Homemade Skin Care Recipes

Beauty Food Bible

This is a PDF book that will certainly show you the fact as well as how it looks to ensure that you can know what to eat in order to ensure that the food that you consume has the opportunity to build you to progress. This is not something that you can ignore. There is a lot that has been discovered in here for your benefit and I can confidently say that absolutely nothing that is relevant or very important has actually been excluded. When you are done reading this ebook, you will certainly know the real and true meaning of what it is when they say 'you are what you eat'. Then, you will understand that what you eat is what is seen out here.The skin, which is the body's largest organ will profit significantly and the beauty that is outright will certainly be seen when someone takes a look at you. More here...

Beauty Food Bible Summary

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Botulinum Toxin Injections

Urethral sphincter botulinum toxin injections may be considered a treatment option for idiopathic and complex bladder outlet dysfunction in which fibrosis, stricture formation, or other anatomic distortions are not the cause of urinary retention. Although first reported in complex cases or neurogenic cases of detrusor sphincter dyssynergia, the encouraging clinical outcomes obtained with this safe, yet reversible treatment have promoted its use in people with various forms of bladder outlet obstruction and in people with an acontractile bladder in which a decrease in outlet resistance may lead to better bladder emptying by Valsalva maneuvers. Botulinum toxin is a reversible inhibitor of acetylcholine release at the presynaptic neuromuscular junction and has proven clinical utility and safety in the treatment of striated, as well as smooth muscle spasticity disorders. The major disadvantage of using this neurotoxin as a neuro-modulator of muscle function in lower urinary tract...

Structural Organization of Tetanus and Botulinum Neurotoxins

Fig. 1 (a) Schematic structure of activated di-chain clostridial neurotoxins. The neurotoxins are composed of a two-polypeptide chain held together by a single disulfide bridge. The C-terminal portion of the heavy chain (H, 100kDa) is responsible for neurospecific binding (domain HC), while the N-terminus (HN) is implicated in the translocation of the light chain in cytosol and pore formation. Structurally HC can be further subdivided into two portions of 25 kDa, HCN, and HCC. The light chain (L, 50 kDa) is a zinc-endopeptidase responsible for the intracellular activity of CNTs. (b) Botulinum neurotoxins are produced as multimeric progenitor toxins. The neurotoxin moiety interacts with a large, nontoxic, nonhemagglutinin protein (NTNH) via its C-terminal domain. This dimeric complex (Mw 300 kDa, 12S) serves as a scaffold for the assembly of larger complexes formed by the incorporation of three types of additional proteins with hemagglutinin activity and with Mw of 17kDa (HA17), 35 kDa...

Botulinum Neurotoxin And Botulism

Botulism is a rare but life-threatening disease caused by spore-forming bacteria of the Clostridia genus, including Clostridium Botulinum, C. baratii, and C. butyricum1. The disease results from bacterial secretion of botulinum neurotoxin, the most poisonous substance known.2 Approximately 7pg of pure neurotoxin is the LD50 for a mouse, and it has been estimated that the human LD 50 is approximately 0.09-0.15 mg intravenously, 0.7-0.9 mg inhalationally, and 70 mg orally.3-6 Naturally occurring botulism can result from ingestion of preformed toxin (food botulism) or from toxin produced in situ due to wound infection (wound botulism) or colonization of the gastrointestinal tract (infant or intestinal botulism). Botulism can also occur in exposed laboratory workers or from an overdose of therapeutic neurotoxin. In addition, the botulinum neurotoxins are classified by the Centers for Disease Control (CDC) as one of the six highest-risk threat agents for bioterrorism, due to their extreme...

Botulinum Toxin

Botulinum toxin (Botox ) has gained widespread use primarily for cosmetic and oculoplas-tic procedures as well as limited use in the treatment of strabismus. Derived from a bacterial toxin, its action arises from blocking the release of acetylcholine. When injected directly into the targeted muscle, it causes a paralysis or relaxation of that muscle. Thus, it is used to relax an over-active extraocular muscle (to straighten the eye) or to calm spasms of the eyelid. The drug's maximal effect is noticed in 1 to 2 weeks but persists over a 2 to 6 month period. No systemic side effects or long-term ocular alignment problems have been reported. However, transient diplopia, blepharoptosis, and subconjunctival hemorrhages can result from botulinum toxin injection. The drug is supplied as a powder that must be reconstituted in solution for injection. It must be stored in a freezer below 23 F and is usable for 4 hours following reconstitution.

Skin Care

Organ, covering the entire body in a four-layer sheath. Like all organs, skin serves specific purposes that contribute to overall physical well-being. Limited ability, for example, to sense potential dangers to the skin or to turn or position oneself, can result in damage to the skin and cause it to break down. Proper skin care is essential to maintain function and prevent breakdown of this vital organ. An understanding of basic anatomy, skin functions, and proper care will allow you to prevent and manage skin problems.

Botulinum A

Botulinum A toxin inhibits the release of acetylcholine from the presynaptic neuromuscular junction that leads to muscle relaxation. The actions are temporary because axonal regeneration occurs in approximately 3 to 6 months. Botulinum A toxin has been used in patients with detrusor sphincter dyssynergia and refractory overactive bladder. Two studies have reported the use of botulinum A in patients with voiding dysfunction. Phelan et al.13 performed a prospective evaluation of the injection of 80 to 100U of botulinum A into the external urethral sphincter in 8 men and 13 women with voiding dysfunction secondary to neurogenic detrusor sphincter dyssynergia, pelvic floor spasticity, or an acontractile bladder. All patients except one were able to void spontaneously, and all but two were able to discontinue the use of catheterization. Kuo14 evaluated the effect of 50U of botulinum A toxin injection in 20 patients (16 women) with voiding dysfunction. Fifteen patients had an areflexic...

Additional Vol Umes In Prepara

There is little commonality in the scientific methods, processes, and formulations required for the wide variety of cosmetics and toiletries in the market. Products range from preparations for hair, oral, and skin care to lipsticks, nail polishes and extenders, deodorants, body powders and aerosols, to quasi-pharmaceutical over-the-counter products such as antiperspirants, dandruff shampoos, antimicrobial soaps, and acne and sun screen products.

Microorganisms Of Concern

Harris et al. 8 extensively reviewed outbreaks associated with fresh produce and reported that the most common human pathogens associated with produce foodborne illness outbreaks are E. coli O157 H7, Salmonella spp., Shigella spp., Listeria monocytogenes, Crytosporidium spp. 9 , Cyclospora spp., Clostridium botulinum, hepatitis A virus, Norwalk virus, and Norwalk-like viruses. These microorganisms can be categorized as follows Soil-associated pathogenic bacteria (Clostridium botulinum, Listeria monocytogenes).

Clostridial Bacteriology

Botulism is caused by the actions of a 150-kDa neurotoxin secreted by spore-forming anaerobic bacteria of the genus Clostridia. C. Botulinum can be classified into at least four genetically and phenotypically diverse groups (I IV).27,28 While these groups are different enough to be classified as separate species, they have all been classified as C. Botulinum since they share the common feature of neurotoxin production. The organisms in group I are referred to as proteolytic, and the organisms in group II as nonproteolytic, based on their ability to digest complex proteins. All serotype A strains are group I, serotype B and F can be produced by either group, and serotype E is produced by group II strains. Two additional Clostridial species, C. butyricum and C. baratii, have been found to produce neurotoxins E29,30 and F,31,32 respectively. Serotypes C and D are both produced by group III organisms. Type C is found in avian species, occurring in domestic flocks and massive outbreaks in...

Neurotoxin Structure and Function

Botulinum neurotoxins are secreted from Clostridial species as a protein complex with an apparent size of approximately 900kDa.47,48 This complex consists of the neurotoxin and a number of proteins collectively called neurotoxin-associated proteins (NAPs). The NAPs include proteins classified as hemagglutinins,49,50 due to their ability to agglutinate red blood cells, and other proteins termed nontoxin nonhemagglutinins (NTNH).51,52 These other proteins stabilize the toxin and protect it from environmental degradation during passage through the gastrointestinal tract.53,54 Recently, the X-ray crystal structure of types A and B neurotoxins have been solved at high resolution (Figure 7.1).67-69 The structural studies, combined with functional studies, provide clear insight into how the botulinum neuro-toxins interfere with normal release of the neurotransmitter acetylcholine, resulting in flaccid paralysis (Figure 7.2). The C-terminal portion of the heavy chain (HC) comprises the...

