Each year, 45 million Americans — many of them women — are consumed with thoughts of muffin tops, love handles and other parts of their bodies, especially as the season for beach and bathing suits looms. Figures from the American Society of Plastic Surgeons show that $11 billion was spent on cosmetic procedures in 2012, accounting for 1.6 million procedures.
For those seeking to battle their perceived problems, a procedure called CoolSculpting is gaining prominence because it doesn’t require pills, exercise, needles or surgery.
“I really like this procedure,” said nationally known, board-certified cosmetic and reconstructive surgeon Kimberley Goh from her office in Myrtle Beach. “It tells the cell it’s time to die. [The cells] go, and they don’t come back.”
The procedure is based on Cryolipolysis (a registered trademark) and was developed by Harvard University scientists Dieter Manstein M.D. and R. Rox Anderson M.D. They discovered that cooling the skin will kill fat cells without harming the skin or tissue surrounding them.
Five years ago, Goh contacted representatives of Zeltiq Aesthetics, which manufactures the apparatus for CoolSculpting. She was satisfied with what she learned and decided to become certified and purchase the needed equipment.
Zeltiq was founded in 2005, and its CoolSculpting procedure has become the most accepted, noninvasive body-contouring method. It has sold its equipment to medical practices in more than 60 countries and reports more than 1 million treatments have been performed worldwide, 427,000 alone in 2013.
Goh is an advocate of CoolSculpting and has been offering the procedure since 2011. She emphasized that it is a body-contouring treatment, not a weight-loss method.
“It’s noninvasive,” she said, explaining that the procedure is U.S. Food and Drug Administration approved.
Audrey Grice, licensed practical nurse for 23 years and licensed esthetician for almost six years, said the four physicians in Wilmington Plastic Surgery decided in 2011 that CoolSculpting would be part of their practice. They and Grice became certified, and she has performed 1,500 treatments.
“It’s for fat that won’t leave,” she said. “Every patient has had good results.”
She has had several treatments herself, some on her upper and lower abdomen and some on her flanks. “It’s wonderful,” she said. “It’s customizing to the person’s body type.”
She emphasized that it is not an appropriate treatment for the obese because it’s not a weight-loss plan. It is appropriate for those who eat well and exercise but have “jiggling fat.”
Goh said she has interested patients contact her office for a free consultation to determine if they qualify, what their goals are and what treatment plan to pursue. Most treatments are last one hour and involve a device being placed on the problem area. Excessive fat is drawn into the device and cooled to 34-degrees Fahrenheit.
“Twenty to 25 percent of the fat cells are gone forever [after one treatment],” Goh said. “The cells go on a hunger strike and die.”
Patients resume their schedules as soon as the treatment is over. They may experience some bruising and reddening, but no scarring results. Skin is not permanently affected, and freezing does not occur because the area is not cooled to the freezing point, 32 degrees Fahrenheit. The procedure has proved to be safe, and the same area can be treated several times until a patient reaches the desired result.
“A candidate has a localized collection of fat,” Goh said. “It doesn’t work well when fat is spread evenly. After the treatment, clothes fit better, but you don’t change size. You have a moderate change.”
The procedure does not tighten skin, produce a loss in weight or require anesthesia or surgery. It does remove fat, reduce bulges and save time.
The procedure works well around the waist, hips, abdomen and thighs. Goh said she won’t do the procedure on the neck, and few people would benefit from having it on the arm because it doesn’t tighten the skin. In her experience, about 50 percent of those who have a consultation do not qualify because they need to lose a large amount of weight, have a medical condition that eliminates them or have another situation that exempts them.
Possible candidates should ask themselves if they can “pinch an inch,” if they exercise and if they are in good general health.
Kimberly Cooper, certified CoolSculpting technician, surgical technician and certified nursing assistant in Goh’s practice, said she’s had the procedure on both flanks and on her upper abdomen.
“I am very happy with it because it’s nonsurgical,” she said, “and there’s no downtime. You can have it done and go back to work. It’s an easy way to get rid of some unwanted areas that diet and exercise don’t always get.”
At Facial Aesthetic Center in Myrtle Beach, a medical spa, licensed esthetician and office manager Catherine Pelton said she took the training and began performing the CoolSculpting procedure in January 2014.
