithmic treatment approach, functional medicine doctors seek to diagnose and treat the underlying dysfunctions influencing a patient's chronic illness.
This document discusses the relationship between nutritional status and pressure ulcers. It provides epidemiological data showing that malnutrition is associated with increased risk of developing pressure ulcers. Experimental studies in animals also demonstrate impaired wound healing in malnourished subjects. However, clinical studies on the effect of nutritional supplementation on pressure ulcer prevention and treatment have shown mixed results, with some finding no effect of supplementation on ulcer outcomes. Overall, while malnutrition and pressure ulcers often coexist, the relationship is complex and a causal link has not been firmly established.
The document discusses the spectrum of health, ranging from positive health to death. It notes that health and disease exist on a continuum, with no single cutoff point. The highest point on the spectrum is positive health as defined by the WHO, while the lowest is death. Health fluctuates within a range from optimal well-being to various levels of dysfunction. The transition from health to illness is often gradual, and where health ends illness begins. The spectrum concept emphasizes that an individual's health is dynamic and constantly changing.
This document discusses concepts related to disease causation and the natural history of disease. It defines disease, illness, and sickness, and describes key concepts like the germ theory of disease, epidemiological triad, multifactorial causation, and web of causation. It discusses factors related to agents, hosts, and environments that influence disease occurrence. It also outlines the pre-pathogenesis and pathogenesis phases in the natural history of disease.
This document discusses the spectrum of health and types of epidemics. It defines health according to the WHO as a state of complete physical, mental and social well-being, not just the absence of disease. Positive health is described as the optimum functioning of the body, mind, and participation in society. An epidemic is an unusual increase in illness or health issues in a defined area over a specific period. Common source epidemics can be from single or continuous exposure, while propagated epidemics spread person-to-person or via vectors. Determinants of health include biological, behavioral, environmental, and socioeconomic factors.
This document discusses concepts related to disease, including definitions of disease, illness, and sickness. It covers concepts of causation from earlier theories to the germ theory and multifactorial causation. The natural history of disease and spectrum of disease are described. Risk factors, risk groups, and the iceberg model of disease are also summarized. The document concludes with concepts of disease control and monitoring.
This document discusses several concepts related to disease causation and pathogenesis. It introduces theories of disease causation including the germ theory, biomedical model, and theories of multifactorial causation. It describes the epidemiological triad of agent, host, and environment. It also discusses the natural history of disease, including prepathogenesis and pathogenesis phases, and the iceberg phenomenon where most disease is hidden and subclinical.
Implementation of the trend marker protocol results in a unique graphical presentation when a hormone and a symptom are plotted as per the day of menstrual cycle. This presentation will indicate behavior of the hormone in relation to the disease independent of whether the hormone levels are normal or abnormal as per the set laboratory limits.
Laura Mann Center Integrative Lecture Series: Fall 2014Cara Feldman-Hunt
The document discusses the history and impact of the Penny George Institute for Health and Healing (PGIHH) at Allina Health, an integrated health system in Minnesota. Key points:
1) PGIHH was founded in 2003 and is now the largest integrative health program integrated within a health system. It focuses on prevention, wellness, and lifestyle-related diseases.
2) Studies show PGIHH services significantly reduce patient pain, anxiety, and length of hospital stays. For example, oncology patients saw a 46.9% reduction in pain and 56.1% reduction in anxiety.
3) PGIHH aims to transform healthcare delivery through a holistic, preventative approach.
The University of Virginia Department of Medicine is hosting its 36th Annual Recent Advances in Clinical Medicine Conference from October 28-30, 2009 at the Omni Charlottesville Hotel. The conference will feature lectures on various medical specialties from allergy/immunology to psychiatry delivered by UVA faculty. Attendees will have opportunities for interactive case discussions and workshops. The goal is for attendees to learn how to better manage and evaluate patients for various clinical issues. Charlottesville provides a beautiful fall setting for the conference near Thomas Jefferson's UVA and Monticello estates.
Introduction to Public Health course for Health Officer Students kaleabtegegne
This document provides an overview of concepts in public health. It discusses definitions of health from different perspectives, determinants of health, and models of disease causation. The history of public health and key developments are described. Public health is defined as working to prevent disease, prolong life, and promote health through organized community efforts. The core activities and disciplines of public health include health promotion, epidemiology, biostatistics, environmental health, and social and behavioral sciences. Clinical medicine focuses on individual patients while public health addresses the health of entire populations.
This document discusses various theories of disease causation. It begins by describing early theories that attributed disease to spiritual or imbalanced bodily elements. It then outlines several modern epidemiological theories: the germ theory that identified microorganisms as causal agents; the epidemiological triangle emphasizing interactions between an agent, host, and environment; and multi-factorial causation theory applying to chronic diseases with multiple interacting factors. Later theories discussed include the web of causation model and Diver's epidemiological model focusing on factors influencing health. The document also covers principles of screening programs and evaluating their effectiveness.
This document discusses chronic illness management. It defines a chronic illness as a condition lasting 3 months or longer that can be unpredictable. Common chronic illnesses include heart disease, cancer, diabetes and arthritis. Risk factors include behaviors like smoking, poor diet and lack of exercise, as well as genetic predisposition. Chronic diseases account for most American deaths each year. Health psychology examines the biological, psychological and social factors related to illness and health. Clinical health psychologists help patients manage chronic conditions through cognitive and behavioral therapies.
The only constant in science has, and always will be, change. Facts that were incontrovertible transform into things that we now have control over. And, new facts are discovered to take their place, which will in turn become altered or understood in new ways in the future. This is the rolling road that science has always followed, and in no other area of medicine is it as apparent as in the investigation into the ways we age.