Clinical History Symptoms and Findings of Botulism

It is quite likely that the first indication of a bioterror attack with botulinum toxin will be the development of clinical disease (botulism) in exposed individuals. It is thus essential that forensic personnel be familiar with the symptoms of the disease and its differential diagnosis (other diseases that may be confused with botulism). The diagnosis of botulism is made clinically, with laboratory findings and confirmation not usually immediately available. The clinical syndrome of botulism is dominated by neurologic signs and symptoms resulting from blockade of neurotransmission at voluntary motor and cholin-ergic junctions.86-88 Patients with botulism usually present with acute onset of weakness in muscles innervated by the cranial nerves, leading to diplopia, dys-phonia, dysphagia, and dysarthria (Table 7.1). In mild cases, no other symptoms may develop. In more severe cases, symmetric weakness progresses in a

Multifunctional Cuticle Treatments

The primary function of cuticle treatment products has changed somewhat over the years. Thirty years ago the emphasis was limited to cuticle removers that aided in pushing back or even dissolving the part of the cuticle, which extends over the base of the nail. Ingredients used for this purpose were very harsh and included potassium hydroxide at a high level. While these products still exist, the primary function and emphasis have become broader and more practical. Cuticle products are now positioned to treat most of the skin tissue that immediately comes in contact with the fingernail. Our own line of nail care products includes several cuticle treatments, none of which contain potassium hydroxide. This change of emphasis offers the consumer products that are more helpful in dealing with real conditions, including hangnails, broken irritated skin where hangnails have been removed, and the thick accumulations of dry skin that form around the sides of the nail. a-Hydroxy acids have...

Evaluation Of Clinical Findings

Ricin induces severe pulmonary disease after inhalation exposure60 as contrasted with severe gastrointestinal signs of nausea, vomiting, diarrhea, and rectal hemorrhage56 after oral administration. The signs and symptoms of Botulinum intoxication and Brucella infection do not differ with route of administration.56

Major Therapeutic Modalities Used in Management of CP

11.3.1 Botulinum Toxin Botulinum toxins are neurotoxins produced by some strains of clostri-dia The use of botulinum toxin is now regarded as an established method of management of spasticity in cerebral palsy patients in many countries With time, the neurotransmission will resume, some botox degradation products are transported through the nerve Brand of botulinum toxin used Many times, we shy away from surgery unless forced to do so, especially before the age of 6-7 or before adult gait pattern in the child is more fully developed. In this period, botulinum toxin can be considered as one component in our treatment armamentarium in the presence of focal hypertonicity affecting function 11.3.1.14 Safety Profile of Botulinum Toxin Do not attempt to increase dose of toxin as a treatment for botulinum toxin unresponsiveness 11.3.1.19 Adjuncts to be Used with Botulinum Toxin Therapy

The Commercial Canning Process

Chemical Indicator For Autoclave

The commercial canning process uses pressurized steam in an industrial-sized autoclave called a retort. Conditions of the process are designed to ensure that endospores of Clostridium botulinum are destroyed. This is critical because surviving spores can germinate and the resulting vegetative cells can grow in the anaerobic conditions of low-acid canned foods, such as vegetables and meats, and produce botulinum toxin, one of the most potent toxins known. Because ingestion of even minute amounts of botulinum toxin can be lethal, the canning process of low-acid foods is designed to kill all endospores of C. botulinum. In doing so, the process also kills all other organisms capable of growing under normal storage conditions. Endospores of some thermophilic bacteria may survive the canning process, but these are usually of no concern because they only can grow at temperatures well above those of normal storage. Because of this, canned foods are called commercially sterile to reflect the...

Aneurysmal Subarachnoid Hemorrhage

SIADH involves the release of ADH, despite a low serum osmolality. It has an average onset at 8 days and lasts 3-9 days. Patients have a normal skin turgor and blood pressure, a normal or decreased hematocrit, hyponatremia with serum hyposmolality and a urine osmolal-ity greater than serum osmolality. Renal and adrenal functions are normal, as is urinary excretion of sodium. Hyponatremia of SIADH is generally associated with normovolemia from ADH-induced free water retention in the kidney.

Conducting A Hazard Analysisrisk Assessment Study Haccp Principle

Step two of hazard analysis is hazard evaluation. Each identified hazard must be carefully considered based on its severity in the extent of exposure and likely occurrence (risk) in a product. For example, Listeria monocytogenes and Clostridium botulinum are both potential microbiological hazards in the fresh-cut produce industry. However, L. monocytogenes, due to its ubiquity, is a greater health risk to consumers of fresh-cut produce, even though C. botulinum would be considered a more severe hazard based on mortality rates 27 . Potential listeria contamination within the processing and or storage environment of fruit and vegetable facilities is a constant threat to products since there is a zero tolerance regulation for this hazard in ready-to-eat (RTE) foods.

Selected Bibliography of Journal Articles

Ubhi T, Bhakta BB et al. (2000) Randomized double blind placebo controlled trial of the effect of botulinum toxin on walking in cerebral palsy. Arch Dis Child 83(6) 481-487 6. Barwood S, Bailieu C et al. (2000) Analgesic effects of botulinum toxin A a randomized placebo-controlled clinical trial. Dev Med Child Neurol 42(2) 116-121 7. Koman LA, Brashear A et al. (2001) Botulinum toxin type A neuromuscular blockade in the treatment of equines foot deformity in cerebral palsy a multicenter, open-label clinical trial. Pediatrics 108(5) 1062-1071 8. Jankovic J, Fehlings D et al. (2004) Evidence-based review of patient-reported outcomes with botulinum toxin type A. Clin Neuropharmacol 27(5) 234-244 9. Fehlings D, Rang M et al. (2000) An evaluation of botulinum A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy. J Pediatr 137(3) 331-337 10. Graham HK, Aoki KR et al. (2000) Recommendations for the use of botulinum toxin type A in the management...

Multifunctional Nail Polish Remover

A wide range of moisturizing ingredients that provide conditioning and moisturization of the nail and cuticle can be included. Ingredients used to moisturize and condition the nail and cuticle are chosen based on their solubility in the active solvent. Almost any therapeutic ingredient useful in other skin care products can be used in nail polish remover. While it is customary to use moisturizers and conditioners that are inexpensive because nail polish remover is typically one of the lowest priced items in the beauty department, it is prudent to use one that provides the maximum effectiveness at the lowest concentration. This strategy provides maximum treatment with the least negative impact on product performance. The test method that follows allows one to create a balance between removal efficiency, cost, and treatment of nail and cuticle.

Plateletderived growth factor

Normal skin appears to be devoid of PDGF receptors. Animal studies illustrate that rapid expression of both a and P receptor subunits is induced upon generation of an experimental wound (e.g. a surgical incision). Receptor expression is again switched off following re-epithelialization and complete healing of the wound.

Quantitative Absorption Data

In experiments that measured the reverse of percutaneous absorption, the potassium flux from the inside of normal skin to water on the stratum corneum was 3.5 ( 3.6) X 10 9 mol cm2 sec (Table 2) (18). Removing the stratum cor-neum doubled the potassium flux. The brief duration of these experiments made it impossible to determine a reasonable permeability coefficient.

Sellarsuprasellar tumours pituitary adenoma

'Adult GH deficiency syndrome' -weight gain, loss of libido, fatigue Amenorrhoea, sterility, loss of libido Glucocorticoid and androgen deficiency, muscle weakness and fatigue Secondary hypothyroidism -sensitivity to cold, dry skin, physical and mental sluggishness, coarseness of hair Failure of lactation

Stage 2 preclinical HIV infection

Although viral titres fall in the circulation at this time there is significant and persistent virus replication within lymph nodes and spleen. The clini-414 cally latent period may last 8-10 years and circulating CD4 T-cell count remains normal for most of this period. However, there is a delayed, gradual but progressive fall in CD4 T lymphocytes in most patients, who may remain asymptomatic for a prolonged period despite modest lym-phopenia. A number of minor skin problems such as seborrhoeic dermatitis are characteristic of the end of the latent phase.

S Evidence statements

Other pharmacological interventions - One systematic review and a further nine studies examined the efficacy of a variety of pharmacological interventions for spasticity. The systematic review of three RCTs, and one additional RCT assessed the efficacy of botulinum toxin. The review compared botulinum toxin to placebo and plaster casts for the treatment of lower limb spasticity in children with cerebral palsy. The results reported no significant differences between those treated with botulinum toxin and those treated with either placebo or plaster casts354 (Ia). The RCT compared three different doses of botulinum toxin to placebo.355 No overall significant differences were reported between the groups with a number of side effects reported for all three of the intervention groups, with these being proportional to the intervention dosage.

Protein Detection Diagnostics

Protein detection diagnostics run similar risks for the assumptions of conservation within the species and uniqueness compared to all other organisms, as described for nucleic acid diagnostics above. One advantage of protein detection is that it allows the toxins created by certain pathogens to be detected in circumstances where the organism itself is no longer capable of being detected via nucleic acid techniques (e.g., botulinum toxin). It also is harder to engineer around protein-based detection and still retain the original virulent characteristics of the pathogen.

