Chocolate as Brain Booster!!!

Chocolate as Brain Booster 

by:

Flavanol is a potent type of antioxidant, a compound that is associated with the capacity to scavenge free radicals and consequently modulate oxidative stress. David Camfield, from Swinburne University (Australia), and colleagues engaged 63 subjects, ages 40 to 65 years, to drink a daily chocolate beverage over a 30-day study period. All participants received the chocolate drink, but in differing cocoa flavanol concentrations: the first group consumed 10 g of dark high-flavanol chocolate (corresponding to 500 mg cocoa flavanols), the second group received 10 g of conventional dark chocolate (250 mg of cocoa flavanols), and the third group received 10 g of dark chocolate (containing only a few cocoa flavanols). 

The researchers asked the subjects to perform spatial working memory tasks, during which concurrent  computer tomography brain scans were conducted. Whereas no differences were found between the groups regarding the accuracy or reaction times in performing the memory tasks, the team did observed via the brain scans that subjects who consumed the chocolate beverage containing either the medium or high proportion of cocoa flavanols were less strained by performing the tasks, as compared to those in the control group. Positive that these findings suggest that higher flavanol chocolate lowers stress levels in the brain, thereby allowing those subjects to achieve the same performance with lower resource usage, the study authors submit that their data provides " evidence of increased neural efficiency in spatial working memory function associated with chronic cocoa flavanol consumption.”

American Society for Aesthetic Plastic Surgery: New Ultrasound Technology Promising for Silicone Gel Breast Implant Monitoring

Significant potential advantages over MRI in screening and diagnosis of breast implant shell failure 

New York, NY (PRWEB) February 15, 2012 

Will high-resolution ultrasound become the new screening and diagnostic method for imaging silicone gel breast implants? A recent study suggests that portable, surgeon-performed, high-resolution ultrasound may have advantages over magnetic resonance imaging (MRI) when screening for implant failure. Preliminary results from the study demonstrated that high-resolution ultrasound provides excellent visualization of current fourth- and fifth-generation silicone gel implants in scanning models. In addition, in vivo surgeon-performed ultrasound accurately identified implant status and correlated with radiologist-performed ultrasound, MRI, and surgical findings. The results of the study, “Surgeon-Performed High-Resolution Ultrasound in the Detection of Silicone Gel Breast Implant Shell Failure: Background, In Vitro Studies, and Early Clinical Results,” appear in the February issue of the Aesthetic Surgery Journal. 

“Our preliminary findings show that portable, surgeon-performed, high-resolution ultrasound is feasible for screening silicone gel breast implants, matching the capabilities of MRI in detecting shell failure,” said lead author Bradley Bengtson, MD, FACS, a plastic surgeon in private practice in Grand Rapids, Michigan. “Although we are still working to define the role of this technology in the screening and diagnosis of patients with different silicone gel breast implant styles, there are several obvious benefits over MRI, including convenience, cost, availability, and dynamic, real-time visualization of the implant.”

Funded in part by a grant from the Aesthetic Surgery Education and Research Foundation (ASERF), the multi-part study evaluated several currently available base and transducer systems, using them for both in vitro and ex vivo scanning model assessments of a variety of normal and damaged implant models (Phase 1). These technologies were also applied clinically to provide imaging experience in three patients previously diagnosed with unilateral implant failure (Phase 2). A preliminary prospective evaluation was then performed to compare the accuracy of MRI, surgeon-performed high-resolution ultrasound, and radiologist-performed high-resolution ultrasound scans in predicting the shell integrity of 29 implants in 15 consecutive breast implant patients who subsequently underwent secondary implant surgery (Phase 3). In Phase 1, all hardware models easily detected both intact and intentionally damaged shells in currently marketed fourth-generation responsive gel implants and in investigational, fifth-generation highly cohesive gel devices. Although multiple transducers were able to detect shell failure, the 12-MHz head produced the best images at the normal clinical depth range. Confirmatory scans in Phase 2 correctly identified the side of rupture and were consistent with MRI and surgical findings. In Phase 3, high-resolution ultrasound accurately predicted implant shell integrity in all 29 imaged breasts (100%) as confirmed at the time of surgery in both symptomatic and asymptomatic patients. MRI is currently is currently recommended by the US Food and Drug Administration (FDA) for device surveillance.