Unhealthy lifestyles like physical inactivity, poor nutrition, smoking, stress and lack of sleep can negatively impact health and increase the risks of diseases. The document discusses definitions of health and lifestyle, the rationale for addressing human lifestyles and health, examples of unhealthy habits and their impact. It also examines factors influencing behaviors, theoretical frameworks for behavior change and lifestyle modification, and recommendations for adopting healthy lifestyle habits.
This document discusses treatment options for climacteric (menopausal) women based on the experience and perspectives of Dr. Manuel Neves-e-Castro. It begins by introducing Dr. Castro and his background. It then discusses definitions and objectives related to treating climacteric women, including critical objectives like diagnosis, risk identification, and symptom/disease treatment. It also discusses specific objectives and targets related to conditions like cardiovascular disease, CNS issues, bones, reproductive organs, and more. The document provides examples of treatment options and projects for various objectives. It continues discussing controversies, lessons from studies like WHI, effects on heart disease and breast cancer risk, and considerations around hormone therapy.
This document outlines the evolution of concepts of health and illness through eight stages: empirical-sensory knowledge, humoral concept, mechanical-systemic concept, biomedical concept, ecological concept, psycho-social concept, holistic concept, and socio-medical concept. It then discusses definitions of health, indicators of health status, determinants of health, and the dimensions of health. Key concepts discussed include viewing health as a dynamic process influenced by various environmental, social, and individual factors.
Health exists on a spectrum, with death on one end and optimal well-being, as defined by the WHO, on the other. Along the spectrum are degrees of health from better to mild to severe sickness. An individual's health is dynamic and constantly changing, with what is considered maximum health one day potentially becoming minimum the next. There are varying levels of both health and illness.
HISTORY OF 3-STEP LADDER WHO
1980 – WHO establishes Cancer Control Programme
Cancer prevention
Early diagnosis with curative treatment
Pain relief and palliative care
1986 – ” Cancer Pain Relief “ published by WHO
Step Ladder WHO
Updated on 1996
Worldwide acceptance protocol
Today, worldwide consensus favouring its used for management of all pain associated with serious illness
The document summarizes research on cancer, stress, and personality. It finds that while stress may accelerate tumor growth in animal models, studies do not show stress causes cancer in humans. Childhood adversity is linked to increased risk behaviors but its relationship to cancer is unclear. Personality does not determine cancer risk but may impact progression. Psychotherapy improves mood in cancer patients but does not extend survival. It can reduce chemotherapy side effects through classical conditioning approaches.
Functional medicine is a patient-centered, science-based healthcare approach that focuses on identifying and addressing the root causes of disease rather than just treating symptoms. It involves comprehensively assessing factors like genetics, environment, and lifestyle that may be contributing to poor health, and developing individualized treatment plans, such as customized diet and supplement protocols, to restore balance and improve function. In contrast to conventional medicine which uses an algorithmic treatment approach, functional medicine doctors seek to diagnose and treat the underlying dysfunctions influencing a patient's chronic illness.
This document discusses the relationship between nutritional status and pressure ulcers. It provides epidemiological data showing that malnutrition is associated with increased risk of developing pressure ulcers. Experimental studies in animals also demonstrate impaired wound healing in malnourished subjects. However, clinical studies on the effect of nutritional supplementation on pressure ulcer prevention and treatment have shown mixed results, with some finding no effect of supplementation on ulcer outcomes. Overall, while malnutrition and pressure ulcers often coexist, the relationship is complex and a causal link has not been firmly established.
The document discusses the spectrum of health, ranging from positive health to death. It notes that health and disease exist on a continuum, with no single cutoff point. The highest point on the spectrum is positive health as defined by the WHO, while the lowest is death. Health fluctuates within a range from optimal well-being to various levels of dysfunction. The transition from health to illness is often gradual, and where health ends illness begins. The spectrum concept emphasizes that an individual's health is dynamic and constantly changing.
This document discusses concepts related to disease causation and the natural history of disease. It defines disease, illness, and sickness, and describes key concepts like the germ theory of disease, epidemiological triad, multifactorial causation, and web of causation. It discusses factors related to agents, hosts, and environments that influence disease occurrence. It also outlines the pre-pathogenesis and pathogenesis phases in the natural history of disease.
This document discusses the spectrum of health and types of epidemics. It defines health according to the WHO as a state of complete physical, mental and social well-being, not just the absence of disease. Positive health is described as the optimum functioning of the body, mind, and participation in society. An epidemic is an unusual increase in illness or health issues in a defined area over a specific period. Common source epidemics can be from single or continuous exposure, while propagated epidemics spread person-to-person or via vectors. Determinants of health include biological, behavioral, environmental, and socioeconomic factors.
This document discusses concepts related to disease, including definitions of disease, illness, and sickness. It covers concepts of causation from earlier theories to the germ theory and multifactorial causation. The natural history of disease and spectrum of disease are described. Risk factors, risk groups, and the iceberg model of disease are also summarized. The document concludes with concepts of disease control and monitoring.
This document discusses several concepts related to disease causation and pathogenesis. It introduces theories of disease causation including the germ theory, biomedical model, and theories of multifactorial causation. It describes the epidemiological triad of agent, host, and environment. It also discusses the natural history of disease, including prepathogenesis and pathogenesis phases, and the iceberg phenomenon where most disease is hidden and subclinical.
Implementation of the trend marker protocol results in a unique graphical presentation when a hormone and a symptom are plotted as per the day of menstrual cycle. This presentation will indicate behavior of the hormone in relation to the disease independent of whether the hormone levels are normal or abnormal as per the set laboratory limits.
Laura Mann Center Integrative Lecture Series: Fall 2014Cara Feldman-Hunt
The document discusses the history and impact of the Penny George Institute for Health and Healing (PGIHH) at Allina Health, an integrated health system in Minnesota. Key points:
1) PGIHH was founded in 2003 and is now the largest integrative health program integrated within a health system. It focuses on prevention, wellness, and lifestyle-related diseases.
