FirstMed Consulting Blog

While it is true that smoking can give you a lift during the day especially when you are tired, it is also known that smoking can relate to that tired all the time feeling. You may think that feeling run down is a normal part of life and it is true that your energy flows in waves, therefore meaning that everyone has energy peaks and troughs throughout the day. However quitting smoking will add enormously to your energy levels after the first few weeks.

It has been reported that as early as 72 hours after stopping smoking, people’s breathing becomes easier as bronchial tubes begin to relax and energy levels increase. This in turn can be beneficial when quitting as many people worry about weight gain that can happen when people quit. Weight gain occurs as smoking actually is associated with an increased use of energy i.e. smoking increases the body’s metabolism or put another way burns upto 200 calories a day in a heavy smoker. A study done in America showed that as expected there was an energy increase between rest and active states. More relevantly, an increase of energy consumption by 3.6% occurred while at rest in a smoker when compared to a non-smoker. This was shown to be directly due to the effects of nicotine. Therefore, quitting smoking means that in turn the body’s metabolism slows.

However, the extra energy which many people experience can be put to good use increasing your exercise levels, even doing things as simple as going for a brisk walk at lunchtime or in the evening, which not only keeps weight gain one may experience to a minimal but can also improve your general health.

Tobacco (Nicotinia spp) is a broad-leafed plant of the nightshade family native to North and South America. It is thought that the first people to start to use leaves of the tobacco plant for chewing and smoking were the Mayan civilisations of Central America in approximately 1000BC. The Mayans viewed tobacco as something of an all-purpose medicine widely believing that it had some magical powers. The practise of chewing and smoking tobacco is thought to have been gradually adopted throughout Central America, spreading across to North and South America.

In 1492 Christopher Colombus was presented with “certain dry leaves” on his travels alongside fruit and spears. It is recorded that the gifts were accepted and taken back to his ship whereby the fruit was eaten and the leaves thrown away. In the same year, Rodrigo de Jerez and Luis de Torres were credited as the first Europeans to be seen smoking. Back in Spain Rodrigo de Jerez was imprisoned after his neighbours were frightened by the smoke seen coming outo f his mouth and nose and he was imprisoned for seven years. On his release, smoking was the latest craze in Spain. By 1498, Columbus visited Trinidad and Tobago, naming the latter island after tobacco.

Throughout the sixteenth century, sailors are credited with the global spread of tobacco. It is thought that tobacco was introduced to England by Sir John Hawkins in 1560. However, it was not readily accepted in England and James I (1566-1625) notably published ‘A Counterblast to Tobacco’ in 1604 in which tobacco was described as “an invention of Satan”. He went on to ban tobacco from London alehouses and introduced a tax. However, he later had a change of heart and even introduced a reduction in the tax on tobacco.

The cigar became increasingly popular in England in the 1820s before the advent of the cigarette. The birth of the cigarette is a topic of controversy among historians. While some believe that they were born from beggars in Seville who picked up the cigar ends thrown down and wrapped them in scraps of paper, others think that the first paper-rolled cigarettes were made by Egyptian soldiers fighting in the Turkish-Egyptian war. It wasn’t really until the Crimean war when British soldiers emulated their Turkish comrades rolling their tobacco in newspaper print that cigarettes were introduced to the Brits. It soon became very popular with the first cigarette factory opening in Walworth, England in 1856.

Quite rapidly a smoking culture built up and after World War 1, in the 1920s smoking became associated with a glamorous, carefree lifestyle and it also became socially acceptable for women to smoke. However, The Lancet was already writing about fears of the impact of smoking on one’s health in 1858 and in 1950 the British Medical Journal published evidence suggesting a link between smoking and lung cancer, to be followed by the announcement in 1964 by US Surgeon General Luther Terry that smoking causes lung cancer. By 1965, UK bans cigarette advertisements on television later followed by a ban for advertising cigarettes on radio in 1971. More recently in 2003, the advertisement and promotion is banned in the UK while over in New York, smoking is banned in all public places.

Tobacco can be smoked (usually in the form of a cigarette, cigar or in a pipe), chewed, “dipped” or sniffed in to the nose as snuff. Chewed tobacco is one of the oldest methods of consuming tobacco leaves known. Native Americans in both North and South America are known to have chewed tobacco, frequently mixing it with lime. These days modern tobacco meant for chewing is produced in produced in three forms; twist, plug and scrap.

