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DIABETES

Obesity is one of the major medical risk factors for diabetes in African-American women, who are 50 percent to 80 percent more likely to develop gestational diabetes than White women. African-Americans are twice as likely to have diabetes as White Americans of the same age and 27 percent more likely to die of the disease. Medical experts say about 2.8 million or 13 percent of African-Americans have diabetes.

Diabetes results from a defect in insulin production or processing, or both. People with diabetes can’t make energy from food. Sugar remains in the blood instead of mixing in the body’s cells, increasing the risk of heart disease, kidney disease, and foot and eye problems.

The two major types of diabetes are Type 1, which is insulin dependent and usually affects children and teens. Most African-Americans have Type 2 diabetes, which usually develops after the age of 40.

Indications that a person might have diabetes include extreme hunger, excessive thirst, irritability, frequent urination, tingling in fingers and toes, unexplained weight loss, fatigue, nausea and vomiting.

THINGS YOU CAN DO TO PREVENT OR DELAY TYPE 2 DIABETES

* Get tested for diabetes.

* Follow your doctor’s advice.

* Get nutritional counseling.

* Choose balanced meals that are nonfat or low fat.

* Avoid eating large meals or snacks.

* Eat meals on a regular schedule.

* Keep your blood sugar as close to normal as possible.

* Have your blood pressure checked.

* Don’t smoke.

* Exercise at least 30 minutes a day to help regulate your metabolism, lower blood glucose, reduce blood pressure and raise the “good” cholesterol level.

* Have your feet checked at least once a year.

* Learn as much as you can about diabetes.

* Share what you learned about diabetes with your family and friends so they can help you.

* Check out www.diabetes.org or call 1-800-342-2383.

HEART DISEASE

Heart disease is the No. 1 killer of African-American women, who are 69 percent more likely to die of heart disease than White women and are less likely to have health insurance. It’s estimated that 50 percent of African-American women are obese, and excessive weight is a risk factor that leads to heart disease.

TO REDUCE THE RISK OF HEART DISEASE TAKE THE FOLLOWING STEPS:

Don’t smoke. Smokers have more than twice the risk of having a heart attack than nonsmokers. Smokers die more often when they have a heart attack.

Introduction

Broth, made from the bones of animals, has been consumed as a source of nourishment for humankind throughout the ages. It is a traditional remedy across cultures for the sick and weak. A classic folk treatment for colds and flu, it has also been used historically for ailments that affect connective tissues such as the gastrointestinal tract, the joints, the skin, the lungs, the muscles and the blood. Broth has fallen out of favor in most households today, probably due to the increased pace of life that has reduced home cooking in general. Far from being old-fashioned, broth (or stock) continues to be a staple in professional and gourmet cuisine, due to its unsurpassed flavor and body. It serves as the base for many recipes including soup, sauces and gravy. Broth is a valuable food and a valuable medicine, much too valuable to be forgotten or discounted in our modern times with our busy ways and jaded attitudes.

Definition

In general, broth is a liquid made by boiling meat, bones, or vegetables. There are many types of broths, based on what is being cooked. For example, Bieler Broth, a vegetable broth made with green beans, zucchini, and celery is a supportive remedy used in detoxification or cleansing protocols. ConsommE, a rich broth made from meat, is another example. It is prepared by reducing, or prolonged simmering. Stock is another word used synonymously with broth, though some chefs denote stock as being made from bones whereas broth is made from meat. In this paper the two names are used interchangeably. Soup is a similar term referring to simmered vegetables, meat, and seasonings, and is defined by Random House Webster’s Dictionary as a liquid food. (1) The difference is that soup contains solids such as meat, beans, grains or vegetables (sometimes disguised by a puree) while a broth is the liquid in which solids have been simmered and then discarded. Soup is what we think of as having for a meal. Broth is a starting ingredient for soup, and must be prepared separately beforehand.