Nonmalignant Skin Disease

The most common and debilitating skin problems arise from the long-term use of glucocorticoids. The manifestations include striae, friable skin, ecchymosis, acne-form rash and cushingoid features. In addition, cyclosporine may cause thickening of the skin, hypertrichosis, gingival hyperplasia, epidermal cysts, pilar keratosis, and folliculitis. Treatment includes reducing the dosage of these medications to the lowest level necessary to maintain immunosuppression and topical measures.

Aortic and visceral revascularization

Embolization to distal sites, particularly in aortic surgery, can occur at various stages during the procedure, releasing atherosclerotic and thrombotic debris to the distal circulation. This becomes most evident in the foot, with patchy areas of cyanosis or necrosis. Prevention is of paramount importance, and treatment should be expectant, with foot cradles for protection and skin care for prevention of infection. In cases where viability of the foot is a concern, thromboembolectomy with a Fogarty balloon catheter, followed by infusion of urokinase, may be an alternative.

Pathogenic Organisms and Shelf Life 19531 Food Safety Risk of MAP Produce

When competitive microflora are eliminated by MAP atmospheres, some pathogens may grow unimpeded. Certain MAP systems can produce anoxic conditions which, while inhibiting growth of spoilage organisms such as aerobic bacteria and molds, can allow growth of obligate anaerobic pathogens such as nonproteolytic C. botulinum even at refrigeration temperatures temperature abuse conditions that increase product respiration can also result in anaerobiosis. Where high levels of CO2 alone restrict growth of susceptible microorganisms, selection of pathogens that can survive under these conditions may also occur 47 . At 13 or 22 C, CO2 was reported to not inhibit growth of E. coli on shredded lettuce in fact, atmospheres of 5 O2 and 30 CO2 (balance N2) actually enhanced growth over storage in air. Atmospheres containing 40 to 50 CO2 were only slightly inhibitory towards Yersinia enterocolitica at 4 C, although inhibition increased as storage temperature decreased 9 . Bennik and others 44...

Psychrotrophic Pathogens

A potential consumer safety risk may occur due to MAP inhibition of the aerobic microorganisms that usually warn consumers of spoilage, resulting in reduction in growth competition, and creation of an altered environment, allowing enhanced or unrestricted growth of anaerobic or facultative anaerobic pathogens capable of growing under MAP conditions at refrigeration temperatures. These include L. monocytogenes, C. botulinum, Yersinia enterocolitica, and Aeromonas hydrophila. C. botulinum poses a significant food safety risk in MAP produce, as previously discussed in this chapter. MAP conditions that extend product shelf life may create an organoleptically acceptable consumer product, but may pose a food safety hazard not immediately visible to the consumer. Macura and others 55 found that anaerobic conditions developed under a range of MAP atmospheres and temperatures employed for storage of ginseng roots at 10 C, C. botulinum toxin was detected in roots while overall product quality...

Presynaptic Neurotoxins with Enzymatic Activities

4 Structural Organization of Tetanus and Botulinum Neurotoxins 8 Regeneration of the Skeletal Neuromuscular Junction and the Innervated Muscle Fibers after Poisoning by Botulinum or Snake Tetanus and botulinum neurotoxins produced by anaerobic bacteria of the genus Clostridium enter peripheral cholinergic nerve terminals and cleave proteins of the neuroexocytosis apparatus, causing a persistent, but reversible, inhibition of neuro-transmitter release. Botulinum neurotoxins are used in the therapy of many human syndromes caused by hyperactive cholinergic nerve terminals. At variance, some snake presynaptic neurotoxins block nerve terminals by binding to the plasma membrane, where they hydrolyze phospholipids with production of lysophospholipids and fatty acids. These compounds change the membrane conformation causing enhanced neurotransmitter release and, at the same time, inhibition of synaptic vesicle recycling. It is possible to envisage pharmacological applications of the...

B Mode of Action Access to the Target Cell

Following membrane passage, y relies on intracellular activation mediated by the plasma membrane H+ATPase Pma1 (Mehlgarten and Schaffrath 2004 Zink et al. 2005). Curiously, though they are not deficient in y uptake, pma1 mutants display class I zymocin resistance which can be overruled by an excess of H+ (Mehlgarten and Schaffrath 2004). Hence, y must exist during the uptake process in a transient dormant form, which is converted by H+ flux into the active conformation (induced either experimentally by acidification of the cell exterior or by the H+ATPase) (Mehlgarten and Schaffrath 2004). Interestingly, other protein toxins gaining access to target cells, such as the botulinum or diphtheria toxins, depend on acidification of endocytotic vesicles by plasma membrane H+ATPases for induction of conformational changes as well, resulting in the insertion of a membrane spanning domain into the endosomal membrane normally facilitating toxin passage into the cytoplasm. It remains to be...

Sympathomimetic syndrome

May be difficult to distinguish from anticholinergic syndrome. Sweating and normal to hyperactive bowel sounds are associated with sympathomimetic overdose, whereas anticholinergic toxidrome manifests with dry skin and diminished bowel sounds.

Toxicity of BoNTs and of SPANs

Tetanus and botulinum neurotoxins are the most potent toxins known, as few nanograms Kg are sufficient to kill most mammals. When injected peripherally the mouse LD50 s of TeNT and BoNTs are between 0.4 ng and 1 ng of toxin per Kg of body weight (Gill 1982). When BoNTA and BoNT B are injected into the brain the LD50s are comparable with those determined by intraperitoneal injection in mice (Luvisetto et al. 2003).

Neuromuscular junction disorders

Other causes of neuromuscular junction blockade are rare and the diagnosis is usually obvious from the clinical setting. Suspect botulism when autonomic features, dry mouth, constipation, poorly reactive pupils, ptosis, and bulbar palsy have heralded acute descending paralysis. In the early stages the symptoms and signs are entirely anticholinergic and the reflexes are normal. These symptoms have usually been immediately preceded by nausea, vomiting, abdominal pain, and diarrhoea from eating foul smelling food contaminated by Clostridium botulinum.27 Magnesium-containing antacids and aperients in patients with impaired renal function can produce severe hypermagnesaemia. The increased magnesium interferes with the release of acetylcholine so as to cause weakness, which may develop into respiratory failure.28 The aminoglycoside and polymyxin antibiotics and some other drugs also cause neuromuscular blockade by interfering with the release of acetylcholine.29 This is usually only...

Clinical Implications and Perspectives

In conclusion, aging is associated with many skin microvasculature changes, all with a negative influence on tissue nutrition, which can explain the increased fragility and vulnerability of elderly skin to the different noxae and to the environment stress. Thermoregulatory adaptive mechanisms are also affected, resulting in a reduced capability to cope with both heat and cold stress. 9. Smith, L. (1989). Histopathologic characteristics and ultrastructure of aging skin. Cutis 43, 414-424.

Prevalence Of Overweight And Obesity

Obesity is now known to be a major contributor to the global burden of disease.3 Obesity is associated not only with some nonfatal but debilitating health problems, such as respiratory difficulties, chronic musculoskeletal problems, skin problems, infertility, sleep apnea, and poor mental health, but also more life-threatening problems, including hypertension, type 2 diabetes, heart disease, stroke, some types of cancer.315 Obese people have higher mortality from all causes 16-19 more than 280,000 deaths annually have been attributed to obesity among U.S. adults.20 In Europe, this number is at least 279,000 deaths, of which 175,000 are attributable to obesity and 104,000 to overweight.21 Furthermore, a large decrease in life expectancy is observed among obese individuals, especially among younger adults.22,23 Severely obese children and adolescents have lower health-related quality of life24 and early-onset obesity has been suggested as a risk factor for morbidity and mortality later...

Managing Consumers Expectations Can Also Be Challenging

Sometimes promised results are so long in coming, or learning proper use is so time-consuming, that consumers give up. Products that take weeks or months to show their multifunctional benefits often are abandoned before the formulations have had a chance to achieve results. Countless bottles of skin care products rotate through consumers' cabinets as any subtle wrinkle or pore reduction goes unnoticed. People move on to the next possibility, hoping that it can work sooner, or even at all. Patience levels need to be queried in consumer research studies. Super-high-margin Rembrandt toothpaste succeeded in spite of itself because consumers perceived that, over time, it was working to whiten their teeth better than other toothpastes. Dentists, however, agreed that there was actually no superior benefit. Researchers need to determine the specifics about how the consumer thinks the MFP will perform, as well as to assess their levels of expectations.

Key Points Of Inquiry

Sometimes, when marketers get it right, just one added ingredient can start a market boom. For example, there has been significant growth in industries such as skin care products because, for example, interest in anti-aging and sun protection have driven the development of new products that incorporate alphahydroxy acids (AHAs) and sunscreens. In recent years, over a thousand new products are launched annually, more than twice as many as a decade ago. AHAs have been responsible for much of this impressive growth. Marketers need to learn more and manage data better to get to these sweet spots.

