Youth by Samuel Ullman

Youth is not a time of life; 

it is a state of mind; 

it is not a matter of rosy cheeks, 

red lips and supple knees; 

it is a matter of the will, 

a quality of the imagination, 

a vigor of the emotions; 

it is the freshness of
the deep springs of life.

Youth means a temperamental predominance of courage over timidity of the appetite, for adventure over the love of ease. This often exists in a man of sixty more than a boy of twenty. Nobody grows old merely by a number of years. We grow old by deserting our ideals.

Years may wrinkle the skin, but to give up enthusiasm wrinkles the soul. Worry, fear, self-distrust bows the heart and turns the spirit back to dust.

Whether sixty or sixteen, there is in every human being’s heart the lure of wonder, the unfailing child-like appetite of what’s next, and the joy of the game of living. In the center of your heart and my heart there is a wireless station; so long as it receives messages of beauty, hope, cheer, courage and power from men and from the Infinite, so long are you young.

When the aerials are down, and your spirit is covered with snows of cynicism and the ice of pessimism, then you are grown old, even at twenty, but as long as your aerials are up, to catch the waves of optimism, there is hope you may die young at eighty.

Common Skin Disorders

The earlier you find a skin cancer, the easier it is to treat successfully. Both skin self-examinations and professional whole-body skin exams are useful in early detection of skin cancers, including melanoma, the deadliest form of skin cancer.

In this article, we will discuss some common skin disorders.

Tinea Versicolor

Tinea versicolor (see pictures here) is a common skin condition caused by an overgrowth of yeast on the skin's surface.  The yeast normally live in the pores of the skin and thrive in oily areas such as the neck, upper chest, and back.  An overgrowth results in a fungal infection that causes uneven skin color, scaling, and sometimes itch.

Tinea versicolor usually produces few symptoms.  Slight itching may intensify when a person becomes hot.

Causes of Tinea Versicolor

Why some people develop tinea versicolor and others do not is not entirely clear.  The yeast which causes tinea versicolor is normally present in small numbers on normal skin, and the yeast can become overgrown on anyone.

• Dark- and light-skinned people are equally prone to developing tinea versicolor
• People with oily skin may be more susceptible than those with naturally dry skin.
• Most commonly develops in teenagers and young adults
• Children and the elderly rarely develop this condition, except in tropical climates.
• In areas with high temperatures and humidity, tinea versicolor occurs in individuals of every age, and people in tropical regions can have these spots year round.
• Tinea versicolor also is more common in temperate climates during the summer when the temperature and humidity are high, with the spots generally fading during the cooler and drier months of the year. 

Diagnosis

Although the light- or dark-colored spots can resemble other skin conditions, tinea versicolor can be easily recognized by a dermatologist.  In most cases, a visual exam of the skin is all that is needed to make the diagnosis.

Treatment

Each patient is treated by a dermatologist according to the severity and location of the disease, the climate, and the desire of the patient.  Treatments may include:

• Topical (shampoos, soaps, creams, or lotions) medications that may contain selenium sulfide, ketoconazole, or pyrithione zinc
• Oral medications, including ketoconazole—the use of prescription medicines should be supervised by your dermatologist.
• Medicated cleansers, used once or twice a month, especially during warm, humid months of the year, may be recommended since tinea versicolor can recur.

It is important to remember that the yeast is easy to kill, but it can take weeks or months for the skin to regain its normal color.

Actinic Keratoses (AKs)

Actinic keratoses (AKs; see pictures here) are common skin growths.  In fact, these growths are so common that treatment for AKs is one of the most frequent reasons that people see a dermatologist.  AKs also are called "solar keratoses" because they are caused by years of sun exposure.  Note that:

AKs are considered precancerous.  Left untreated, AKs may turn into squamous cell carcinoma.

 Symptoms

Most AKs share common qualities such as being dry, scaly, and rough textured.  Not all AKs look the same though.