“Patients love it,” Grice said. “They come back for more and more and more. They come for CoolSculpting because it is not uncomfortable. It’s easy and there’s no surgery.
“Results often improve a patient’s self-image. Surgery is a great option, but it’s not always the best option. [CoolSculpting] is another tool in the toolbox to get patients where they want to be.”
FOR MORE INFORMATION
Learn more about CoolSculping at www.coolsculpting.com.
Of the mice that received the treatment, 75 percent got their memory functions back.
Australian researchers have come up with a non-invasive ultrasound technology that clears the brain of neurotoxic amyloid plaques – structures that are responsible for memory loss and a decline in cognitive function in Alzheimer’s patients.
If a person has Alzheimer’s disease, it’s usually the result of a build-up of two types of lesions – amyloid plaques, and neurofibrillary tangles. Amyloid plaques sit between the neurons and end up as dense clusters of beta-amyloid molecules, a sticky type of protein that clumps together and forms plaques.
Neurofibrillary tangles are found inside the neurons of the brain, and they’re caused by defective tau proteins that clump up into a thick, insoluble mass. This causes tiny filaments called microtubules to get all twisted, which disrupts the transportation of essential materials such as nutrients and organelles along them, just like when you twist up the vacuum cleaner tube.
As we don’t have any kind of vaccine or preventative measure for Alzheimer’s – a disease that affects 343,000 people in Australia, and 50 million worldwide – it’s been a race to figure out how best to treat it, starting with how to clear the build-up of defective beta-amyloid and tau proteins from a patient’s brain. Now a team from the Queensland Brain Institute (QBI) at the University of Queensland have come up with a pretty promising solution for removing the former.
Publishing in Science Translational Medicine, the team describes the technique as using a particular type of ultrasound called a focused therapeutic ultrasound, which non-invasively beams sound waves into the brain tissue. By oscillating super-fast, these sound waves are able to gently open up the blood-brain barrier, which is a layer that protects the brain against bacteria, and stimulate the brain’s microglial cells to activate. Microglila cells are basically waste-removal cells, so they’re able to clear out the toxic beta-amyloid clumps that are responsible for the worst symptoms of Alzheimer’s.
The team reports fully restoring the memory function of 75 percent of the mice they tested it on, with zero damage to the surrounding brain tissue. They found that the treated mice displayed improved performance in three memory tasks – a maze, a test to get them to recognise new objects, and one to get them to remember the places they should avoid.
“We’re extremely excited by this innovation of treating Alzheimer’s without using drug therapeutics,” one of the team, Jürgen Götz, said in a press release. “The word ‘breakthrough’ is often misused, but in this case I think this really does fundamentally change our understanding of how to treat this disease, and I foresee a great future for this approach.”
The team says they’re planning on starting trials with higher animal models, such as sheep, and hope to get their human trials underway in 2017.
You can hear an ABC radio interview with the team here.
In the first evidence of a natural intervention triggering stem cell-based regeneration of an organ or system, a study in the June 5 issue of the Cell Press journal Cell Stem Cell shows that cycles of prolonged fasting not only protect against immune system damage — a major side effect of chemotherapy — but also induce immune system regeneration, shifting stem cells from a dormant state to a state of self-renewal.
In both mice and a Phase 1 human clinical trial, long periods of not eating significantly lowered white blood cell counts. In mice, fasting cycles then “flipped a regenerative switch”: changing the signaling pathways for hematopoietic stem cells, which are responsible for the generation of blood and immune systems, the research showed.
The study has major implications for healthier aging, in which immune system decline contributes to increased susceptibility to disease as we age. By outlining how prolonged fasting cycles — periods of no food for two to four days at a time over the course of six months — kill older and damaged immune cells and generate new ones, the research also has implications for chemotherapy tolerance and for those with a wide range of immune system deficiencies, including autoimmunity disorders.
“We could not predict that prolonged fasting would have such a remarkable effect in promoting stem cell-based regeneration of the hematopoietic system,” said corresponding author Valter Longo, the Edna M. Jones Professor of Gerontology and the Biological Sciences at the USC Davis School of Gerontology, and director of the USC Longevity Institute.
