Monthly Archives: November 2015

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stress

Stress & Healing – Pt 5

Check former parts for important info

 

Tape stripping skin barrier function

 

The next wound healing model, which we notice, involves the repeated application of cellophane tape to remove by stripping a layer of skin cells.  

 

tape

This causes a disruption of the stratum corneum barrier of the skin. This changes the skin’s permeability. Healing here was evaluated by measuring the skin recovery rate of recovery as seen in the skin barrier function using TEWL measurements.

 

Acute laboratory stressors can delay the skin function recovery following the disruptive by tape stripping. Twenty-five women were given the Trier Social Stress Test (TSST), a psychosical stressor. The TSST, a standardized laboratory stressor with a mock job interview and a mental arithmetic task, causing changes in heart rate, cortisol and cytokine production, and subjective anxiety responses.  

 

Skin barrier repair was slowed in women following the TSST, as compared to a more unstressed period.

 

This result by researchers was repeated involving a larger study group of 85 fit men and women. Those who participated in the test showed a slower skin recovery function when the TSST was applied.

 

Academic examination was found causing stress and impacted skin barrier recovery. Twenty-seven professional and medical students were given a tape stripping procedure on 3 different occasions.  Two were right after their winter and spring vacations.  The third was during their winter final examination week.

 

Skin barrier recovery was significantly delayed after tape stripping during the examination period as judged against the two vacation periods.

 

Furthermore, students who reported the higher levels of stress during the examination period had slower recovery in skin barrier function, compared to participants who experienced less examination-induced stress.

 

Stress related to the dissolution of a marital relationship slowed recovery of the stratum corneum barrier function of the skin. Twenty-eight women involved in an on going divorce or separation and also 27 women who said they were in a relationship of marital satisfaction were subjected to the tape stripping procedure on both facial cheeks. Socially stressed women had delayed skin barrier following the tape stripping, judged against to less stressed women.
There have also been animal studies on this. For example different types of stressors can also impair skin barrier recovery. Three days of immobilization stress given to the animals slowed the skin barrier function recovery for up to 7 days, compared to other rats which had not been exposed to stress. Social stress for the rats associated with cage changing also slowed the recovery of skin barrier function. These results parallel the human data which indicates that psychological stress slows skin barrier recovery.

stress hurts healing

Stress & Healing – Pt 4

Check former parts for important info

Blister Studies

 

Blister wounds were used in another experimental template to study the effects of psychological factors (that is stress) on wound healing. They produced blisters wounds by using a vacuum pump on the participants forearms. A gentle suction creates a separation of the skin layers for about an hour.

 

One of the strengths of this method is that it allows  the wound healing is assessed via measurement of the rate of transepidermal water loss (TEWL).  A major function of the skin is to regulate movement of water in and out of the body.  Water permeability of the skin increases after creation of the blister wound, but while in healing it decreases as healing progresses.

 

An evaporimetry instrument aided by a computer can be used to measure vapor pressure in the air layers existing close to the skin surface. TEWL measurement is a noninvasive method to monitor changes in the function of the skin.  This provides an objective method for evaluating of wound healing.

Using a blister wounds model, it was found that discussing a marital disagreement, a commonplace stressor, delayed wound healing. Married couples came for two 24-hour hospital visit at the research unit. During both visits, the scientists created a eight 8 mm suction blisters on the participants’ nondominant forearm. Their wound healing was later monitored for 14 days using TEWL measurements.

 

During the first admission, couples participated in a structured social support session. During the second visit, couples were directed to discuss marital disagreements for a 30-minutes.

marital stress

In each case, the couples stayed in the research facility until the next morning to allow for cytokine measurements and to limit external influences that might affect wound healing.

 

The couples’ blisters healed more slowly after the marital conflict thirty minutes than after the social support visit.  This suggested that the stress marital disagreement induced interfered with wound repair.

