Longevity Health and Wellness Protocol

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The premature ageing syndromes

It was of interest to find out whether the rare genetic disorders known as premature ageing syndromes (Pesce & Rothe 1996) are related to a disorder in the secretion of GH or IGF1. All are characterized by marked growth retardation associated with early and fast ageing, various dermal changes (wrinkling, loose skin), hypotrichosis and early greying of the hair, and early death mostly by heart attacks due to atherosclerosis or congestive heart failure. In summary, the finding ofonly very few patients with GH deficiency among the patients with 'premature ageing syndromes' of genetic origin, the majority of whom have normal pituitary functions, indicates that their accelerated ageing and various complications are not related to GH or IGF1. The rare instances of GH deficiency must be considered coincidental.

The Impact of Science on Life Expectancy

These and other aging-related genes that could be manipulated by methods being developed in molecular biology. There is reason to believe that breakthroughs in this area are forthcoming and that by controlling genes that influence diseases of aging, it may become possible to allow more people to survive longer and healthier than is currently the case. Just how much longer and healthier people can survive through manipulating the genome is the subject of intense debate. It may also become possible to achieve increases in longevity by introducing pharmaceuticals that alter the environment in which the genome operates. One example is the effort to introduce into the human diet natural and artificial antioxidants (i.e., substances that reduce the amount of damage caused by the presence of free radicals, products of normal metabolism implicated in the aging process). The result may be a general deceleration of the entire aging process. If methods of increasing human longevity are realized...

Life Span and the Aging Process

This increase was likely due to several factors, but perhaps the most important was the improvement of sanitation, hygiene, and public health from 1900 to 1998. These improvements included purification of drinking water, treatment of wastewater, widespread vaccination, and improved access to health care. However, even as these sanitary measures were adopted, other elements of modern life emerged as strong influences on life span, such as diet, exercise, and socioeconomic status. Studies have shown that individuals who exercise regularly, eat a diet lower in saturated fats, and avoid unnecessary risk-taking live longer. This may be because such a lifestyle reduces the risk of developing cardiovascular disease and cancer, the top causes of death in developed countries. Finally, life span is in part genetically determined. Studies of life span in large families have shown that longevity is, to some degree, inherited. This may be due to shared genetic risks of diseases or behaviors that...

Theories Of Aging And Life Extension

Goal is to describe the current understanding of the biological mechanisms that underlie aging. The final goal is to review successful cases of longevity intervention in laboratory animals and discuss their implications for humans. More extensive details and references on these general topics can be found in Arking (1998), Masoro and Austad (2001), and the Science of Aging-Knowledge Environment website.

Effects of growth hormone and insulinlike growth factor 1 deficiency on ageing and longevity

Abstract Present knowledge on the effects of growth hormone (GH) insulin-like growth hormone (IGF)1 deficiency on ageing and lifespan are reviewed. Evidence is presented that isolated GH deficiency (IGHD), multiple pituitary hormone deficiencies (MPHD) including GH, as well as primary IGF1 deficiency (GH resistance, Laron syndrome) present signs of early ageing such as thin and wrinkled skin, obesity, hyperglycemia and osteoporosis. These changes do not seem to affect the lifespan, as patients reach old age. Animal models of genetic MPHD (Ames and Snell mice) and GH receptor knockout mice (primary IGF1 deficiency) also have a statistically significant higher longevity compared to normal controls. On the contrary, mice transgenic for GH and acromegalic patients secreting large amounts of GH have premature death. In conclusion longstanding GH IGF1 deficiency affects several parameters of the ageing process without impairing lifespan, and as shown in animal models prolongs longevity. In...

Life Expectancy And Life Span

In the United States in 1900, the average life expectancy (also referred to as longevity) of a newborn baby was 47.7 years 46.4 for males and 49.0 for females. By 1990 the average life expectancy increased to 75.4 years 78.8 for females and 72.0 for males. Why did life expectancy increase so rapidly in the twentieth century, and what are the prospects for increasing it further Perhaps more important, has the overall health of the population improved or worsened during this transition, and what are the health consequences of further increases in life expectancy The measure of life expectancy at birth is a statistic that represents the expected duration of life for babies born during a given time period, usually one calendar year. Calculated from death rates observed at every age, it is based on the critical assumption that the age-specific risks of death observed during a given year will prevail for all babies born in that year, for the remainder of their lives. In contrast, life span...

Laboratory Interventions into the Aging Process

An obvious limitation of the laboratory record is that there are few human data One cannot experiment on humans for both ethical and practical reasons. There are four species of multicellular animals that account for most of the recent research into longevity extension. Two of those model systems, the mouse and the rat, are mammals commonly used in biomedical research. The other two are invertebrates beloved of geneticists the fruit fly and the worm. Also, some laboratories focus on the use of in vitro cell cultures with which to investigate the biology of the individual cells of the mammalian organism. Modular organization and common descent ensures that the genes each of these organisms carries are homologous to the genes humans carry and often have similar if not identical functions. For example, some 62 percent of the genes that are recognized to cause human diseases are known to exist in flies and to give rise to similar disorders when mutated. By investigating these model...

Application Of Gas Packaging For Shelflife Extension Of Food

The application of MAP using various gas mixtures has been used successfully by many food-processing and food-packaging companies around the world to extend the shelf life and retain quality of a variety of food products. Examples of food products currently gas packaged as well as the composition of gas mixtures used to extend the shelf life of each product are shown in Table 5. The optimum blend of gases for a specific product can be determined not simply by trial and error but only through a detailed, systematic study of the interdependent variables influencing product shelf life. These include the physical, chemical, and microbiological composition of the food product, the expected shelf life of the product under the normal storage conditions, and the choice of packaging film of correct gas-and moisture vapor-permeability characteristics. The application of MAP involving gas mixtures for shelf life extension of selected food groups is briefly reviewed.

Pharmaceutical Interventions into the Aging Process

The genetic manipulations used in the laboratory are not likely to be well received as therapeutic tools. Once the longevity extension mechanisms described above were identified, many scientists independently tried to develop pharmaceutical interventions by feeding various drugs suspected of regulating those two processes to their laboratory animals. Five of those experiments have shown signs of success. Although those independent experiments used different intervention strategies and administered different molecules to the laboratory animals, they all recorded significant increases in the animals' health span (comparable to those in Figure 1) and or a significant extension of the animals' functional and mental abilities. A recent experiment done by Kang et al. (2002) may serve as an example of this category of data. Those researchers fed a drug called 4-phenylbutyrate to fruit flies throughout all or part of their lives. This dietary pharmaceutical intervention resulted in a delayed...

Effects of Extended Life Expectancy on General Population

Observing historical trends in mortality, and anticipating future improvements, raises the question of how the overall health of the population is influenced by these trends. From a historical perspective, there is little doubt that the thirty-year increase in life expectancy in the twentieth century was a result of trading one set of diseases and causes of death for another. The epidemiologic transition allowed much larger proportions of each birth cohort to survive to older ages, something that had never before been experienced by the human population. There is little doubt this was a worthwhile trade. Now that the focus of modern medicine is to attack the causes of death that were traded for earlier in the century, we are faced with the same sort of question What do we get in return for reducing the risk of death from vascular diseases and cancer This is a particularly interesting question, since successful efforts to reduce the death rate from fatal diseases will produce much...

Extending Life Expectancy

The prospect for increasing life expectancy further is a subject of intense scientific debate. Projections of life expectancy can have a significant influence on anticipated changes in social programs, such as Social Security and Medicare, that are influenced by the future size and health status of the older population. Some scientists have argued that life expectancy at birth for humans cannot practically exceed about eighty-five years (Olshansky et al., 1990). This conclusion is based on the facts that (1) survival up to and beyond the age of 110 is as rare in the early twenty-first century as it has always been (2) the rapid increase in death rates from aging-related diseases that begins in the second decade of life has not changed in recorded history instead, death rates have shifted down at comparable rates for most age groups (3) the reduction in death rates required at every age to increase average life expectancy at birth to eighty-five years is extremely large in fact, larger...

