By L. Thorek. Michigan Jewish Institute.
The word “nootropic” comes from the Greek words noos order cialis black 800 mg otc, which means “mind purchase 800mg cialis black with amex,” and tropos buy cialis black 800mg lowest price, which means “changed” or “turn cialis black 800 mg lowest price. Dietary Recommendations Foods to include: • Brewer’s yeast, wheat germs, spirulina, and eggs contain B-complex vitamins, which are essential for memory and cognitive function. Wheat germ and whole grains also contain the antioxidant vitamin E, which helps protect against free radical damage. In particular spinach, broccoli, and leafy greens have been shown to offer cognitive benefits. Foods to avoid: • Alcohol destroys brain cells and alters brain chemistry causing memory loss; minimize or avoid completely. Of the types of vegetables studied, green leafy vegetables had the strongest associ- ation with slowing the rate of cognitive decline. Also, reducing foods high in saturated fat and cholesterol and eating fish with beneficial omega-3 fatty acids, such as salmon and tuna, may benefit brain health (Neurology, 2006: 67; 1370–1376). Lifestyle Suggestions • Don’t smoke, as smoking damages blood vessels and hampers memory. Challenging the brain with such activities as reading, writing, do- ing puzzles and crosswords, and playing games stimulates brain cells and the connections between the cells, and may help improve memory and prevent cognitive decline. Being overweight increases the risk of high blood pressure and cholesterol, factors associated with memory loss. Top Recommended Supplements Acetyl-L-carnitine: An amino acid derivative that crosses into the brain and increases the levels of acetycholine, a brain neurotransmitter essential for memory and learning. Studies have found it helpful for improving memory and cognitive function in the elderly. Ginkgo biloba: Improves memory and cognitive function by increasing blood flow to the brain. It is particularly helpful for the elderly and those with atherosclerosis or Alzheimer’s. Dosage: 120–240 mg daily, standardized to 6 percent terpene lactones and 24 percent flavone glycosides. Several studies involving more than 1,000 people have found it effective in improving memory in both college-age people and the elderly. Complementary Supplements M Bacopa monnieri: An herb that has been shown to enhance several aspects of mental function. It increases availability of acetylcholine in the brain, which improves memory and cognition. A deficiency of B1, B6, and B12 is more common among the elderly, and can hamper memory and cognitive function. Those with poor intestinal health may require monthly injec- tions of vitamin B12. Melatonin: A hormone that regulates sleep/wake cycles; having adequate sleep is important for cognitive function. Supplements of melatonin have been found to improve sleep quality, mood, and memory. Vitamin E: A potent antioxidant that protects the brain from damage due to oxidative stress and inflammation. Studies in older adults have found that those with higher blood levels of vitamin E have better brain function. Consider supplements of acetyl-L-carnitine, fish oils, ginkgo biloba, and phospha- tidylserine. At puberty ovulation starts and eggs are released by the ovaries each month for the pur- pose of conception. As the years go by, the amount of eggs gradually declines until menopause, when the ovaries shut down and stop producing estrogen and progester- M one, the two main female sex hormones. Menopause occurs when ovulation ceases and a woman can no longer conceive naturally. After menopause the adrenal glands, which supply some sex hormones through- out life, become the primary source. Women who have poor adrenal function, which can be caused by chronic stress, poor diet, lack of sleep, or excessive caffeine, are not able to provide adequate hormone amounts, and may have more severe menopausal symptoms.