2) Studies show PGIHH services significantly reduce patient pain, anxiety, and length of hospital stays. For example, oncology patients saw a 46.9% reduction in pain and 56.1% reduction in anxiety.
3) PGIHH aims to transform healthcare delivery through a holistic, preventative approach.
The University of Virginia Department of Medicine is hosting its 36th Annual Recent Advances in Clinical Medicine Conference from October 28-30, 2009 at the Omni Charlottesville Hotel. The conference will feature lectures on various medical specialties from allergy/immunology to psychiatry delivered by UVA faculty. Attendees will have opportunities for interactive case discussions and workshops. The goal is for attendees to learn how to better manage and evaluate patients for various clinical issues. Charlottesville provides a beautiful fall setting for the conference near Thomas Jefferson's UVA and Monticello estates.
Introduction to Public Health course for Health Officer Students kaleabtegegne
This document provides an overview of concepts in public health. It discusses definitions of health from different perspectives, determinants of health, and models of disease causation. The history of public health and key developments are described. Public health is defined as working to prevent disease, prolong life, and promote health through organized community efforts. The core activities and disciplines of public health include health promotion, epidemiology, biostatistics, environmental health, and social and behavioral sciences. Clinical medicine focuses on individual patients while public health addresses the health of entire populations.
This document discusses various theories of disease causation. It begins by describing early theories that attributed disease to spiritual or imbalanced bodily elements. It then outlines several modern epidemiological theories: the germ theory that identified microorganisms as causal agents; the epidemiological triangle emphasizing interactions between an agent, host, and environment; and multi-factorial causation theory applying to chronic diseases with multiple interacting factors. Later theories discussed include the web of causation model and Diver's epidemiological model focusing on factors influencing health. The document also covers principles of screening programs and evaluating their effectiveness.
This document discusses chronic illness management. It defines a chronic illness as a condition lasting 3 months or longer that can be unpredictable. Common chronic illnesses include heart disease, cancer, diabetes and arthritis. Risk factors include behaviors like smoking, poor diet and lack of exercise, as well as genetic predisposition. Chronic diseases account for most American deaths each year. Health psychology examines the biological, psychological and social factors related to illness and health. Clinical health psychologists help patients manage chronic conditions through cognitive and behavioral therapies.
The only constant in science has, and always will be, change. Facts that were incontrovertible transform into things that we now have control over. And, new facts are discovered to take their place, which will in turn become altered or understood in new ways in the future. This is the rolling road that science has always followed, and in no other area of medicine is it as apparent as in the investigation into the ways we age.
Unhealthy lifestyles like physical inactivity, poor nutrition, smoking, stress and lack of sleep can negatively impact health and increase the risks of diseases. The document discusses definitions of health and lifestyle, the rationale for addressing human lifestyles and health, examples of unhealthy habits and their impact. It also examines factors influencing behaviors, theoretical frameworks for behavior change and lifestyle modification, and recommendations for adopting healthy lifestyle habits.
This document discusses lifestyle medicine and the formation of a lifestyle medicine interest group at UCSF. It provides background on lifestyle medicine, including its focus on using lifestyle interventions like nutrition, exercise, and stress management to treat and manage disease. It summarizes evidence that lifestyle factors account for the majority of chronic disease risk and that lifestyle changes can significantly reduce risks. The interest group aims to help members develop expertise in lifestyle medicine, practice healthy living themselves, and do outreach and coaching to others. Meetings will include discussions, speakers, and health education on various topics related to lifestyle and chronic disease.
Prof. Serge Jurasunas Biological Aging vs. Chronological Aging Part 1.pdfSheldon Stein
Biological Aging VS. Chronological Aging - How to Build a Healthy Longevity - An Important Role for the Mitochondria
Part I
Professor Serge Jurasunas, M.D. (hc) N.D. M.D (Hom)
Topics in Part 1:
A Longer Lifespan No Longer Means a Healthier Lifespan
What are the Causes of Normal Aging or Premature Aging?
Mitochondria, Oxidative Stress, and Premature Aging
What are Mitochondria?
Brain Neurons
The Brain and Alzheimer’s
This lecture discusses the history and development of health psychology. It covers how health psychology is unique in emphasizing how behavior influences health and exploring ways to motivate healthy behaviors. Current issues addressed by health psychologists include stress reduction, weight management, smoking cessation, nutrition, and reducing risky behaviors. The early history of health psychology involved debates around the relationship between the mind and body. The field emerged in the 1970s to address changing healthcare needs as infectious diseases declined and chronic lifestyles increased life expectancy.
The care of older adult is crucial in the present scenario. there are changes that occur in all aspects in the late years of life. the presentation explains the comprehensive changes and their effective management by health care personal.
This document discusses the history and scientific evidence around hormone replacement therapy (HRT) and its relationship to breast cancer. It notes that while early studies found HRT improved quality of life and reduced fractures, the large Women's Health Initiative studies from the 1990s-2000s found HRT increased risks of breast cancer, heart disease, and blood clots. However, sub-analysis indicated lower risks for younger women using HRT short-term. Current recommendations are that HRT may be used at lowest effective dose for shortest time to treat menopausal symptoms.
This document introduces the concept of lifestyle medicine, which aims to manage lifestyle-related health problems through behavioral and environmental modifications rather than simply treating disease. Lifestyle medicine differs from conventional medicine in its focus on active patient participation and long-term lifestyle changes over simply treating individual risk factors. While no single discipline is fully equipped to practice lifestyle medicine alone, it typically involves teams of healthcare professionals including doctors, nurses, dietitians, exercise physiologists, and psychologists. The document outlines some of the evidence and frameworks that guide lifestyle medicine and discusses how care plans can help implement lifestyle interventions in clinical practice.
