Connect with us


Lifestyle factors and glaucoma: a lot of common sense, little evidence



SAN DIEGO — According to the review presented here, limited evidence supports a role for lifestyle factors in the prevention or treatment of glaucoma.

Intuitively, diet, mental health, and good posture should contribute to good eye health, but the evidence does not support this intuition. Despite the paucity of positive research, the “better safe than sorry” approach remains good advice for patients, Simon Lowe, MD, UCLA, said during a meeting of the American Society for Cataract and Refractive Surgery.

“Perhaps I have more questions than answers,” Lo said. “I didn’t make any suggestions about nutrition, mental health, or [body] positioning for glaucoma because I don’t believe we have enough evidence. I have only two or three recommendations for patients. I tell them to have a balanced diet and behavior. I tell them to try to exercise more and get in the habit of sleeping regularly.”

“When patients ask questions, use it as an opportunity to connect with the patient,” he added. “When a patient says, ‘Doctor, I have one more question,’ it is often the most important question. Try not to neglect them. Take this as an opportunity to connect. Listen and understand their concerns.”

He added that ophthalmologists should also use discussions with patients to highlight the proven benefits of conventional glaucoma therapy. Whatever patients are currently doing or thinking should not interfere with or replace proven conventional glaucoma therapy. At the same time, patients do not have to give up their beliefs or hopes in order to accept the clinician’s projection of reality.

The matter of diet

The adage “we are what we eat” suggests that nutrition should be important for health and disease, Lo said. However, research on nutrition and glaucoma has been based primarily on the pathophysiological theories associated with glaucoma and is not well understood.

Most studies to date have been cross-sectional and based primarily on food questionnaires and surveys. Interactions between different nutrients, between nutrients and diet, and food processing have not been studied, he continued. Most of the studies failed to control for variables and studies treated glaucoma as a single entity, ignoring potential differences between subtypes.

“Of course, lack of evidence does not mean evidence of absence,” Lo said.

A recent study assessed contrast sensitivity 2 hours after consumption. dark chocolate or milk chocolate and showed that the sensitivity was slightly better after the first. A follow-up study failed to reproduce the findings.

Numerous studies have examined the effects of flavonoids on eye health, but conclusive evidence has been limited. A long-term population study found no association between flavonoid intake and risk of open-angle glaucoma. Data from Nurses’ Health Study showed a small protective effect of some flavonoids contained in tea against primary open-angle glaucoma, but not flavonoids in general.

Mitochondrial abnormalities may be an early factor in neuronal dysfunction in glaucoma, Low says. Laboratory studies of nicotinamide and pyruvate suggested a protective effect on mitochondrial function, which led to the study of their combination in patients with glaucoma. Preliminary data showed a statistically significant short-term improvement in visual function compared to placebo, but Lowe warned that the results are still too premature to draw conclusions.

Studies on vitamin intake and glaucoma have produced conflicting results. A meta-analysis showed an association between vitamins A and C and a lower risk of glaucoma, but blood vitamin levels did not correlate with glaucoma risk. Vitamin D has been linked to a host of diseases, Low says, but has no consistent association with intraocular pressure or glaucoma.

Similarly, research on dietary patterns has not shown a consistent association with age-related macular degeneration, cataracts, or diabetic retinopathy, but data on glaucoma are lacking.

“My recommendation [regarding nutrients and glaucoma] very conservative,” Lo said. “I advise patients to maintain a balanced diet, include a wide range of foods, and maintain a moderate intake.”

mental stress

Most people consider vision to be their most important sense. As a condition that can lead to blindness, glaucoma causes stress for many patients, Lowe says. Glaucoma is closely associated with depression, key risk factors which include advanced disease, advanced age, female gender, and more rapid progression of vision loss.

In addition to potential vision loss, comorbid factors can increase the stress caused by the disease itself: financial burden, comorbidities, stressful life events, and family and work-related stress. The law used to tell patients that stress did not increase intraocular pressure (IOP). His opinion changed after prospective study from Europe showed a slight increase in IOP and a trend towards worse visual performance in humans after a mental exercise test.

A study evaluating anxiety and depression in visually impaired patients found that visual impairment has multiple adverse effects on patients’ quality of life. Patients complained of frustration with their inability to complete tasks and loss of independence that accompanied vision problems. They lacked self-confidence and felt socially isolated and lonely.

