Erectile Dysfunction and Low Testosterone Levels Linked to Death by Major Cariovascular Events?

As if having erectile dysfunction isn’t bad enough, researchers have found that many men with erectile dysfunction and low testosterone levels have an increased chance of dying of a major cardiovascular event. First it is important to understand what erectile dysfunction is.

Erectile dysfunction is a male’s repeated inability to have or sustain an erection. An erection occurs due to the filling of the corpora cavernosa of the penis with blood. The corpora cavernosa is a chamber of the penis made up of spongy tissue. After the mind is stimulated and sends a signal to the local nerves causing the muscles of this chamber to relax, blood begins to flow into the spongy tissue. The increased blood flow will create pressure that causes the penis to expand. A membrane called the tunica albuginea traps the blood in the spongy tissue of the chamber. This helps sustain the erection.

The components of the penis involved in an erection are shown in the figure to the right. When the muscles contract again, the blood flow is stopped allowing the erection to be reversed. If a problem occurs in any of the steps leading to an erection, the erecting may not occur or might not be sustainable.

Now how does testosterone affect an erection, or contribute to erectile dysfunction disorder? Testosterone actually does not directly affect an erection. It has an indirect affect because it helps stimulate a male’s sexual interest. Without the testosterone fueling a man’s sexual interest, the stimulation for an erection may not happen or may not be enough for a strong erection could occur.

5% of men who have erectile dysfunction have been diagnosed with low levels of testosterone. This small portion of men were also found to have a higher rate of mortality caused by a major cardiac event. Neither the low testosterone, or erectile dysfunction were directly connected to the cardiac event, however, the men with the lowest testosterone levels were found to have a statistically significantly higher rate of mortality than the men with normal or higher testosterone levels (the reason for this is still to be determined). The information leading to this conclusion came from a study which was conducted on 1687 subjects with erectile dysfunction. 137 of the patients had a major cardiac event within 4.3 years, and 15 of them died.

The researchers hope to conduct another study with more test subjects to help further solidify their hypothesis that men with erectile dysfunction coupled with low testosterone have a greater chance of dying due to a major cardiac event. However, this hypothesis was proven with the sample size used.

Sources:
http://www.sciencedaily.com/releases/2010/04/100426181612.htm
http://kidney.niddk.nih.gov/kudiseases/pubs/impotence/
http://www.whitelotuseast.com/Erection.htm

Can ghrelin levels and leptin levels reduce your weight without exercise?

So constantly I argue with my mother to work out if she wants to lose weight, and tell her that it’s the only way. Later she tells me that if she eats right she can still lose weight. Then echos of Dr. Vanata, my nutrition professor, saying Ghrelin over and over came into my mind. Ghrelin is a peptide hormone produced by the stomach that stimulates feeding which is sometimes called the hunger hormone. The levels of ghrelin rise prior to a meal and fall quickly after consumption of food. The rise in Ghrelin also stimulates the hormone Neuropeptide Y (NYP) which is a hormone like factor in the brain that powerfully stimulates appetite. Along with Ghrelin, Leptin also stimulates the NYP. Leptin is a hormone produced by adipose cells that signals the amount of body fat content that influences food intake. Opposing signals from ghrelin and leptin link to how much they both stimulate NYP which maintains weight in the body. So can Ghrelin and leptin be controlled in weight loss was my next question.

Based on a study in Washington University with thirteen obese subjects ghrelin was tested to see if it could be regulated with proper dieting. All subjects were at least 18 years old and had had stable body weight for at least three months. Criteria for exclusion included chronic medical or psychiatric illness, pregnancy, tobacco use, substance abuse, consumption of more than two alcoholic drinks per day, aerobic exercise for more than 30 minutes three times per week, and previous gastrointestinal surgery. In this study leptin, insulin, and ghrelin levels were measured to determine if their levels changed throughout the study. At the end of the study there was weight lost and it was associated with lower levels of leptin, insulin, blood pressure, and increase insulin sensitivity. Researchers did this by spanning meals within 4 to 5 hours of each other with low-fat, high-protein, liquid-formula diet of 1000 kcal per day, supplemented with daily multivitamins and minerals, for three months. Subjects then underwent a gradual transition over the course of two weeks to a solid diet containing fat, protein, and carbohydrates. Ghrelin levels rose after weight loss in this study and led to conclusions in how it operates in our metabolism. Exogenous ghrelin decreases the metabolic rate and increased ghrelin beyond what the body is regularly used to increases body weight. The study concluded plasma ghrelin levels rise with diet-induced weight loss and suggests that increased levels of circulating ghrelin may participate in the adaptive responses that constrain such weight loss.