In 1998, recognizing that exposure to hazardous environmental conditions can be particularly detrimental to the health of children, the NIEHS, the U.S. Environmental Protection Agency (EPA), and the Centers for Disease Control and Prevention initiated the Centers for Children’s Environmental Health and Disease Prevention Research program. This highly successful program promotes the translation of basic research findings into applied intervention and prevention methods. In the past five years, researchers have discovered that

* blood and urine specimens from pregnant women show measurable levels of pesticides, which means that the fetus is exposed to these chemicals during early development;

* children in urban and rural environments are exposed to a complex mix of agricultural and household pesticides, environmental tobacco smoke, and polycyclic aromatic hydrocarbons that, in combination with social factors, can impact their early growth;

* exposures to lead in the urban environment can have life-long effects such as behavioral problems and criminal behavior in adulthood;

* exposure to polychlorinated biphenyls can affect cochlear function, which may cause hearing loss in early life;

* air pollution can cause inflammation in the lung, and its effects can be seen in school-age children as exacerbation of asthma symptoms and more days absent from school; and

* asthma symptoms in children can be reduced by reducing allergens from dust mites and cockroaches in the home.

The NIEHS and the EPA announce the continuation of funding for six centers and the start of one new center. There are also four existing centers. The research at these centers includes toxicological, epidemiological, exposure assessment, genetics, and community-based participatory methods to address pressing questions related to children’s susceptibility and exposure to harmful environmental agents and their health consequences. There are close ties with community organizations that assist in the dissemination of research findings to the community. The program also includes opportunities to develop new and creative strategies to inform health care practitioners, policy makers, and the public about environmental health concerns relevant to children.

Health & Disease in Britain: From Prehistory to the Present Day. Charlotte Roberts and Margaret Cox. Sutton Publishing. [pounds sterling]25.00. xix + 476 pages. ISBN 0-7509-1844-6. This important study, jointly written by an archaeologist and an archaeologist-anthropologist sets out ‘to assess the health and disease of the population of Britain from prehistory to the present’. It is a mammoth task for, as the authors write, ‘health and disease are necessary parts of life and death’. The first chapter acts as an extended introduction to the nature of health and disease and to the means by which both can be studied in the British Isles. In itself this first chapter is worth the price of the book. After this the authors follow a chronological approach and each chapter is itself introduced with a discussion of the factors that affected the health of people in that period, factors such as environment, climate, economy, diet, living conditions, hygiene, population, occupations and historical events that affect health, e.g. war. The book not only gives one a wonderful understanding of the subject but a wealth of facts. In the pre-Roman period (10500 BC to 43 AD) men got shorter whilst women got taller. Between c. 1559 and c. 1850, as unplanned urbanisation led to lower standards of hygiene, childhood killers such as measles increased whilst tuberculosis replaced smallpox and plague as the major causes of death. In recent years we have made significant progress in some fields, such as infant mortality, but regressed in others, such as smoking related illnesses. There is a wealth of information in this study that any student of history will find invaluable to a fuller understanding of British life. (J.M.)

Vaccines: Preventing Disease Protecting Health does not provide the type of vaccine-specific information as Plotkin and Orenstein’s Vaccines (1), nor does it provide the details on the immune system of Bloom and Lambert’s The Vaccine Book (2). The book does not cover every important vaccine issue, such as ethical issues in vaccine trials and the conduct of clinical trials; most critically, it lacks an index. But these limitations are minor compared to what the book provides.

This relatively small book provides state-of-the-art information by those who are directly involved with vaccine and immunization programs. The book evolved from a meeting held November 25-27, 2002, in Washington, D.C., at which many of the world’s top vaccine scientists reported on their research. As the book jacket states, the roster of authors reads like a Who’s Who in vaccine research and public health immunization programs. This publication comes from the Pan American Health Organization (PAHO), the World Health Organization (WHO) Regional Office, which has been at the forefront of almost every major vaccine initiative for the past 30 years, including the eradication of polio, elimination of measles, and strategies to control rubella and neonatal tetanus. These programs have served as models emulated by other WHO regions in the world. The editor, Ciro A. de Quadros, former director of PAHO’s Vaccine and Immunization Program, has a scholarly hand, as well as an eye towards what is practical and useful. This book conveys not only what has been achieved in the arena of vaccine-preventable diseases in the 30 years since the first such conference was convened by PAHO in 1970 but also what is most likely to happen during the next 30 years.

Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Lung Biology in Health and Disease, Volume 183. By Nikos M. Siafakis, Nicholas R. Anthonisen, and Dimitris Georgopoulos, eds. New York, NY: Marcel Dekker, 2004; 603 pp; $199.95

The Lung Biology series published by Marcel Dekker covers a wide range of topical issues. Some are collections of illuminating essays aimed at fellow researchers, while others target comprehensive coverage of their theme, in effect addressed “to whom it may concern.” No. 183, cast in the latter mold, is a detailed review of the epidemiology, pathology, physiology, presentation, and treatment of acute exacerbations of COPD (AECOPD). This is timely, in view of the current investment of time and effort that at long last is being directed toward the amelioration of this distressing group of conditions. In total, 66 contributors from 10 countries (11, if we count Scotland separately) have written all of 32 chapters. These are headed conventionally: definition, epidemiology, pathology, radiology, and so on.

All hospital physicians know what is meant by acute exacerbations of COPD: patients experience worsening dyspnea and cough and an increase in the volume and purulence of their sputum. These clinical observations were encapsulated in 1987 by Anthonisen et al in the Annals of Internal Medicine, and a universal definition of AECOPD might have resulted from this work. Regrettably, many different definitions have emerged that muddied the waters and made it somewhat difficult to review the AECOPD literature.

The evidence-based answers to many common questions about AECOPD can be found in this book. Do steroids help? (yes); should antibiotics be prescribed? (yes, if the sputum is purulent); do bacterial infections damage the airways permanently? (probably); why does oxygen administration cause Pco2 to rise sometimes? (because it worsens ventilation/perfusion dispersion); does noninvasive positive pressure ventilation have a role? (sometimes). Strikingly, electrolyte and water balance have hardly been investigated since 1980; the causes of edema, the role of comorbid left ventricular dysfunction, and the effects of loop diuretics are still not well studied and are dismissed throughout the book as self-evident.

Gene Therapy in Lung Disease: Lung Biology in Health and Disease; Volume 169 By Steven M. Albelda, ed. New York, NY: Marcel Dekker, 2002; 576 pp; $185

The use of natural products refined into pharmaceutical agents in order to treat patients suffering the effects of disease has been the traditional approach of medicine for generations. With the completed sequencing of the human genome, inherited or acquired genetic defects are increasingly recognized as a cause of many aliments. In this new era of medical genomics, researchers are investigating novel mechanistic approaches to cure specific diseases. Gene therapy is one of these approaches that has evolved from the concept of inserting a normal copy of a gene to restore the proper function of a damaged one. Initial excitement over gene therapy from the first clinical trials in 1990 has waned with the appreciation of numerous hurdles, present both at the bench and the bedside, which need to be overcome in order for gene therapy to benefit patients.

Gene Therapy in Lung Diseases, edited by Steven M. Albelda, is the 169th volume in the Lung Biology in Health and Disease series from executive editor Claude Lenfant. This multiauthored book is a comprehensive and balanced review of the application and limitations of gene therapy to pulmonary disease. The book commences with a historical overview of the field of gene therapy and a discussion of the mechanisms of public oversight of human gene therapy trials by the National Institutes of Health and Food and Drug Administration, immediately drawing the attention of the reader to the regulatory hurdles physicians face in applying new technologies to patient care.

Many efforts in gene therapy have focused on finding the proper vector and delivery systems to introduce a corrected gene to the affected cell or tissue. Chapters 2 through 6 in the first section of the book, “Vectorology,” describe the advances that have been made in the development of gene delivery systems to the lungs. These chapters discuss adenoviral and adeno-associated viral vectors, cationic lipids or liposomal delivery, replicating vectors, and strategies used to improve the targeting and expression of transgenes in specific cell types.