Clinical Radiological And Pathologic Characteristics

Venous malformations (VMs ) are the most common intramuscular vascular anomalies the patient is usually a child or an adolescent, sometimes a young adult, brought to consultation for localized pain, soft-tissue swelling, and intermittent functional impairment. Pain develops during physical activities (6) but also in the morning on waking up and during cold rainy weather. Physical signs include a tender mass under a normal skin the situation is distinct clinically from an intramuscular VM of the extremities trunk with blue skin involvement (20) , no local inflammation, no pulsation, no bruit, and no general symptoms. If lower limb pain was present for several years, atrophy of the limb may develop as a consequence of the limitation of physical activities. Limitation of joint motion may also occur.

The Multidisciplinary Team

The nurse's main responsibilities are to work with client and family to increase independence in personal care with a 24-h approach advice regarding skin care, diabetes, continence and general health promotion liaising with district nurses and general practitioners, teaching self-help strategies dietary advice understanding medication methods of lifting and handling.

Acscodh Genes in Bacteria

While most clostridia do not have an ACS CODH complex (or use the Wood-Ljungdahl pathway), numerous clostridial genomes encode homologs of the single subunit CODH protein. Pathogenic clostridia (Clostridium botulinum, Clostridium difficile, and Clostridium tetani) contain one or more copies of the CODH gene, as do environmental and solvent-producing clostridia such as Clostridium acetobutylicum, M. thermoacetica, and Ruminococcus albus. These bacteria are phylogenetically scattered throughout the clostridia. Therefore we may infer that the ancestor of the clostridia encoded a similar protein and that the CODH enzyme is quite old.

Specific Orolingual Issues

Not wanting to throw the baby out with the bath water the team recognised the need to work specifically on one of the impairments, i.e. the distressing lingual dystonia and oral clicks that were becoming very marked. She was losing food from her mouth constantly during meal times and the involuntary noises were becoming very loud. She was referred to a neurophysiologist at the neighbouring hospital, and it was decided to try botulinum toxin injections into the genioglossus muscle. The results of the botulinum toxin were impressive, showing reduction in lingual dystonia and improvements in eating, which started to wear off after 8 weeks as expected (Figs. 1-5). She had two injections 8 weeks apart. However, she decided not to have further injections due to the pain of the injection and she returned to the strategies which she had previously learnt. Behavioural therapy showed improvements in most objective measures, but in general was not as effective as it required great effort and was...

Building a World Wide Database

The most important aspect, however, from a clinical point of view, is the gathering of detailed information about past treatments. Experiences with botulinum toxin injections were recently collected among the patients (via neuroacanthocytosis yahoogroups.com) but this approach must be extended using a systematic protocol. Similarly, the effects of deep brain stimulation ought to be compared between the few patients who so far have undergone the procedure. Drug treatments such as sulpiride, tetrabenazine, tiapride, levetiracetam 21 or other substances should be documented, as should be approaches such as physiotherapy, dysphagia treatment, and psychotherapy. Accumulation of an extensive set of therapeutic experiences may then be followed by the design of observational treatment studies that in such uncommon medical conditions are only feasible if close international collaboration is achieved. Collectively, these activities effectively constitute a Virtual Neuroacanthocytosis Institute.

Xavier Intes PhDa Britton Chance PhD ScDb

Light absorption in tissue originates from many different analytes. The main relevant chromophores are oxyhemoglobin and deoxyhemoglobin, melanin, water, lipids, porphyrins, NADH, flavins, and other structural components. In the NIR spectral range, however, the chromophores exhibiting significant extinction coefficients can be limited to four as shown in Fig. 1 (melanin is overlooked because of its confinement to the normal skin) (1) oxyhemoglobin, (2) deoxyhemoglobin, (3) water, and (4) lipids. NIR interrogation of tissue at multiple wavelengths correlated with appropriate photon propagation models provides the average or local quantitative concentrations of these compounds. Consequently, NIR optical techniques allow noninvasive monitoring of the metabolic activity of deep tissue through the hemoglobin concentration and oxygen saturation. This monitoring, combined with the inexpensive cost of instrumentation, opens many potential medical applications to NIR techniques.

Normal Flora of the Skin

Microscopic Arachnid Skin Causes Acne

The skin represents a distinct ecological habitat, analogous to a cool desert, compared to the warm, moist tropical conditions that exist in other body systems. Large numbers of microorganisms live on and in the various components of the normal skin. For example, depending on the body location and amount of skin moisture, the number of bacteria on the skin surface may range from only about 1,000 organisms per square centimeter on the back to more than 10 million in the groin and armpit, where moisture is more plentiful. The numbers actually increase after a hot shower because of increased flow from the skin glands where many reside. Most of the microbial skin inhabitants can be categorized in three groups diphtheroids, staphylococci, and yeasts (table 22.1, and see figure 22.1). Although generally harmless, skin organisms are opportunistic pathogens, meaning that they can only cause disease in people with impaired body defenses. Table 22.1 Principal Members of the Normal Skin Flora...

Anaerobic Chemoorganotrophs Fermentation

Members of the genus Clostridium are Gram-positive rods that can form endospores (see figure 3.46). They are common inhabitants of soil, where the vegetative cells live in the anaerobic microenvironments created when aerobic organisms consume available O2. Their endospores, a dormant form, are indifferent to O2 and can survive for long periods by withstanding measures of heat, desiccation, chemicals, and irradiation that would kill all vegetative bacteria. When the appropriate conditions are renewed, these endospores germinate, and the resulting vegetative bacteria may once again multiply. Vegetative cells that arise from soil-borne endospores are responsible for a variety of diseases, including tetanus (caused by C. tetani), gas gangrene (caused by C. perfringens), and botulism (caused by C. botulinum). Some species of Clostridium are normal inhabitants of the intestinal tract of humans and other animals. endospores, p. 67 tetanus, p. 698 gas gangrene, p. 701 botulism, p. 672

Causative Organism Of Cesnavan Disease

Botulism is caused by the strictly anaerobic, Gram-positive, spore-forming, rod-shaped bacterium, Clostridium botulinum. Its endospores, formed near the ends of the cells (figure 26.12), generally resist boiling for hours, but they are killed by auto-claving. Different strains of C. botulinum vary markedly in their biochemical activity, but all produce toxins that act in a similar way to cause paralysis. Seven antigenically different toxins, designated A, B, C1, D, E, F, and G, are synthesized by different strains of C. botulinum. Types A, B, E, and F are responsible for most human cases, while types C and D affect only birds and other animals. In strains C and D, toxin production results from lysogenic conversion. The toxins are released in an inac- Figure 26.12 Clostridium botulinum Notice the spores that form near the ends of the bacteria.These spores are not reliably killed by the temperature of boiling water. Figure 26.12 Clostridium botulinum Notice the spores that form near the...

Reservoirs of Infectious Agents in Hospitals

Many hospital-acquired infections originate from the patient's own flora. Nearly any invasive procedure can transmit microorganisms that are part of the normal flora to otherwise sterile body sites. When intravenous fluids are administered, for example, Staphylococcus epidermidis, a common member of the normal skin flora, can potentially gain access to the bloodstream. While the immune system can usually readily eliminate these normally benign organisms, the underlying illness of many hospitalized patients compromises their immunity and they can develop a bloodstream infection. Patients who undergo intestinal surgery are prone to surgical site infection by their normal bowel flora. Similarly, patients who are on cer- Just as urinary catheters can introduce bacteria into the bladder, intravenous (IV) catheters can introduce micro organisms into the bloodstream. This can happen when normal skin flora colonize the tip of an indwelling catheter or when environmental organisms contaminate...

Fermented Meat Products

Traditionally, fermented meat products, such as salami, pepper-oni, and summer sausage, were produced by enabling the small numbers of lactic acid bacteria naturally present to multiply to the point of dominance. Relying on the natural fermentation of meat is inherently risky, however, because the incubation conditions used to initiate fermentation can potentially support the growth and toxin production of pathogens such as Staphylococcus aureus and Clostridium botulinum. The development and use of reliable starter cultures assures rapid production of lactic acid, inhibiting the growth of pathogens and enhancing flavor development. Starter cultures used by U.S. sausage-makers typically contain species of Lactobacillus and or Pediococcus, depending on the type of sausage. To make fermented sausages, meat is ground and combined with a starter culture and other ingredients including sugar, salt, and nitrite. The sugar serves as a substrate for fermentation, because meat does not...