“When you starve, the system tries to save energy, and one of the things it can do to save energy is to recycle a lot of the immune cells that are not needed, especially those that may be damaged,” Longo said. “What we started noticing in both our human work and animal work is that the white blood cell count goes down with prolonged fasting. Then when you re-feed, the blood cells come back. So we started thinking, well, where does it come from?”
Prolonged fasting forces the body to use stores of glucose, fat and ketones, but also breaks down a significant portion of white blood cells. Longo likens the effect to lightening a plane of excess cargo.
During each cycle of fasting, this depletion of white blood cells induces changes that trigger stem cell-based regeneration of new immune system cells. In particular, prolonged fasting reduced the enzyme PKA, an effect previously discovered by the Longo team to extend longevity in simple organisms and which has been linked in other research to the regulation of stem cell self-renewal and pluripotency — that is, the potential for one cell to develop into many different cell types. Prolonged fasting also lowered levels of IGF-1, a growth-factor hormone that Longo and others have linked to aging, tumor progression and cancer risk.
“PKA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode. It gives the ‘okay’ for stem cells to go ahead and begin proliferating and rebuild the entire system,” explained Longo, noting the potential of clinical applications that mimic the effects of prolonged fasting to rejuvenate the immune system. “And the good news is that the body got rid of the parts of the system that might be damaged or old, the inefficient parts, during the fasting. Now, if you start with a system heavily damaged by chemotherapy or aging, fasting cycles can generate, literally, a new immune system.”
Prolonged fasting also protected against toxicity in a pilot clinical trial in which a small group of patients fasted for a 72-hour period prior to chemotherapy, extending Longo’s influential past research: “While chemotherapy saves lives, it causes significant collateral damage to the immune system. The results of this study suggest that fasting may mitigate some of the harmful effects of chemotherapy,” said co-author Tanya Dorff, assistant professor of clinical medicine at the USC Norris Comprehensive Cancer Center and Hospital. “More clinical studies are needed, and any such dietary intervention should be undertaken only under the guidance of a physician.”
“We are investigating the possibility that these effects are applicable to many different systems and organs, not just the immune system,” said Longo, whose lab is in the process of conducting further research on controlled dietary interventions and stem cell regeneration in both animal and clinical studies.
- Chia-Wei Cheng, Gregor B. Adams, Laura Perin, Min Wei, Xiaoying Zhou, Ben S. Lam, Stefano Da Sacco, Mario Mirisola, David I. Quinn, Tanya B. Dorff, John J. Kopchick, Valter D. Longo. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell, 2014; 14 (6): 810 DOI:1016/j.stem.2014.04.014
Surgeons in Cambridgeshire have performed the first heart transplant in Europe using a non-beating heart.
Donor hearts are usually from people who are brain-stem dead, but whose hearts are still beating. In this case, the organ came from a donor after their heart and lungs had stopped functioning, so-called circulatory death. Papworth hospital says the technique could increase the number of hearts available by at least 25%. The recipient Huseyin Ulucan, 60, from London, had a heart attack in 2008. He said: “Before the surgery, I could barely walk and I got out of breath very easily, I really had no quality of life.” He said he was “delighted” with the improvement in health since the transplant. “Now I’m feeling stronger every day, and I walked into the hospital this morning without any problem,” he said.
There have been 171 heart transplant in the past 12 months in the UK. But demand exceeds supply, and some patients have to wait up to three years for a suitable organ. Many patients die before an organ becomes available. Non-beating-heart donors provide kidneys, livers and other organs, but until now it has not been possible to use the heart because of concerns it would suffer damage. The new procedure involved re-starting the heart in the donor five minutes after death and perfusing it and other vital organs with blood and nutrients at body temperature. The lead transplant surgeon, Stephen Large, said: “We had the heart beating for about 50 minutes, and by monitoring its function were able to tell that it was in very good condition.”
The organ was then removed and transferred to a heart-in-a-box machine, where it was kept nourished and beating for a further three hours before the transplant surgery at Papworth. The organ care system is also used for maintaining lung, liver and kidneys outside the body. The standard method for transporting hearts and other organs for transplant is to pack them in ice, but some organs can be damaged by this process. The Papworth team said that restoring the heartbeat after death and keeping the organ nourished had helped reduce damage in the heart muscle. Last year surgeons in Australia performed the world’s first transplant using a non-beating heart, also using the heart-in-a-box technology.