“For both the patient and the surgeon, portable, high-resolution ultrasound has many potential benefits over MRI in the setting of breast implant screening,” said co-author Felmont Eaves, MD, Associate Clinical Professor at the University of North Carolina at Chapel Hill and immediate past president of the American Society for Aesthetic Plastic Surgery (ASAPS). “This office-based technology may also have broader applications, such as hand and facial fracture identification and treatment, vein surgery and ablation, visualization prior to shaped implant rotation, identification and management of seroma, and general breast evaluation.”

A prospective study is currently ongoing to help define the sensitivity and specificity of high-resolution ultrasound in the evaluation of current implant designs.

“Portable, high-resolution ultrasound that can be performed by the surgeon has the potential to enhance many areas of aesthetic breast surgery practice,” said Foad Nahai, MD, Editor-in-Chief of Aesthetic Surgery Journal. “We look forward to more information from this study.”

About ASJ:

The Aesthetic Surgery Journal is the peer-reviewed publication of the American Society for Aesthetic Plastic Surgery (ASAPS) and is the most widely read clinical journal in the field of cosmetic surgery, with subscribers in more than 60 countries

 

 

Platelet-Rich Plasma Procedure May Improve Facial Appearance

 

Platelet-rich plasma (PRP) therapy involves injection of the patient's own platelets and fibrin for the cosmetic treatment of wrinkles or scars in the face, hands, and neck. Known to some as the "vampire facelift" (a term trademarked by Alabama cosmetic surgeon Charles Runels), it is less invasive than plastic surgery, takes about 20 minutes for each treatment, and offers improvements for up to 18 months. Cost of the procedure is generally similar to that of fillers and may range from $600 to $1800 per treatment.

 

However, the efficacy and safety of PRP for cosmetic treatment have not been studied in controlled clinical trials. To learn more about the role of PRP therapy in cosmesis, Medscape interviewed Alan Matarasso, MD, and Lauren Zeifman, rPA-C, both in clinical practice in New York City. 

 

Dr. Matarasso is Clinical Professor of Plastic Surgery at Albert Einstein College of Medicine and has hospital privileges at numerous New York City medical institutions, including Manhattan Eye, Ear & Throat Hospital and New York Eye & Ear Infirmary. His contributions to many areas of aesthetic surgery include pioneering advances in surgical and noninvasive techniques. He is widely published and is the senior scientific editor of the Aesthetic Surgery Journal.

Medscape: Please define the PRP therapy procedure for improving facial appearance.

Dr. Matarasso and Ms. Zeifman: Selphyl® (UBS Aesthetics; Bethlehem, Pennsylvania) is a patented system for safe and rapid preparation of platelet-rich fibrin matrix, which is a type of regenerative medicine that uses platelets to rejuvenate the skin.

Medscape: What is the rationale behind the use of PRP therapy to improve facial appearance?

Dr. Matarasso and Ms. Zeifman: A steady trend over the past 15 years has been for patients to seek less-invasive procedures for facial rejuvenation. Selphyl has been used by surgeons over the past 7 years to speed up soft-tissue healing from sports injuries as well as to treat burn victims and patients with severe ulcers. It is also used as an adjunct to implant therapy in dentistry.

Selphyl is now being used cosmetically to treat volume loss in the face, hands, and neck -- particularly the crepey skin under the eyes and neck -- as well as wrinkles, acne scarring, and stretch marks.

Medscape: By what mechanisms do injections of PRP restore facial appearance?

 

Dr. Matarasso and Ms. Zeifman: Platelets play a role in stopping bleeding and in repairing damaged blood vessels and cells in the body. Platelets also contain substances called "growth factors" that activate and rejuvenate cells in our body. Unlike fillers that use various synthetic substances, Selphyl uses the patient's natural biology to address skin defects and volume loss, triggering production of new cells and collagen formation.

Medscape: How long does the procedure take, and how is it performed?

 

Dr. Matarasso and Ms. Zeifman: This cutting-edge rejuvenation is a quick 20-minute procedure. After 9 cm³ of blood (approximately 1 vial) is drawn from the patient, it is spun down in a centrifuge for 6 minutes at a precalculated speed to retrieve the most viable fibrin and platelets. After centrifugation, the platelet and fibrin component of the blood (the top layer) is extracted and reinjected into the area of concern.

Medscape: What type of results can generally be expected?

 

Dr. Matarasso and Ms. Zeifman: The results are subtle, with gradual improvement in the injected area over a 3- to 5-week period. Full correction occurs at 4-7 weeks and can last as long as 18 months.

Medscape: What are the risks or complications?