Longevity and Aging

After about 50 of standard lifetime, the aging process follows development. Well before that period, however, during very early periods of postnatal life, degenerative processes occur, such as degeneration of neurons and synaptic contacts. It was possible to study the effects of microgravity on a few aged individuals, including animals and humans. Observations showed that basically spaceflight was tolerated by all ages. In humans, a 76-year old astronaut flew on STS-95 and three 55-65 year old tourist cosmonauts flew on board Soyuz flights to the ISS. No signs of decreased physiological and mental capacity were observed in these older astronauts cosmonauts compared to younger crewmembers. Some post flight observations concerning longevity were obtained from houseflies Musca domestica after 7 days in space and from the Chinese silkworm Bombyx mori L. that flew for 12 days on board Bion-10. Compared to ground controls, houseflies exhibited similar longevity but their reproductive output...

Ageing and Longevity

Studies of rodents subject to intrauterine insult suggest that lifespan may be shortened and degenerative processes associated with ageing may be enhanced. Studies of rats and mice exposed to maternal low protein diets indicate that lifespan may be shortened by as much as 15 .79 81 This is of considerable interest as the impact of prenatal undernutrition appears to be the opposite of postnatal restriction of energy intake. It is well-established that postnatal caloric restriction increases longevity and provides resistance to cancer in a range of species from Droso-phila to primates.82

Shelf life extension

The shelf life of a food product is the period of time between harvest or manufacture to consumption during which the food remains safe and wholesome (Day, 1993). It is determined by the characteristics of the product, and the production and storage conditions. Fresh or minimally processed products can be expected to have a shorter shelf life under MAP than a more fully processed product. Mixed vegetable salad, for example, has an expected shelf life of about ten days, though two or more weeks are possible with improved minimal processing and MAP technology. Fresh fruits keep longer under controlled atmosphere storage (CAS) than under MAP. This is because optimum atmosphere and storage conditions can be maintained throughout the storage period under CAS. Such control is not possible with MAP since the metabolic process and microbial activities will continually change the composition of the headspace atmosphere once the product is packaged and sealed. Unfortunately, not all fruits can...

Gender over the Life Cycle

Adolescent and young men who are not yet married constitute the kinibo, and in former times acted as a kind of police force, carrying out the judgments of older men. With marriage, a man enters the age group known as sidibo or soldiers. This is a corporate age-based organization, with internal officers, shared ownership of ritual equipment and drums, and their own meeting house, the tiba kae. Based on the accounts of 19th century missionaries, historian Jane Martin (1968) has concluded that the internal politics of Glebo communities was dominated by an ongoing power struggle between the sidibo and the council of elders (the gbudubo or takae), made up of the oldest living male member of each residentpano, or patri-clan, in a town. This council is not technically an age grade, since neither cohorts nor individuals are automatically promoted into it at a certain age or life stage rather, some very elderly men remain soldiers all their lives due to the longevity of a slightly older...

The Flavour and Fragrance Industry Sectors and Materials

Engineering Design For Perfume Industry

All these attributes and a number of others continue to characterise the current food trends. Additionally, health, wellness, variety and anti-aging are the major driving forces of today's functional foods. Never before has the consumer been so sensitive to the correlation between health consciousness, diet and long life, nutrition and fortification with a simultaneous acceptance and growing consumption of better tasting, ready-to-use convenience foods 12, 13 .

Laparoscopic Biliary And Gastric Bypass

Distal Biliary Obstruction

Randomized trials have demonstrated a reduced hospital stay and similar early morbidity and mortality with endoscopic stent placement compared to surgical bypass.42,43 However, long term complications appear increased, with recurrent jaundice due to occluded or dislodged prosthesis and cholangitis occurring in 13-60 of cases.34,35,44,45 In patients who are expected to live longer than a few months these complications may make endoscopic palliation less than optimal.

Food Preservation Through Control Of Water

Bound Water Food

One of the most important concepts in understanding the relationship between moisture removal and shelf-life extension is that of free versus bound water in foods, which are terms that grew in importance particularly during the latter half of the twentieth century. It was realized that active water is more important to the stability of a food system than the total amount of water present, or water content (34). The term water activity (aw) is a thermodynamic property defined as the ratio of the vapor pressure of water in a food system (p) to the vapor pressure of pure water (p0) at a given temperature or the equilibrium relative humidity (ERH) of the air surrounding the food system at a given temperature, such that aw p p0 ERH 100. Water activity is currently the most common term used by researchers and industry professionals in the food processing business. A sorption isotherm is a graphical illustration of the relationship of water activity, or relative humidity of the vapor space...

Nutritional Management in COPD

Nutritional depletion is an independent risk factor for mortality and hospitalization in patients with COPD. Studies have indicated a hospital stay of approximately 30 days for patients with a body mass index (BMI) of less than 20 compared with 18 days for those with a BMI of less than 30. If a patient with COPD begins to lose weight progressively, the average reported life expectancy is only 2.9 years, and it is considerably less in malnourished patients who have survived an episode of acute respiratory failure during an acute exacerbation of their disease. However, it is not certain whether this implies a casual relationship or whether low weight is a marker for more severely impaired lung function.

Dennis E McGuire PhD and Brian A Chicoine MD

At the turn of the twentieth century, a person with Down syndrome (DS) was expected to live only about 9 years. Today, life expectancy is about 56 years more than a sixfold increase (Eyman et al., 1991). As professionals and caregivers working with people with DS, we must do our best to ensure that this longer life is also a full and healthy one, both in terms of general health as well as emotional wellness and social functioning. The normal aging process is accelerated in adults with DS, who age some 10-20 years earlier than the general population. Caregivers often perceive this premature aging as a shortened middle age or a rapid onset of aging accordingly, a 40- or 50-year-old person may be more like someone who is 60 or 70. Skill loss at what would be considered an early age can actually be the result of the normal aging process associated with DS. We tell caregivers that, like retirees in the general population, adults with DS who remain active are more likely to live longer and...

Indications For Laparoscopic Ultrasound

There continues to be an explosive increase in the applications of LUS in minimal access surgery. Therefore the indications for LUS continue to evolve as different centers continue to report the fine nuances of this emerging technology. In addition to preoperative diagnostic studies or laparoscopy alone, LUS provides additional information regarding the resectability of pancreatic or liver tumors. LUS is also utilized for accurate staging of primary gastrointestinal tumors. Diagnostic laparoscopy with LUS-guided biopsies of intra-abdominal malignancies reduces exhaustive diagnostic work-ups while avoiding unnecessary laparotomies. With a potentially protracted life expectancy, these patients benefit from this diagnostic approach with quicker recovery times. Quicker recovery times and shorter hospital stays translate into substantial cost containment. Finally, combining LUS in the diagnosis, staging and treatment of intra-abdominal malignancies, the laparoscopic conduct of the...

An Introduction to Enzymes

Much of the history of biochemistry is the history of enzyme research. Biological catalysis was first recognized and described in the late 1700s, in studies on the digestion of meat by secretions of the stomach, and research continued in the 1800s with examinations of the conversion of starch to sugar by saliva and various plant extracts. In the 1850s, Louis Pasteur concluded that fermentation of sugar into alcohol by yeast is catalyzed by ferments. He postulated that these ferments were inseparable from the structure of living yeast cells this view, called vitalism, prevailed for decades. Then in 1897 Eduard Buchner discovered that yeast extracts could ferment sugar to alcohol, proving that fermentation was promoted by molecules that continued to function when removed from cells. Frederick W. K hne called these molecules enzymes. As vitalistic notions of life were disproved, the isolation of new enzymes and the investigation of their properties advanced the science of biochemistry.

Principles of M0 activation

Thus fully activated for host defense elicited Mo share many properties with activated Mo because of their recent recruitment, but do not express high levels of MHC class II antigens or produce the full range of cytotoxic mediators. Other distinguishing features include differential downregulation by IFN7 of man-nose receptors, lectins that recognize a range of microbial ligands. Both elicited and activated M0 can aggregate and interact with persistent particulates (foreign bodies, microorganisms, respectively) and other host cells to form granulomata. Recruited Me in diffuse or focal infiltrates thus vary in their phenotype, longevity and turnover it is likely that Fas Fas ligand, as well as TNFa TNFa receptors (TNFR I,II), regulate apoptosis and resolution of Mo-rich lesions. Resident Me are longer-lived cells, but even terminally differentiated Me such as microglia in the brain, can be induced to express markers of activation by appropriate stimuli. Locally reactivated Me are soon...