• Some are skin colored and may be easier to feel than see. 
• These AKs often feel like sandpaper, can appear in groups and cover larger areas of skin.
• Other AKs can appear as red bumps; thick red scaly patches or growths; or crusted growths varying in color from red to brown to yellowish black.

 AK may range from the size of a pinhead to larger than a quarter.  AKs often seem to disappear for weeks or months and then return.  This makes treatment important.  Left untreated, the damaged cells can continue to row and skin cancer may develop.

When AKs develop, they tend to appear on skin that receives the most sun, including the:

• face, forehead and scalp, especially a bald scalp
• ears
• neck and upper chest
• back
• arms and hands
• lower legs, especially in women

Causes of AKs?

Fair-skinned people have a higher risk for getting AKs.  Also, people who have one or more of the following traits:

• Blond or red hair color
• Blue, green or hazel eyes
• Skin that freckles or burns when in the sun
• 40 years of age or older

Treatment

When treating AKs, dermatologists may use one or several therapies.  Treatments available in a dermatologist's office include:

• Cryosurgery
• Photodynamic Therapy
• Chemical Peeling
• Laser Skin Resurfacing
• Curettage

Some treatments are prescription medications that patients apply to their skin.  If you are prescribed one of the following medications, you will apply it at home as directed by your dermatologist.

Imiquimod can be used to treat a skin condition of the face and scalp called actinic keratosis (AK), which is caused by too much sun exposure. Imiquimod may be used to treat certain types of skin cancer called superficial basal cell carcinoma (sBCC)

Other Common Skin Disorders

• Athlete's Foot
• Non-prescription drug: Lamisil Cream
• Acne
• Atopic dermatitis (eczema)
• Rosacea
• Seborrheic keratosis
• Noncancerous, Precancerous and Cancerous Tumors (images)
• Canker sore / Cold sore

Acknowledgement

All content solely developed by the American Academy of Dermatology.

References

1. Mapping the role of NAD metabolism in prevention and treatment of carcinogenesis
• Analyses of normal human skin tissue from individuals diagnosed with actinic keratoses or squamous cell carcinomas show that NAD content of the skin is inversely correlated with the malignant phenotype.
• NAD exists in two forms: an oxidized and reduced form, abbreviated as NAD+ and NADH (H for hydrogen) respectively.
2. Niacin and carcinogenesis
• In addition to its well-known redox functions in energy metabolism, niacin, in the form of NAD, participates in a wide variety of ADP-ribosylation reactions.

Taking Control of Your Bladder

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Most people take bladder control for granted until it interrupts your ability to carry on an ordinary social and work life.

In this article, we will discuss how to take control of your bladder.

Signs of a Bladder Problem

• Inability to hold urine or leaking urine (i.e.,  Urinary Incontinence)
• Needing to urinate eight or more times in one day.
• Waking up many times at night to urinate.
• Sudden and urgent need to urinate.
• Pain or burning before, during, or after urinating.
• Cloudy or bloody urine.

Here we will focus mainly on Benign Prostatic Hyperplasia (B.P.H.) and Urinary Incontinence.

Benign Prostatic Hyperplasia (B.P.H.)

B.P.H.is a nonmalignant growth of the prostate gland. As the prostate enlarges with age, it squeezes the urethra that passes through it and can disrupt normal urinary function.

The prostate is a walnut-shaped gland that produces the seminal fluid in a man’s ejaculate. The gland typically starts to enlarge in men’s 40s as smooth muscle and lining cells proliferate. As the gland gradually increases in size, nearly half of men develop moderate to severe symptoms of the lower urinary tract by their eighth decade of life.

Risk Factors

Common risk factors for developing B.P.H. include:

• Age
• Family history of the condition
• Obesity
• Metabolic syndrome
• Sedentary lifestyle and diabetes. 
• Ethnic Group
• There is a higher incidence among African-American men. 
• Diets
• Diets high in starches and meat have been linked to progression of BPH, while a vegetable-rich diet has been associated with less severe symptoms.

Alternatives to Surgery for B.P.H.)