Often confused with chewing tobacco is dip. In contrast, a small pinch of ‘dip’ is taken from a tin and placed inbetween the lower lip and gums. In this spot, blood vessels are plentifuol and close to the surface meaning that the nictine easily passes into the blood system. Saliva which comes into contact with the dip is very nauseating if swallowed and is commonly spitted out.

These days snuff is a generic term for finely ground tabacco although it initially referred to a dry snuff popular in the eighteenth century. European (dry) snuff was sniffed in up the nose where as American snuff was much stronger and intended to be used in dipping. When snuff was popular, it was placed in a small depression formed by three tendons below the thumb on the back on the hand before it was sniffed. This depression is know named the anatomical snuff box.

Currently, the most popular intake of tobacco is via smoking, with cigarettes leading the way. Cigarettes rarely contain pure tobacco but instead have a whole host of things added. Nicotine is the active ingredient in cigarettes and is what people become addicted to. It does however have limited carcinogenic effects. More than 4000 chemical compounds have however been identified in tobacco smoke, of which at least 43 are known to be related to carcinogenesis. The precise make up of individual makes of cigarettes varies greatly, in particular with reference to nicotine and tar content.

Unfortunately, symptoms of high cholesterol usually are very rare. Blood test is usually carried out to determine the levels of cholesterol. The symptoms are actually from the end-result of high cholesterol for health issues such as coronary disease, stroke, and peripheral vascular disease. Each of these health issues will be explained further below:

Coronary Disease – the primary symptom of coronary heart disease is called Angina (also know as chest pain). A feeling of “pressure” or “squeezing” is usually felt by patients. These types of feelings can spread to other parts of the body, such as the jaw, neck or arm. However, these feelings are usually located in the chest region.

Other symptoms include nausea, shortness of breath, sweating, light-headedness or dizziness and heart palpitations. Angina can be directly correlated to coronary heart disease and should be taken seriously. In some circumstances a short period of rest will reduce or eliminate the pains. However, whenever you feel any chest pain or any of these symptoms, you should seek medical attention as soon as possible.

Stroke – there are four main symptoms associated with stroke and it is a very sudden event with little or no warming.

* Patients feel sudden numbness or weakness of face, arm, or leg, especially on one side the body.
* Unable to speak or understand what is going nearby and causes confusion.
* Sudden inability of vision in one or both eyes.
* Dizziness, loss of balance and lack of coordination.

In addition, there are other symptoms related to stroke, they are nausea/vomiting, fever, fainting, convulsions and sometimes more serious coma.

Peripheral Vascular Disease – this disease involves arteries being narrowed or blocked which carry blood around the body. This is very serious because it slows blood down or even stops it from flowing completely. When this happens, there will be numbness and/or tingling in the lower extremities. A cold sensation might be felt and open sores or ulcers on the lower extremities might not heal properly.

Which are the symptoms of a heart attack?
The symptoms of a heart attack may be quite gentle that’s why many people take too long to recognize they need help.

The most common symptoms are a feeling of heavy pressure or deficiency, crushing pain or unusual discomfort in the centre of the chest or a feeling like indigestion. Pain or tightness may extend to the shoulders, neck or arms, or it may affect the jaws or throat, making the person feel like they’re choking. Some people don’t get chest discomfort, and only get symptoms in their arms or throat. Others don’t get pains in their arms, but their arms feel heavy or useless.

The symptoms would usually last about more than 15 minutes. They may stop, or diminish and then return. The person may sweat, feel sick, faint or be short of breath.

Many people having a heart attack won’t admit they are in trouble, or they think it’s not serious.

What should you do?
Make sure the person is resting quietly, sitting or lying down. Get them to take half an aspirin immediately (be aware they are not allergic to it). If breathless, get them to sit up. If they feel faint, get them to lie flat. Call an ambulance. If, for some reason, an ambulance can’t get there quickly enough, drive the person to hospital right away.

If you feel these symptoms yourself, or see the first signs of someone else suffering from them, don’t wait. Medical help is most important in the first few hours. Prompt medical attention can help reduce the amount of heart muscle damage and can help improve the person’s chances of survival.

Cardiac arrest
How do you know if someone has had a cardiac arrest?
The person is unconscious. Their heart has stopped beating. Their skin turns pale or blue. You feel no pulse.

What should you do?
Act as fast as possible: get someone to call for skilled help. A person who has had a cardiac arrest won’t survive unless the blood starts pumping and the body gets a supply of oxygen very quickly.

Start CPR (cardiopulmonary resuscitation). CPR involves mouth-to-mouth breathing and external heart massage through the chest.

Call an ambulance: tell the emergency services that someone has had a cardiac arrest.