 

Dr. Matarasso and Ms. Zeifman: Because this filler is made from the patient's own blood, there is no risk for rejection, infection, or an allergic reaction.

Medscape: For what types of patients is this procedure most and least suitable?

 

Dr. Matarasso and Ms. Zeifman: Any patient who wishes to reduce volume loss, fine lines, and textural changes of the skin is suitable for this procedure. It also appeals to the patient who is looking for a natural approach to volumizing the face and treating or reducing fine lines.

Medscape: How long are the improvements maintained? If necessary, can the procedure be repeated, and if so, with what anticipated outcome?

 

Dr. Matarasso and Ms. Zeifman: Selphyl can be repeated, and better results are seen with a total of 2-3 treatments given 3-4 months apart. Patients can expect to see better results as they receive more treatments. With time, the results of Selphyl get better and better.

Medscape: How does PRP therapy compare with injections of filler, Botox(Botox® Cosmetic; Allergan, Inc; Irvine, California), or surgical facelifts?

 

Dr. Matarasso and Ms. Zeifman: This procedure can be combined with dermal fillers, Botox injections, and laser surgery, as well as facial surgery. PRP builds tissue over time, whereas traditional filler breaks down over time.

Medscape: In what situations might PRP therapy plus filler injections be helpful?

 

Dr. Matarasso and Ms. Zeifman: It is nice to layer Selphyl with traditional fillers. If a patient has volume loss with a lot of fine lines and textural changes, I like to inject Selphyl to create a new foundation of collagen and use dermal fillers for the fine lines.

Medscape: What is your overall opinion of the role that PRP therapy should play in facial restoration?

 

Dr. Matarasso and Ms. Zeifman: PRP therapy is very promising in facial restoration. Results are optimal when patients receive a combination of PRP, dermal fillers, and laser therapy.

 

By: Laurie Barclay, MD; Alan Matarasso, MD; Lauren Zeifman, rPA-C

New Silicone Breast Implant Approved by FDA

Dr. Z wants to share this article from:

March 9, 2012 — The US Food and Drug Administration (FDA) today approved a new silicone gel–filled breast implant, bringing the number of such products in the United States to 3, but continued to warn that women who receive any of these implants require lifelong monitoring.

The new silicone breast implant, made by Sientra, is indicated to increase breast size in women aged 22 years and older, and to reconstruct breast tissue in women of any age.

Sientra's product joins 2 other silicone-filled implants made by Allergan and Mentor that are currently on the market.

The safety of silicone breast implants has come into sharp focus after the French version of the FDA recalled implants made by Poly Implant Prothese (PIP) in 2010. PIP had used a nonapproved, industrial-grade silicone that is more prone to ruptures and leakage. As many as 300,000 women worldwide received the implants, and roughly 2000 have lodged complaints about adverse events, which include 8 cases of cancer.

In December 2011, the French government offered to pay to have the PIP implants removed from 30,000 French women.

PIP folded in 2010, but the company's founder, Jean-Claude Mas, continues to make headlines. Now facing charges of causing bodily harm, as well as committing fraud, Mas was jailed earlier this week by French authorities for not paying his bail.

Silicone Breast Implants Are Not "Lifetime Devices"

Here in the United States, the FDA has sounded cautionary notes about silicone breast implants. Last year, it reported that 20% of women who receive implants for breast augmentation will need them removed within 10 years. That percentage goes up to almost 50% for women who receive implants for breast reconstruction. The agency advised women with silicone implants, but not saline-filled implants, to undergo magnetic resonance imaging for silent ruptures 3 years after implantation, and every 2 years afterward.

Nevertheless, the FDA deems the new Sientra implant and those from Allergan and Mentor as safe. "Data on these and other approved silicone gel–filled breast implants continue to demonstrate a reasonable assurance of safety and effectiveness," said William Maisel, MD, deputy director for science in the FDA's Center for Devices and Radiological Health, in a press release.

Dr. Maisel also reiterated the need for watchfulness.

"It's important to remember that breast implants are not lifetime devices," said Dr. Maisel. "Women should fully understand risks associated with breast implants before considering augmentation or reconstruction surgery and recognize that long-term monitoring is essential."

The FDA's approval of the Sientra implant was based on 3 years of clinical trial data on 1788 women. Adverse events and outcomes, which resembled those for other silicone breast implants, included capsular contracture, reoperation, implant removal, asymmetry, and infection.