Effects of Impact Energy and Bone Integrity

Cancer, infection, or any of the multitude of diseases affecting bone metabolism will surely lead to decreased bone strength (50). Unfortunately, the natural aging process also leaves our bones less able to resist external forces (67). Regardless of the specific etiology, weakened bones are surely more prone to fracture. In general, fractures to osteoporotic bone, for example, will have a higher level of comminution than would

The Mthfr Gene Product MTHFR

Some of the clinical implications of MTHFR 677C T are summarized in Chapter 2. The implications of MTHFR 677C T and MTHFR 1298A C in cardiovascular disease, cerebrovascular disease, venous thrombosis, longevity, neural tube defects, pregnancy, congenital abnormalities, preclampsia, diabetes, cancer, psychiatry, and renal failure are reviewed in refs. 19 and 20.

Physiological factors

After slaughter, a series of chemical reactions take place in animal tissue. Physiological changes in fresh meat are related to the changes in skeletal muscles after the onset of rigor mortis, the time for which varies with type and size of animal. The storage temperature and time, i.e., the ageing process, affect these changes after the onset of rigor mortis. These changes affect the organoleptic quality, especially the tenderness, juiciness and aroma of meat. Being high in protein and fat with relatively high pH, meat is also an excellent growth medium for spoilage and pathogenic microorganisms. Furthermore, red meat requires O2 to maintain its bright red colour. Therefore, MAP must be applied with extreme caution and requires a strict quality control programme to extend the shelf life of meat while ensuring safety.

Worldwide patterns of disease

In most developed countries CVD rates are declining due to primary prevention of CVD risk factors, and improved secondary prevention strategies.12 However, in developing countries an epidemiologic transition from acute infectious diseases to a rise in the major non-communicable diseases is occurring. Reasons for this include increasing life expectancy associated with a decline in childhood and adult deaths from infections, and an increase in the prevalence of CVD risk factors associated with industrialization and urbanization.13

Telomerase the Primary Target in Human Cells

Ends from degradation and fusion with other chromosomes. When telomeres are eroded below a certain threshold, they fail to protect chromosome ends, and this causes senescence and crisis. In contrast, rodent somatic cells possess stable and substantially longer telomeres. The control of telomere length offers an additional level of protection against tumor formation in animals with a higher life expectancy (for a review, see 17 ). Dogs are valuable animal models in drug testing, as they are less expensive than nonhuman primates and the results can be better extrapolated to human physiology. Cellular systems derived from dog primary cells are desirable to improve interpretation and study design. However, similar to human - and in contrast to rodent primary cells - dog telomerase activity also is tightly regulated 18 .

Ethylene and senescence

Been demonstrated to induce the expression of SAGs (Davies and Grierson, 1989 Park et al., 1998 Weaver et al., 1998 Kinoshita et al., 1999 Hajouj and Gepstein, 2000). A peroxidase, which is up-regulated during ethylene-induced senescence (Abeles et al., 1988 Morgens et al., 1990), has been identified in and cloned from cucumber (Cucumis sativus). The ethylene-insensitive mutant, etrl-1, of A. thaliana, has been shown to exhibit a 30 increase in longevity before the onset of senescence, when compared to wild-type plants. This delay in senescence coincided with delayed induction of SAGs and higher expression levels of photosynthesis-associated genes (Grbic and Bleecker, 1995).

Leisure Recreation and the Arts

Calendars have numerous holidays when the births of important deities are honored, significant new and full moons are venerated, harvest is celebrated, and ancestors are worshipped. Fasting and other purificatory rites precede some festivals one example is the annual women's festival of Tij in which the longevity of husbands is prayed for. The most important celebration in Nepal, Dasai, takes place over 2 weeks after the rice harvest in the autumn, and honors the warrior goddess Durga, the Hindu national goddess.

Other Cross Sex Relationships

The closest and deepest cross-sex relationship is that between sisters and brothers. Sisters are considered sacred by their consanguinal relatives, and their brothers ardently express this. Sisters are worshipped as goddesses during the fall harvest festival, and at other religious times in devout families. In return for sacred tributes such as clothing and money, sisters confer longevity and prosperity on their brothers. Brothers are expected to take care of their sisters until their marriage, and even after, if necessary.

Evasion of the host defenses

Several parasite and host factors may contribute to the longevity and survival of these flukes within the biliary system, which may be considered to be an immunologically privileged site. Both IgG antibody and complement previously reported to kill these parasites are present in low quantities in bile. However, overwhelming evidence points to the conclusion that the antibody produced, regardless of its isotype, seems to have very little protective power. Moreover, a suppressive serum factor that interferes with macrophage function has been reported in patients

The Nature of Senescence

Aging has been described as ''a series of time-related processes that ultimately bring life to a close,'' that is, a process of physiological 'wearing out.' Physiology is the basis of human functionality, as well as of our susceptibility to disease. The late gerontologist, Nathan Shock, established the principle of a progressive decline in physiological reserves as a consequence of 'normal' aging, recognizing that the rate of decline differed markedly among the body's organ systems. In fact, one cannot really separate the concept of the physiology of older persons from the physiology of the aging process itself. Similarly, the high prevalence of chronic diseases in older persons challenges our ability to discriminate 'normative' senescence from pathophys-iological changes. The origin of physiological changes in older persons begins within the domain of cellular senescence. The extension to tissue and organ levels originates in what we interpret to be the physiological changes of human...

Mitochondrial Senescence and Oxidative Stress

The intracellular mitochondria, organelles involved in energy metabolism, are central to the process of cell senescence. They are also involved in regulating thermogenesis, calcium buffering, and integrating apoptosis. With aging, mitochondria become less efficient, in part due to mutations in the cell nucleus, derepressing the expression of proteins that compete with mitochondrial function. This disrupts energy metabolism for the cell and makes the mitochondria more porous, releasing reactive oxygen species into the rest of the cell. The mitochondrial production of reactive oxygen species is inversely proportional to longevity in animals. The oxidative activity also damages the mitochondria themselves. Mitochondria have their own DNA strands, and these accumulate mutations with age. In tissues dependent on progenitor (stem) cells, mitochondrial DNA mutations can disrupt replication.

Approaches In Animal Sciences

While mathematical models of population dynamics may not be frequently used in the animal sciences, the concepts contained therein remain important. Reproduction has been frequently identified as the most important contributor to the economic success (or failure) of livestock and poultry production systems. Further, producing replacements for females that are culled is a major source of cost in many production systems. Significant resources have been invested in efforts to increase numbers of live offspring per female per year and functional longevity of breeding females. Finally, models of gene flow allow increased understanding of dissemination of genetic improvement from seedstock breeders to the commercial industries.

Successful Aging Normative Aging and Frailty

Factors that modify risk of disease and dysfunction determine one's position in these alternative outcomes in the aging process. In this view, more optimal nutrient intake, food selection, and life-style choices could reduce the heterogeneity, retaining more individuals in the successfully aged category for most of their life span. Others consider that genetic constitution may be as important in determining the course of aging as any positive or negative influences during our lifetime.

Overview of Specific Factors of Aging Influencing Nutritional Requirements

The discussion of nutrient requirements and recommended dietary intakes of nutrients in older persons has proceeded on both the theoretical and empirical level. Since the peak years for human reproduction occur before advanced middle age, and well before older age begins, the forces of selective reproduction cannot exert themselves for Darwinian selection of traits favoring longevity in the evolution for any traits related to longevity per se or physiological sustained function. Hence, there is little evolutionary selection for nutrient requirements to achieve advanced age or for long-term survival. It is more for the preservation of comfort and function for those surviving to advanced age that optimization of nutritional intakes for the elderly would apply, that is for humanitarian and public health importance in the face of the physiological and anatomic changes of senescence.