Essential Fatty Acid Requirements

Columbinic acid (C18 3n-6, 9, 13 cis, cis, trans), found in the seed oil of the columbine, Aquilegia vulgaris, and dihomocolumbinic acid (C20 3n-6, 9, 13 cis, cis, trans) have been used to differentiate the roles of EFA as structural components in biomembranes versus their roles as eicosanoid precursors ( 115). Neither columbinic acid nor dihomocolumbinic acid can be converted to PG however, columbinic acid can be incorporated into membrane PL in contrast to dihomocolumbinic acid. As EFAD results in decreased tissue concentrations of C20 4n-6, EFAD symptoms are worsened further by dietary addition of dihomocolumbinic acid. Columbinic acid given to EFA-deficient rats, either orally or by topical skin application, efficiently restores their growth rate and normal skin function ( 114). When EFA-deficient rats treated with columbinic acid became pregnant, however, they died of inadequate labor during parturition, since uterine labor depends on normal PG biosynthesis ( 116).

Skin Microcirculation in the Elderly

Age-related structural alterations in the skin have been well documented by histologic and ultrastructural examination of skin biopsy specimens from younger compared to older people 9 . The fine, regular epidermal surface pattern changes to coarser and less regular ridges with aging. Epidermal projections into the dermis are retracted and the dermal-epidermal junction is flattened. The dermis becomes thinner, and there are fewer fibrillar collagen and elastic fibers in older skin. A progressive reduction with age in the dermis hyaluronic acid content has been also demonstrated, which could account for some of the most striking alterations of the aged skin, including decreased turgidity, altered elasticity, and less support for microvessels. Basic mechanisms underlying skin aging can be represented by a reduced cellular turnover and a prolonged time to recover after an injury 10 . According to the majority of the experts in this field, the morphofunctional state of skin, to a large...

Other Supranuclear Oculomotor Disorders

Was superior to vigabatrin in a small series of patients 69 others have also reported an improvement due to gabapentin 70, 71 . Cannabis, which acts as a retrograde presynaptic inhibitory transmitter and in this way is similar to gabapentin, which also acts presynaptically, was recently reported to be equally effective 72, 73 . A bilateral retrobulbar botulinum toxin injection was successfully used in some patients to induce a complete external ophthalmoplegia, thereby diminishing the acquired pendular nystagmus 74, 75 however, it proved unsatisfactory in other patients 76 .

Epidemiology of intentional Botulism and differential diagnosis

The intentional release of botulism is most likely to be associated with the outbreak of a large number of cases of flaccid paralysis with prominent bulbar palsies. Other features may include an outbreak with an unusual toxin type (C, D, F or G, vide infra), an outbreak with common geographic features but without a common dietary exposure, or multiple simultaneous outbreaks with no common source. The incubation period for intentional botulism is unknown, but is likely related to the route of exposure and amount of toxin administered. For oral exposure to toxin, one may obtain some idea of the incubation period from the foodborne botulism literature. Foodborne botulism has an incubation period of 6 hours to 10 days,96 with the majority of cases developing between 18 to 72 hours after ingestion of contaminated food. It is difficult to know precisely the incubation period for aerosol exposure to botulinum toxin, due to the paucity of data. In one study, monkeys exhibited signs of...

Moist Heat Kills Microorganisms By An Irreversible Coagulation Of Proteins

The most important aspect of the commercial canning process is to ensure that endospores of Clostridium botulinum are destroyed. (Figure 5.5) 2. Nitrate and nitrite are added to some foods to inhibit the germination and subsequent growth of Clostridium botulinum endospores. They also react with myoglobin to form

State 4 Properties Conferred By Prophages

Structure Filamentous Phage

Clostridium botulinum Synthesis of botulinum toxin Lysogenic cells may also differ from their nonlysogenic counterparts in other important ways. The prophage can confer new properties on the cell, the phenomenon of lysogenic conversion. For example, strains of Corynebacterium diphtheriae that are lysogenic for a certain phage (b phage) synthesize the toxin that causes diphtheria. Similarly, lysogenic strains of Streptococcus pyogenes and Clostridium botulinum manufacture toxins that are responsible for scarlet fever and botulism, respectively. In all of these cases, if the prophage is eliminated from the bacterium, the cells lose the ability to synthesize toxin. The genes that code for these toxins are

Kaposis Sarcoma Associated Herpesvirus KSHV or HHV8

In 1994, Chang et al used representational difference analysis (RDA) to search for DNA sequences present in AIDS-associated KS but not in adjacent normal skin. Using this approach, they were able to identify a then unknown human g-herpesvirus in KS tissue, which they called the Kaposi's sarcoma-associated herpesvirus (KSHV) or human herpesvirus 8 (HHV-8) 5 . KSHV belongs to the genus Rhadinovirus, and its genomic structure is most similar to the closely related lymphotropic g-herpesviruses Epstein-Barr virus (EBV), the only other known human her-pesvirus associated with human cancers. Compelling evidence points to KSHV as the infectious etiologic agent for KS (i) Epidemiological studies have established a pattern of KSHV infection that precedes KS development and overlaps with KS risks. (ii) Examination of KS biopsies revealed that KSHV DNA is present in KS tumor (spindle) cells and in endothelial cells lining vascular spaces of KS lesion. (iii) In vitro studies have demonstrated that...

Clinical Disorders of the Eyelid and Its Interaction with Saccades

Been reported to occur with thalamic 132, 133 , subthalamic 132, 134 , and brainstem 135, 136 lesions, but it is often associated with PD or PSP 137 . Benign essential blepharospasm may be caused by an overexcitatory drive of the basal ganglia. As initial treatment, artificial tear drops are recommended, since ocular surface irritation (due to decreased blink rate) may also contribute to increased OO tone 108 . Blepharospasm may also be secondary to Bell's palsy and may be relieved by passive eyelid lowering 138 . Otherwise, injections of botulinum toxin to weaken the affected muscles, in particular the pre-tarsal portion of the upper eyelid, are the appropriate treatment 139-141 . Blepharospasm may be restricted to dystonic contraction of only the pretarsal portion of the OO without concomitant contraction of the OO (pretarsal LP inhibition, pretarsal blepharospasm) 142 . In contrast to the typical ble-pharospasm, the eyes appear to be nearly closed, and there is a concomitant...

Molecular Control of Skin Angiogenesis

Keratin Family Member Mice

Whereas angiogenesis is a common feature in developing skin during embryogenesis, blood vessels in healthy adult skin are quiescent with the exception of the cyclic expansion of perifollicular vessels during the hair cycle. In normal skin, vascular quiescence is maintained by the dominant TSP-2 expression during embryonic development and in adult tissues is spatially and temporally different from TSP-1. The expression of TSP-2 is downregulated in epithelial squamous cell carcinoma cells, whereas a strong upregula-tion of TSP-2 is found in the mesenchymal stroma during skin carcinogenesis, representing a natural tumor defense mechanism 6 . Mice that are deficient in TSP-2 show increased skin vascularization, enhanced and prolonged inflammatory reactions, and enhanced skin carcinogenesis, confirming the important role of endogenous TSP-2 in the control of skin angiogenesis. Accordingly, genetic overexpression of TSP-2 protects from skin cancer development and inhibits the growth of...

Monocyte Migration To Sites Of Inflammation

CXCL14 BRAK, which selectively recruits circulating monocytes in homeostasis, as well as monocytes activated by prostaglandin E2 (PGE2). CXCL14 breast and kidney-expressed chem-okine (BRAK), which is thought to be made constitutively by normal skin keratinocytes, dermal fibroblasts, as well as lamina propria cells 60 , Monocytes cultured with PGE2 have been shown to gain chemotactic responsiveness to CXCL14 BRAK, while losing responsiveness to CCL2 MCP-1, CCL5 regulated upon activation, normal T cell expressed and secreted (RANTES), and CXCL12 stromal cell-derived factor (SDF) -1 60 , The receptor for CXCL14 BRAK is yet unknown. The authors propose that once monocytes enter sites of inflammation, local secretion of PGE, polarizes monocytes to be responsive to high levels of CXCL14 BRAK.

Blepharospasm Definition

Treatment This depends on the cause of the disorder. Mild cases can be controlled well with muscle relaxants. Severe cases may require transection of the fibers of the facial nerve supplying the orbicularis oculi muscle. The disorder may also be successfully treated with repeated local injections of botulinum toxin.

Can Starving Yourself Affect Rate Of Healing Of Surgery Wounds

Two principal forms exist cholecalciferol (vitamin D3) and ergocalciferol (vitamin D2). Vitamin D2 is obtained from the diet (Table 9.1), in which case it is absorbed, with the help of bile salts, in the small intestine. Vitamin D3 is produced endogenously by keratinocytes in the skin via biosynthesis from 7-dehydrocholesterol upon exposure to ultraviolet light. The epidermis is where the greatest amount of vitamin D production occurs (49). It is conceivable that large cutaneous wounds and scarring impair the process of epidermal vitamin D synthesis (50,51). Burn scar and normal skin adjacent to the wound show a fivefold decrease in the ability to transform 7-dehydrocholesterol to vitamin D3 (51). 5. Shapiro, S.S. and Saliou, C., Role of vitamins in skin care, Nutrition, 2001 17 839-844.