The agency attached a number of conditions to its approval of the new implant. Sientra must:

• follow the 1788 women who participated in the clinical trials for 7 more years;
• study 4782 women who receive the implant for 10 years for signs of long-term local complications such as capsular contracture, rheumatoid arthritis, and breast and lung cancer; and
• conduct 5 case–control studies to evaluate the link between the silicone implants and rare connective tissue disease, neurological disease, brain cancer, cervical/vulvar cancer, and lymphoma.

By: Robert Lowes 

Interview: Dr. Edward M. Zimmerman, A Cosmetic Surgeon In Las Vegas

Edward Zimmerman MD is a cosmetic surgeon and owner of

 Las Vegas Laser & Liposuction.

 

Name: Edward M Zimmerman, MD
Location: Las Vegas, NV
Website: lasvegaslaserandliposuction.com,  zimmermanmd.com

That's interesting: Dr. Zimmerman is currently serving as the President of the American Board of Laser Surgery.

What inspired you to enter the realm of cosmetic medicine?

I grew up in DC, the son of a professional artist who allowed me to build, dismantle and tinker with just about everything mechanical and biologic. I brought the first CO2 laser into an outpatient office in Western PA as part of our faculty practice in the early 1990’s. One day a patient asked me to take off a benign mole, which is my first cash paying procedure. The rest is history.

 

Can you tell us more about your clinic and how it's organized? 

I designed it and I am the Medical Director of Las Vegas Laser & Lipo, an 8000sf, state licensed, state of the art facility. I supervise and perform aesthetic procedures including Botox and filler injections; ablative resurfacing, lipo-sculpting, laser assisted blepharoplasty and facelifts using monitored tumescent anesthesia and conscious sedation. Our goal is to educate and help design programs and treatments that help patients regain and keep their own natural, youthful appearance and vitality. We welcome new cosmetic laser technologies. We have medical students and MA’s rotate through the office and and physicians to observe and train. 

My wife Marilyn in the practice manager for 15 years.  My RN and most of my staff have been with me for years as well. Our patients are 80+% women-mainly 30 to 65 years old, from a mixture of backgrounds, economies and ancestry. The office is conveniently located just off the SW bend of the I-215, a short drive from the airport and the Strip, in the first floor of a newer professional building. It is close to 2 of the newest hospitals in Las Vegas.  Patients come and go with privacy and security in one of Las Vegas’s newest professional centers, featuring plentiful, well lite parking and attractive landscaping.

Creating a successful medspa can depend on the staff. Have you developed a set of hiring practices? 

We have little staff turnover... usually when spouses relocate etc.  We are a small, tight knit group who have to help each other.  Base salaries with communal compensation and bonuses seem to encourage that better than straight salary or 1099 employment.  

We recently had a front office staff move to Zappos after I lent her their CEO’s book on “Delivering WOW and Creating Happiness....through Service..” In interviewing dozens of candidates, and trying a number on for a day to a week before we settled on one person to bring in to training and probation, we developed better job descriptions and training policies with measurable guidelines and endpoints. Having written policy and procedure has helped us evolve from a “mom and pop” clinic to an organization that is run like a business.

What IPL or laser technologies are you using? What are your considerations before buying a new equipment?

We utilize cosmetic lasers, light, IPL, CoolSculpting, laser/water/power assisted liposculpting and fat grafting with and without PRP at this point.  We are on the verge of bringing in focused US. With limited funds and minimally cooperative banks, it’s important to analyze every purchase with the most pessimistic but realistic ROI, shop for the best lease and lending rates and know when to back off and cut your losses if things don’t work out.

The laser companies “sell” me by putting me in touch with like-minded docs who have made their tech work in similar practices and have excellent reputations with others - like Medical Spa MD - and being flexible with letting us try the equipment to see if it’s a “fit” for the practice. Companies that offer extended warranties, help with marketing, training and negotiate the cost of disposables and have good delivery and service reputations get more attention from me.  

What are your core strategies for marketing your clinic?

We use the FotoFinder Suite to take digital pictures of just about everything-for patient education and to remind patients of how far they’ve improved, plot their continuing procedures and maintenance and  to analyze the success of our treatments.  It is a tool that has paid for itself many times over. 

We also use Patient Pads for information intake and consents and Touch MD for our consultations-all high tech devices that let us show lots of before and after pictures, educate patients on realistic results and confirm that the patient-practice relationship is solid from the start and stays that way.  We screen all procedure patients for Body Dismorphic Disorder with a standardized set of questions and discuss the results frankly with patients.  We don’t take short-cuts that compromise patient safety or results and we’re not afraid to refer patients elsewhere if we don’t seem to be on the same page.  I have lots of my own before and after pictures and the practice mission and philosophy on our new website, which I built with my daughter.