Eating behaviour In an alternative approach to understanding the causes of obesity 800mg cialis black amex, research has exam- ined eating behaviour discount cialis black 800 mg on line. Research has asked ‘Are changes in food intake associated with changes in obesity? The results from this data- base illustrate that cialis black 800 mg on-line, although overall calorie consumption increased between 1950 and 1970 cheap cialis black 800 mg amex, since 1970 there has been a distinct decrease in the amount we eat (see Figure 15. Prentice and Jebb (1995) examined the association between changes in food intake in terms of energy intake and fat intake and changes in obesity. Their results indicated no obvious association between the increase in obesity and the changes in food intake (see Figure 15. Therefore, using population data there appears to be no relationship between changes in food intake and changes in obesity. Throughout the 1960s and 1970s theories of eating behaviour emphasized the role of food intake in predicting weight. Original studies of obesity were based on the assumption that the obese ate for different reasons than people of normal weight (Ferster et al. Schachter’s externality theory suggested that, although all people were responsive to environmental stimuli such as the sight, taste and smell of food, and that such stimuli might cause overeating, the obese were highly and sometimes uncontrollably responsive to external cues. It was argued that normal weight individuals mainly ate as a response to internal cues (e. Within this per- spective, research examined the eating behaviour and eating style of the obese and non- obese in response to external cues such as the time of day, the sight of food, the taste of food and the number and salience of food cues (e. Research exploring the amount eaten by the obese has either focused on the amount consumed per se or on the type of food consumed. Because it was believed that the obese ate for different reasons than the non-obese it was also believed that they ate more. Research therefore explored the food intake of the obese in restaurants and at home, and examined what food they bought. They weighed all members of the families and found no relationship between body size and the mass and type of food they consumed at home. In an attempt to clarify the problem of whether the obese eat more than the non-obese, Spitzer and Rodin (1981) examined the research into eating behaviour and suggested that ‘of twenty nine studies examining the effects of body weight on amount eaten in laboratory studies. Therefore, the answer to the question ‘do the obese eat more/differently to the non- obese? Over recent years, research has focused on the eating behaviour of the obese not in terms of calories consumed, or in terms of amount eaten, but more specifically in terms of the type of food eaten. Population data indicates that calorie consumption has decreased since the 1970s and that this decrease is unrelated to the increase in obesity (see Figures 15. However, this data also shows that the ratio between carbohydrate consumption and fat consumption has changed; whereas we now eat less carbohydrate, we eat proportionally more fat (Prentice and Jebb 1995). One theory that has been developed is that, although the obese may not eat more than the non-obese overall, they may eat proportionally more fat. Further, it has been argued that not all calories are equal (Prentice 1995) and that calories from fat may lead to greater weight gain than calories from carbohydrates. To support this theory, one study of 11,500 people in Scotland showed that men consuming the lowest proportion of carbohydrate in their diets were four times more likely to be obese than those consuming the highest pro- portion of carbohydrate. A similar relationship was also found for women, although the difference was only two- to three-fold. Therefore, it was concluded that relatively lower carbohydrate consumption is related to lower levels of obesity (Bolton-Smith and Woodward 1994). A similar study in Leeds also provided support for the fat proportion theory of obesity (Blundell and Macdiarmid 1997). This study reported that high fat eaters who derived more than 45 per cent of their energy from fat were 19 times more likely to be obese than those who derived less than 35 per cent of their energy from fat. Therefore, these studies suggest that the obese do not eat more overall than the non-obese, nor do they eat more calories, carbohydrate or fat per se than the non- obese. But they do eat more fat compared with the amount of carbohydrate; the proportion of fat in their diet is higher.
According to one study cheap 800mg cialis black, regular exercises (walking 15 minutes three times per week) reduced the risk of Alzheimer’s and dementia by 40 percent in individuals over age 65 cialis black 800mg on line. The theory is the more you use your brain cialis black 800mg discount, the more synapses you create buy cialis black 800mg line, which provide a greater reserve as you age. A Bacopa monnieri: An herb that has been shown to enhance several aspects of mental function. It increases availability of acetylcholine in the brain, which improves memory and cognition. Ginkgo biloba: An herb that improves memory and cognitive function and slows the progression of Alzheimer’s. Dosage: 120–240 mg daily, standardized to 6 percent terpene lactones and 24 percent flavone glycosides. Phosphatidylserine: A nutrient that is related to lecithin, which is naturally occurring in the brain. Several studies involv- ing more than 1,000 people suggest that phosphatidylserine is an effective treatment for Alzheimer’s disease and other forms of dementia. It improves both behaviour and mental function and reduces symptoms of depression. Vitamin B1 is involved in nerve transmission and may be deficient in those with Alzheimer’s. Regular consumption of fish reduces Alzheimer’s risk and is important for brain function. Vitamin E: A potent antioxidant that protects the brain from damage due to oxidative stress and inflammation. Higher blood levels of vitamin E are associated with better brain function in older adults and some research has shown that supplements can lower the risk of Alzheimer’s. Consider supplements of acetyl-L-carnitine, bacopa, ginkgo, phosphatidylserine, and fish oils. Anemia impairs the ability of blood to transfer oxygen to the tissues throughout the A body. Either the body produces too few healthy red blood cells, loses too many, or destroys them faster than they can be replaced. The body needs iron to produce hemoglobin, the oxygen-carrying component of red blood cells. This form of anemia can result from poor diet (inadequate iron), blood loss (menstruation, surgery, or hemorrhoids), malabsorption diseases such as celiac, or increased iron needs during pregnancy. In addition to iron, the body needs folate and vitamin B12 to produce healthy red blood cells. It is more common among the elderly and those with intestinal disorders, which impair B12 absorption. Bariatric surgery, gastric ulcers, stomach tumours, and excessive alcohol consump- tion are other known risk factors for the development of pernicious anemia. Certain chronic diseases such as cancer, Crohn’s disease, kidney failure, rheuma- toid arthritis, and other inflammatory disorders can impair red blood cell production, which results in anemia. Aplastic anemia is a rare, life-threatening disease caused by a decrease in the bone marrow’s ability to produce blood cells. This may result from chemotherapy, radiation, exposure to environmental toxins, pregnancy, and lupus. Hemolytic anemia is a condition in which the red blood cells are destroyed faster than they can be produced in the bone marrow. This may result from autoimmune disease and use of certain medications, such as antibiotics. Sickle cell anemia is an inherited form of anemia caused by a defective form of he- moglobin that causes the red blood cells to become an abnormal (sickle) shape. Untreated pernicious anemia can lead to nerve damage and decreased mental function, as vitamin B12 is important not only for healthy red blood cells but also for optimal nerve and brain function. A Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threat- ening complications.