Clinical Manifestations of Hypothyroidism

Succeeding months, especially in severe cases, protuberance of the abdomen, dry skin, poor growth of hair and nails, delayed eruption of the deciduous teeth, and delay in reaching the normal milestones of development (e.g., holding up the head, sitting, walking, and talking) become evident.

Antimicrobial Activity Of Map Gases 1921 Co2

Low to moderate levels of CO2 have been shown to inhibit growth of many common aerobic produce spoilage bacteria. Moderate CO2 levels of 20 to 60 have been found to reduce the ax and Nmax of Pseudomonas spp. and Moraxella spp., two predominant spoilage bacteria found on produce 7 . Low CO2 levels below 20 were found to primarily increase x, with slight reductions in ax and no changes in Nmax. CO2 is not antimicrobial towards all microorganism strains or species, and may in some cases actually promote growth. Lactobacillus spp. are generally unaffected by CO2 however, some levels can enhance growth, and 100 CO2 environments have inhibited growth of some strains. In absence of O2, it has been generally shown that the growth and toxin production of Clostridium botulinum is only minimally affected by CO2 concentrations less than 50 100 CO2 has been reported to delay toxin production compared to a 100 N2 atmosphere 1 and decreases growth at 5 and 10 C 8 . Levels of 10 CO2 have been found...

Views Regarding the Term Cosmeceutical

An aspect of the cosmeceutical revolution to consider is its reason for being in the first place. Historically, consumer needs and demands have driven the cosmetic market to evolve to this point. Many years ago, a cosmetic or toiletry product was expected to have one simple function. For example, a lotion helped to moisturize dry skin, and a deodorant was used to mask body odors. As consumers increasingly demanded substantially more benefits from cosmetics and toiletries, multifunctional products were born 1,2 . For example, now a moisturizing lotion also may have antiitch benefits, promote skin exfoliation to reduce flakiness, and promote the healing of dry skin by supplying substances essential to maintain the barrier layer function. Most deodorants now are also OTC drugs because they contain antiperspirants to keep underarms dry in addition to masking body odors.

Wound Reepithelialization

Surgeons have long known that a key factor in wound healing is excellent tissue perfusion. Vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), and TGF-b are the critical factors involved in wound angiogen-esis. VEGF is expressed at low levels in normal skin but highly upregulated in keratinocytes during wound healing. Angiogenesis appears to be tied to matrix deposition and granulation tissue formation. Application of a neutralizing anti-VEGF antibody to a wound is associated with decreased wound angiogenesis. Conversely, application of topical VEGF increases wound angiogenesis, granulation tissue formation, and wound closure rates 6 . Diabetic wounds are found to have decreased levels of VEGF expression, but demonstrate very high levels of angiopoetin-2, an antiangiogenic protein. Although angiopoetin-2 production in wounds is not unusual during specific phases of wound healing when vessel growth requires destabilizing preexisting vessels, such high levels are...

Dystonias focal segmental idiopathic

Turning of the head is specially noticeable when the patient is walking. Eventually hypertrophy of the sternomastoid occurs. Pathology unknown. Diagnosis is based on clinical findings. Treatment anticholinergics and phenothiazincs produce some benefit in 50 of patients. Injection of Botulinum toxin into the sternomastoid muscle gives variable symptomatic relief though requires regular repetition. Constant involuntary prolonged tight eye closure (blepharospasm) is associated with dystonia of mouth, tongue or jaw muscles (jaw clenching and tongue protrusion). Response to treatment is poor though phenothiazines should be tried. Section of the nerves to orbicularis oculi muscles will relieve blepharospasm. Botulinum toxin injection is also effective.

Contamination By Human Pathogens

The risk of Clostridium botulinum on ready-to-eat modified atmosphere packaged (MAP) fresh-cut fruits and vegetables has been investigated extensively by a number of research groups in recent years 53-57 . C. botulinum is a spore-forming bacterium commonly found in agricultural environs. Under suitable environmental conditions (temperatures above 5 C, low oxygen conditions, and a pH above 4.6) this microorganism may produce a deadly toxin. Recent research efforts have examined C. botulinum risk factors for various fresh-cut MAP produce. In general, overt gross spoilage of fresh-cut produce occurs well before toxin is produced on shredded cabbage, shredded lettuce, broccoli florets, sliced carrots, and rutabaga. The endemic microflora on fresh-cut produce play an important role in signaling the end of shelf life and are also believed to suppress toxin production by C. botulinum

Oregano Contains Antimicrobial Substances

Already in 1948 it was shown by Dold and Knapp (1948) that spices belonging to Lamiaceae family had antimicrobial activity. Inhibitory ability of ethanol extracts of oregano against Clostridium botulinum was reported by Huhtanen in 1980 and by Ueda et al. in 1982, and reduction of aflatoxin production in culture medium of Aspergillus paraciticus by ground oregano was shown by Salzer (1982) in the same year. Salmeron etal. (1990) have reported that although oregano stimulates the growth of both A. paraciticus and Aspergillus flavus, at the same time it acts as antiaflatogenics.

An Example of Combination Claims

Another interesting multifunctional skin care product includes a three-in-one product containing san protection factor (SPF) a moisturizer, and skin-lightening performance characteristics. Manufacturers of moisturizing products in general tend to focus on consumer use of moisturizers in regions that are cold and low in humidity. Although dry skin in these climatic regions does indeed present with the usual flakiness, itching, and general consumer discomfort, consumers in regions with hot weather and low humidity present with some different cosmetic skin care needs.

Cornelia de Lange syndrome

Many children are diagnosed at birth or within a few days of birth. They show characteristic features of hypertricosis (hirsutism, synophrys, long eyelashes), facial abnormalities including depressed nasal bridge, ocular anomalies, prominent philtrum, thin lips, anteverted nostrils, a down-turned angle of mouth, bluish tinge around eyes, nose and or mouth, widely spaced teeth, high arched palate, low set ears, micrognathia, and short neck. Limb deformities include grossly malformed upper limbs, small hands and feet with short digits, limitation of extension of elbows, proximally placed thumbs, clinodactyly of fifth finger, a single transverse palmar crease (in about 51 per cent of cases), and webbing of second and third toes. Other anomalies include cryptorchidism and hypoplastic genitalia in males (57 per cent of cases), a small umbilicus (53 per cent of cases), a low-pitched cry, and small nipples (55 per cent of cases). (33) Systemic abnormalities include severe gastrointestinal...

Experimental Design

A complete factorial design is one in which all combinations of the different factors are investigated (Figure 1.1). This allows straightforward modeling of interactions between, for example, environmental factors influencing growth or inactivation of microorganisms. The experimental design is simple, easy to set up, and easy to handle statistically. The main disadvantage is the large increase in number of experiments for every new factor level added to the experiment. A simple example of a complete 3 x 3 x 3 factorial design was applied by Chhabra et al.4 for investigating thermal inactivation of Listeria monocytogenes in milk. The factors were milk fat content, pH, and heating temperature the experiment was performed in triplicate, resulting in 34 81 experiments. A complete factorial experimental design was also used by Uljas et al.5 for modeling the combined effect of different processing steps on the reduction of Escherichia coli O157 H7 in apple cider. The response variable...

Conclusion

In the opinion of the author, the most exciting achievements in this arena are those in which the cosmetic scientist has been able to elevate the performance of a subfunctionality to a level of such magnitude that it is perceived as creating a new product category. A prominent example, cited many times throughout this chapter, is the two-in-one shampoo. While the likelihood of attaining comparable achievements in the future may be diminished by consideration of the numbers of scientists presumed to have unsuccessfully explored these areas in the past, it is also increased by the significant strides being made on a regular basis in true cosmetic science. Prominent among these are the achievements contributing to truly efficacious skin care.

Types of Botulism

Five types of botulism occur in humans foodborne, wound, infant, intestinal, and inadvertent. A sixth type, intentional or bioterror botulism, is likely to occur during our lifetimes. Each type is associated with different epidemiology and pathogenetic mechanisms. The first recognized case of botulism in the U.S. occurred in 1899 and was caused by a beef tamale.13 Food botulism was the most common form of botulism in the U.S. prior to 1980.1 Infant (or intestinal) botulism was first described in 1976 by two groups14,15 and is now the most frequently reported type of botulism in the U.S.1 Wound botulism was first described in the U.S. in 1951, with initial cases primarily due to traumatic wounds of the extremities.16 More recently, the incidence of this form of botulism has increased and has been associated with injection drug users injecting black tar heroin.17 An adult variant of infant botulism, variously called botulinal autointoxication, or hidden, adult intestinal, or adult...