The good news is there are now quite a number of ways to alleviate the symptoms of B.P.H. short of surgery to remove part or all of the prostate, which can cause other problems, including erectile dysfunction. According to guidelines published by the American Urological Association, recent treatments have focused on slowing the progression of the condition and preventing its complications.

Here are the list of alternatives to surgery for B.P.H.:

• Lifestyle changes
• Reducing overweight
• Minimizing liquid intake late in the day
• Getting regular physical activity
• Avoiding 
• smoking and consumption of alcohol, caffeine and highly seasoned foods
• Treating constipation
• Double-voiding
• After urinating normally, wait about 20 to 30 seconds and try again. Men are likely to have more success emptying their bladders by sitting on the toilet and leaning forward instead of standing.
• Taking Medication
• Alpha-blockers like Flomax
• 5ARIs like finesteride
• PDE5 inhibitors like tadalafil
• Notes
• There is also a combination drug of an alpha-blocker and a 5ARI that is said to work better than either one alone. 
• While the sexual side effects of surgery are usually permanent, if such effects are caused by a medication, they can be reversed by stopping the drug and perhaps switching to another one.

Urinary Incontinence

Often, the causes of urinary incontinence are out of a person's control. For example, in women, incontinence is a common side effect of childbirth. For men, it's most often a side effect of treatment for prostate problems.

Although it may not be possible to avoid incontinence, you can take steps to lower the chances that you will develop this distressing problem.

1. Watch your weight 
• Excess weight and incontinence can go hand in hand, particularly for women. 
• One theory is that extra abdominal fat can weaken the pelvic floor muscles and lead to stress incontinence (leaking when coughing, laughing, sneezing, etc.). In some cases, simply losing weight can improve incontinence.
2. Don't smoke
• Smoking threatens your health in many ways. It also doubles the likelihood that a woman will develop stress incontinence. Nicotine has also been linked to urge incontinence.
3. Stay active
• In the Nurses' Health Study, middle-aged women who were most physically active were least likely to develop incontinence.
4. Minimize bladder irritants
• Caffeine and alcohol have been linked to urge incontinence (the feeling you need to urinate even when the bladder isn't full). Carbonated drinks, the artificial sweetener aspartame (NutraSweet), spicy foods, and citrus fruits and juices cause urge incontinence in some people.
5. Don't strain with bowel movements
• This can weaken the pelvic floor muscles. If your stools are frequently hard or take considerable effort to pass, talk with your doctor. 
• In a study involving people ages 65 and older, treating constipation improved a variety of urinary symptoms, including frequency, urgency, and burning. 

Treatments for urinary incontinence are more effective and less invasive than ever. If you have problems with the unintentional loss of urine, don't suffer in silence. Talk with your doctor.

For more on treating bladder and bowel incontinence, buy Better Bladder and Bowel Control, a Special Health Report from Harvard Medical School.

References

1. Bladder control problems in women: Seek treatment
2. Alternatives to Surgery for an Enlarged Prostate

Global Foot Ulcers and Pressure Ulcers Market―All Things Considered

The global foot ulcers and pressure ulcers is primarily being driven by:^[1]

1. Chronic diabetes
• A rampant rise in chronic diabetes affecting thousands of people on a yearly basis. 
• This is mainly due to the fact that people affected with diabetes are prone towards bruises and ulcers caused on feet and even other parts.
2. Prolonged hospital stays
3. Neuropathic diseases
4. Reduced mobility 
5. Increasing geriatric population

With a rising awareness among the masses to treat these maladies, a higher demand for relevant medications is being felt, consequently propelling extensive growth in the global foot ulcers and pressure ulcers market.