The role of evolutionary and environmental pressures

What possible pressures on the vertebrates necessitated the imposition of acquired or adaptive immunity on the very effective immune defenses of the invertebrates After all, the invertebrates evolved successfully over several hundreds of millions of years to occupy every habitat and niche and to comprise of 95 of all animal species, without the need of a sophisticated vertebrate-type immune system. A possible explanation may involve the common occurrence of somatic mutations in vertebrates which, unless removed by a surveillance system, would develop into cancer. The increased size, longevity 4. Cancer associated with increasing complexity and longevity

Priming and Activation

Priming refers to a process whereby the response of cells to an activating stimulus is potentiated, sometimes greatly, by prior exposure to a priming agent (Table 2). Neutrophil and monocyte priming by agents such as TNF-a, G-CSF, GM-CSF, and LPS causes a dramatic increase in the response of these cells to an activating agent. This process has been shown to be critical for phagocyte-mediated tissue damage both in vitro and in vivo. The principal consequence of priming (aside from direct effects on cell polarization, deformability, and integrin selectin expression) is to permit secretogogue-induced superoxide anion generation, degranulation, and lipid mediator release (LTB4 and arachadonic acid). It is now recognized that most priming agents also serve an additional function of delaying apoptosis and hence increasing the functional longevity of these cells at sites of inflammation. The mechanisms underlying priming include changes in receptor number and or affinity, G-protein...

Modeling Fungal Decay Communities

The majority of natural environments display both spatial and temporal heterogeneity or patchiness in terms of both abiotic and biotic factors, which may profoundly effect the functioning and development of fungal communities (Ritz and Crawford 1999). So models that address environmental heterogeneity are the most likely to produce realistic theory. Certain distinctive biological attributes displayed by the fungal form should also be incorporated into any reasonable theoretical model. Features such as indeterminacy, inter-connectedness, variation, and versatility (genotypic and phenotypic plasticity), all contribute to varying degrees and at different scales, to the success of filamentous fungi within the natural heterogeneous environment. As indeterminate life-forms the growth of filamentous fungi is potentially unlimited, unlike that of determinate life forms such as unicells and animals, which possess genetically programmed limits in both space and time. However this statement may...

Potential Health Effects

There is substantial epidemiological evidence that populations that consume diets rich in plant foods have a reduced risk of cardiovascular disease and various cancers, and the potential role of bioactive compounds in plants in this association is gaining significant attention within nutrition research. Identification of the role of flavonoids in the primary mechanisms that may protect against cellular damage may yield clues to slowing aspects of the aging process and postpone age-related diseases.

Cessation of smoking Grade A

Cigarette smoking has many adverse health effects, including a significant risk of coronary disease. Given the addictive nature of smoking, most smoking cessation programs have limited success ( 6 more patients stop smoking in 12 months than do controls).21 As reviewed in previous chapters, observational data suggest that those who succeed in quitting experience a sharp decline in the high cardiovascular risk associated with smoking in the first 6 months, and their risk reaches the level of non-smokers after 1-2 years. This decrease in cardiovascular risk from smoking cessation has been estimated to increase life expectancy for each quitter by between 2 and 5 years.22 Furthermore, each smoker who quits is associated with an average reduction in CAD-related medical costs of about 900 over the ensuing 8 years.23 In the arena of secondary prevention, Krumholz and colleagues evaluated the effect of a nurse counseling smoking cessation program for post-MI patients.26 Data from a previously...

Growth Of Map Technology

Despite the paucity of visibility, MAP technology has emerged as the premier packaging technology of the last years of this century. Currently, the United States leads the way in MAP technology, followed by the United Kingdom, France, and Germany. Thousands of food processors around the world use MAP technology for shelf-life extension and food distribution. It is estimated that the production of CAP MAP vacuum-packaged foods in North America is well in excess of 30 billion lb annually. The growth of MAP technology, for both medium- and long-term preservation of food, is due to a number of interrelated factors consumer desire for higher-quality, more nearly fresh, and higher nutritional quality foods the development of better but still imperfect distribution systems improved packaging technologies and energy costs.

Increasing Energy Costs

Increasing energy costs associated with traditional methods of food preservation storage, such as freezing, has resulted in the growth of less energy-intensive and more economical methods of short- and long-term preservation, such MAP. It has been estimated that MAP is 18 to 20 less energy intensive compared to freezing for shelf-life extension of bakery products. Thermal processing to achieve ambient temperature shelf stability is energy intensive, but not nearly as much as freezing, which requires removal of heat of fusion as well as temperature reduction and maintenance of low temperature. Further, it has been demonstrated repeatedly that the 0 F (- 18 C) traditionally employed for frozen storage is well above the optimum temperature. Frozen foods are best stored at below their glass transition temperatures, a more costly and energy-intensive process being overtly resisted by commercial frozen food-distribution interests. These groups have failed to recognize the quality and hence...

Methods Of Atmosphere Modification

A novel method of active modification is through the use of oxygen absorbents after mechanical oxygen removal. These consist of sachets that are placed inside the packaged product. Alternately, the oxygen scavenger may be incorporated into the film. Another method of active modification is the use of ethanol vapor generators that modify the gas atmosphere by producing ethanol vapor within the package headspace to suppress mold growth. Both oxygen absorbents and ethanol vapor generators have been used for shelf-life extension of food.

The Impact of Global Aging on Population Health Status

The extension in life expectancy underlying population aging has been the result of decreased infant and maternal mortality and delayed mortality among persons aged 65 and over due to improvements in nutrition, sanitation, control of communicable diseases, and medical services (Miles & Brody, 1994). Developing countries are currently undergoing various stages of the epidemiologic transition, that is, the shift in the major causes of morbidity and mortality from infectious and parasitic diseases to chronic diseases (Omram, 1971) that typically occurred in industrialized countries from the 19th century onward (Levison, Hastings, & Harrison, 1981 Rogers & Hackenberg, 1987 Wolleswinkel-Van den Bosch, Looman, Poppel, & Mackenbach, 1997). Modernization has also spread risk factors for many chronic diseases of aging through the nutrition transition to a Westernized high-fat, low-fiber diet (Popkin, 1994), increased seden-tarism, obesity, and smoking, that contribute to the growing epidemics...

The Importance of Transcription Factors

With few exceptions, every cell in a multicellular organism contains the same set of genes as every other cell. Despite this genetic equivalence, cells differ greatly in form, function, longevity, and many other characteristics. These differences are due to the differential expression of genes within each cell type. Thus, a nerve cell will express a certain subset of the entire genome, while a gut cell will express a different subset. (To express a gene means to use it to create its encoded product, usually a protein.) Cells become different from one another, therefore, by expressing different sets of genes. Thus, the problem of development can be addressed by understanding how initially identical cells come to express different sets of genes.

Nursing Homes and Home Health Care Agencies

The trend toward quality home health care is on the rise as a result of the increased cost of traditional health care and the higher life expectancy rate associated with medical and technological advances. Home health care professionals travel to patients' home settings to provide health care services. Removed from the traditional corporate infrastructure, a home health care provider faces unique challenges. In order to provide quality care, home health care providers must be able to conveniently access patient information when needed, capture admission assessments, and collaborate with other health care team professionals in a timely and effective manner. They must also be able to stay in touch with their supervisors or managers in order to ensure that appropriate actions are taken and the appropriate people are kept informed.

Connective Tissue Disease

Ehlers-Danlos syndrome is a heterogeneous group of inheritable connective tissue disorders characterized by skin laxity, joint hypermobility, and tissue fragility. There are six types classified according to their signs and symptoms. The vascular type (type IV) has an associated shortened life expectancy because of rupture of

Complications of Thyroid Surgery

Thyroid surgery has progressed dramatically since the mid-1850s when half or more of the patients undergoing this operation would die from the procedure. Currently, thyroidectomy is a very safe operation which has an associate mortality rate that approaches zero. In other words, the mortality of a thyroidectomy is really the mortality of a general anesthetic. The morbidity associated with thyroid surgery is also very low. Nevertheless, the complications of thyroidectomy remain a matter of concern especially since thyroid disease often occurs in younger patients who have long life expectancy. Most complications associated with thyroidectomy can be minimized or even avoided by an experienced thyroid surgeon who has in depth knowledge of the anatomy of the central neck compartment and who employs meticulous surgical technique to protect the vital structures within it.

Bioethics Perspective I Health Disparities

The excessive rates of illness contribute to the higher mortality rate of African Americans the National Vital Statistics Report puts life expectancy for white women at 80.0 years 74.9 years for black women 74.8 years for white men and for black men it is 68.2 years (Arias).