I employ social media to maintain our Facebook, Linked-In and Twitter accounts. We run monthly internet “specials” on different fillers, procedures and toxins and have regular “Evenings of Beauty” where we cater a Power Point presentation at the office and offer free consultations, drawings and special pricing. We are not shy about asking patients to post positive reviews about their experiences and send them personalized thank you notes with coupons good for discounts on future procedures when the send friends who actually do new procedures.

We have a billboard a couple of exits up from our office and a 4 x 26 foot, backlit sign “Las Vegas Laser & Lipo” across the top of the building that is easily visible to the hundreds of commuters on the I-215 each day-one of the reasons we choose this location for our new office.

We also have uniform scrubs with the practice logo, water bottles, pens, day-timers, chap sticks and business cards and brochures that all brand the practice and purvey the passion and professionalism of our special practice.  

You and your staff should be enthusiastic, walking examples of the procedures you offer. Talk the talk and walk the walk! Have a list of patients who will rave about your work and your office to perspective patients who want to talk to someone who had a similar procedure already.

What are the most sought after treatments and how do you select cosmetic treatments that will most likely fit to your patient's needs?

I simply don’t offer treatments that I don’t have passion for and skill at delivering optimal results, which is to say, I don’t offer every procedure because I choose NOT to.  I refer patients out to physicians I would send my family to who would benefit from more invasive procedures or ones that I feel are beyond my training, experience or enthusiasm.

That said, do your homework and invest time and money in technologies that “fit” in your practice. Market the coming of a new tech/procedure well in advance of it’s arrival, have a waiting list of patients to schedule after your training and offer special pricing during it’s initial use so that you get plenty of your own Before and After pictures as soon as possible. 

In Las Vegas, most patients want easily visible, even dramatic, but natural results. Non-ablative technologies have not been a good fit in my practice. Minimally invasive surgeries utilizing proven technologies are money makers in my practice along with fillers-especially Radiesse and Artefill. Toxins, laser hair removal, IPL and superficial peels are all good, solid procedures, but more “loss leaders” which allow us to educate patients about what else we offer.  We are always looking at new cosmetic technologies and teaming up with other physicians and technology companies to joint venture and share risk as well as profit. Technologies that consistently perform stay and those that don’t are replaced.

Patients appreciate that we are both innovative, honest and always searching for the next brick in the fountain of youth.

Any lessons learned from practicing cosmetic medicine? 

I’m lucky to have a job that I have passion for and actually get paid to do and teach to others. I’ve surrounded myself with upbeat, supportive and talented staff and peers. I try to stay open to suggestion and criticism. We continually evolve and re-invent ourselves and the practice to perform our mission. That requires continual surveillance, honest evaluation and directed education-output of time, money and effort. I think the most successful practices operate as a business, have a reasonable sense of humor and demonstrate their care and respect for their patients by being honest and respectful--especially when what the patient asks for is unsafe or too much.

I have no qualms about charging a reasonable amount for our expertise and what we’ve built and most patients respect that and feel they are getting more than their money’s worth.  We routinely create happiness by delivering safe, sage, science-based WOW.

Want some stories?...we’re actually keeping track...you can’t make this stuff up, but you can buy the book when it comes out!

Finally, never allow a patient to cajole, compliment, beg or embarrass you in to performing a procedure you are not comfortable doing.  Don’t be afraid to share your passion and excitement about what you do.  It’s contagious and you’ll attract patients who will really appreciate and enjoy your services.

About: Edward M. Zimmerman, MD has a passion for office-based cosmetic procedures. He has degrees from Johns Hopkins and Georgetown University and The George Washington University School of Medicine. He is a Fellow of the American Society of Laser Medicine and Surgery since 1994; member of the American Society of Cosmetic Laser Surgery; member of both the American and European Academies of Cosmetic Surgery and the American College of Phlebology. He has received the prestigious Award for Academic Excellence in Cosmetic Surgery Education from the American Academy of Cosmetic Surgery. Dr. Z is a Diplomate of, and currently serving as, the President of the American Board of Laser Surgery. He received the “Best of Las Vegas” award for Cosmetic Surgery for 2009, was selected as one of America’s Top Surgeons-2010 by the Consumer’s Research Council of America, was elected a Lifetime member of the Cambridge Who’s Who Registry. He has been a PSP “Top Doc” in 2010 and 2011. His office has been acclaimed for Excellent Customer Care by CMUS Talk of the Town - 2010, 2011, 2012. He has held multiple faculty appointments, lectured nationally and internationally and is a sought after consultant in the aesthetic industry.