Gentamicin is widely used and has a Chloramphenicol inhibits bacterial ribosome function by broad spectrum best 800 mg cialis black, but is ineffective against anaerobes generic cialis black 800 mg mastercard, many inhibiting the 50S ribosomal peptidyl transferase 800 mg cialis black overnight delivery, thereby pre- streptococci and pneumococci buy 800mg cialis black free shipping. Amikacin is more effective than gentamicin for Adverse effects pseudomonal infections and is occasionally effective against These include: organisms resistant to gentamicin. Topical gentamicin or tobramycin anaemia occurs unpredictably with an incidence of eye drops are used to treat eye infections. Chloramphenicol accumulates in neonates (especially if Adverse effects premature) due to reduced glucuronidation in the immature liver (see Chapter 10). Therapeutic monitoring is performed by measuring plasma concentrations before dosing Pharmacokinetics (trough) and at ‘peak’ levels (usually at an arbitrary one hour Chloramphenicol is well absorbed following oral administra- after dosing). Eighth nerve damage is potentially catastrophic tion and can also be given by the intramuscular and intra- and is often irreversible. Drug interactions Pharmacokinetics Chloramphenicol inhibits the metabolism of warfarin, phenytoin and theophylline. Aminoglycosides are poorly absorbed from the gut and are given by intramuscular or intravenous injection. Distinctively, they are effective reduction and/or an increased dose interval is required. Uses include respiratory infections (including Mycoplasma pneumoniae, psittacosis and Legionnaires’ disease), whooping cough, Campylobacter enteritis and non-specific urethritis. It is useful for skin infections, such as low- Chloramphenicol has a broad spectrum of activity and pene- grade cellulitis and infected acne, and is acceptable for patients trates tissues exceptionally well. It is bacteriostatic, but is with an infective exacerbation of chronic bronchitis. It is most extremely effective against streptococci, staphylococci, commonly administered by mouth four times daily, although H. Nausea, vomiting, diarrhoea and abdominal cramps are the most common adverse effects reported, related to Pharmacokinetics direct pharmacological actions rather than allergy. Cholestatic Tetracyclines are well absorbed orally when fasting, but their jaundice has been reported following prolonged use. They undergo Intravenous administration frequently causes local pain and elimination by both the liver and the kidney. The shorter-acting drugs are given four times daily and the longer-acting ones once daily. Doxycycline is Erythromycin inhibits cytochrome P450 and causes accumu- given once daily, can be taken with food and is not contraindi- lation of theophylline, warfarin and terfenadine. Uses Azithromycin and clarithromycin are more expensive than erythromycin, but cause fewer gastro-intestinal side effects. Fusidic acid is combined with other drugs to treat staphylo- coccal infections, including penicillin-resistant strains. Gram-positive and Gram-negative organisms and, in addition organisms such as Rickettsia, Chlamydia and Mycoplasma. They Adverse effects are used in atypical pneumonias and chlamydial and rick- Adverse effects are rare, but include cholestatic jaundice. Pharmacokinetics They are not used routinely for staphylococcal or streptococ- When administered either orally or intravenously, its half-life cal infections because of the development of resistance. It is Mechanism of action eliminated by a combination of hepatic metabolism and renal Vancomycin inhibits bacterial cell wall synthesis. Drug interactions Adverse effects Metronidazole interacts with alcohol because it inhibits alde- These include: hyde dehydrogenase and consequently causes a disulfiram- • hearing loss; like reaction. Sulphonamides and trimethoprim inhibit the production of folic acid at different sites of its synthetic pathway and are synergistic in vitro. There is now widespread resistance to sulphonamides, Pharmacokinetics and they have been largely replaced by more active and less toxic Vancomycin is not absorbed from the gut and is usually given antibacterial agents.