“If glaucoma is associated with a mood disorder, and mental well-being can affect treatment efficacy and outcomes, we should focus more on identifying the disorder,” Lo said. “Depression and Anxiety Screening Tools Available Online”.

“Obviously, mental health is a huge topic and cannot be covered in a few minutes, but I want to emphasize one point – be caring,” he added. “Take care of the mental well-being of our patients. We must also take care of ourselves. We must be mentally healthy before our patients can find hope in us.”

body position

With the rise in popularity of yoga, more and more glaucoma patients are asking about the effect on IOP. Some yoga poses may involve turning the body, which can drastically increase IOPLo said. IOP returns to baseline as soon as the patient returns to the sitting position. Patients with progressive optic nerve disease should avoid prolonged inversion.

Several studies have shown that sleeping position can affect IOP. IN one study75% of patients preferred to sleep on their side (lying on their side). Three-quarters of patients with this preference had more severe glaucoma in the eye, consistent with their sleeping position.

“I believe sleep disorders, sleep apnea, insomnia, sleep deprivation are common,” Lowe said. “These issues bother me more than my sleeping position. Glaucoma is also associated with sleep disturbance.”

  • Charles Bankhead is a senior editor for oncology and also focuses on urology, dermatology and ophthalmology. He joined MedPage Today in 2007. Follow

Information disclosure

The law does not disclose any relationship with industry.

main source

American Society of Cataract and Refractive Surgery

Link to source: Law S “Eat Sleep Breathe Glaucoma: How Diet, Mental Health and Body Position Affect Glaucoma” ASCRS 2023; Specialization Program: Glaucoma.

Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *


Republicans Trying to Stop Biden Loan Bailouts Push State Forgiveness Programs



Florida Gov. Ron DeSantis has criticized President Joe Biden’s plan to write off student loans, calling it “very unfairIowa Gov. Kim Reynolds decided policy as “unfair”, “wrong” and “out of touch with reality”. “non-Americanand “socialism” are words used by Arkansas Governor Sarah Huckabee Sanders.

However, all three Republican governors offer at least one state student loan write-off or repayment program.

They are far from the only ones.

NBC News reviewed student loan write-off policies in states where a Republican governor called for an end to the Biden plan or a Republican attorney general sued to stop it.

The study found that the vast majority of these states actually offer their own taxpayer-funded student loan write-off programs. Almost as many have seen Republican-sponsored bills in current legislative sessions to expand these programs or create new ones.

Last year, Republican governors in 22 states signed letter Demanding Biden to “revoke” his student debt relief plan immediately. A few weeks later, a group of six Republican-led states filed a lawsuit against the Biden administration in federal court seeking to block the plan’s implementation — one of two lawsuits heard by the Supreme Court whose decisions in the next two months will determine the program’s future.

But 20 of the 23 states that signed the letter and/or sued have at least one, and in most cases several, state programs that offer student loan forgiveness or repayment.

And in 17 out of 23 in the current legislative session, there is at least one GOP-sponsored bill that proposes expanding an existing or creating a new program that offers student loan forgiveness or repayment.

Supporters of student loan write-offs say the position taken by officials in these Republican states is tantamount to hypocrisy. They point to the fact that many Republican leaders are keen to criticize Biden, but not their own states or legislatures, for pursuing plans with similar goals.

“The first thing that jumps out at me is the hypocrisy,” said Natalia Abrams, president of the Student Debt Crisis Center, an impartial nonprofit group advocating the total cancellation of all federal student loan debt.

However, Republican officials in states with existing loan write-off programs and expansion proposals say there is a difference between total loan write-offs and efforts by their own states to fill gaps in certain occupations by offering financial incentives. They also claim that their state programs are constitutional, while Biden’s is not. His program, they say, is an overreach by the federal government.

But one of the most prominent Republicans criticism is that loan forgiveness provides “unfair” an advantage for people who still have debt over others who have already paid off theirs or decided to forego college altogether.

“College may not be the right decision for every American, but for students who took out loans, it was their decision: able adults and willing borrowers who consciously agreed to the terms of the loan and agreed to take on debt in exchange for receiving a loan. classes,” the 22 Republican governors wrote in their joint letter. “A high-paying degree is not the key to realizing the American dream—it’s hard work and personal responsibility. Many borrowers have worked hard, made sacrifices, and paid off their debt. salary, not extra school and credit.”