http://www.ncbi.nlm.nih.gov/pubmed/12023994

Electolyte Replacement

Chemically, an electrolyte is a substance that, when in fluid, dissociates into electrically charged ions. The positive or negative charge carried by these ions is what allows our body's cells to use electrolytes to carry electrical impulses throughout the body. When one is going through strenuous exercise, or athletic events, electrolytes are crucial in maintaining your body's ability to transmit nerve impulses and contract muscles. Electrolytes also maintain other biological balances too, including water balance and distribution to working cells as well as acid-base balance.

The electrolytes we need to perform these functions are sodium, chloride, potassium, magnesium and calcium. In everyday situations with the food sources that are abundant in America it is easy to retain balance in electrolytes. However under strenuous conditions electrolytes are lost through sweat at a higher rate than normal. Sodium and potassium are lost at the highest rate, while magnesium and calcium are lost at a much lower rate.

Sweat loss rates can range from 0.3 to 2.4L per hour (roughly a half pound to 5 pounds per hour). The easiest way to find how much you sweat when under strenuous activity is to weigh yourself before and after. Each pound of weight lost equates to approximately 2 cups of fluid. Although individual concentrations will vary widely, one pound of sweat contains approximately 80-100mg of potassium and 400-700mg of sodium.

Noticeable signs of electrolyte imbalance are the same as dehydration symptoms. This is because the imbalance of electrolytes and dehydration symptoms go hand in hand. These symptoms are cramps, nausea, feeling lightheaded, etc.

I have always wondered what is better, sport drinks or water. Water is good to rehydrate, however it does not replace electrolytes. Before or after strenuous activity it is more beneficial to drink water and eat foods high in electrolytes such as bananas. This is because food has much higher amounts of electrolytes than sport drinks do.

However, during long amounts of exercise sport drinks are the way to go. Despite providing your brain and muscles with a fresh supply of energy, the carbohydrates in sports drinks have benefits related to hydration and electrolyte replacement. Research has shown that glucose, the primary sugar in most sports drinks, can increase the absorption of both water and sodium. Furthermore, sports drinks containing sodium increase fluid retention and stimulate the thirst mechanism, which can often be delayed or masked during intense workouts or competitions. When considering sports drinks to consume during exercise, look for ones containing sodium and potassium as well as around 14-16g of carbohydrate per 8 fluid ounces. This concentration is high enough to provide adequate carbohydrates for energy but not too high that it would cause cramping, nausea and/or diarrhea.

Other research has shown that combining glucose with fructose help promote a greater absorption rate than just glucose alone. This is a great finding and I expect sport drinks to start having mixtures of fructose and glucose in them. I am very curious as to why this is and believe research needs to be done to find out why this is on the physiological level.

By getting the adequate electrolytes replaced, along with water to stay hydrated, one will find that they have better strength, control, and endurance throughout their strenuous activity.

Replacement Explained
Fructose/Glucose
Electrolytes

Effects of Electrolyte Imbalance

The effects of electrolyte imbalance are typically not a common concern for most people. I know that worrying about having the right amount ions present in my body fluid is not something I think about on a daily basis. Although electrolyte imbalance does not seem to important, the effects on the body can be severe. Electrolytes are chemicals dissolved in the body fluid that become ions in solution. Electrolytes have the ability to conduct electricity and are found in body fluid, tissue and blood. An imbalance in electrolytes can cause our cells and organs to not function properly. Healthy muscle, heart, and nerve functioning rely on the proper balance of electrolytes too.