This document discusses treating women transitioning to menopause, focusing on hormone therapy (HT) options. It begins by defining menopause and perimenopause, then discusses common symptoms like hot flashes and vaginal atrophy. It reviews the STRAW staging system for classifying menopause. Treatment options for symptoms include various forms of HT like oral pills, patches, and local vaginal therapies. Studies like KEEPS found HT can help reduce symptoms when started in newly menopausal women. Guidelines support HT for relieving vasomotor symptoms in recently menopausal women.
This document discusses the basic principles of palliative care, including definitions, goals, ethical issues and barriers. It provides statistics on palliative care needs in Palestine, including causes of death, cancer rates and lack of services. Recommendations are made to establish national palliative care policies and programs, train healthcare workers, ensure availability of pain medications, and incorporate palliative care into existing healthcare systems to improve end of life care.
Women live over half of their life after menopause, but what was a transition viewed with dread can now be managed, and women are leading vibrant and rewarding lives, through and after menopause. This presentation helps women learn how to feel like themselves through the midlife transition and beyond.
CONCEPT OF HEALTH and DISEASE ACCORDING TO NATUROPATHY.pptxDrManjuRater
This slide explains the concept of health and disease according to Naturopathy with scientific evidence-based, this includes health according to western medicine. health according to naturopathy, definitions of health according to naturopathy, vitality, determinants of health according to naturopathy difference between naturopathy and allopathy, characteristics of the human body, and Diagnostic criteria according to Naturopathy. Concept of disease according to western principles and disease according to naturopathy. upas tree, violation of natures law, morbid matter theory, source of toxemia and examples, the primary cause of disease and secondary cause of disease, free radicles acute disease and chronic disease, unity of disease and unity of cure, factor affecting the unity of cure, goals of naturopathy,
Women’s health – beyond reproductive yearsGulrukh Hashmi
This document discusses women's health issues beyond their reproductive years. It notes that as populations age, there is an increased focus on women's health after menopause. Common health problems among post-menopausal women include menopause, osteoporosis, cardiovascular disease, mental health issues, and various cancers. Interventions like hormone replacement therapy, immunizations, early diagnosis and screening, and lifestyle changes can help address these health issues. The document advocates for a life-cycle approach to women's health and gender-sensitive policies that meet women's needs at all stages of life.
This document discusses menopause and hormone replacement therapy. It begins by defining menopause as the permanent stoppage of menstruation due to declining ovarian function. It then discusses the stages of menopause including perimenopause and the changes in hormones like FSH and estrogen that occur. The document notes that menopause is a natural process but can cause both short term symptoms and long term health issues if estrogen is not replaced. It evaluates the risks and benefits of different treatment options for menopause including lifestyle changes, alternative therapies, medical treatments, and hormone replacement therapy.
This document provides an introduction to health psychology. It discusses the emergence of health psychology as a field and the shift from the biomedical model to the biopsychosocial model. Key topics covered include definitions of health and health behavior, factors that led to the development of health psychology, areas of focus in health psychology, and common research methodologies used. The challenges of healthcare in India are also briefly outlined.
352 BUMC PROCEEDINGS 2001;14:352–357
The technological advances of the past century tended tochange the focus of medicine from a caring, service-oriented model to a technological, cure-oriented model.
Technology has led to phenomenal advances in medicine and
has given us the ability to prolong life. However, in the past few
decades physicians have attempted to balance their care by re-
claiming medicine’s more spiritual roots, recognizing that until
modern times spirituality was often linked with health care.
Spiritual or compassionate care involves serving the whole per-
son—the physical, emotional, social, and spiritual. Such service
is inherently a spiritual activity. Rachel Naomi Remen, MD, who
has developed Commonweal retreats for people with cancer, de-
scribed it well:
Helping, fixing, and serving represent three different ways of see-
ing life. When you help, you see life as weak. When you fix, you
see life as broken. When you serve, you see life as whole. Fixing
and helping may be the work of the ego, and service the work of
the soul (1).
Serving patients may involve spending time with them, hold-
ing their hands, and talking about what is important to them.
Patients value these experiences with their physicians. In this
article, I discuss elements of compassionate care, review some
research on the role of spirituality in health care, highlight ad-
vantages of understanding patients’ spirituality, explain ways to
practice spiritual care, and summarize some national efforts to
incorporate spirituality into medicine.
COMPASSIONATE CARE: HELPING PATIENTS FIND MEANING IN
THEIR SUFFERING AND ADDRESSING THEIR SPIRITUALITY
The word compassion means “to suffer with.” Compassionate
care calls physicians to walk with people in the midst of their
pain, to be partners with patients rather than experts dictating
information to them.
Victor Frankl, a psychiatrist who wrote of his experiences in
a Nazi concentration camp, wrote: “Man is not destroyed by suf-
fering; he is destroyed by suffering without meaning” (2). One
of the challenges physicians face is to help people find meaning
and acceptance in the midst of suffering and chronic illness.
Medical ethicists have reminded us that religion and spiritual-
ity form the basis of meaning and purpose for many people (3).
At the same time, while patients struggle with the physical as-
pects of their disease, they have other pain as well: pain related
to mental and spiritual suffering, to an inability to engage the
deepest questions of life. Patients may be asking questions such
The role of spirituality in health care
CHRISTINA M. PUCHALSKI, MD, MS
From The George Washington Institute for Spirituality and Health (GWish), The
George Washington University Medical Center Departments of Medicine and
Health Care Sciences, and The George Washington University, Washington, DC.
Presented at Baylor University Medical Center on February 28, 2001, as the Baylor-
Charles A. Sammons Cancer Center Charlotte ...
Holly Thacker, Update on: Menopause, Hormone Therapy, Sex, Politics, and the ...Cleveland HeartLab, Inc.