TransMedics, the US company that makes the organ care machine, said each unit cost £150,000 plus £25,000 per patient transplanted. Papworth and Harefield hospitals are the only two heart transplant units in the UK who use the device. Prof James Neuberger, associate medical director for organ donation and transplantation at NHS Blood and Transplant, said: “Sadly, there is a shortage of organs for transplant across the UK and patients die in need of an organ. “We hope Papworth’s work and similar work being developed elsewhere will result in more hearts being donated and more patients benefiting from a transplant in the future. “We are immensely grateful to the donor’s family, and we hope they are taking great comfort in knowing that their relative’s organs have saved lives and have also made an important contribution to heart transplantation in the UK.”
Dr. S is a young surgeon who graduated shortly after the outbreak of the crisis in Syria. He now works in a makeshift hospital in a semi-rural neighbourhood located to the east of Damascus. This is a facility that received dedicated MSF support and supplies throughout the period of siege, support that continues on a regular monthly basis to this day. He tells the story of his medical journey – an experience that parallels the war in the country.
A temporary truce that death could not penetrate
There was a pregnant woman who was trapped during the time we were under full siege. She was due to deliver soon. All negotiation attempts to get her out failed. She needed a cesarean operation, but there was no maternity hospital we could get her to, and I had never done this operation before.
A few days before the expected delivery date, I was trying to get a working internet connection to read up information on doing a C-section. The clock was ticking and my fear and stress started to peak. I wished I could stop time, but the woman’s labour started. The atmosphere was tense already, with mad shelling hammering the area. The bombardments had reached a deafening level. We brought the woman into the operating theatre and I did the operation. Joy overwhelmed me when we knew the baby girl was healthy, and her mother too.
In this madness, our work as surgeons is to save as many lives as we can. Sometimes we succeed, and sometimes we fail. It is as if we repair the damage that the war left. But this operation was not the usual damage repair; it helped bring new life to this earth. It was a magical moment; a temporary truce that death could not penetrate.
I chose a deserted school as my hospital
I graduated as a surgeon shortly after the crisis started in Syria. In the Summer of 2011, with the acceleration of events and medical needs increasing, I started working in small private hospitals. A few months later, I was arrested, as were many of my colleagues. At the beginning of 2012 I was out, and I returned to treat people and carry on my general surgery specialization. I was working in improvised field hospitals, operating in conditions that were largely unsuitable for medical work. We worked in the east of Damascus and then in the Ghouta area, where the medical need was urgent.
At the end of 2012, a semi-rural neighbourhood located to the east of Damascus witnessed violent clashes. The area was packed with displaced people at the time, without any medical centre to treat wounded people. I went there and decided to set up a field hospital. Following a search, I chose a deserted school that had previously been hit. The upper floors were damaged, but the ground floor, as well as the basement, were in a good shape. Despite the daily, continuous shelling on the area, and the constant fear and stress, the medical team with which I worked managed to provide tremendous medical care to those who needed it the most.
One day in July 2013, around 10:00 am, the hospital was hit by a rocket. The massive explosion turned the place upside down and its pressure tore out the wooden walls. Medical tools and people were thrown in all directions. Soon a dust cloud settled over the building and made it impossible to see. The explosion was like nothing before. I thought that worse could follow and this explosion might be only the beginning of something very bad. Indeed, shells rained on the area and we could hear the clashes getting worse.
As we were getting over the shock, one of the hospital workers collapsed. She lived near the hospital. Her young boy was at home and the area was coming under heavy shelling. She could not keep it together and she wanted to save her child. A medic offered to go out and look for the child. I did not like the idea because we did not know what was going on outside. As soon as the medic was out of the hospital door, he saw a tank with its gun facing towards him. A healthy man walked out, and few moments later, he came back with shards of metal in his body. It was only then that we realized the severity of the situation outside. We decided to evacuate the hospital – two medics per patient to carry them – and we got out of the back door.
It was apocalyptic! We tried to walk fast towards a small medical centre not far from there. Shelling was hammering the fields around us. I was expecting the worst with every shell we heard. We managed to arrive at our destination unharmed. It was like a miracle. We had left our equipment in the evacuated hospital, but we did not dare to go back there. Over the next days, we heard that the fighting was moving away from the area around the hospital. Under heavy bombardment, we decided to go back and bring our equipment. We had to do that to be able to treat people. Taking turns to do the trip, we managed to retrieve as much as possible after ten days.