Great Reasons for Taking Vitamin D!

Here are some great reasons for taking Vitamin D--I take 5000 IU/day myself,  Dr. Z:

One of the most replicated findings in vitamin D research is that the higher a person’s vitamin D level, the less one weighs; the lower the vitamin D, the more one weighs. We report on a study published last month where researchers found that in just 12 weeks, the vitamin D group lost 5 more pounds than the control group, suggesting vitamin D3 as a potential addition to a weight loss program.  Researchers also found improved scores in lipoprotein/cholesterol ratios for better heart health in the vitamin D group versus the placebo group. 

Body Weight and Plasma Vitamin D

What about the possibility of vitamin D playing a causative role, not just an associative role, in obesity and body mass?  That is, to a limited extent, does vitamin D act like a diet pill?  Published last month, Dr. Selehpour of the Tehran University of Medical Sciences described some interesting results in her randomized controlled trial.¹

In this RCT of 77 overweight and obese women with an average age of 38, researchers randomly assigned them to receive either a small daily dose of vitamin D3 (1,000 IU/day) or placebo for 12 weeks.  At the end of 12 weeks, the vitamin D3 group lost five more pounds than the control group. They also found improved scores in lipoprotein/cholesterol ratios for better heart health in the vitamin D group verses placebo.¹ Which brings some readers to the question: “If I want to diet, how much vitamin D should I take?”

In a study published in 2009, researchers at the University of Minnesota showed that higher vitamin D levels at the start of a low-calorie diet predict weight loss success.  On average, overweight subjects had pre-diet baseline vitamin D levels considered in the insufficient range.  However, the researchers found that pre-diet vitamin D levels predicted weight loss in a linear relationship.  For every increase of 1 ng/mL in 25(OH)D level, subjects lost almost a half pound more on their 11-week calorie-restricted diet.² 

Cardiovascular Risk

Dr. Selehpour reported that HDL cholesterol levels increased in the vitamin D group, but decreased in the placebo group.  LDL cholesterol levels displayed the same trend in the groups, with increases observed in the vitamin D group.¹ 

However, an increase was observed in the ratio of LDL to ApoB, the main apolipoprotein of LDL cholesterol that is responsible for the transport of cholesterol to tissues.¹ 

This result “indicates less atherogenic properties of LDL cholesterol particles, whereas this ratio declined in the placebo group indicating that LDL cholesterol particles were smaller and higher density,” explained the researchers. 

This study has shown that a daily supplementation of 1,000 IU of vitamin D3 has a beneficial effect on HDL cholesterol, apoA-1 concentrations, apoA-1:apoB-100 and LDL cholesterol:apoB-100 ratios in overweight and obese women.¹ 

Is Vitamin D Absorbed in Fat?

In a 2012 published study of 686 adults, researchers at Creighton University found that circulating vitamin D (25(OH)D) levels were inversely correlated with total body weight, but not correlated with the amount of a patient’s fat or muscle.  There was no evidence for sequestration of supplemental or endogenous vitamin D3.  Researchers concluded that vitamin D replacement therapy needs to be adjusted for body size to achieve desired 25(OH)D plasma concentrations.³ 

These researchers calculate that if you want the average patient to have a 25(OH)D level of 40 ng/ml, that person needs 70-80 IU/kg/day.  A 250 pound man would need 7-8,000 IU/day from all sources, while a 125 pound woman would need 3,500-4,000 IU/day from all sources.  Because it is difficult to adjust for daily variations in un-sunscreen protected whole-body sun exposure, a typical (non-dieting) adult recommendation is simply 5,000 IU/day.

Recommendation

John Cannell, MD, founder of the Vitamin D Council, recommends 5,000 IU/day oral vitamin D3 for healthy, average weight adults (125-200 pounds).  If the patient is above this weight, 32 IU per pound per day is a good rule of thumb.  This means that a 300 pound person would need 10,000 IU/day, though it wouldn’t surprise him if they needed more (because overweight people tend to spend less active time in the sun).  The only way to know is to test blood levels (25(OH)D).  As the dieting patients’ weight decreases, it is appropriate to reduce the dose.