There are three substances that help balance electrolytes; sodium, potassium, and calcium. Sodium and potassium are the major substances that can affect electrolyte imbalance. Both substances are filtered and excreted in urine and feces according to what our bodies need. Having a poor diet, dehydration, medication, and disease can cause there to bee too much or too little sodium and potassium levels in the body. Too much sodium is known as hypernatremia and too little sodium is known as hyponatremia. Having too much or too little of sodium in the body can be fatal. The most common electrolyte imbalance is hypontremia which is associated with nephrotic syndrom, a kidney disease, where large amount of proteins are leaked from the blood into the urine. Young people and older adults are more likely to experience this type of electrolyte imbalance rather than young adults for some reasons. Too much potassium is known as hyperkalemia and too little potassium is known as hypokalemia. Hypokalemia can affect the nervous system and raise blood pressure levels, while hyperkalemia can lead to an increased chance for arrhythmias (irregular heartbeat). Diabetes Insipidius can also be associated with electrolyte imbalance and metabolism which causes too much urine to be produced and increased levels of thirst.

Most common electrolyte imbalance is due to irregular levels of sodium, potassium, and calcium levels, but there are also less common reasons for the imbalance such as dehydration, severe diarrhea, or vomiting. Electrolytes are vital for homeostasis throughout the body and it is important for there to be a proper balance of electrolytes to avoid these types of effects or the vital outcomes that an imbalance of electrolytes can have on our bodies.

http://ijpba.info/ijpba/index.php/ijpba/article/view/183/134

Are Nitric Oxide Levels in Urine an Indicator for Oncoming Hypertension?

As we saw in Dr. Beall's research, NO appears to have a large effect on dilating blood vessels and increasing blood flow in Tibetan highlanders. This research paper I found asks the question "Is NO in urine an indicator for risk of high blood pressure?" This deals with those who may have high NO production at sea level rather than those at altitude and the effect that has on their blood pressure. This study takes information from normotensive and hypertensive subjects in order to compare differences in NO levels in the urine. The researchers in this study hypothesized that oncoming high blood pressure could be predicted by measuring NO levels in normal blood pressure subjects. In order to have a baseline for all subjects to be judged on they said that anyone with a systolic blood pressure of greater than 140 mmHg or a diastolic higher than 90 mmHg was considered "hypertensive". They then took took samples from 62 subjects- one base line and then another later on. Taking a beginning sample and then a later sample gave them the opportunity to see if certain subjects developed hypertension and then compare the samples to see differences in NO concentration.

The results of this study showed that subjects with less NO metabolites in their urine actually were more prone to hypertension. This was shown the best in the subjects that progressed from normo to hypertensive throughout the study. These subjects are shown in the two graphs on the far right of the figure above. As these graphs show, subjects with greater blood pressure have less NO metabolites. This conclusion makes sense because higher levels of NO would cause blood vessel dilation which, in turn, would lower blood pressure not raise it. So a low amount of NO in the urine is a good indicator for high blood pressure.

This is an interesting finding because it gives the opportunity for doctors to

further predict future hypertenstion in patients. If a patient has a family history

of high blood pressure they can also look at NO metabolite concentration in the urine

to get a better idea of whether they are at a higher risk.

DOI: 10.1177/174182671038941

Good News About a Very Bad Cancer

Pancreatic carcinoma, or cancer of the pancreas, is one of the most deadly forms of cancer that has hit mankind, killing majority of it's victims within a few months of diagnosis. The pancreas is an organ that is involved in the creation and release of enzymes that enable the body to absorb nutrition for the body. The pancreas is also responsible for the production of insulin and glucagon. It is typically more common in women than in men and smokers versus non-smokers and the risk of getting pancreatic cancer also increases with age. The reason that this cancer is so deadly is because it involves co-opting leukocytes and instead of the WBC's attacking the cancerous cell, they enter it and "wall it off" from the ani-tumor aspects of the immune system.


Most commonly, pacreatic cancer is found in the form of a tumor and it may grow undetected without any kinds of symptoms at first. Because of this, when the cancer is discovered it is often in fairly advanced stages. Early symptoms may include; pain or discomfort in the belly/abdomen region, loss of appetite and weight, jaundice, dark urine, fatigue/weakness, and nausea and vomiting. The tests that are performed include MRI's, CT scans of the abdomen, Ultrasounds, and also a biopsy. Like previously mentioned, by the time the cancer is detected, little can be done in the way of removal of the tumor. A Whipple Procedure can be performed as well as radiation thereapy and chemothereapy may be recommended for patients. Although these treatments have showed some small success, scientists are now reporting that there is a new treatment that kick-starts a specific immune cell that extends the lives of a pancreatic patients by more than 30%.