Defenders point out that the government programs offered in most of these gubernatorial states nonetheless provide the very kind of write-offs they have neglected.

“Republican politicians speak on both sides,” Sen. Elizabeth Warren, D-Mass., said in a statement to NBC News. “Their hypocrisy shows what hard-working Americans already know: student debt relief is badly needed and widely popular.”

Biden’s program will write off up to $10,000 of debt for borrowers making less than $125,000 a year (or couples who file taxes together and earn less than $250,000 a year)—regardless of their profession or location. Pell grant recipients, who make up the majority of borrowers, will be eligible for an additional $10,000 in debt relief.

Existing government programs and proposed programs and extensions apply or will apply to the cancellation and repayment of student debt for people working in certain professions or fields.

For example, the five states that have both sued the Biden administration and whose Republican governors have asked the president to withdraw the program—Nebraska, Missouri, Arkansas, Iowa, and South Carolina—now have a total of at least 10 programs that partially or completely abolished. publicly funded, which offer student loan forgiveness or repayment for certain occupations, including teachers, nurses, and health workers in rural areas.

This year, Republican lawmakers in these states sponsored bills to expand these programs for mental health professionals in Iowa another Nebraskafor public health professionals and veterinarians in Missourito more teachers and doctors in rural areas in Arkansas and law enforcement officials in South Carolina.

Texas, whose governor and two GOP senators criticized the Biden plan as “unfairis currently proposing at least nine targeted student loan write-off plans—to certain nurses, doctors, teachers, legal aid attorneys, and state Attorney General staff—while 11 more bills have been proposed by state Republican lawmakers in the current legislative session. These proposals include expanding the current student loan write-off policy to nurses and creating new programs to help write off student loans for math and science. teachers, lawyers in the countryside, mental health professionals and another workers.

Georgia is the home state of Republican Party member Marjorie Taylor Green, who criticized Biden’s plan as “unfair” despite having millions in federal loans her own forgiven – currently proposes one student loan cancellation plan for doctors in rural areas, while Republican legislators in the Legislative Assembly have so far introduced at least five bills that propose student loan cancellations for “peacekeepers” health workers, nurses another members of the State General Assembly.

However, GOP governors in both countries — Brian Kemp of Georgia and Greg Abbott of Texas — signed a letter demanding Biden withdraw his own student loan write-off plan.

NBC News contacted all Republican governors in the 22 states that signed the letter, as well as six Republican attorneys general in the states who have filed a lawsuit to block the plan.

Many have defended their states’ programs, arguing that there is a marked difference, both substantively and legally, between the broader policies proposed by Biden and the more targeted policies proposed by their states, although none of the responding officials answered the question, why it was so. it is acceptable for states, but not for the federal government, to forgive debts.

Some also reiterated one of the legal arguments used in the Biden lawsuit: that the White House plan is illegal and unconstitutional because it circumvents Congress, which they say has sole power to make laws regarding student loan write-offs, and because it is incorrectly supported The Biden administration claims a decade-old law allows it to cancel loans to counter the economic impact of the Covid pandemic.

“The Uniform Ivy League Alumni Student Debt Relief Program, which bypasses the legislature of Congress and is formed by executive order, is in no way comparable to legislation designed to attract and grow a top-level workforce that can fill critical provisions related to with public safety and health, and are being scrutinized by the State House of Representatives and the Senate,” Garrison Douglas, a spokesman for Kemp, Georgia’s governor, said in a statement.

“Unlike President Biden’s unconstitutional executive order, the Florida Nursing Student Loan Forgiveness Program is authorized by Florida Statute Chapter 1009.66,” DeSantis spokesman Jeremy Redfern said in a statement.

Kansas Attorney General Chris Kobach said in a statement that there was no hypocrisy in his office’s decision to sue Biden despite the state having multiple plans to write off student loans because “one is unconstitutional and the other isn’t.” .

“The executive branch of the federal government does not have the unilateral authority under the US Constitution to forgive loans and spend money to pay off debt without an act of Congress,” he said.

Alexa Henning, a spokeswoman for the Arkansas governor, said the federal program and Arkansas’ student loan write-off programs “are not even remotely similar.”