Treatment

Treatment of botulism includes (1) early administration of botulinum antitoxin to prevent progression of moderate illness or reduce the duration of mechanical ventilation in patients with rapidly progressive severe botulism, (2) close monitoring of respiratory function (vital capacity and maximal inspiratory force, MIF), and (3) intensive care for patients with significant paralysis and evidence of respiratory insufficiency or failure. Vital capacity (VC) should be measured as soon as the diagnosis is suspected and followed closely In one study, 10 of 11 patients requiring mechanical ventilation had vital capacities less than 30 of predicted.116 Patients with VC less than 10cc kg should be monitored in an ICU for progression of respiratory failure requiring mechanical ventilation.117 Patients requiring mechanical ventilation obviously merit ICU care. Equine antitoxin has been administered rarely to infants with botulism, because of the risk of lifelong hypersensitivity to equine...

Oxygen

Some bacteria cannot use molecular oxygen and can even be harmed by it. Examples include Clostridium botulinum, the bacterium that causes botulism, and Clostridium tetani, the bacterium that causes tetanus. These organisms are called obligate anaerobes. Molecular oxygen (O2) is a poisonous gas to obligate anaerobes. Toxic forms of oxygen are

Survival Models

Our ability to understand and model the survival of pathogens in foods or during processing of food is critical to the safety of the food supply. Thus, models to describe microbial death due to heating have been used since the 1920s, and constitute one of the earliest forms of predictive microbiology. Much of the early work centered around the need to achieve destruction of C. botulinum spores in low acid canned foods,1778 79 and much effort has been put towards characterizing the kinetics of spore inactivation. In this section of the chapter we will focus on the evolution of survival modeling from the classical linear approach to the more complex models required to describe inactivation curves that deviate from linearity. From the first-order reaction it is not possible to achieve complete destruction of all C. botulinum spores in a given volume of product one spore will always be

Aminopyridines

The aminopyridines (4-aminopyridine 3,4-diaminopyri-dine) accelerate spontaneous exocytosis at central and peripheral synapses. There is also an increase in the number of transmitter quanta released by a nerve action potential. This is probably the result of increased Ca++ inflow at the terminals due to a reduction of K+ conductance and prolongation of the nerve action potential. Muscle strength is increased in patients with the Lambert-Eaton myasthenic syndrome and in others poisoned with botulinum E toxin (discussed later). Improvement in uncontrolled spasms, muscle tone, and pulmonary function is noted in patients with multiple sclerosis or long-standing spinal cord damage. Side effects that limit clinical utility include convulsions, restlessness, insomnia, and elevated blood pressure. Of the two agents, 3,4-diaminopyridine is the more potent and crosses the blood-brain barrier less readily.

Intravesical Therapy

Botulinum toxin (Botox) inhibits acetylcholine release at the presynaptic membrane, thereby decreasing muscle contractility and causing muscle atrophy at the site of injection. This action is temporary because the nerves regenerate in 3 to 6 months. Traditionally, botulinum toxin has been used to treat detrusor-sphincter dyssynergia because the toxin produces a chemical denervation at the neuromuscular junction of the external sphincter. Schurch et al.16 demonstrated increases in mean maximum bladder capacity of 296 to 480 mL (P < .016) and a decrease in mean maximum detrusor voiding pressure of 65 to 35 cm H2O (P < .016) measured 6 weeks after injection in spinal cord-injured patients with detrusor hyperreflexia who received intravesical injection at up to 30 sites. In our experience, patients respond well to Botox injections, but symptoms are likely to recur within 6 months. Limited clinical data are available on Botox for OAB, and it is not FDA approved for this indication.

Neuromodulation

Neurotoxins Botulinum Toxin Injections Botulinum toxin inhibits the calcium-mediated release of acetylcholine at the presynaptic neuromuscular junction. By creating a reversible field denervation at the site of injection and subsequent muscle atrophy, botulinum toxin injections have proven to be a safe and effective therapy for a variety of somatic and autonomic disorders and are being used in a variety of clinical applications such as the refractory OAB. Botulinum toxin injection in the office setting under a topical bladder and urethral anesthetic addresses not only the hyperactivity of the bladder muscle from motor efferent innervation, but may also address the hypersensitivity of the bladder's sensory afferent nerves that may contribute to refractory OAB symptoms. In the United States (US), the procedure is done on an outpatient basis under local anesthesia provided by instilling 90mL of a 1 lidocaine solution in the bladder for 10 to 15 minutes. Under cystoscopic visualization,...

Spasticity

For those with intractable spasticity, a high-tech approach is necessary. Cutting tendons, ligaments, and the spinal cord is, for the most part, a thing of the past. Sometimes, the injection of botulinum toxin (Botox) can relieve the muscle stiffness, but often the dose is too high to be effective without causing side effects. Canniboids are thought by some to be of value in treating difficult spasticity, but they have never been found to be effective in a well-conceived study. The baclofen pump allows for the administration of baclofen intrathecally,

Longneck

Physical description Shape varies from serpentine to thick and bunched up. Length, 15-65 feet. Dark brown on top, with black-and-gray or whitish mottling. Underside much lighter. Skin looks smooth when wet, but up close, it appears wrinkled and rough. Small, round head with two small horns. Small eyes. Tapered muzzle, sometimes described as like a seal's or dog's and at other times like a horse's or camel's. Long, slender, flexible neck. A collar behind the head is sometimes reported. There are one to three dorsal humps, with the middle being the largest. A slight ridge along the spine. Four webbed flippers. The hind pair sometimes resembles a bilo-bate tail.

Benzoyl peroxide

Benzoyl peroxide is first-line therapy for mild acne. It is available over-the-counter. The liquids and creams (Benoxyl) are less irritating and are useful for dry skin. The gel (Benzagel, Persa-Gel) is more irritating but more effective for oily skin. Mild redness and scaling occurs during the first week. It may irritate the skin, bleach the clothes, and inactivate simultaneously applied tretinoin and other anti-acne products.

Microcheck 222

The normal skin flora are important because they help protect against colonization by pathogens. Occasionally, they cause disease when body defenses are impaired. They are responsible for body odor, and probably contribute to acne. Name and describe the three groups of organisms generally present on normal skin.

Highaffinity Ligands

FIGURE 15.1 A representation of a bi-dentate ligand that recognizes the botulinum toxin. Figure courtesy of Rod Balhorn, LLNL. (See color insert.) FIGURE 15.1 A representation of a bi-dentate ligand that recognizes the botulinum toxin. Figure courtesy of Rod Balhorn, LLNL. (See color insert.)

Dental Infections

This means that bacteria that operate normally in the oxygen-containing environment of the mouth are subjected to the oxygen-starved environment of the tooth root tip and the internal tooth pulp. When these oxygen-requiring bacteria are deprived of their oxygen, their metabolism undergoes a radical transformation. Enormously toxic by-products begin to be produced under these circumstances. The waste products of this oxygen-deprived metabolism are enormously toxic. In fact, they have been demonstrated in unpublished tests to have toxic effects on some human enzymes that are many times greater than the toxic effects of Clostridium botu-linum. When one realizes that traditional scientists and doctors still consider botulinum toxin to be the most potent toxin known, the implications of this anaerobic oral toxicity are enormous. Viewed from a different perspective, a root canal tooth could be considered a little manufacturing plant for the low-grade and chronic production of toxins...

Botulism

An uncommon, lethal disease caused by the exotoxins of the anaerobe Clostridium botulinum. Botulism is most commonly a food-borne disease, especially associated with canned foods. It may be contracted by wound contamination with aquatic soils. The toxin is carried in the blood to cholinergic neuromuscular junctions where it binds irreversibly. Symptoms begin between 6 h and 8 days after contamination and are more severe with earlier onset. Botulism is diagnosed by isolating Clostridium botulinum from the stool or by mouse bioassay (survival of immunised mice and death of non-immunised mice when infected serum is injected).

Skin Lightening

To evaluate the skin-lightening effect of a product, we perform punch biopsies (2 mm) in the periauricular area of the ear at baseline prior to treatment and following 8 weeks of topical treatment to the contralateral ear region. Following 8 weeks, a second 2 mm punch biopsy sample is obtained from the treated periauricular region of the ear. The skin biopsy specimens are snapped, frozen, and stained with, for example, S-100 monoclonal antibody (which stains specifically for pigment cell and melanin presence when an indirect immunoperoxidase staining procedure is used). Figure 1 shows untreated skin (baseline). One can see dendritic melano-cytes at the basal region of the epidermis (arrows). Figure 2 shows S-100 staining following 8 weeks of topical treatment. Note the subtle yet quantitative reduction in the absolute number of visible pigment-producing melanocytes. Although this difference is not clinically significant to the test subject, t is an objective quantitative observation...