Medicine in Ethiopia

The geography and lack of transportation infrastructure is challenging. Eighty-five percent of the population is rural, with agricultural production as their primary livelihood activity. Ethiopia is bounded on the north by Eritrea, on the east by Djibouti and Somalia, on the south by Kenya, and on the west by Sudan. The country is among the poorest in the world, with an annual income of less than 100 U.S. per capita, 51 percent health coverage, 19 percent and 40 percent literacy rate among women and men, respectively, and a life expectancy of 43.4 years. The country scores low in almost all social and economic indicators. For example, in 2001, it ranked 158th out of 162 countries on the global human development index. Ethiopia is a typical developing country its large proportion of children reflects high fertility rates and low life expectancy. The mortality rate for infants and those under the age of five started to decrease at the beginning of 1990s, but no further progress...

Michael Lye Christina Donnellan

It is estimated that 20 of people in Europe will be over 65 years of age in the year 2000. The proportion of the population over 80 years, the so-called old old , is increasing most rapidly. Life expectancy at all ages is also increasing. At 65 years life expectancy ranges from 14.9 to 18.9 years and at 80 years from 6.9 to 9.1 years for men and women, respectively. Cardiovascular disease is the most frequent single cause of death in persons over 65 years of age1, and most importantly it is responsible for considerable morbidity and a large burden of disability, particularly in the community. Cardiovascular pathologies such as hypertension and cerebrovascular disease, and heart diseases such as coronary artery disease, arrhythmias, and heart failure, increase in incidence with increasing age.w1 The aging process itself also effects the cardiovascular system. It is difficult to differentiate normal aging, which is inevitable, from age related pathology,...

Personality Differences by Gender

Despite stereotypes of women as emotional and dependent, in the context of the post-Soviet economic and social crisis in Ukraine, in many ways women seem to cope better than men. Women exhibit less criminality, drink less, and live longer than men (Bohachevsky-Chomiak, 2000). Women express more interest in stability, and they have made the lion's share of efforts to stop up the gaps of the country's troubled welfare system by organizing charitable organizations to assist dispossessed citizens.

Diet Nutrition and Quality of Life

It is probably safe to conclude that suffering nutritional deficiency and dying a premature death from infectious illness is more likely to occur among the rural agrarian peasantry than among the urban masses. But for rural individuals who survive accidental and infectious deaths, their plant-based diets and rigorous lifelong physical activity patterns makes the goal of 'dying healthy in old age' a stronger possibility. With extended life expectancy among urban populations, ensuring the quality of life in later life is important as both a humanistic and economic consideration. Cardiovascular and malignant diseases produce lingering debility and dependency, robbing individuals of well-being and placing a burden of healthcare on relatives and governmental resources. Global and sustainable interventions to reduce sedentariness and pathogenic dietary practices in the growing segment of the world's population living in cities are an imperative for social and economic stability going...

Persistence in the Dry and Wet State

(c) the inherent longevity of the seeds in the wet or dry state, depending on the natural environment and The only type of dormancy that plays a direct role in seed persistence is hardseededness or physical dormancy (see Overcoming Physical Dormancy in Seeds) when the seeds remain dry during storage in the soil. Such sealing in of dryness probably contributed to the exceptional longevity reported for seeds of Nelumbo nucifera - sacred lotus. These viable seeds, which were encased in the dry, hard fruit, were buried in a lake bed deposit in southern Manchuria, and radiocarbon dating indicated a survival period of around 600 years (79). A similar record exists for seed of Canna compacta (Cannaceae) found within a walnut shell rattle in Argentina. However, subsequent seedling growth was S effects of reducing moisture content and temperature on longevity) that dry bank conditions of around 5 seed moisture content and -20 C (17). Bacteria appear to be even more successful survivors in the...

Cardiac transplantation

Cardiac transplantation is performed for terminal heart disease in patients less than 55 years of age when the estimated life expectancy would be 6-12 months. The two major indications for cardiac transplantation are idiopathic cardiomyopathy and ischemic heart disease with left ventricular failure. The heart is placed orthotropically in the chest after removing the recipient's heart but leaving the back wall of the right and left atria with the atrial septum to which the appropriate part of the donor atria is anastomosed followed by the pulmonary artery and aortic anastomoses. The results of cardiac transplantation are very similar now to those of the kidney with around 80 1-year graft survival and 60 at 5 years. Chronic rejection manifest by coronary atherosclerosis is a major problem in the medium term for many patients.

The Authors Experience

From December 1990 to April 1997 we treated 52 patients with significant pericardial effusions and tamponade in whom pericardiocentesis had failed. Twenty-one of these patients, with a life expectancy of 6 months or more, underwent VATS pericardial resection (Table 23.1). There were no hospital deaths, and the average hospital length of stay was 4 days. Pleural sclerosis was performed in five patients without sequelae. In the remaining 31 patients, a subxiphoid approach or left anterior transthoracic pericardiectomy under local anesthesia was employed. As shown in Table 23.1, the latter patients were older and had a considerable 30-day mortality and increased hospital length of stay. Our experience with pericardial effusion and tamponade in patients with metastatic cancer demonstrates two well-defined groups of patients. The first is composed of patients who are essentially moribund with a pericardial effusion with tamponade that is a preterminal event. These patients are best...

Middle Age and Old Age

Today, the Yuqu,i especially women, are living well into their sixties and even their seventies. Medical care provided by the mission and, more recently, by Yuqui health practitioners has greatly extended life expectancy. Unlike many recently contacted groups that lose large

Inactivation of spoilage microorganisms

The preservation of food that is already produced, i.e., control of food spoilage on minimally processed fruits and vegetables, is a current area of extensive research interests (Salunkhe and Desai, 1984 Shewfelt and Prussia, 1993). High-intensity light treatments for control of food spoilage and shelf life extension of smooth surface, non-opaque foods is proving to be an effective and versatile application of high-intensity light technology.

Locus Of Control Theory

More than any other one person, formalized a mature and complete mechanistic theory or mechanistic psychology i.e., the study of the problems of mind are reduced to the form of general problems cf., the vitalism theory approach of the French philosopher Henri Bergson (1859-1941) which holds that a vital force not subject to physical, mechanical, or chemical laws is responsible for life in the closing years of the 19th century. As one of the early animal psychologists, Loeb influenced the thinking of John B. Watson, the founder of behaviorism. Loeb's basic impact on psychology was as a forerunner of an objective, scientific, and naturalistic psychology. His work emphasized experimental methods and de-emphasized the role of consciousness in behavior. See also BEHAVIORIST THEORY LIFE, THEORIES OF MECHANISTIC THEORY.

The Evolution of Disease

Evolutionary medicine provides clues for understanding chronic degenerative diseases (CDD) that affect elders in contemporary populations. The human species evolved over several million years in ecosystems unlike from the modified environments and subsistence patterns of the last 10,000 years. The human genome derived from a highly active, mobile lifestyle, an omnivorous, high-protein diet, a relatively short average life expectancy, and endemic parasitic infections. As Gerber and Crews (1999, p. 447) note, alleles that have been retained in the gene pool are those associated with enhanced early survival, growth, development, and maturation to reproductive age, regardless of any late-acting detrimental effects they may have. Alleles that

Enculturation See socialization

Can refer to a number of demographic transitions (such as when humans became food producers) but usually refers to the more recent transition which includes lowering of infant mortality, longer birth spacing, and the lengthening of life expectancy in recent times. Also called demographic transition. epidemiology. Involves the use of population-based statistical methods of data collection and analysis to elucidate and predict the patterns of development and distribution (including associated causal factors) and potential control of disease across and within populations. epilepsy. A chronic neurological disorder that is characterized by sudden and recurrent seizures and convulsions

The Origins and Meanings of Disease Pattern Categories

The category of time also covers a wide set of processes. Calendar time measured as days, years, or other periods plays its own role in disease distribution, measured through variables such as the time between moment of exposure and appearance of symptoms, or duration of infectivity, or age at onset, or life expectancy after onset. But the cultural practice of dividing time into weekdays versus weekends itself influences disease, since the meaning of these time periods structures activities like drinking, sexual activity, recreation, and work. Time can be a marker of biological influence for example, in the seasonality of disease fluctuations due Dressler is following some of the connections between social stratification and health that have been explored by the social epidemiologist Richard Wilkinson (1996) and others (Davey-Smith et al. 1990, Kawachi et al. 1997, Marmot et al. 1991). For example, Wilkinson argues that relative poverty, the size of the gap between rich and poor, not...