 

Beyond that, the intensity of the discussion also influenced the healing rate. Couples who presented more hostile and negative interactions across both the support and the conflict discussions were found to heal slower than couples with less negative interactions. The overall differences that were hostility related proved substantial. The blister wounds of the highly hostile couples healed at only 60% of the rate which was noted in low hostile couples.

 

In a different group subset from the same study, positive behaviors during the social support task were also related to wound repair. Individuals displaying more self-disclosure, more acceptance of their partner, more relationship-enhancing statements, and more humour healed the blister wounds faster than those who manifested less positive behaviors during the marital interaction task.

 

Difficulties in managing anger has also been noted as negatively impacting wound healing.  Blister wounds were made on 98 community-dwelling participants who were then monitored 14 days to evaluate their healing speed. Anger management styles were evaluated using the Spielberger Anger Expression Scale.

 

Participants who showed difficulty controlling their anger were found to be 4.2 times more likely to be slow healers than individuals who reported better anger control.

 

Also, individuals who had anger management issues secreted more cortisol during the blistering procedure. This increased glucocorticoid production related to delayed healing.

 

stress

Stress & Healing – Pt 3

Check former parts for important info

 

A Little Stress Goes A Long Ways.

stress

Delay in healing was found to be also true of people with less stressful circumstances.  Stress can still impede healing.  Twenty-four healthy young men were evaluated  for 21 days following a 4 mm punch biopsy was performed on their forearm.

 

In that study, the wound healing was evaluated using ultrasound biomicroscopy. The participants’ stress levels were measured with a self-report questionnaire, the Perceived Stress Scale. Higher perceived stress on the day of the biopsy foreshadowed slower wound healing. A basis of the correlation was found between perceived stress and healing progress between the days 7 and 21 post biopsy.

 

Pain, which is a body and mind stressor, effects also wound healing. In a study there was 2 mm wound created on the upper arm’s back of obese women.  This was done prior to having elective gastric bypass surgery. The subjects that experienced greater pain immediately following surgery and had continuing pain for 4 weeks after surgery were found to have slower healing in the experimental wound.  Pain causes, as this experiment results indicate, mental distress, and, when added to other stressors, can put a person at greater risk of slowed wound healing.

 

Scientific animal studies support this understanding of stress in wound healing in humans. Mice put under restraint, which causes stress, healed after receiving 3.5 mm punch biopsy wound on average healed 27% more slowly than the mice who were not restrained. Restraint stress was also associated with delayed wound healing in a tree lizard experiment.

 

Social stress factors also impaired wound healing. Mice healed from a punch wound more slowly when separated from their fellow mice, compared to when they were continuously involved with other mice.

mouse

Mucous membrane wounds’ healing is also affected by psychological stress.  This was shown in a study using academic examination stress. Eleven dental students had a biopsy taken from their hard palate while they were on their summer vacation, and later another biopsy was taken 3 days before a major examination.  The wounds received before the school testing healed on average 40% slower than the self same wounds happening during summer vacation.  While there was some individual differences in rate of healing, the rate of healing was absolutely the same in that no student healed as rapidly during examinations as they did during their unstressed vacation.

 

Negative emotions cause stress.  Therefore, it was not surprising to find that the impact of negative emotions on wound healing was the same in a larger study.  Using 193 healthy undergraduate students who got a 3.5 mm biopsy on the hard palate, individuals who reported higher levels of depression like symptoms proved to be almost 3.6 times classified as slow healers, compared to less emotionally depressed students.

stress

Stress & Healing – Pt 2

Check former parts for important info

 

Created Wound Studies

Both animals and humans have been studied by making standard wounds.  Then scientists closely observed the healing over time.  This gave us some of the best evidence about the stress and its impact on healing. They used three types of wounds to examine the stress effect on healing.  They created wounds by puncture, blister, and stripping skin barrier.

 

Punch biopsies were made which provided standard skin wounds for observation. Each day pictures were taken of the wound for a recorded evaluation of changes in the wound.