Wound Care Market 

The global diabetic foot ulcers and pressure ulcers market is projected to exhibit a positive CAGR (Compound Annual Growth Rate) of 6.6% between 2016 and 2024. Thanks to this, the market’s valuation will reach US$4.9 bn by the end of 2024, a significant growth achieved from an earlier revenue worth US$2.8 bn clocked in 2015.^[1]

Key Segments 

The global diabetic foot ulcers & pressure ulcers market is segmented on the basis of type of

• Wound
• Among the type of wound segment, the diabetic foot ulcers accounted for the largest share of the global diabetic foot ulcers & pressure ulcers market in 2015, and is expected to continue the dominance during the forecast period. 
• Treatment 
• Among the treatment type segment, the wound care dressings segment accounted for the largest share of the global diabetic foot ulcers and pressure ulcers market in 2015. 
• End users
• Among the key end users, including hospital inpatients settings, hospital outpatient settings, community health centers, home healthcare, and others, hospital inpatient settings constituted the leading segment in 2015.
• Hospital inpatient settings held over 36% of the market and is forecast to remain dominant through the course of the report’s forecast period.

Wound Care Dressings

Wound care dressings segment can be further classified into 

• Antimicrobial dressings
• Foam dressings
• Hydrocolloid dressings
• Film dressings
• Alginate dressings
• Hydrogel dressings
• Other dressings

Growth of the wound care dressings segment is primarily driven by usage of antimicrobial dressings in the treatment of ulcers.

Comprehensive Care Plan

Addressing the many aspects of wound care usually requires a multidisciplinary approach.

Members of your care team might include: 

• A primary care physician who oversees the treatment plan
• A physician or nurse specializing in wound care
• Nurses or medical assistants who provide both care and education for managing wounds
• A social worker who helps you or your family access resources and who addresses emotional concerns related to long-term recovery
• A physical therapist who helps with improving mobility
• An occupational therapist who helps to ensure appropriate seating surfaces
• A dietitian who monitors your nutritional needs and recommends a good diet
• A doctor who specializes in conditions of the skin (dermatologist)
• A neurosurgeon, orthopedic surgeon or plastic surgeon

and the care may include below active therapies

• Skin grafts and substitutes
• Growth factors
• Others 
• Hemostatic agents
• Sealants
• Collagen sealants
• Fibrin sealants

Finally, a serious ulcer that fails to heal might require surgery. One method of surgical repair is to use a pad of your muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).

References

1. Diabetic Foot Ulcers and Pressure Ulcers Market is Projected to be WorthUS$4.9 bn by the End of 2024
2. Pressure Ulcers (Bedsores)―All Things Considered (Travel to Health)

Pressure Ulcers (Bedsores)―All Things Considered

Pressure sores can develop even when you’re in confined for a short period. This includes people who must stay in bed or wheelchair because of an illness or an injury. Chronic diseases make it difficult for pressure sores to heal. These include diabetes and hardening of the arteries.

Treating pressure ulcers involves reducing pressure on the affected skin, caring for the wounds, controlling pain, preventing infection and maintaining good nutrition.^[2]

Symptoms of Pressure Sores

Symptoms look different at each of the 4 stages:.^[1]

• Stage 1.
• The area looks red. It may feel warm to the touch. It may burn, hurt, or itch. The pressure sore may look blue or purple in people who have dark skin.
• Stage 2.
• The area is more damaged. The sore may be open. It may look like a cut or blister. The skin around the sore may be discolored. The sore is painful.
• Stage 3.
• The sore will have a crater-like look. This is due to increased damage below the surface. This makes the wound deeper.
• Stage 4.
• This is the most serious. Skin and tissue are severely damaged. It becomes a large wound. Infection is possible. You are likely able to see muscle, bones, tendons, and joints.

Pressure Ulcers Treatment Market

The global pressure ulcers treatment market was valued at US$ 4,500.0 Mn in 2017 and is anticipated to expand at a CAGR of about 5% from 2018 to 2026 to reach US$ 7,000 Mn by 2026.^[3]

Key Market Segments

In terms of treatment type, the global pressure ulcers treatment market has been segmented into^[4]

• Wound care dressings
• Has been further classified into antimicrobial dressings, foam dressings, hydrocolloid dressings, film dressings, alginate dressings, hydrogel dressings, and other dressings.
• Growth of the wound care dressings segment is primarily driven by usage of antimicrobial dressings in the treatment of pressure ulcers.
• Wound care devices
• Has been further categorized into negative pressure wound therapy (NPWT), ultrasound therapy, and others (HBOT and electromagnetic therapy).
• Active therapies, 
• Has been further divided into skin grafts & substitutes, growth factors, and others (hemostatic agents, sealants (collagen and fibrin sealants)).
• Others
• Has been further segmented into pressure relief devices, traditional wound care products, and others. 