“As the governor said, what Joe Biden did is socialism and unconstitutional, he, those who didn’t go to school or have already paid off their loans, want to retroactively pay off hundreds of billions of dollars of other people’s debts,” the statement said. .

NBC News also reached out to 20 of the dozens of Republican lawmakers who have proposed bills in their current sessions to expand or create new state programs that offer student loan forgiveness. No one agreed to be interviewed, although one assistant answered questions.

Jason Moyer, chief of staff for Texas State Representative Frederick Fraser, who sponsored a bill to expand the student loan write-off program for some teachers, said his boss’s proposal “has no comparison to federal student debt write-offs.”

“This is tuition compensation, but the federal program is much broader,” he said.

This distinction, however, does not ring true for student loan proponents.

“You know, it all depends on what they want to call excessive,” Abrams of the Student Debt Crisis Center said, referring to the Republicans. “And it seems to come down to who is the messenger with that.”

Continue Reading


Season 4 release schedule for Barry



HBO BARRY always had an extremely unique tone. With a star – both co-creator, writer, and frequent director – like Bill Hader, comedy will always follow the territory. This is to be expected from a man who started Saturday night life and has since appeared in modern classics such as Superbad, Trainwreck, Hot Rod, Adventureland, and much more. But a very specific kind of black comedy has always been just part of the equation for barry, which over the years has managed to show elements of drama, thriller and even direct action, always leaving open the possibility of upsetting you at any moment.

Now that the show is coming to an end with season 4, the show is just as dark and ready. go there with any of these sub-genres, as always.

“It’s funny because when the show came out, people were like Wow, it’s really dark and then it got even darker,” Hader said with a laugh, talking to Man’s health. “And then I think that now… people might think, for example, What the hell is this? But I’ve always loved it.”

After Season 3 ended – spoiler alert! – Protagonist Hader is finally caught by the police (with the help of Henry Winkler’s Gene Cousino) during his latest assassination attempt, Season 4 begins with Barry treading uncharted waters again: jail. And not any a prison, but a prison where his former mentor/father/nemesis Fouches (Stephen Root) is being held. And that’s not even to mention the incessant tales of rapidly failing actress/multi-hyphen Sally (Sarah Goldberg), goofy NoHo gangster Hank (Anthony Carrigan) and, of course, the all narcissistic but likable Mr. Cousino (only the legendary winkler) gets into himself.

That’s all there is to say: if you’ve been out in the wild Barry drive you won’t want to miss an episode of the last season. And if you look below, we can be sure that this will not happen.


When is the next episode Barry Season 4 coming out?

Every Episode Barry Season 4 will air on HBO on Sundays at 10 p.m. EST and will simultaneously be available for streaming on HBO Max (soon to be known only as Max). This means the next episode will air on Sunday, May 14, 2023 at 10:00 AM EST.

How many episodes Barry 4 season left?

season 4 Barry There will be 8 episodes in total, and the first five of those eight have already aired. That means there are three episodes left on the show – and three weeks of intense and darkly hilarious storytelling.

streaming Barry season 4 is here

Here’s the full release schedule for HBO. barry, season 4.

Episode 1 – airing from April 16th.

Episode 2 – Aired April 16.

Episode 3 – Aired April 23rd.

Episode 4 – Aired April 30.

Episode 5 – airing from May 7th.

Episode 6 – Broadcast May 14

Episode 7 – Broadcast May 21

Episode 8 – Broadcast May 18

preview for Richard Branson |  Gym and fridge

Evan is a culture editor for Men’s Health and a contributor to The New York Times, MTV News, Brooklyn Magazine, and VICE. He likes weird movies, watches too much TV, and listens to music more than listening.

Continue Reading


Dozens of countries have tamed malaria, but can we eradicate it?



A child receives the RTS,S malaria vaccine in Gisambai, Kenya, in March.


Forty-two countries or territories have been certified malaria-free by the World Health Organization (WHO). This is largely due to the use of bed nets and insecticides, as well as the effective diagnosis and treatment of parasitic diseases.

But with climate change creating new breeding grounds for malaria-carrying mosquitoes and making an effective vaccine too expensive for many countries, eradicating malaria from the world is no easy task.

An estimated 247 million cases and 619,000…

Continue Reading