From then, we were under siege – impossible to get in and out of there. This was also true for medical supplies. We received a flow of injured people since the first day of the siege. I often operated on two people at once. We worked around the clock. Sleeping and resting were an impossible luxury. We managed to stop for few moments before dawn to eat some food and drink some water, before getting back to work. Most days heavy shelling and raging fighting brought us more injured people, leaving us no chance to rest. The numbers of injured people were way beyond what we could handle, and that forced us to make painful clinical decisions.
After the siege
We were under siege for eight months, up until February 2014. Eight months of suffering and stress, followed by a ceasefire, during which many people managed to go back to their homes. It became easier to get hold of supplies, and that helped us to continue providing medical care to people in need. Nevertheless, the humanitarian situation remained bad. There were still often clashes at the edges of the this area and the shelling was still frequent. This formal ceasefire did not change the nature of our work, but we finally found enough time to expand the hospital. People returning to the neighbourhood meant an increase in the needs, thus more pressure on us. We setup an obstetrics department and clinics to provide basic medical care and chronic diseases management. We could start doing bone, internal and urinary surgeries; all operations we could not perform before because we had suffered critical shortages of supplies and we had been prioritizing life-saving operations.
MSF continued to provide us with much of what we needed. We even received laboratory kit, which allowed us to carry out diagnostic tests. And we received an incubator for the obstetrics unit. Little by little, we could start to respond to all the basic general medical needs for the people in the area.
It has to stop, one day
Three years of non-stop surgery under tough circumstances – I have maxed out. I’ve had enough of scenes of misery. I was on the phone recently with my surgery professor and he said: “regardless of the operating conditions, your work during these three years matches my whole 30 years’ experience as a doctor. You have reached retirement in just three years.” And indeed, every moment of every day I feel I have had enough, but we have no other choice. People here need us. They are in desperate need of all kinds of medical care, from the most simple to the most complicated. We cannot add another reason for the deterioration of this already disastrous situation.
Today, I am almost certain that, when the war is over, I will quit medicine. Any human being would make that decision after living what I have lived through. I look forward to the end of this war. It has to stop, one day. Then, I can choose what to do. Only then, will we be truly alive again.
At some point in your life, you’ve probably been labeled a “right-brain thinker” (you’re so creative!) or a “left-brain thinker” (you’re so logical). Maybe this has shaped the way you see yourself or view the world.
“This is an idea that makes no physiological sense,” she says.
Blakemore believes that the concept of “logical, analytical, and accurate” thinkers favoring their left hemisphere and “creative, intuitive, and emotional” thinkers favoring their right hemisphere is the misinterpretation of valuable science. She thinks it entered pop culture because it makes for snappy self-help books. And of course people love categorizing themselves.
In the ’60s, ’70s, and ’80s, the renowned cognitive neuroscientist Michael Gazzaniga led breakthrough studies on how the brain works. He studied patients who — and here’s the key — lacked a corpus callosum, the tract that connect the brain’s hemispheres. During this time doctors had experimented on patients suffering from constant seizures due to intractable epilepsy by disconnecting the hemispheres.
Gazzaniga could thus determine the origins in the brain of certain cognitive and motor functions by monitoring the brains of these patients.
He found, for example, that a part of the left brain he dubbed “The Interpreter” handled the process of explaining actions that may have begun in the right brain.
He discovered “that each hemisphere played a role in different tasks and different cognitive functions, and that normally one hemisphere dominated over the other,” Blakemore explains.
This was breakthrough research on how parts of the brain worked. But in a normal human being, the corpus callosum is constantly transmitting information between both halves. It’s physically impossible to favor one side.
Blakemore thinks that this misinterpretation of the research is actually harmful, because the dichotomous labels convince people that their way of thinking is genetically fixed on a large scale.
“I mean, there are huge individual differences in cognitive strengths,” Blakemore says. “Some people are more creative; others are more analytical than others. But the idea that this has something to do with being left-brained or right-brained is completely untrue and needs to be retired.”
You can listen to Blakemore and many other experts taking down their least favorite ideas in the Freakonomics Radio episode “This Idea Must Die,” hosted by “Freakonomics” co-author Stephen J. Dubner.