This document provides an overview and summary of a presentation on menopause, hormone therapy, cardiovascular health, and women's health issues. It discusses the aftermath of the Women's Health Initiative study 12 years later, compares risks of hormone therapy to other medications, and examines risk/benefit ratios of hormone therapy for cardiovascular disease. It also addresses politics surrounding women's health issues and "war on women" narratives related to hormone therapy. The presentation aims to provide an updated perspective on these issues based on newer research findings.
This document is an introduction to the book "Fit for Life" which presents principles of natural hygiene and proper food combining to achieve health and fitness. The book argues that diets don't work long term and instead promotes balancing food energy intake with output through eating high water content and properly combined foods to achieve metabolic balance. It claims the standard medical advice on nutrition is outdated and promotes an energy-based approach focused on wellness rather than illness. The introduction argues the book provides an important foundation for integrative medicine and a new paradigm focused on prevention through lifestyle rather than treatment of symptoms.
1) The WHI study found small increases in cardiovascular risks and breast cancer for women taking combined estrogen and progestin HRT. However, the absolute risks for individual women were very small.
2) The results do not necessarily apply to lower drug doses, different formulations, or non-oral routes of administration. Absolute risks were far smaller than relative risks suggested.
3) The main goal for women's health practitioners should be maintaining overall health and disease prevention for postmenopausal women, not long-term hormonal treatment alone. Alternative non-hormonal strategies also exist.
The document discusses controversies around the management of perimenopause and postmenopause. There are debates due to a lack of proper evaluation of published results, ignoring the whole woman in medical practice, political lobbying, and a lack of scientific honesty. The document also summarizes discussions and conclusions from several international symposiums on menopause, including debates between European and US perspectives on the implications of clinical trials like WHI for cardiovascular disease and cancer risk in younger women. Overall, the document examines ongoing controversies and perspectives regarding hormone therapy management in the menopausal period.
Este documento resume uma reunião científica sobre a saúde da mulher madura. Aborda temas como o envelhecimento com ou sem terapia hormonal, a abordagem holística à saúde da mulher, e como melhorar a qualidade de vida das mulheres mais velhas através de estratégias preventivas e terapêuticas.
This document summarizes key learnings from major observational studies and clinical trials on menopause. It discusses that systemically administered progestogens may negate some benefits of estrogens and slightly increase breast cancer risk with treatment durations over 5 years. It notes that isolated estrogens did not impact breast cancer risk in hysterectomized women compared to controls in WHI. It also states that metabolic effects of estrogens and progestogens may differ based on administration route and regimen of sequential vs. continuous combined therapy.
El documento critica a los "terroristas hormonales" que imponen reglas sobre la práctica clínica sin experiencia. Argumenta que los estudios epidemiológicos como el WHI tienen validez interna pero no externa, y que los riesgos asociados con la THR son mínimos. Aboga por que los médicos informen a las mujeres para que tomen sus propias decisiones sobre el tratamiento de
Este documento resume a IX Reunião Científica da SPM. Apresenta informações sobre envelhecimento com ou sem terapia hormonal substitutiva, abordando o assunto de uma perspectiva holística que considera fatores biopsicossociais. Discute também a importância de ações preventivas e terapêuticas para promover a saúde e qualidade de vida das mulheres em idade madura.
The document discusses controversies around the management of menopause and quality of life (QoL) for menopausal women. It discusses two types of medical practice - individual clinical medicine and population-based social medicine. It argues practitioners should not overemphasize epidemiological associations that are not necessarily cause-effect findings. The document also discusses interactions between cardiovascular disease, osteoporosis and obesity, and reviews evidence that hormone therapy may be safe and effective for relieving menopausal symptoms in younger women.
Este documento presenta un resumen de las nuevas perspectivas en el manejo de la mujer posmenopáusica. El autor discute los riesgos de depender exclusivamente de la evidencia de estudios epidemiológicos y los medios de comunicación para determinar la práctica clínica, y enfatiza la importancia de considerar la experiencia clínica. También advierte sobre los riesgos de desinformación y alarmismo cuando solo se consideran riesgos relativos sin tener en cuenta riesgos absolutos.
This document discusses the interpretation of results from the Women's Health Initiative (WHI) study on hormone therapy (HT).
[1] The WHI study was not designed to study the effects of HT in symptomatic women during the early postmenopausal period. It studied older women, on average over 10 years past menopause, using a single continuous regimen of HT.
[2] Initial reports of increased health risks from the WHI study were overstated and not justified based on further analysis, particularly for peri- and early postmenopausal women. More recent analyses show HT may have benefits for cardiovascular health when started soon after menopause.
What has been learned from the major observationalfalcaoebarros
The document discusses 4 main lessons learned from major observational studies and clinical trials on hormonal treatments: 1) Progestagens may suppress some benefits of estrogens and slightly increase breast cancer risk with long-term use; 2) Estrogens alone did not increase breast cancer risk; 3) Metabolic effects of hormones differ by route and regimen; 4) Hormones are effective for vasomotor symptoms but not secondary cardiovascular prevention. It also discusses the need for evidence-informed practice over strictly evidence-based medicine and emphasizes balancing risks and benefits of treatments tailored to individual needs and preferences.
This document discusses the crisis facing women and physicians regarding hormone replacement therapy (HRT) and menopause. It notes that volcanic studies like the Women's Health Initiative have spread wrong information about HRT, scaring women and doctors about side effects like breast cancer. As a result, many women give up HRT and suffer from vasomotor symptoms, while doctors fail to persuade them to continue HRT due to its benefits outweighing risks. The document will focus on HRT and breast cancer, reasons for doctors' failed persuasion, and lessons learned from menopausal women over 40 years.
1. Are hormones the only best tools to
drive women into
a healthy geronarche ?
by
Manuel Neves-e-Castro,M.D.
