Ишемическая болезнь сердца-Ischemic heart disease

Other studies examined lymphocyte activity among sufferers of endometriosis. In one such study, it was postulated that if an immune system misfunction were entirely the cause, women with endometriosis would show a higher incidence of infectious diseases and cancer. Increased illness, however, seems net to be a factor among the women who participated in this study. Newer experiments have focused on the effect of the cellular antigen CA-125, a cell that acts like a foreign substance in the body. How this antigen is produced by the body is unknown.

Two particular studies, one conducted by Dr. Donald Pittaway and colleagues at the Bowman Grey School of Medicine in Winston-Salem, North Carolina, and the other by Dr. Phillip Patron and colleagues at Minnesota’s Mayo Clinic, have both turned up evidence to show that women with advanced endometriosis had elevated levels of CA-125. as did women who had acute pelvic inflammatory disease (PID) and unexplained infertility. However, patients with less advanced stages of the disease, and women who did not have endometriosis, tended to have similar and lower CA-125 levels. Still, these investigators believe, this antigen bears further study because of marked elevated levels of kin women with endometriosis. They are also looking for a possible test for detecting endometriosis by analyzing CA-125 levels, and antigenic proteins like it, in blood samples.

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The four major types of skin infection are bacterial viral fungal and parasitic. These groups will be considered in turn and examples of the most common forms of infection described Bacteria live permanently on the skin surface, and are known as the permanent bacterial flora. In addition, transient organisms are constantly arriving at the skin surface but are usually prevented from multiplying by the normal defence mechanisms. Under certain circumstances either the permanent or transient organisms may become established, multiply excessively, and then cause disease or infection. The factors governing the host resistance or defence mechanism are several. Firstly there are the factors inherent in the skin itself, for example the amount of moisture or other secretions present, and whether there is a point of entry or an abrasion on the surface. Secondly there is the degree of interaction between the permanent flora and the invading organism. Finally, there is the factor of the various cellular and circulatory interactions provoked by the invasion. These may be influenced by the body’s general health or level of immunity.

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Starches, because of their more compound nature, have been thought to be more slowly digested and therefore to offer great benefits in the treatment of disease such as diabetes and for fat loss. However, recently it has been shown that digestion and metabolism are not that simple. The speed with which carbohydrates are broken down and absorbed is not simply determined by whether they are ‘simple’ or ‘complex’ and another measure has been developed to classify this.

The Glycaemic Index (GI) is a method of classifying the glycaemic (i.e. blood sugar) response to carbohydrate-rich foods. Put another way, it is a measure of how quickly carbohydrate reaches the bloodstream. Foods can be tested and ranked according to a measure of their GI. The GI is calculated by measuring the area under the curve (of glycaemia) versus time, after consuming a food containing 50g of available carbohydrate by comparison with 50g of reference food (either glucose or white bread). Blood glucose testing is carried out every 15-30 minutes for 2-3 hours.

The lower the GI of a food, the flatter the curve of blood glucose response, meaning the slower this is digested and converted to blood sugar.

It does not necessarily follow that all sweet sugary foods will be quickly absorbed and therefore have a high GI. It is much more complex and depends on a number of characteristics of the food consumed, e.g.:

Type of sugar—Glucose (GI = 100) has a higher GI than fructose (GI = 20). Temperate fruits (e.g. apples, pears, oranges) have a higher fructose content and therefore lower GI than tropical fruits (e.g. watermelon, rockmelon, mangoes).

Nature of the starch—The ratio of two types of starches (amylose: amylopectin) can affect the GI of foods. Amylopectin is more easily digested than amylose. Therefore, foods such as legumes, with a high amylose: amylopectin ratio have a lower GI than rice which has a higher amylopectin content.

Processing and particle size—Food particle size is a determinant of GI. This is shown with bread processing. Whole meal bread has a finer texture than rye bread and thus a higher GI.

Cooking methods—Cooking affects the degree of gelatinisation of fruits and thus GI. Stewed fruits have a higher GI than fresh fruits.

Starch-nutrient interactions—Carbohydrate forms molecular complexes with fats and proteins. This happens, for example, in a baked cake where GI will be reduced.

Fat—Large amounts can reduce GI (e.g. in ice cream) and hence high-fat foods may have a desirable GI but still be undesirable in terms of energy content.

Fibre—This depends on type of fibre. Insoluble fibre appears to have no immediate effects. However, soluble fibre (e.g. guar gum) can decrease the rate of absorption of glucose and hence decrease GI. Fibre supplements will not have the same effect because the fibre is not packaged into the food. Resistant starch will also lower the GI of a food.

Taking these properties into account we can see why, in Table 9.3, wholemeal bread has a higher GI than rye bread and a pineapple has a higher GI than an apple. GI is not a simple function of the sugar content of foods and detailed tables showing the GIs of a wide variety of foods are now available.

There are day-to-day variations in GI due to physiological effects, and the GI of component foods can predict the likely effect of a meal. Sydney University studies have shown that low-GI foods may be beneficial for fat loss as they decrease hunger ratings. Due to the slower absorption of low-GI foods, they may result in less rapid fluctuations in blood glucose and appetite changes for some individuals.

Australian researchers are leading the world in GI research. For more information on this evolving topic, please refer to The GI Factor by Sydney University’s Professor Jennie Brand Miller.

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It is usual for the partner to have a sperm test before the woman undergoes any testing.

The reason for this is that a sperm test is a simple procedure and certainly the most convenient of all fertility tests.

A sperm analysis is carried out to see if sperm are present, how many there are, how many are moving (motility) and how many are normal (morphology). The analysis also establishes if there is an infection in the reproductive tract and whether there are any sperm antibodies present. The testing of these factors will give a guide to your partner’s potential for fertility.

The sperm sample must be taken to the testing laboratory within an hour of collection as a delay may harm the specimen. Most infertility experts advise that intercourse should be delayed for at least three days before the sample is taken as a shorter period may affect the volume and sperm numbers.

A recent illness can affect the quality of the sperm, so if your partner has had a cold or flu recently it may be advisable to repeat the sample if the results are not favourable. Your doctor will advise if this is necessary.

Some medications may also affect the quality of sperm so, again, advise your doctor if your partner is on any medication.

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CT scans (computerised tomography) and ordinary X-rays are of no value in the diagnosis and monitoring of endometriosis. Ultrasound can have a role in some situations.

Ultrasound involves the use of high frequency sound waves to create an image or picture of the body on a screen or film. Over the last decade it has been used increasingly in the diagnosis and management of a number of gynaecological and obstetrical conditions, including the detection of ovarian cysts and determining the age and size of a foetus in early pregnancy.

Ultrasound has a limited role in the diagnosis and monitoring of endometriosis. At present, the machines used are not sensitive enough to detect small implants and adhesions. They can only detect cysts greater than two centimetres in diameter and determine their size and location. Ultrasound cannot determine the nature of a cyst nor can it distinguish it from other types of cysts or conditions.

Ultrasound should not be used as a substitute for laparoscopy to diagnose endometriosis. Its use is limited to confirming the existence of a cyst felt during a pelvic examination and determining its size and location prior to surgery. In some circumstances ultrasound may be used to help monitor the change in the size of a cyst after a laparoscopic diagnosis has been made.

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