Dr. Cannell comments that he “doubts that vitamin D is a classic diet pill. It may work by increasing your activity as your “get up and go” is back.  Just lying on the sofa popping vitamin D pills will get you nowhere, however.  Dieters are encouraged to follow that urge to take a walk, clean out the garage, and take that weekend trip.”

Vitamin D3 is 10x as Effective as D2

Vitamin D3 is the form of vitamin D that occurs naturally in the human body, whereas vitamin D2 is produced by irradiating yeast with ultraviolet light.  Since the 1930's, it has been generally assumed that vitamin D3 and D2 are equally effective in humans. Researchers in 2004 found that while initial 25(OH)D plasma response was similar for D2 and D3 in human volunteers, the calculated area under the curve from day 0 to infinity indicated the potency of vitamin D2 is only 10.6% that of vitamin D3.⁴

Professor Goran Bjelakovic evaluated 50 randomized controlled trials (RCTs) that included a total of 92,000 participants who took some form of vitamin D.  Mortality rates were reported as either primary or secondary outcomes. While 74,000 participants in 32 trials used D3, the remaining 18,000 participants in the other 12 trials took D2. He discovered that the relative risk increased by 2% for participants in the vitamin D2-group, while those in the D3-group had a relative riskreduction of 6%.⁵

Thus Rejuvenation Science® Vitamin D3 is significantly more effective than prescription Drisdol (D2). Fortified foods (milk, cheese, bread, etc. which use the cheaper vitamin D2 without specifying the form of vitamin D on the label) are generally poor sources of vitamin D. 

Safety and Toxicity

Recommended doses of Vitamin D are increasing with the increase in published studies describing vitamin D benefits.   I thought our friend, Dr. Cannell’s discussion on Vitamin D safety and toxicity published in August 2010 to be timely information for you to ensure safety in your recommendations.  After reading, I expect that you will feel more comfortable recommending moderate (5,000 – 10,000 IU) daily doses of Vitamin D3 in conjunction with 25(OH)D testing.  Please request a copy, by responding to this email, of my 3-page Vitamin D Safety and Toxicity review. 

Conclusion

These studies suggest that Vitamin D3 may be part of a weight loss or weight maintenance program.  Rejuvenation Science® provides Vitamin D3 in 1000, 2000, 5000, and 10000 IU doses.  There are 1,000 IU of vitamin D3 in Maximum Vitality® multivitamin and we have a special Pediatric liquid Vitamin D3 formula.  Here is a link to our Vitamin D product options:  Vitamin D Products.  You may review a number of new Vitamin D studies, as well as an article: Compelling Research Supports Increased Vitamin D Intake.  

1.       Salehpour A, Shidfar F, Hosseinpanah F, Vafa M, Razaghi M, Hoshiarrad A, Gohari M. Vitamin D3 and the risk of CVD in overweight and obese women: a randomised controlled trial. Br J Nutr. 2012 Feb 9:1-8. [Epub ahead of print]

2.       Sibley S. Successful Weight Loss with Dieting is Linked to Vitamin D Levels.  Presentation at The Endocrine Society’s 91^stAnnual Meeting in Washington, D.C. 2009.

3.       Drincic AT, Armas LA, Van Diest EE, Heaney RP.  Volumetric Dilution, Rather Than Sequestration Best Explains the Low Vitamin D Status of Obesity.  Obesity (Silver Spring).  2012 Jan 19. doi: 10.1038/oby.2011.404.

4.       Armas LAG, et al. Vitamin D2 is much less effective than vitamin D3 in humans. J Clin Endocrinol Metab 2004;89:5387-5391.

5.       Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Wetterslev J, Simonetti RG, Bjelakovic M, Gluud C. Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2011 Jul 6;(7):CD007470.

Radiation May Turbocharge Yervoy Against Metastases

Dr. Z is sharing this article from:

New York — Researchers at Memorial Sloan-Kettering Cancer Center say that radiating one tumor can trigger the immune system to kill other tumors in patients being treated with the cancer drug Yervoy (ipilimumab, Bristol-Myers Squibb). 

Bloomberg reports that during a Memorial Sloan-Kettering clinical trial, a 41-year-old female patient with advanced melanoma was given Yervoy, which stimulates the immune system to fight cancer cells. She did not respond to the drug until she had radiation treatment to shrink a tumor that was pressing on a nerve and causing severe back pain. 