Neves-e-Castro,M.D
Clinica de Feminologia Holistica
Lisboa/Portugal
Lisboa/Portuga
E-mail: manuel@neves-e-castro.org
Website: http://neves-e-castro.pt
The 5th International Symposium of the
Portuguese Menopause Society
Porto, October 2011
2. Hormonal Treatments
are very good
for symptom relief
to improve quality of life
for the prevention of some diseases
3. For some in menopause,
hormones may be the only option
“There is no alternative treatment that works
very well, whether it’s a drug or over-the-
counter herbal preparation.”
Dr. Deborah Grady
4. But…
Hormonal Treatments
are far from being enough…
enough
• To maintain a climacteric woman in good
health
• To add more years to her life
• To add more life to her coming years
5. The “stay-in-good-health” issue
Good counselling techniques
by
Manuel Neves-e-Castro,M.D.
Neves-e-Castro,M.D
The 6th Amsterdam Menopause Symposium
September 2010
6. A good counselling technique
is to demonstrate and persuade women that
• lifestyle modifications are independent of the
use of drugs, and may
• diminish the need to use drugs to prevent
diseases and preserve Health
7. I shall talk about...
• Life Style Medicine
• Aging
• Genetics
• Psychosomatics
• Hormonal and non-Hormonal treatments
9. “Our main goal, as attending physicians
of postmenopausal women, is the
maintenance of their health and the
primary and secondary prevention of the
diseases, which are more prevalent after
age 50”.
Neves-e-Castro M. When hormone replacement therapy is not
possible. The Management of the Menopause. The Millennium
Review, Parthenon 2000:91-102.
10. What is a menopausal woman?
woman
she is an individual with a name
she is a woman in distress caused by
symptoms and psycho-sociocultural
influences
she is a woman who is growing in age
she is a woman who became hypo estrogenic
MNC
11. menarche menopause
postmenopause
Puberty reproductive years Climacteric
gerontarche
geronarche
Fertilarche Fertilpause
Infants adolescents adults aged old
quality of life
compression
morbidity
Chronobiology
The Time Table of a Woman’s Life Span
M.Neves-e-Castro,2008
21. LIFESTYLE MEDICINE:
MEDICINE
TREATING THE
CAUSES OF DISEASE
Mark A. Hyman, MD; Dean Ornish, MD;
Michael Roizen, MD
ALTERNATIVE THERAPIES, NOV/DEC 2009, VOL. 15, NO. 6;12-14
26. What is Wellness?
Wellness is more than simply the absence of
illness
It is instead a state of optimal health including all
aspects of our Being :
Body,
Mind and
Soul.
http://www.integrative-medicine.com.au
27. Lifestyle Medicine
is defined as the “evidence-based practice of
assisting individuals and families to adopt
and sustain healthy behaviors that can
improve health and quality of life.”
Lianov L and Johnson M. JAMA 2010;304(2):202-3
28. The principles of
Lifestyle Medicine
are foundational to
health promotion,
disease prevention and
chronic disease management.
management
Lianov L and Johnson M. JAMA 2010;304(2):202-3
29. Lifestyle Medicine
The practice of lifestyle medicine covers
primary prevention (preventing a disease
from developing),
secondary prevention (modifying risk factors
to avert the disease) and
tertiary prevention (rehabilitation from a
disease state and prevention of
recurrence).
30. Lifestyle Medicine
requires the patient
to change their high risk health behaviors
to adopt a lifestyle that includes health
behaviors that will help to reverse the
pathology and or reduce the likelihood of
disease progression.
31. Lifestyle modifications included a
lowfat (10% of calories from fat),
whole foods,
plant-based diet high in fruits,
vegetables,
unrefined grains,
legumes, and
low in refined carbohydrates;
moderate aerobic exercise (walking 30 min/day, 6
days/week);
stress management (gentle yoga-based
stretching, breathing, meditation, imagery, and
progressive relaxation techniques 60 min/day, 6
days/week), and a 1-h group support session
once per week.
32. PHYSICIAN COMPETENCIES FOR PRESCRIBING
LIFESTYLE MEDICINE
Physicians cannot abdicate their responsibility
for effecting behavior change in their patients
and for leading change within their practices.
Lianov L and Johnson M. JAMA 2010;304(2):202-3
33. ‘Lifestyle Medicine’
Exercise and nutrition are the ‘penicillin’ of
Lifestyle Medicine;
psychology is the ‘syringe’
through which these are delivered.
Egger G, Binns A and Rossner S. Med J Aust. 2009 Feb 2;190(3):143-5.
34. Minimum amount of physical activity for
reduced mortality and
extended life expectancy
15 min a day or 90 min a week
of moderate-intensity exercise
might be of benefit
Wen CP et al –The Lancet ,2011(1 Oct) 378(9798):1244-1253
35. PHYSICIAN COMPETENCIES FOR PRESCRIBING
LIFESTYLE MEDICINE
the majority of physicians are not following
these guidelines, citing lack of knowledge,
skill, or confidence in counselling patients
about lifestyle interventions.
Lianov L and Johnson M. JAMA 2010;304(2):202-3
36.
37. Lifestyle Medicine
can prevent risk factors
• We are today using only medicines to
modify risk factors but we are not looking
at what causes risk factors.
• Women’s health must be primarily the
medicine of lifestyles
39. Effect of Intensive Lifestyle Changes on
Endothelial Function and
on Inflammatory Markers of Atherosclerosis
Intensive lifestyle changes have been
shown to
regress atherosclerosis,
improve cardiovascular risk profiles, and
decrease angina pectoris and cardiac
events.
events
Dod HS et al. Am J Cardiol 2010;105:362–367
40. Combined impact of lifestyle factors on mortality:
prospective cohort study in US women
even modest differences in lifestyle
can have a
substantial impact on reducing
mortality.
Van Dam RM, Li T, Spiegelman D et al.BMJ 2008;337:a1440
41. The recent INTERHEART study of
30.000 patients from 52 countries
found that
almost 95% of coronary heart disease
could be prevented by changing diet and
lifestyle.