 

a memory

 

The first experiments involved examining stress impact on wounds involving dementia caregivers.  These were people who were related to the mentally impaired person. These people had to lovingly deal daily with the loss of memory, inappropriate emotions, and wandering and restless behavior of their loved ones.  For such caregivers stress has been noted and manifested in a heightened anxiety and depression, immune dysregulation, increased risk of heart problems, and even death.
These family caregivers therefore represents an excellent model to examine chronic stress in humans.  A 3.5 mm punch biopsy wound was made in the nondominant forearm.  The study was of 13 women caregivers and 13 sociodemographically similar non caregiving controls. The caregivers were found to take 24% longer to heal the standardized wound than matched controls.  This would tend to indicate that chronic stress delays healing.

stress

Stress & Healing – Pt 1

Wounds and Stress

 

stress

When we are talking about wound healing, we are talking about the process of recovery from injury and surgical procedures. The slower the healing process the more there is a risk of increasing wound infections or complications, it also makes for longer hospital stays, intensifies patient discomfort, and slows the patient’s return to activities of everyday life. From many different research studies the evidence is building that psychological stress and other behavioral factors can affect wound healing.

 

I have read of several studies using different types of wounds’ healing and outcomes.  They seem to agree that there is a quantifiable correlation between psychological stress and wound healing. This would tend to suggests that the relationship between stress and wound recovery is not only a matter of statistical interest, but it also has a practical clinical relevance.

 

The data and methods from observational, experimental, and interventional studies reaffirm stress’ impact on wound healing.  

 

Observation Investigation

 

stress

Studies which examine wound and healing involved complications after surgeries provide evidence regarding the impact of stress on wound healing.  Greater fear or distress before surgery has been linked to less positive outcomes including longer hospital time, more complications after the surgery, and higher rates of complications that required a return to the hospital.

 

For example, one study followed 111 patients having gallstone surgery.  Those who reported having more stress on the third day after the procedure had a longer hospital visit, that is when compared to less anxious individuals.  Another study used 309 patients who underwent an elective heart bypass surgery.  The patients who were more optimistic ended up being less likely to be rehospitalized than the pessimistic people.

 

On the other hand, the patients who had more depressive like symptoms proved more likely to require hospitalization later for infection related complications from the surgery than individuals reporting less distress.

 

This finding was duplicated in another study including 72 patients undergoing bypass surgery. In that study the patients who had more stress/depression symptoms when discharged develpoed more infections and poorer wound healing over the following 6 weeks after surgery.  That is when you compare them to others who reported less distress.

 

Psychological issues can also modulate chronic wound healing. There was a study with fifty-three older adults with chronic lower leg wounds.   After they were followed to assess speed of healing, patients who had the highest depression/anxiety levels were found to have a 4 times more likelihood to have a delayed healing, compared to individuals who reported less distress.  Surprisingly, in these studies, distress predicted consistently healing outcomes better than differences in sociodemographic context and medical status.

Psychological distress, a form of stress,  clearly appears to be a major influence in recovery from medical procedures and chronic wound healing.

garlic plant

Garlic As A Supplement pt. 11

Check out previous parts for important info

 

21. Garlic and Heavy Metals

heavy metals

When taken at high doses, garlic’s sulfur compounds have been shown in studies to protect against organ damage which is caused from heavy metal toxicity.

 

A four week study of people who worked at a car battery plant (excessive exposure to lead exposure there) found that garlic had reduced lead in the blood by 19%. Also they found that garlic had reduced many clinical toxicity markers.  This included headaches and blood pressure.

Just three garlic doses of per day outperformed the drug D-penicillamine in these symptom reduction.

 

22. Garlic and Bone Health

bone health

To my knowledge no human trials have measured the effects of garlic as it relates to bone loss.  However, laboratory rat studies found that it can minimizes bone loss by increasing estrogen in females.

 

One study involving menopausal women discovered that taking a daily dose of dry garlic extract (about 2 grams of raw garlic) significantly decreased a markers related to estrogen deficiency.  This would tend to suggests that garlic may have beneficial effects and help concerning bone health in women.
Foods like garlic and onions have also been proven to have beneficial effects on osteoarthritis.

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