Degenerative valve disease

Standing Seam Panels

Although there has been a dramatic reduction in rheumatic valve disease in the industrialised countries over the past 30 years, there has not been a similar reduction in valve surgery. This is because the types of patients being referred for surgery have changed. The significant increase in life expectancy in developed countries partly accounts for this change in aetiology, especially in aortic valve disease. In one surgical series over a five year period (from 1981 to 1985), it was found that while the proportion of patients with congenitally bicuspid aortic stenosis remained stable (from 37 to 33 ), postinflammatory valve disease decreased from 30 to 18 while degenerative valve disease increased from 30 to 46 .6 The prevalence of degenerative valve disease is not known in underdeveloped countries. Presumably, it is low as life expectancy is much shorter and atherosclerotic heart disease is much less prevalent than in industrialised countries.

Poultry Manure Treatment And Utilization

Chicken Litter Storage Methane Alarm

Manure application that exceeds a crop's ability to take up N may threaten water quality. Nitrogen as nitrate is a highly mobile compound that may cause human and animal health problems if drinking water concentrations are greater than 10 mg l. Soil P enrichment occurs as a result of overfertilization with P. Phosphorus applied to fields as inorganic fertilizer or from manure can move into bodies of water through erosion and runoff events and can accelerate eutrophica-tion (the natural aging process of lakes and streams), leading to excessive algae growth, oxygen deficiency, and fish mortality.

Contents In Fruits And Vegetables And Its Products

Epicatechin by dry weight as well as other flavonoids and their glycosides (26). Thearubigins, highly colored catechin oxidation products and their gallate are of major significance in determining the quality and flavor of tea. Black tea as consumed by humans contains about 36 thearubigins, 3 theaflavins, 5 epigallocatechin gallate, and 1 gallic acid by dry weight. Due to the large amounts of these phenolic compounds in tea, heavy drinkers of tea in Japan may consume 1 g of epigallocatechin gallate per day per person. Dry whole cocoa beans contain approximately 12 to 18 phenolic compounds and the major compound is epicatechin (27). Phenolic compounds in roasted coffee beans are produced during thermal processing from carbohydrates, chlorogenic acid, and lignins. Phenolic compounds in beer that contribute to bitterness, astringency, harshness, and the formation of haze are catechin and epicatechin (approximately 40 mg L), gallocatechin (less than 15 mg L), and hydroxycoumarins and...

Religious and Moral Issues

The widespread moral acceptance of contraception has taken place well within the twentieth century. Individuals do not make moral judgments in the abstract. As indicated previously, a number of significant social factors have influenced the acceptance of contraceptive practices. These include the increased life expectancy of all human beings, the massive improvements in infant and child health resulting in more survival, the realities and pressures of an increasingly urban and industrialized society, the changing role and function of women in society, the wider and more accurate understanding of the physiology of human reproduction, the recognition of the population explosion and the need to limit population, and the development of accessible, effective methods of contraception.

Posthumanism and Anti Posthumanism

The reader will find new articles entitled Transhumanism and Posthumanism, Cybernetics, Cloning, Human Dignity, Embryo and Fetus III. Embryonic Stem Cell Research, Enhancement Uses of Medical Technology, Nanotechnology, and Aging and the Aged VI. Anti-Aging Interventions Ethical and Social Issues. Collectively, these articles and others accentuate the question of what it means to be human. One of the wiser minds of the last century, Hans Jonas (d. 1993), an intellectual inspiration for today's anti-posthumanists, articulated the ethical questions around human malleability with thoroughness. He asked how desirable would the potential power to slow or arrest aging be for the individual and for the species Do we want to tamper with the delicate biological balance of death and procreation, and preempt the place of youth Would the species gain or lose Jonas, by merely raising these questions, meant to cast significant doubt on the anti-aging enterprise. In current discussion, debate grows...

Two Arms Of The Immune System Affected By Stress

Immune System Arms

Catacholamines and glucocorticoids on adhesion molecule expression by vascular endothelial cells and circulating neutrophils prevents this first line of immune defense from gaining access to infected tissues, leaving animals susceptible to diseases caused by opportunistic pathogens. The macrophage barrier to infection in peripheral tissues is also compromised during stress because glucocorticoids inhibit expression of key inflammatory molecules, including prostaglandins, chemokines, cytokines, and free radicals, which normally clear pathogens, initiate neut-rophil recruitment to the site, and activate appropriate adaptive immune responses. Glucocorticoids also dramatically reduce circulating numbers of y8 T cells in ruminants and alter the expression of key apoptosis genes to induce death in developing T cells and longevity in circulating neutrophils. This partly accounts for the altered tissue and circulating cell numbers during stress. Some degree of species specificity is evident...

Confucianism and Daoism

The Chinese developed two other perspectives on death a return to nature and physical immortality. The Daoist philosopher Chuang Tzu (365-290 b.c.e.) wrote that life and death were two aspects of the same reality, mere differences of form. Death was a natural and welcomed release from life, and was to be neither feared nor desired. Because individuals were reabsorbed into nature, both birth and death were as natural as the progression of the four seasons. Other Daoists were interested in alchemy, macrobiotic diets, exercises, fasting, and meditation. Besides desiring health, youth, and longevity, they wanted immortality. They had several views of the latter the physical body would rise to heaven the real body, not the physical one in the tomb, would rise the physical body would go to the Isles of the Blessed, said to be off the northeast coast of China or the self would emerge from the body at death, like the butterfly from its cocoon, to wander freely about the universe or go to the...

Rationale For Laparoscopic Staging

The goal of clinical oncological staging is to accurately define the extent of disease, direct appropriate therapy and avoid unnecessary intervention. Minimal access surgery offers a new approach to this problem. In theory, decreased surgical morbidity, reduced hospital stay, shorter recovery, and potentially improved qual-ity-of-life would be of benefit to the patient expected not to live longer than a few months.

A brief history of enzymology

At that time the prevailing theory in science was vitalism, the assumption that living organisms are distinguished from their surrounding by a force of life (lat. vis vitalis). Thus free ferments like diastase and pepsin could degrade compounds, but synthesis was possible only to organised catalysts inside the cell. Wilhelm Kuhne suggested in 1876 to limit the term ferment to those organised catalysts of living cells, and to use enzyme (from the Greek word for sour dough) for both the unorganised catalysts for example in digestive juices and the organised enzymes of living organisms. The German scientists Hans and Eduard Buchner tried in 1897 to preserve a cell-free juice pressed from yeast with sugar, so that they could market it for medical purposes. Much to their surprise they found that yeast juice could turn the sugar into alcohol just like whole yeast cells do, this observation effectively put an end to vitalism. It is now held that metabolism inside cells follows the same rules...

Hidden Problems in Stoma Care

As the proportion of people aged over 65 continues to grow, the proportion of elderly patients with stomas continues to grow (Ebersole and Hess, 1998). Currently, in the UK the average life expectancy is 83 years for men and 87 years for women. Certain areas of the UK, especially on the south coast of England, have high populations of people over the age of 70 years - as high as 27.9 . In 2000, 10.6 of the population was over the age of 80 (Black, 2000). For many of these patients, there are already other long-standing physical problems and cognitive problems which are going to be complicated further by stoma surgery. For those patients needing to learn self-care for their new stoma, individual assessment of the patient's psychological and cognitive function will be needed to assess how teaching strategies can be adapted. Fine and gross impairment in motor skills will complicate package opening, skin cleansing and appliance application. Visual and hearing impairments make it difficult...

Hematologic Disorders Affecting the Spleen Hereditary Spherocytosis

Thalassemia is a group of genetic disorders that result in a defect in the synthesis of hemoglobin subunits. Structurally abnormal hemoglobin subunits result in its intracellular precipitation. There is an increased uptake of these abnormal RBCs as well as a higher rate of RBC destruction in the spleen. The increased uptake of RBCs results in splenomegaly as well as splenic infarcts. Thalassemia major (homozygous) is the more severe form of the disease in which patients require frequent blood transfusions and have a decreased life expectancy. Thalassemia minor (heterozygous) on the other hand may be completely asymptomatic and only detectable on peripheral blood smear.