And the only side effects are beneficial ones.
Ornish D et al. The Journal of Urology 2005;174:1065-1070
42. Brown CH, Baidas SM, Hajdenberg JJ, et al. Lifestyle interventions in the prevention and
treatment of cancer. American Journal of Lifestyle Medicine. 2009;3(5):337-348
44. Is aging a disease ?
The fact that genes explain only part of individual
varibility in aging means that aging
75% must be accounted for by other factors:
- life style variables
(nutrition, exercise)
- powerful effects of environment
(effects on older age)
45. Anti-Aging ?
One cannot stop aging ...
One cannot stop growing older ...
but
One can prevent
senescence !
46. Restricting caloric intake
Is the most proven method to
extend life
Avoid high caloric foods
Try short term fasting
Undereating is anti-aging !
47. Lifestyle and nutrition, caloric restriction,
mitochondrial health and hormones:
Scientific interventions for anti-aging
Vitetta L and Anton B;
Clinical Interventions in Aging 2007:2(4) 537–543
48. Vitetta L and Anton B; Clinical Interventions in Aging 2007:2(4) 537–543
49. Mediterranean Diet, Lifestyle Factors, and
10-Year Mortality in Elderly European
Men and Women
Among individuals aged 70 to 90 years, adherence to a
mediterranean diet lifestyle is associated with a more
than 50% lower rate of all-causes and cause-specific
mortality.
Knoops K et al. JAMA 2004;292:1433-9
50. Okinawa Island:
Island
A model of “healthy” aging
The exceptional longevity of the Okinawa
population may result from a combination of
favorable factors and not only genetic
determinants.
Nguyen C. NPG Neurologie-Psychiatrie-Geriatrie 2008 ;8(43):35-41.
51. Okinawa Island:
Island
A model of “healthy” aging
The association of a protect environment with a way
of life which combines specific
food habits,
low energy intake,
physical activities,
stress reduction,
good familial support and
rich social relations
could explain this exception despite the low income
in this population.
Nguyen C. NPG Neurologie-Psychiatrie-Geriatrie 2008;8(43):35-41 .
53. There are two forms of age :
chronological age i.e. how old you are in
years
and
biological age whereby the cells of some
individuals are older (or younger) than
suggested by their actual age.
Issued on 07 February 2010 by University of Leicester at
http://www2.le.ac.uk
57. The best characterized function of the
telomeric complex is to protect the
chromosome ends from degradation
Werner C, Hanhoun M, Widmann T, et al. J Am Coll Cardiol 2008;52:470–82
58.
59. Telomers
• The little tips of chromosomes get shorter
every time a cell divides,and this shortening is
a mark of cellular aging.
• If they get short enough,the cell dies or stops
dividing
• Exercise correlates with longer telomers,as
does levels of omega-3 fatty acids in the blood
Elizabeth Blackburn
Nobel Laureate 2009
60.
61.
62.
63.
64. Genes reveal 'biological aging'
From birth, every time a cell divides, the
telomeres get shorter and there is some
evidence that people with shorter telomeres,
may be at higher risk from age-related illness.
illness
Feb.2010 at http://crabsalloverhealth.blogspot.com/
65. • Telomerase repairs and lengthens telomeres,
which cap and protect the ends of
chromosomes housing DNA.
• As people age, telomeres shorten and cells
become dying.
dying
Published on 16th Sept.2008 at http://crabsalloverhealth.blogspot.com
66. Telomers
These cellular clocks,known as telomers,may
act as barometers of wether a person will
remain healthy or not
Elizabeth Blackburn
Nobel Laureate 2009
67. Clean living slows “cell aging”
It is the damage and death of cells that causes
aging and disease in people.
Several factors such as smoking, obesity and
a sedentary lifestyle are associated with
shorter-than-average telomeres.
Published on 16th Sept.2008 at http://crabsalloverhealth.blogspot.com
68. Sedentary life 'speeds up aging'
Leading a sedentary lifestyle may make us
genetically old before our time, a study suggests:
A study of twins found those who were physically
active during their leisure time appeared biologically
younger than their sedentary peers.
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/7212698.stm
Published: 2008/01/29
69. Leukocyte telomere length is preserved with aging in
endurance exercise-trained adults and related to maximal
aerobic capacity
• LTL is preserved in healthy older adults who
perform vigorous aerobic exercise and is positively
related to maximal aerobic exercise capacity.
• This may represent a novel molecular mechanism
underlying the "anti-aging" effects of maintaining
high aerobic fitness.
Larocca TJ, Seals DR, Pierce GL. Mech Ageing Dev. 2010;131(2):165-7
70. Increased telomerase activity and
comprehensive lifestyle
changes: a pilot study
Ornish D et al. Lancet Oncol 2008; 9: 1048–57
71. Telomerase activity in peripheral-blood
mononuclear cells
Ornish D et al. Lancet Oncol 2008; 9: 1048–57
72. Lifestyle medicine stimulates telomerase
thus avoiding DNA damage and
maintaining chromossomal integrity.
the incorporation of new lifestyles may lead
to a better compliance and better
outcomes in terms of health and longevity
74. Vitamin D
for Cancer Prevention:
Global Perspective
Garland CF, et al
Ann Epidemiol 2009;19:468–483.
75. Vitamin D for Cancer Prevention: Global
Perspective
Raising the minimum year-around serum 25(OH)D
level to 40 to 60 ng/mL (100–150 nmol/L) would
prevent
• 58,000 new cases of breast cancer and
• 49,000 new cases of colorectal cancer each year,
and
• ¾ of deaths from these diseases in the USA and
Canada.
There are no unreasonable risks from intake of
2000 IU per day of vitamin D3
Garland CF et al. Ann Epidemiol 2009:19(7);468-483
76. Relative risk of breast cancer mortality
Garland CF et al. Ann Epidemiol 2009:19(7);468-483
81. Exactly how psychological and social factors,
personal beliefs, and stress affect the
development of disease continues to be
studied.