Pancreatic cancer is extremely tricky especially since it uses the WBC's previously mentioned for it's own benefit however, the new thought that scientists have come upon is that they could activate CD40 which is a receptor protein used by defensive cells. Research shows that the activation of the CD40 is very necessary to the immune cells who are responsible for the attack on tumors in the body.

Scientists began dosing patients with a standard chemotherapy drug, gemcitabine, and an anitbody that turns on the CD40. Results of the tests reported that the tumor size had decreased or had ceased growth in almost 70% of the patients. In other patients the treatments seemed to have shrank metastatic tumors that had spread to other parts of the body. Patients that had previously only gotten the chemotherapy treatment lived on average only 5.7 months whereas the patients included in this research had survived 7.4 months which is still grimm but this treatment is leaving hope for a more promising future.

The expected response was that the CD40 would encourage a couterattack from the T cells in the body, but instead they found that it was really macrophages that were responsible for the results. These cells were able to get through the WBC blockade that the cancer cells had made and the macrophages started to eat away at the tumor cells. These results are extremely promising and this experiment has been greeted with a lot of enthusiasm and new hope.

http://news.sciencemag.org/sciencenow/2011/03/good-news-about-a-very-bad-cance.html?ref=hp

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001283/

http://www.cancercenter.com/pancreatic-cancer.cfm?source=GOOGLEMW&channel=paid%20search&c=paid%20search:google:Google%20-%20Midwestern%20Core%20Terms%20New:Cancers:%20Pancreas:pancreas%20cancer:Broad&ef_id=ujlNj-7SswMAAMEv:20110328032154:s

Female Incontinence

We have all experienced that sudden urge to urinate and you have to do it now before it is too late. However, half of women aren’t so lucky and don’t realize they have to go until it is too late; the leakage has already occurred.

Urinary incontinence (UI) is that involuntary loss of urine. Many people will refrain from certain activities in order to avoid an embarrassing, public episode. Several types of UI exist; the most common type of UI is stress urinary incontinence which is the leaking of small amounts of urine because of physical activity such as coughing, sneezing, laughing, running, etc. Urge UI releases large amounts of urine unexpectedly because of sudden, uncontrollable contractions of bladder muscles. Overflow leakage occurs at random times because the bladder is so full that the sphincter cannot retain the urine. Transient leakage can also occur from infections or other temporary ailments. Finally, mixed UI can occur which combines certain types of UI but is usually a combination of stress and urge UI.

The cause behind incontinence lies with the muscles and nerves in the urinary system. In some cases, the muscles will contract out of nowhere. Another cause is when the sphincter muscles are not strong enough to hold the urethra shut allowing small amounts of urine to escape.

UI occurs twice as frequently in women than men due to the structure of their urinary tracts, pregnancy, childbirth, and menopause. Men and women can both get UI from: birth defects, strokes, multiple sclerosis, and certain problems that come with age. But have no fear, though this is an embarrassing condition, different treatments and cures exist to control the leaks.

Kegel exercises are the easiest way to try to control UI. They consist of contracting the bladder muscles repeatedly to strengthen them (especially the sphincter), which would hopefully help with the leakage in 3-6 weeks.

However, more cutting edge surgeries exist. Retropubic suspension uses sutures that will support the neck of the bladder that leads down to the urethra. An incision is made in the abdomen then sutures are attached to other ligaments in the pelvic region which will support the sphincter. Another surgery uses slings that can be inserted through a vaginal incision. The patient’s own tissue is used to support the bladder neck by attaching the other side to the pubic bone or just above it. Then midurethral slings are the newest, outpatient procedure that cures UI by using synthetic mesh tapes, either transvaginal tapes or transobturator slings, which are controlled through slits in the abdomen or vagina until the proper amount of support is given by the tape to the urethra. Studies show that two years after the surgeries two-thirds of women with a sling and half of women with a suspension were cured from stress UI.

Sources:

• htttp://kidney.niddk.nih.gov/kudiseases/pubs/uiwomen/

• http://news.health.com/2010/05/20/female-incontinence-surgeries-look-equally-effective/

• http://www.fibroid.com/sling/