My constant trawl through medical archives in search of developments in the treatment of erectile dysfunction occasionally throws out some interesting and useful information. It appears that grapefruit juice can also affect the absorption of the popular erectile dysfunction drug Viagra (Sildenafil).

Researchers in Köln, Germany, conducted a study using 24 healthy, male subjects whose average age was 29 years. The men received a glass of grapefruit juice on an empty stomach and then one hour later another glass of grapefruit juice with Viagra 50 mg. Blood samples were collected over the next 24 hours. A week later the experiment was repeated with water being substituted for grapefruit juice.

Researchers found that the absorption of Viagra increased by 23% when taken with grapefruit juice instead of water. Grapefruit juice also delayed the absorption of Viagra. This latter point is important because Viagra is supposed to be taken one hour before sex, and taking the drug with grapefruit juice may result in disappointment for some users of Viagra.

The grapefruit juice used in this study was white juice and supplied by Döhler-Euro Citrus NBI, GmbH. Other brands, types and doses of grapefruit juice may have different effects. The researchers suggest that the combination of Viagra and grapefruit juice be “avoided.”
Men who use protease inhibitors are usually prescribed less-than-normal doses of Viagra because protease inhibitors can raise levels of Viagra several times greater than normal, which can cause dangerous side effects. Therefore, men who use protease inhibitors and Viagra may wish to also avoid taking Viagra with grapefruit juice.

They stock our medicine cabinets and yet it occurred to me that that the average consumer knows very little about the pharmaceutical industry. It occurred to me that it might be interesting to talk a bit about the pharmaceutical giants behind the three main erectile dysfunction treatments, namely Pfizer’s(Viagra), Bayer HealthCare (Levitra) and Lilly Icos (Cialis).

Bayer is a German chemical and pharmaceutical company founded in Barmen, Germany in 1863. Today it is headquartered in Leverkusen, North Rhine-Westphalia, Germany and has some 60,000 employees worldwide and generated sales of EUR 11,724 million in 2006. It is perhaps most well-known for its original brand of aspirin but that is not the only thing Bayer has discovered. The following is a list of some of Bayer’s most famous discoveries.

Aspirin - a pain reliever, arguably the most successful drug ever

Heroin (diacetylmorphine) - an addictive drug, originally sold as a cough treatment, and arguably the most successful illegal drug ever. Heroin was a Bayer trademark, until World War I.

Ciprofloxacin - an antibiotic used to treat anthrax and urinary tract infections.

Levitra - a treatment for Erectile Dysfunction

Polycarbonate - the material of the CD, Lego etc. (Makrolon)

Pfizer Inc is the world’s largest research-based pharmaceutical company. The company is based in New York City. Pfizer Limited, the UK subsidiary, has become the largest Pharmaceutical Company in the UK. The Company is the top supplier of medicines to the NHS and every month in 2005, over two million patients in the UK were prescribed a Pfizer medicine. With 2005 actual spending of $7.4 billion in research & development (R&D), Pfizer boasts the industry’s largest pharmaceutical R&D organization: Pfizer Global Research and Development. It produces

Lipitor (atorvastatin) - used to lower blood cholesterol
Diflucan (fluconazole) - oral antifungal medication
Zithromax (azithromycin) - long-acting antibiotic
Viagra (sildenafil citrate) - ED medication
Celebrex (celecoxib) - anti inflammatory
Chantix - Anti-Smoking pill

Lilly Icos is a global pharmaceutical company and one of the world’s largest corporations. Its global headquarters is located in Indianapolis, Indiana, in the United States. A Fortune 500 corporation, Lilly Icos had revenues of $15.6 billion in 2006, making it the 148th largest company in the United States. Among the company’s major pharmaceutical breakthroughs are

Prozac (fluoxetine) - the world’s most successful selective serotonin reuptake inhibitor for the treatment of clinical depression.
Insulin – treatment for diabetics
Cialis – ED medication
Gemzar - treatment of pancreatic cancer

Males who are obese are likely to opt for partners with a similar body weight, a study has suggested.

Research conducted by the University of Aberdeen and the Rowett Research Institute and published in the American Journal of Clinical Nutrition has found that people who are overweight choose partners with a similar body mass to their own.

The findings add to earlier studies which have shown that people often select partners with characteristics which are similar to their own in terms of height, social class, educational class and race.

Dr Diane Jackson from The Rowett Research Institute said that the findings were nothing new because previous research had uncovered similar results.

“What is currently unclear is how these associations come about,” said Professor John Speakman from the University of Aberdeen.