In terms of type of wound, the global pressure ulcers treatment market has been categorized into stage 1, stage 2, stage 3, and stage 4.  Incidence of stage 2 pressure ulcer is higher than other stages; however, the treatment cost of severe stages (stage 3 and stage 4) of pressure ulcer is higher than stage 2.

The stage 2 segment held the largest market share in 2017.

Treatment team

Addressing the many aspects of wound care usually requires a multidisciplinary approach. Members of your care team might include:

• A primary care physician who oversees the treatment plan
• A physician or nurse specializing in wound care
• Nurses or medical assistants who provide both care and education for managing wounds
• A social worker who helps you or your family access resources and who addresses emotional concerns related to long-term recovery
• A physical therapist who helps with improving mobility
• An occupational therapist who helps to ensure appropriate seating surfaces
• A dietitian who monitors your nutritional needs and recommends a good diet
• A doctor who specializes in conditions of the skin (dermatologist)
• A neurosurgeon, orthopedic surgeon or plastic surgeon

Reducing pressure

The first step in treating a bedsore is reducing the pressure and friction that caused it. Strategies include:

• Repositioning. 
• If you have a pressure sore, turn and change your position often. How often you reposition depends on your condition and the quality of the surface you are on. Generally if you use a wheelchair, try shifting your weight every 15 minutes or so and change positions every hour. If you're in a bed, change positions every two hours.
• Using support surfaces. 
• Use a mattress, bed and special cushions that help you sit or lie in a way that protects vulnerable skin.

Cleaning and dressing wounds

Care for pressure ulcers depends on how deep the wound is. Generally, cleaning and dressing a wound includes the following:

• Cleaning
• If the affected skin is not broken, wash it with a gentle cleanser and pat dry. Clean open sores with water or a saltwater (saline) solution each time the dressing is changed.
• Putting on a bandage
• A bandage speeds healing by keeping the wound moist. This creates a barrier against infection and keeps the surrounding skin dry. Bandage choices include films, gauzes, gels, foams and treated coverings. You may need a combination of dressings.

Removing damaged tissue

To heal properly, wounds need to be free of damaged, dead or infected tissue. Removing this tissue (debridement) is accomplished with a number of methods, such as gently flushing the wound with water or cutting out damaged tissue.

Other interventions

Other interventions include:

• Drugs to control pain. 
• Nonsteroidal anti-inflammatory drugs — such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) — might reduce pain. These can be very helpful before or after repositioning and wound care. Topical pain medications also can be helpful during wound care.
• Drugs to fight infection. 
• Infected pressure sores that aren't responding to other interventions can be treated with topical or oral antibiotics.
• A healthy diet. 
• Good nutrition promotes wound healing.
• Negative pressure therapy. 
• This method, which is also called vacuum-assisted closure (VAC), uses a device to clean a wound with suction.

Surgery

A large pressure sore that fails to heal might require surgery. One method of surgical repair is to use a pad of your muscle, skin or other tissue to cover the wound and cushion the affected bone (flap reconstruction).

References

1. Pressure Scores
2. Bedsores (pressure ulcers)―Mayo Clinics
3. Global Pressure Ulcers Treatment Market
4. Pressure Ulcers Treatment Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2018 - 2026
5. Antimicrobial dressings - Wounds International (PDF)
6. Diabetic Foot Ulcers and Pressure Ulcers Market is Projected to be WorthUS$4.9 bn by the End of 2024

Stem Cell Therapy