Hobbes Psychological Theory

The English philosopher Thomas Hobbes (1588-1679), often referred to as the founder of British empiricism (cf., Locke's psychological theory), asserted in his primary principle of psychology that all knowledge is derived through sensations. By suggesting that nothing exists internal or external to the individual (except matter and motion), Hobbes grounded his psychology firmly in the philosophical positions called materialism and mechanism (cf., Brennan, 1991). The materialistic approach stresses that the only means through which reality is known is through an understanding of physical matter (cf., mental-ism which emphasizes the necessity for using mental units or phenomena in explaining human behavior, and vitalism which maintains that a nonchemical, nonphysical, and non-mechanical vital force is responsible for life). The mechanistic approach holds that all events, phenomena, or behavior may be explained in mechanical terms for instance, Hobbes' theory of sensation states in...

The Aging of the Population and its People

The maximal human life span is about 120 years. Approaching this degree of longevity, however, was not a prominent feature in the evolutionary phases of our species, Homo sapiens. The imperative was to survive the various mortal hazards long enough to reproduce and provide initial care for the offspring. The twenty-first century has ushered in an unprecedented longevity. The life expectancy of infants born today in Western Europe or Japan is over 75 years. The most rapidly increasing population segment in the world today is the centenarian. By the year 2020, there will be over 1 billion people over 60years of age, constituting 13.3 of the global population, and three-quarters of them will be living in developing countries.

Patient Selection Criteria and Overt Rationing

Observers have raised concerns about the appropriateness of treating patients with a limited life expectancy and limited quality of life (Fox Levinsky and Rettig). Specifically, questions have been raised about the appropriateness of providing dialysis to two groups of patients those with a limited life expectancy despite the use of dialysis and those with severe neurological disease. The first group includes patients with kidney failure and other life-threatening illnesses, such as atherosclerotic cardiovascular disease, cancer, chronic pulmonary disease, and AIDS. The second group includes patients whose neurological disease renders them unable to relate to others, such as those in a persistent

Variants Of Sickle Cell Disease Sickle Cell Trait

Clinically, patients with sickle cell trait have minimal complications. The kidney is the most frequently affected organ. Microinfarcts occur in the medulla, leading to papillary necrosis and impaired concentrating ability. Hematuria can be found in 1 percent of patients with sickle cell trait. Exposure to high altitude has been associated with splenic infarction and cerebrovascular complications. Women with sickle cell trait have an increased incidence of urinary tract infections and hematuria during pregnancy. Persons with sickle cell trait have an increased incidence of sudden death during physical training, presumably due to increased sickling with extreme exertion. However, the majority of patients with sickle cell trait are asymptomatic, lead normal lives, and overall have a normal life expectancy.

Variants of Sickle Cell Disease

Clinically these patients have minimal complications, with the kidney being the most commonly affected organ. Hematuria is found in about 1 percent of patients with SCT and is most likely due to papillary necrosis following microinfarcts in the renal medullary tissue. Severe hypoxia and or exposure to high altitudes can cause splenic infarction and CNS complications there is also an increased incidence of sudden death in these patients during physical exertion training. This is thought to be secondary to increased sickling under these extreme conditions. In general, the vast majority of these patients are asymptomatic and lead normal lives with a normal life expectancy.

Allostasis allostatic load and ageing

A feed-forward cascade of disinhibited HPA activity, and other dysregulations such as loss of oestrous cycling, impaired hedonic function (decreased spontaneous motor activity, caloric intake and sweet food preference, and intracranial self-stimulation), and decreased adaptive behaviours (Hatotani et al 1977, 1979, Katz 1982). These effects of chronic stress resemble those seen in ageing. Consistent with this similarity is the decreased longevity of inbred rat strains that are hyperreactive to stress. Mean lifespan is 15 months in the spontaneously hypertensive rat (SHR), and 21.5 months in the Wistar Kyoto (WKY) rat, compared with 31 months for the Brown Norway rat (Gilad & Gilad 1987, Brandle et al 1997). In summary, the neuropathological and neuroregulatory changes of normal ageing resemble those associated with chronic stress. These findings are consistent with the proposal that longevity is affected by allostatic load, and give new meaning to Selye's famous phrase, 'the stress of...

Regulation of eosinophil function

1) Eosinophils from patients exhibiting an immune response and eosinophilia have enhanced functions as compared with normal eosinophils. These functions include chemotaxis, cytotoxicity, respiratory-burst activities and arachidonic acid metabolism. Eosinophils from these patients also have a slightly-increased longevity in culture and a reduced density. 2) In vitro treatment of purified eosinophils with defined immunologic mediators can enhance or suppress measurable responses to activating stimuli, increase longevity in culture, and alter cell density (Table 2). Thus, certain mediators can induce pheno-typic changes in normal eosinophils similar to those observed in eosinophilic patients.

Therapy versus Enhancement

Whereas the somatic versus germline distinction has stood the test of time, the therapy versus enhancement distinction has been criticized (Juengst, 1997 Stock and Campbell Parens Resnik, 2000a). Some critics of the second distinction argue that many genetic enhancements would be morally acceptable. For example, some day it may be possible to transfer disease-resistance genes to human beings. If childhood immunizations, which enhance the human immune system in order to prevent disease, are morally acceptable, what is wrong with genetic immunizations It also may be possible some day to manipulate genes that affect the aging process. If nongenetic means of prolonging life such as organ transplants are morally acceptable, what is wrong with genetic means of prolonging life

Risk as Self Governance

Activities designed to assist with the avoidance of misfortune and danger are ubiquitous in the history of humankind, but the idea of being at risk in its technical, epidemiological meaning is a construct of modernity. In theory, morally neutral risk provides a means whereby experts can distance themselves from direct intervention into people's lives while employing the agency of subjects in their own self-regulation through risk-management. Among the numerous examples of this process, the transformation of aging, in particular female aging, into a discourse of risk is illustrative. Given that women live longer than men it seems odd that female aging has been targeted for medicalization, but this move is in part driven by a fear of the enormous expense to health care budgets that very old infirm people, the majority of them women, are believed to incur.

Tissue and Cell Culture

Space biology research benefits humans back on Earth, as crewmembers on board the ISS perform long-duration research that could lead to medical advancements, new materials, and breakthroughs in technology-, including the development of countermeasures to the symptoms of the aging process. Photo courtesy of NASA. Figure 1-24. Space biology research benefits humans back on Earth, as crewmembers on board the ISS perform long-duration research that could lead to medical advancements, new materials, and breakthroughs in technology-, including the development of countermeasures to the symptoms of the aging process. Photo courtesy of NASA.

The Acute Phase Response and Alzheimer Disease

Elevated plasma levels of cortisol have been found in moderate to severe AD (65,75,132,234,283,313). Orell and O'Dwyer (283) have explained that this may be initiated by excessive cytokine production by injured brain cells which trigger release of corticotropin releasing factor (CRF) from the hypothalamus. CRF stimulates corticotropin release from the pituitary which in turn stimulates glucocorticoid release from the adrenal glands. The activity of this loop is, in part, regulated by the binding of glucocorticosteroid to corti-costeroid receptors in the hippocampus. In animals, aging is acompanied by an impairment in the ability of the hippocampus to inhibit corticotropin release, and is accompanied by a sustained high concentration of steroid production. In persons with AD, there is a delay in the decline of corticotropin concentration after challenge with dexamethasone. It is thought that the excessive and or prolonged cortisol secretion in AD may result in the persistent...

Withholding and Withdrawing Dialysis

The Patient Self-Determination Act, which applied to institutions participating in Medicare and Medicaid and which became effective December 1, 1991, was intended to educate healthcare professionals and patients about advance directives and to encourage patients to complete them. Although the ESRD program is almost entirely funded by Medicare, dialysis units were inadvertently left out of the act. Nonetheless, the completion of advance directives by dialysis patients has been specifically recommended for three reasons (1) the elderly, who constitute roughly half of the dialysis population, are those who are most likely to withdraw or be withdrawn from dialysis (2) dialysis patients have a significantly shortened life expectancy compared to non-renal patients and (3) unless an advance directive to withhold cardiopulmonary resuscitation (CPR) is given, it will automatically be provided, and CPR rarely leads to extended survival in dialysis patients (Moss et al., 1992).