“Perhaps the social activities of the overweight and obese people coincide, making them more likely to meet partners who are also overweight and obese,” he added.

Males recovering from prostate surgery may want to think about using an anti-impotence treatment such as Viagra to reduce their chances of long-term erectile dysfunction, it has been suggested.

Following a study by the Harvard Medical School which found that long-term damage may result after failing to achieve an erection after the prostate has been removed, researchers believe that rather than leaving erection function to return naturally, it may be more beneficial to use an enhancing aid.

According to the findings, when the penis is flaccid over a long period of time, it is starved of blood rich in oxygen, which can cause some of the cells to lose their flexibility.

To prevent damage the researchers suggest that males try treatments such as impotence drugs like Viagra or Cialis, or opt for a vacuum pump.

Dr Marc Garnick, editor in chief of Perspectives on Prostate Disease and a Harvard oncologist, said: “Although the evidence supporting this ‘penile rehabilitation’ isn’t perfect, you may want to ask your doctor about the options. Such early intervention may help increase the odds that you will regain erectile function.”

An earlier study into penile rehabilitation found that with some treatments, post-surgery men could engage in sexual activity within two or three months of their operation, according to Dr Rupesh Raina, of MetroHealth Medical Center, Case Western Reserve University, in Cleveland, Ohio.

200 years ago Parkinson’s disease was first discovered, but little progress has been made since then about the cause. Now, in the largest study of its kind, researchers from the Mayo Clinic have discovered that genetics may play a small but significant role in determining one’s risk for the disease.

The study found that genes play as much as a 3 percent role in one’s overall risk for developing Parkinson’s disease. With this new information, further research on the role of these genes may lead to better treatments or even a cure.

This is an important step forward, said a lead study investigator, because the contribution of common genetic risk factors to the development of Parkinson’s has long been suspected.
The researchers collected genetic information from almost 2,700 patients with Parkinson’s disease and compared it with that of healthy men and women of the same age. They found that in many of the Parkinson’s patients, there was one segment of DNA that was a bit longer than in the healthy patients. This section of DNA supports the expression of another gene, alpha-synuclein. So, in Parkinson’s patients this gene is over expressed, or turned on more than in a person without Parkinson’s disease.

While it is not yet known how this genetic defect leads to Parkinson’s, the researchers were able to determine that people with the extra-long DNA segment have a 1.5 greater risk for Parkinson’s disease than someone who doesn’t.

Parkinson’s disease affects around 1 million people in the United States and causes the decay of brain cells. This can cause symptoms of uncontrollable shaking, stiffness, imbalance and uncoordinated movements. There are a few treatments to reduce these symptoms, but, in general, their impact is short-lived.

With this new information, however, researchers can turn their attention to the alpha-synuclein gene.

Findings support the development of therapies that reduce alpha-synuclein gene expression. Such therapies have the potential to prevent or delay the beginning of Parkinson’s disease or to stop or slow its progression.

Treatment of a hamstring strain is again dependent on the severity of the injury. The RICE method is the essential treatment for treating hamstring injuries in the early stages. Rest, Ice, Compress and Elevate. Due to the bleeding and swelling, patients should stop the activity that caused the strain, rest immediately to allow healing to take place and prevent further damages done to the muscles. Ice should be used at once to control the swelling and relieve the pain caused. Heat should not be applied to the affected area since this may increase swelling and bleeding within the muscle. To assist with the swelling control, an elastic wrap or compressive stocking can be applied. Finally, lying down periodically with you leg elevated allows gravity to assist with your effort to control the swelling.

The RICE treatment described above can be performed by individuals or a trained professional; it can be used for first degree, second degree and third degree severity. However, both second and third degree require longer recovery time and there are possibilities that specialised techniques or treatments will be prescribed by doctors to enhance healing and recovery.

In the first phase of the recovery stage, some gentle stretching and light resistive exercises will help to prevent stiffness, improve range of motion, and restore the joint’s normal flexibility and strength. These exercises should be done several times a day, it is very important to stick to the exercises because they help reduce swelling, prevent stiffness, and restore normal and pain-free range of motion. The second phase consists of more demanding exercises to increase strength and regain flexibility as pain decreases and function improves. At the final stage of recovery, patients are allowed to return to full daily activities including sports. However, it is utmost important to return to full activity only when the problem is fully recovered, that is when the patients have gained normal range of motion, flexibility and strength. Attending to full activity with pain or muscle soreness will increase the chance of re-injury and may lead to a chronic problem.