Fact and Fantasy

We reported two decades ago that biomolecules and molecular assemblages such as membranes and proteins can be stabilized in the dry state in the presence of a sugar found at high concentrations in many anhydrobiotic organisms, trehalose.1 We also showed that trehalose was clearly superior to other sugars in this regard.2 This effect seemed so clear it quickly led to wide-spread, and often uncritical, use of the sugar for preservation and other purposes. In fact, an array of applications for trehalose have been reported, ranging from stabilization of vaccines and liposomes to hypothermic storage of human organs.3 Other workers showed that it might even be efficacious in treatment of dry eye syndrome or dry skin in humans.4'5 Trehalose is prominendy listed as an ingredient in cosmetics, apparendy because it is reputed to inhibit oxidation of certain fatty acids in vitro that might be related to body odor.6 Trehalose has been shown by several groups to suppress free radical damage,...

Donna A Chow

NF-kB , an important transcription factor for inflammatory and innate immune responses, is thought to promote keratinocyte viability during their upward migration and differentiation, contributing to spacial control and maintenance of tissue architecture. Kerat-inocytes except those in the granular layer express Fas constitutively, and all appear relatively resistant to the Fas pathway which is dominant in lymphocytes reviewed in 1 , The regulation of keratinocyte survival and death is considered a complex, redundant and highly coordinated process, with stem cell proliferation in the basal layer and terminal differentiation and apoptosis limited to the upper layers of the epidermis reviewed in 1,2 , Apoptotic keratinocytes shrink and are phagocytosed by nearby keratinocytes acting as non-professional phagocytes, while terminally differentiated keratinocytes flatten, form the stratum corneum and eventually are sloughed off reviewed in 1 ,

Research questions

Choosing research priorities is not easy. Most people, when asked, will focus on relatively specific questions that are undoubtedly important for particular patients, but do not necessarily address questions that have a large general impact. This problem has been discussed in relation to rehabilitation research priorities.6 Within the field of MS there are hundreds of potential specific research questions such as what dose of intramuscular botulinum toxin is effective in the biceps to control the development of contractures, do silver-coated catheters reduce morbidity if used long term, and is exercise specifically effective at reducing fatigue

Biosensors

Many types of biosensors have been developed, such as enzymes (a great variety of enzymes have been used), antibodies (polyclonal and monoclonal), nucleic acids, cellular materials, and others. Whole cells may also be used as biosensors. Analytes detected include toxins (staphylococcal enterotoxins, tetrodotoxins, saxitoxin, botulinum toxin, and others), specific pathogens (salmonella, staphylococcus, Escherichia coli O157 H7, etc.), carbohydrates (fructose, lactose, galactose, etc.), insecticides and herbicides, ATP, antibiotics (e.g., penicillins), and others. The recognition signals used include electrochemical (potentiometry, voltage changes, conductance and impedance, light addressable, etc.), optical (such as UV, bioluminescence and chemilumin-escence, fluorescence, laser scattering, reflection and refraction of light, surface plasmon resonance, and polarized light), and miscellaneous transducers (such as piezoelectric crystals, thermistors, acoustic waves, and quartz crystals).

Atmosphere

Genus Pseudomonas are obligate aerobes, and consequently they cannot grow in foods stored under conditions that exclude all of their required oxygen. Excluding oxygen from a food, however, may enable the growth of other bacteria, including the obligate anaerobe Clostridium botulinum. A case of botulism was traced to the consumption of a thick homemade stew that had been slowly cooked and then left at room temperature overnight. The cooking process did not destroy the endospores of C. botulinum and had created anaerobic conditions in which the organism thrived and produced toxin. oxygen requirements, p. 88

Microcheck

Moist heat such as boiling water destroys vegetative bacteria and viruses. Pasteurization significantly reduces the numbers of heat-sensitive organisms. Autoclaves use pressurized steam to achieve high temperatures that kill microbes, including endospores. The commercial canning process is designed to destroy the endospores of Clostridium botulinum. Dry heat takes longer than moist heat to kill microbes. Why is it important that the commercial canning process destroys the endospores of Clostridium botulinum

Book Layout

Chapters 5 and 6 discuss the formulation of multifunctional products for skin care. Chapter 5 provides a detailed look at the development of ingredient mixtures for multifunctionality in skin care products. Methods for choosing appropriate materials and evaluating their effectiveness for various functionalities are given. Similarly, Chapter 6 discusses formulation of multifunctional nail care products and methods for their evaluation. The final three chapters are related to areas that affect the development of multifunctional products but do not specifically deal with formulating. Chapter 11 reviews the techniques involved in developing claims support for multifunctional products. Numerous methods are proposed for both skin care and hair care products. Additionally, an overall strategic approach is proposed for specifically dealing with products of these types. Chapter 12 examines the role of packaging in the development of multifunctional products. Numerous aspects of the package are...

Table 1424

Phillips, T., Demircay, Z., and Sahu, M., Hormonal effects on skin aging, Clin. Geriatr. Med., 17, 661-672, 2001. 96. Phillips, T., Demircay, Z., and Sahu, M., Hormonal effects on skin aging, Clin. Geriatr. Med., 17, 6610-6672, 2001. Thomas, P., Age related changes in wound healing, Drugs Aging, 18, 607-620, 2001. Bolognia, J., Aging skin, Am. J. Med., 98, 99-102, 1995.

Oral Dysfunction

Perhaps the most encouraging treatment for drooling in PD was introduced by Bhatia and colleagues in 1999 when they performed intraparotid injections of botulinum toxin type A (BTX) in four patients, one of whom had PD.67 The possibility of using BTX in this fashion had first been suggested in 1997 by Bushara, who actually had patients with amyotrophic lateral sclerosis in mind when making the proposal.68 Subsequent open label studies in PD patients confirmed subjective reduction of drooling in 67 to 88 of subjects and objective reduction in saliva production in 88 to 89 of patients tested.69-71 Recent double-blind studies have further demonstrated the safety and efficacy of this technique.7273 BTX doses employed have varied considerably, from the 5 units per parotid employed by Friedman and Potulska71 to the 225 units per side used by Mancini and colleagues, who injected both parotid and submandibular glands.73 The latter investigators also performed their injections under...

History

The use of pathogenic agents as weapons has been documented for more than two millennia. The ancient Romans carried out biological warfare by putting carrion into the wells of their enemies to poison the water supply Such crude biowarfare tactics continued well into the 20th century.3'4 During the 14th-century siege of Kaffa (now Feodossia, Ukraine), the attacking Tartar soldiers experienced an epidemic of bubonic plague. The Tartars capitalized on the devastating disease and used the bodies of plague victims as weapons. They catapulted their own soldiers' diseased bodies into the walled city of Kaffa in an attempt to inflict harm on their enemy and likely contributed to the European plague epidemic during the Middle Ages.5-7 Smallpox and measles contained within blankets and clothing were used by the Conquistadors and British as biological weapons against Native Americans. It is believed that such tactics influenced the outcome of the French and Indian Wars.5'7 Plague was used as a...

Vegetable Microflora

Coli Fruit Surface

The packaging and storage conditions for minimally processed vegetable products, including the use of modified atmosphere packaging, may significantly alter microbial ecology. The extended shelf life of some minimally processed vegetable products may result in an undesirable safety index,'' a concept developed to define the risks associated with modified atmosphere packaged foods 33 . This safety index is defined as the ratio of spoilage to pathogenic bacteria in foods, measured as the relative cell concentrations of these organisms. It has been argued, however, that the primary effect of modified atmosphere packaging in extending the sensory quality of vegetable products may be to decrease the metabolic activity of the vegetable material 34 . In a model system, it was found that growth rates for L. monocytogenes, A. hydrophilia, and Bacillus cereus may be reduced by modified atmosphere conditions, but final cell density was not affected 35 . One major source of concern is that...

Damage to the Host

Exotoxins are either secreted by the bacterium or leak into the surrounding fluid following lysis of the bacterial cell. In most cases, the pathogen must colonize a body surface or tissue to produce enough toxin to cause damage. With foodborne intoxication, however, the bacterial cells multiply in a food product where they produce toxin that is then consumed. In the case of botulism, caused by ingestion of botulinum toxin produced by Clostridium botulinum, ingestion of minute amounts of toxin is sufficient to cause paralysis. Like most other exotoxins, botulinum toxin can be destroyed by heating. botulism, p. 672 Exotoxins may act locally, or they may be carried in the bloodstream throughout the body, causing systemic effects. For example, Corynebacterium diphtheriae, the organism that causes diphtheria, grows and releases its exotoxin in the throat. There, the toxin destroys local cells, leading to the formation of a pseudomembrane composed of dead host cells, pus, and blood. This...

Tretinoin Retin A

Fair-skinned patients may begin by applying the 0.025 cream shortly after washing nightly. The quantity of tretinoin applied may be gradually increased as tolerated, and twice-daily applications may be appropriate. The cream is best for dry skin the gel is best for oily skin.

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