In the case study, published in the New England Journal of Medicine, the authors reported that soon after the radiation all the other tumors in her body began shrinking. According to Charles Drake, M.D., a Johns Hopkins medical oncologist quoted in the Bloomberg article but not involved in the study, the case is the best demonstration to date of a phenomenon called the abscopal effect, in which radiation to one tumor causes other tumors to regress. 

Bloomberg quotes Memorial Sloan-Kettering oncologist Jedd Wolchok, M.D., the study’s senior author, as saying that harnessing the effect may enable researchers to boost the response rate to Yervoy.

Dr. Wolchok is working with several major hospitals to start a clinical trial that would combine Yervoy and radiation in an attempt to duplicate in more patients the abscopal effect observed in the Memorial Sloan-Kettering case, according to Bloomberg.

Meanwhile, Bristol-Myers Squibb is reportedly studying whether radiation can enhance Yervoy’s effects in a trial the company is conducting on the drug in patients who have received radiation for advanced prostate cancer.

By: Bill Gillette

Sunless Tanning Promotion Tied to Reduced Sunbathing

Sunless Tanning Promotion Tied to Reduced Sunbathing...However, adolescent use of sunless tanning products linked to indoor tanning and sunburns.

An intervention aimed at promoting the use of sunless tanning products appears to reduce sunbathing and increase sunless tanning, according to a study published in the September issue of the Archives of Dermatology. According to another study in the same issue, approximately 11 percent of U.S. adolescents use sunless tanning products, a practice linked to risky behaviors associated with ultraviolet radiation exposure.

In a randomized, controlled trial of 250 women, Sherry L. Pagoto, Ph.D., of the University of Massachusetts Medical School in Worcester, and colleagues evaluated the impact of a skin cancer prevention intervention that promoted sunless tanning as a substitute for sunbathing. The investigators found that the intervention was associated with reduced sunbathing and sunburns as well as increased use of protective clothing at two months. The intervention was also linked to reduced sunbathing and increased sunless tanning at one year.

In another study, Vilma E. Cokkinides, Ph.D., of the American Cancer Society in Atlanta, and colleagues conducted a telephone-based, random-digit-dialed, cross-sectional survey between July 1 and Oct. 30, 2004 among 1,600 adolescents, aged 11 to 18 years, and their caregivers. The investigators found that 10.8 percent of adolescents used sunless tanning products in the past year, with use independently associated with indoor tanning as well as higher frequency of sunburn, though not with use of sunscreen.

"Adolescents, therefore, must be educated about these products and the importance of avoiding indoor tanning and practicing sun-protective behaviors," Cokkinides and colleagues write.

By: HealthDay News

Two Topicals Boost Botox Treatment

Omaha, Neb. — Botox users looking to enhance their skin appearance may want to try a new combination of two topical skin treatments, Medical News Today reports. 

A new study, co-authored by Omaha dermatologist Joel Schlessinger, M.D., suggests that a specifically designed 4 percent hydroquinone skincare system in combination with tretinoin (Retin-A) further enhances improvements in skin appearance attained with onabotulinumtoxinA (Botox, Allergan). Applying the hydroquinone system plus tretinoin may offer multiple clinical benefits over standard skincare, including significantly milder fine lines/wrinkles and hyperpigmentation, according to the research. 

In the multicenter, randomized study, 61 patients who had received upper facial Botox treatment were randomly assigned to use either the hydroquinone system (cleanser, toner, proprietary 4 percent hydroquinone, exfoliant and sunscreen) plus 0.05 percent tretinoin cream, or a standard regimen (cleanser, moisturizer and sunscreen) for 120 days. Outcomes were assessed by investigators and through a patient questionnaire. 

Compared with standard skincare, the hydroquinone system plus tretinoin resulted in significantly milder fine lines/wrinkles and hyperpigmentation at days 30, 90 and 120 and in significantly superior overall ratings for each of nine patient assessments at days 90 and 120. More than 85 percent of the patients in the hydroquinone system plus tretinoin group said their treatment had further enhanced Botox-attained improvements, as compared with 8 percent of the standard skincare group. Both regimens were generally well tolerated. 

Medical News Today quotes Dr. Schlessinger as saying, “The new hydroquinone system is not only effective, it is also easy for patients to use, increasing the likelihood that they will be able to get maximum benefits. Most importantly, using the system in combination with tretinoin significantly improved how patients perceived themselves, which is the ultimate goal of any aesthetic treatment.” 

By: Bill Gillette