THE LANGUAGE OF LIFE: How Cells Communicate in Health and Disease

DEBRA NIEHOFF

Cells within a human body function much as the ideal human society does, each member working for the survival of the whole. The key to this harmony is communication. Niehoff explores the various methods by which cells communicate on topics ranging from growing into an embryo to committing suicide for the good of the human body. Scientists have discovered the signaling pathways that orchestrate such changes. When these pathways become disrupted–often by mutation–birth defects and diseases such as cancer and diabetes occur. Niehoff clearly defines the acronym-laden and inscrutable jargon of cell biologists. She explains the cellular functions underlying how the body reacts to stress, why dieting is so difficult, and how memories are formed in the brain. By learning how cells signal each other, scientists are developing drugs and other treatments that can be introduced when the signaling goes awry. Joseph Henry Press. 2005, 260 p., b&w illus., hardcover, $27.95.

How unfair! Only one health, and so many diseases Victor Schlichter

Since eternity, infections have plagued mankind and caused untold human suffering. Even today, respiratory viral infections are the most common cause of seeking relief from the physician. Another disease known to occur since antiquity is asthma, and, much to everyone’s consternation, morbidity due to this intriguing illness has rapidly increased over the last few decades. Not too long ago, it would appear strange if these two entities were spoken about in the same breath. However, recent insights have indicated that an amalgam of these two conditions exists and that this nexus could possibly be emerging as a major cause for concern.

The editor of the Lung Biology in Health and Disease series must be complimented for persuading Drs. Sebastian L. Johnston and Nikolaos G. Papadopoulos to edit this state-of-the-art monograph, Respiratory Infections in Allergy and Asthma, a field that is very complex, in which information is rapidly evolving. This volume is divided into eight parts and comprises 29 chapters. The introductory chapter must be singled out for a succinct and lucid overview of asthma, especially in terms of immunology, the role of the airway epithelium, and airway remodeling. This chapter sets the pace for the rest of the book.

Part two on “Epidemiology” has four chapters that acquaint the reader with recent advances in understanding of the interaction between viral infections and asthma. The paradox of viruses being protective as well as a trigger for asthma has been debated and is well-covered here. The five chapters on immunopathology explore at length the mechanisms of the disease process induced by viruses, and outside of this volume it would not be easy to find such in-depth knowledge on this subject assimilated in one place. The section on “Models of Viral Infections and Virus-Induced Asthma” would be extremely useful to anyone who is working in this area. The chapter on “Human Experimental Models of Virus Infection and Asthma” highlights the importance of such a tool to study the role of viruses in asthma and other atopic disorders. The experimental protocol and relevant safety concerns are elegantly summarized here.

Interventional Pulmonary Medicine: Lung Biology in Health and Disease;
Until recently, interventional pulmonary medicine was limited to invasive bronchoscopic procedures including foreign-body removal, debulking of endobronchial tumors, or insertion of stents for the palliation of lung cancer. Most of these procedures were performed under general anesthesia by thoracic surgeons using a rigid bronchoscope, and as a result only a few pulmonary physicians developed an interest in interventional techniques. In recent years, however, there have been advances in many areas of pulmonology, including interventional techniques, and many pulmonary physicians train in, and practice, interventional pulmonology. Significantly, these new interventions have been shown to improve lung function and quality of life in patients with serious pulmonary conditions that have hitherto been considered irremediable.

Interventional Pulmonary Medicine presents an extensive overview of the techniques encompassed by interventional pulmonary medicine. The editors are unquestionably leaders in this burgeoning field, and have drawn on other experts from the Americas, Europe, Asia, and Africa to compile the 30 chapters in this valuable text. The book begins with an historical review of rigid and flexible bronchoscopy, followed by chapters that discuss 27 diagnostic and therapeutic interventional procedures, including 18 bronchoscopic and 4 thoracoscopic procedures. Additional chapters cover whole-lung lavage, percutaneous tracheostomy, and other specialized applications. The organization of the chapters is consistent, putting each intervention into perspective as well as providing the detailed overview that one would expect, but not including a step-by-step “how-to-do-it” approach. Nevertheless, the techniques are explained in broad terms, and the reader is referred to appropriate sources for the details. In this sense, Interventional Pulmonary Medicine serves as a reference book rather than a handbook of pulmonary interventions.