It is known, however, that the mind and
body communicate constantly.
what the mind thinks, perceives, and
experiences is sent from our brain to the rest
of the body.
82. Depression and Cancer
Depression also affects components of
immune function that may affect
cancer surveillance.
Spiegel D. Biol Psychiatry 2003; Vol 54(3):269-82
83. Effect of a psychosocial treatment on survival
of patients with metastatic breast cancer
Survival from time of randomisation and
onset of intervention was:
- a mean 36.6 (SD 37.6) months in the
intervention group
- compared with 18.9 (10.8) months in the
control group.
Spiegel D. Lancet 1989; 2(8668):888-91
84.
85. A stress response pathway
regulates DNA damage…
through β(2)-adrenoreceptors and β-arrestin-1
The human mind and body respond to stress… by
activating the sympathetic nervous system and
secreting the catecholamines adrenaline and
noradrenaline in the 'fight-or-flight' response.
Hara Mr et al. Nature 2011 Aug 21.
86. A stress response pathway
regulates DNA damage…
through β(2)-adrenoreceptors and β-arrestin-1
When chronic… epidemiological studies
strongly indicate that chronic stress leads to
DNA damage.
Hara Mr et al. Nature 2011 Aug 21.
87. A stress response pathway
regulates DNA damage…
through β(2)-adrenoreceptors and β-arrestin-1
This stress-induced DNA damage may promote :
ageing,
tumorigenesis,
neuropsychiatric conditions
Hara Mr et al. Nature 2011 Aug 21.
88. A stress response pathway
regulates DNA damage…
through β(2)-adrenoreceptors and β-arrestin-1
“Our results … reveal how DNA damage may
accumulate in response to chronic stress”.
Hara Mr et al. Nature 2011 Aug 21.
89.
90.
91.
92.
93. Chronic stress - reduces telomere lenght maintenance
A SOBERING THOUGHT ...
“Every stress leaves an
indelible scar and the
organism pays for its
survival after a stressful
situation by becoming a
litle older”. (Hans Selye)
94.
95. Psychosomatics
Benson Institute for
Mind Body Medicine
The Relaxation Response
96. the relaxation response is a physical state of deep
rest that changes the physical and emotional
responses to stress (e.g., decreases in heart rate,
blood pressure, rate of breathing, and muscle
tension).
When eliciting the relaxation response:
• Your metabolism decreases
• Your heart beats slower and your muscles relax
• Your breathing becomes slower
• Your blood pressure decreases
• Your levels of nitric oxide are increased
100. • Too much concerns and interest about HRT
• Too little attention to the life styles that
prevent risks, diseases and increase longevity
101. Updated IMS recommendations on
postmenopausal hormone therapy and
preventive strategies for midlife health
D. W. Sturdee and A. Pines on behalf of the
International Menopause Society Writing Group
CLIMACTERIC 2011;14:302–320
102. Symptomatic changes in postmenopause
with different methods of hormonal
therapy
HT should be initiated for relief of symptoms
through suitable selection of the route of
administration and drug that has the greatest
effect on the predominant symptoms of each
patient, for which medical evaluation was
sought.
Hernandez-Valencia M et al. Open Journal of Preventive Medicine 2011
Vol.1, No.2, 20-24
103. Individualizing Hormone Therapy to
Minimize Risk
Estrogen is a medication that can decrease
mortality, decrease cardiovascular disease,
decrease osteoporosis fracture, urogenital
atrophy and dementia. Strategies to minimize risk
include initiation of therapy within 10 years of
menopause or under 60 years of age, using low-
dose estrogen, adding a low-dose progestin in
women with a uterus, and use of transdermal
therapy in women with risk factors for
cardiovascular disease.
Donna Shoupe. Women's Health. 2011;7(4):475-485.
104. Timing of hormone therapy,
type of menopause, and
coronary disease in women
Shufelt CL et al. Menopause 2011;18(9):943-950
105.
106. HRT and breast cancer risk:
a realistic perspective
It should be remembered that women using CEE alone
showed a significant decrease in breast cancer risk in
the WHI trial and follow-up. Even if combined
estrogen-progestogen HRT did cause an increase in
breast cancer risk, and this is not proven, the
magnitude of that risk is small, and less than that risk
seen with many lifestyle factors.
factors
HRT is a benefit, not a risk,
for those women requiring it.
Stevenson JC, Hodis HN, Pickar JH, Lobo RA; Climacteric (Aug 2011)
112. To know
the disease that a woman has
is as important as
to know
the woman who has the disease
William Osler
113. Let us not medicalize the Menopause..
instead…
Let us holistically approach the
Climacteric and aging women.
women
MNC
114. Holistic Model
The aim of the therapy is not only to
produce a physical cure but also
to cure whole person.
Ruiz R, et al. La incorporacion de um nuevo modelo en medicina:
consequencias teórico-práticas. Aten Primaria 1992;10:629-34
115. I am not a
Menopauselogist…
instead
my Speciality (?!...) is
Women’s Holistic Health
116.
117. The Take Home
Messages
1. Promote changes in Life Style : they avoid risk factors that
cause Diseases.
2. See if you can make the Biological Age to be younger than
the Chronological Age.
3. Promote Mental Health,proper Nutrition and frequent
Health
Exercice ,based on what one knows about the Telomers.
4. Give Vitamin D to everybody
5. Remember that Estrogens are the best treatment for
Vasomotor Symptoms and to improve Quality of Life.
6. Hormonal Treatments have more benefits than risks if
started early in the postmenopause
7. The Wellness of a Woman is the TARGET !
118. And...as I told you before,
The best Anti-Aging (?)
(Anti-Senescence !) Treatment
is
The practice of GOOD MEDICINE