The concept of frailty and successful ageing

Although definitions of successful ageing in gerontology are numerous, there is still no generally accepted definition. Rowe and colleagues defined it as including three main components low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life (Rowe & Kahn 1997). Fries, amongst others, defined successful ageing as optimizing life expectancy while simultaneously minimizing physical, psychological and social morbidity (Fries 1988). Vaillant argued that in addition to physical health, there are three further dimensions, or outcomes, of successful ageing mental health, psychosocial efficiency and life satisfaction (Vaillant & Vaillant 1990). Part of the ageing process affecting body composition (loss of muscle size and strength, loss of bone, and increase in fat mass) might well be related to changes in the endocrine system (Korenman et al 1990, Rudman et al 1990).

Lifespan Development Theories See Aging Theories Of

On decaying meat, but which occurred, in fact, as a result of flies' laying eggs on the meat). Across the centuries, theories of life have focused predominantly on the form of organization displayed, as compared to the other forms, such as the chemical bases (cf., electron-proton theory - the atomistic or reductive approach which states that everything about a living organism, both overt and covert, is nothing more than a grouping of electrons and protons in a dynamic structure). For example, according to Aristotle's theory, the soul is the form or formal cause of the organized body, the matter of which is the material cause of the living creature. Later, in the 10th through the 15th centuries, the Scholastic theory postulated a vital force or vitality principle cf., pneumatism theory, proposed by the early Greek physician Erasistra-tus (c. 310-250 B.C.), is the semi-mystical proposition that breathing is caused by a vital principle or holy spirit Erasistratus also asserted that the...

Nutrients in the soil in the absence of permanently cultivated fields hotcold health systems See humoral medicine human

The average number of years people might be expected to live in a particular population. It is based on the ages of death over a period of time. Populations with high infant mortality may have low life expectancies because of a large number of deaths at young ages such populations might still have many people living to older ages.

Sickle Cell Hemoglobin C Disease HbSC Disease

This heterozygous sickle cell variant results when the gene for HbS is inherited from one parent and the gene for HbC is inherited from the other parent. Hemoglobin C results from a single point mutation in the beta-chain gene lysine is substituted for glutamic acid at the sixth position. About 2.4 percent of US African-Americans carry the gene for HbC. This gene frequency is one-fourth that for HbS, but the prevalence among adults of SC and SS disease is almost the same because those with HbC have a near-normal life expectancy. The red blood cells of these patients contain 50 percent HbS and 50 percent HbC. Because HbC does not polymerize as readily as HbS, the disease generally has less severe clinical consequences. These patients have a mild to moderate hemolytic anemia and mild reticulocytosis. The peripheral smear shows abundant target cells and a few sickle cells, and HbC may be seen precipitated as a rhomboid crystal in the red blood cells. Splenomegaly is a feature of HbSC...

Increased standard of living leading to deleterious health behaviors

A third reason to arouse concern is that, if population levels of CVD risk factors rise as a consequence of adverse lifestyle changes accompanying industrialization and urbanization, the rates of CVD mortality and morbidity could rise even higher than the rates predicted solely by demographic changes. Both the degree and the duration of exposure to CVD risk factors would increase as a result of higher risk factor levels, coupled with a longer life expectancy. The increase in body weight (adjusted for height), blood pressure and cholesterol levels in Chinese population samples aged 35-64 years between the two phases of the Sino-MONICA

Sex Differences in Life History

Human life histories are unusual among primates, our closest relatives. If we followed the typical primate pattern (in which many phenomena vary with size), women would nurse their children until about age 7 years, and then their daughters would have their first children at about age 8 or 9 years (review in Low, 2000). Human distortions of typical primate patterns appear to be linked to our extreme sociality. Any glance at census data suggests that there are also significant sex differences in human life history. Women live longer than men and have greater life expectancy at birth. In this, humans are like most mammals, in which males engage in risky competition for mates, and females specialize in expensive but risk-averse post-natal care females tend to mature significantly earlier, to be less aggressive, and to live longer than males (Low, 2000). Of course, there are social reinforcements of these patterns (Geary, 1998 Low, 2000), but the differences follow the general mammalian...

Glucose tolerance glucose utilization and insulin secretion in ageing

Ageing is associated with a decline in function in many, if not all, human physiological systems. Cardiovascular, haemodynamic, metabolic and renal functions generally decrease with advancing age. Insulin has been causally related in the aetiology of many of these decrements (Reaven 1988, Kaplan 1989, Stout 1990, DeFronzo & Ferrannini 1991). The reduction in whole-body carbohydrate metabolism in the elderly is one of the hallmarks of the ageing process and substantial evidence shows that increasing age is associated with decreased

Non Adaptive Evolution

Non adaptive evolution suggests that the ageing process has evolved as an optimum balance between the limited energy sources available to the organism and the demands of normal function and repair. In general, it remains fair to say that the ageing process is incompletely understood at present.

The first paradigm specific etiology and immunization

Putrefaction of animal tissue was thought of as another form of fermentation, one that led to noxious products. All of these were thought to be caused by chemical agents that catalyzed chemical reactions. The catalysts were called 'ferments' yeast was the ferment known to be responsible for the production of alcohol and wine and the rising of dough. Even though Schwann and others had showed in 1837 that yeasts were living entities more closely related to plants than animals, the great chemists and their followers did not see any value in microscopic evidence. The idea that living agents were involved was relegated to 'vitalism', which was anathema at that time to great chemists like Leibig, Berzelius, Helmholz and Wohler. They considered the yeast seen in fermentation to be chemical precipitates. The great Leibig summed up the chemists' view of a vitalistic nature of ferments 'As to the opinion which explains the putrefaction of animal substances by the presence of...

Arguments for and against IGM

IGM can benefit patients by preventing genetic diseases as well as the disability, pain, and suffering associated with those diseases (Zimmerman Berger and Gert Munson and Davis). IGM also can benefit patients who will enjoy the effects of enhancements of health, longevity, intelligence, and so on (Stock and Campbell Glover Silver).

Clinical Versus Pathological Dimensions of AD

*It is beyond the scope of this book to adequately address the debate over the relationship between so-called normal aging and AD (refs. a-e). Some of the pertinent issues are considered in the sections addressing AD pathology (Chapter 3) and early cognitive changes (Chapter 8). Two antithetical views have been posed one emphasizing the continuity and the other the differences between normal aging and AD. On a pathological plane, some would argue that qualitatively, normal aging and AD are very similar. The differences are only quantitative, with AD reflecting greater plaque and tangle burden (ref. f). AD is seen as an inevitable consequence of the aging process, such that anyone who lived long enough would develop the disease. From this perspective, the dividing line between normal aging and AD is relatively arbitrary. If the more extreme version of this view turns out to be correct, it would pose a challenge to efforts to identify individuals in the presymptomatic stages of AD. Even...

Antiaging Interventions Ethical And Social Issues

An estimated 2,500 physicians in the United States had established specialty practices devoted to longevity medicine by 2003, and the American Academy of Anti-Aging Medicine (A4M) boasted 11,000 members in that year. The goal of this clinical community is to extend the time their patients can live without the morbidities of the aging process namely memory loss, muscle loss, visual impairment, slowed gait and speech, wrinkling of the skin, hardening of the arteries, and all the other maladies we call aging (Shelton). At the beginning of the twenty-first century, however, there was little the practitioners of anti-aging medicine could prescribe that had any scientific validation (Olshansky, Hayflick, and Carnes Butler et al.). But the scientists who study the biology of human aging, known as biogerontologists, are slowly making headway, and a central research agenda for this community is to provide clinicians with the tools they require to make anti-aging medicine a reality (Kirkwood...

Mortality Transition Patterns

There are two interesting patterns in the epidemiologic transition of the United States. In 1900 the average life expectancy for women was 2.6 years greater than that of men. By 1990 this difference had increased to 6.8 years. Although the increasing gender gap in longevity is attributable to more rapid declines in death rates for women at every age and for most causes of death, it is unclear why the mortality transition of women has proceeded at a faster pace than that of men. The prevailing explanation for the widening gender gap in life expectancy in the twentieth century is a combination of lifestyle characteristics among men that make them more prone to vascular diseases and cancer, and, with extended longevity, the increased expression of genetic differences. Another interesting pattern in the U.S. mortality transition is the difference observed in historical trends in longevity between blacks and whites. In the early part of the twentieth century, the expectation of life at...

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How To Add Ten Years To Your Life

How To Add Ten Years To Your Life

When over eighty years of age, the poet Bryant said that he had added more than ten years to his life by taking a simple exercise while dressing in the morning. Those who knew Bryant and the facts of his life never doubted the truth of this statement.

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