Botulinum toxin (Botox)

Treatment Overview
The injection of botulinum toxin, commonly known as Botox, has become very popular for reducing wrinkles and rejuvenating the aging face. The effects are only temporary, but the injections can be done quickly, require no recovery time, and are not as complicated as many other cosmetic procedures for the face.
Botulinum toxin is produced by Clostridium botulinum bacteria. When a small amount of Botox is injected into a muscle, it blocks nerve signals that tell your muscles to contract. The effect is that it temporarily weakens or paralyzes the facial muscles and smoothes or eliminates wrinkles in the skin for a few months.
Getting a Botox injection takes just a few minutes.

What To Expect After Treatment
For the first 2 to 3 hours after treatment, take it easy and do not rub the treated area. After that, you can return to your regular activities.
It can take 3 to 4 days before you notice an effect from the Botox. The full effect may take up to 1 week. The results may last 90 to 120 days. After that, you will begin to see the wrinkles return.

Why It Is Done
Botulinum toxin has been approved by the U.S. Food and Drug Administration (FDA) for treating frown lines in adults younger than 65.1 Botox injections also are frequently used to reduce other wrinkles on the face and neck, such as crow's feet, brow furrow, and forehead lines.2
Botulinum toxin is also approved by the FDA to treat eye muscle disorders, including strabismus (cross-eyes), abnormal neck and shoulder contractions, and vocal cord spasms.

How Well It Works
Within 72 hours after treatment, the injection of Botox partly or completely smooths wrinkles for most people. It works in up to 85% of adults younger than 50 and up to 70% of adults between 50 and 65.1 But the results are temporary, typically lasting only 3 to 4 months. You will have to return for injections every 3 to 4 months to maintain the effects. The dose of Botox usually is the same each time you get an injection.
The long-term effects of repeated Botox injections are not known.

Risks
The most common side effects are:
Headache.
Bruising.
Drooping eyelid (rare).
Other side effects include flu-like symptoms, nausea, temporary facial pain, redness at the injection site, reduced blinking, and weakness in the muscles of the face. In extreme cases, this muscle weakness can limit your facial expressions. On rare occasions, a sore may develop on the white of the eye (corneal ulceration).
The risks of repeated Botox injections are not known.

What To Think About
Botox injections are more convenient and less painful than other procedures for reducing wrinkles and making your face look younger (chemical peels, dermabrasion, laser resurfacing, face-lift). Keep in mind that the effects of an injection last only a few months. To maintain the effects, you will have to receive injections several times a year. While a single injection may seem inexpensive, the cost of repeated injections can quickly add up.
There are no known serious side effects from Botox. But be aware that it is too soon to know whether any long-term problems will result from repeatedly injecting a paralyzing agent into the muscles.

Spring Clean Your Diet

It's that time of year again ... the birds are chirping away, the trees are blooming, and maybe you're wondering how you're going to get in shape for the summer season. Well, just like your house and wardrobe, your diet can probably use a spring cleaning as well.
Here are some tips to help you spring into your healthiest weight ever.
Salads. Add unusual toppings to give extra zest to your salads. Some of my favorite toppings include craisins (dried cranberries), pineapple (fresh, or in its own juice), raspberries, blueberries, raw pumpkin seeds (somewhat higher in calories but with plenty of fiber and protein to help fill you up), alfalfa sprouts, edemame (raw soy beans), and walnuts (higher in calories too, but great for fiber, protein, and omega-3 fats—aim for about ¼ cup here). Also, try substituting arugula for traditional greens; it has a lot of vitamins and minerals and a yummy, peppery flavor.
Salad Dressings. Try the newer "salad spritzers." They're high in flavor yet low in calories, and can help you avoid the high-calorie salads that result from pouring on those rich dressings. For a light summer salad or meal, I find that drizzling balsamic vinegar and some extra-virgin olive oil over fresh sliced mozzarella cheese, sliced tomatoes, and fresh basil is a winner.
Pastas. Look for the higher-protein (and sometimes lower-calorie) pastas, such as those made from lentils and whole wheat. Add plenty of fresh or canned tomatoes to increase the nutrients without weighing yourself down. Or add lean ground turkey or soy crumbles for "meatballs" that will cut the fat and calories without stealing the flavor. Shredded low-fat cheeses are full of protein and make great additions to these "meatballs."
Herbs. I love fresh herbs, especially from the farmer's market. They taste great and are so good for you and your waist. Two of my spring-time favorites are basil and cilantro.
Pizzas. You can use pita bread instead of traditional dough for a light yet tasty pizza. Low-carb pita bread can up the fiber content and lower the calories further. Top your pizzas with low-fat shredded mozzarella and tons of veggies for a nutritious pizza that won't weigh you down!
Sandwiches. Use low-carb pita breads made from soy or oat/wheat instead of regular bread, to ensure higher protein and fiber and fewer calories. These pita breads are so versatile, you might want to try roasting some of your favorite veggies and adding some low-fat goat cheese for a yummy, yet healthy, veggie pita pocket! You could also use low-carb wraps for great nutrition and calorie bargains. Or, skip the bread altogether: Just roll up some low-fat cheese along with low-fat turkey or other lean luncheon meats, with some lettuce and tomato. Get in the habit of taking these sandwiches to work and you'll save both calories and money!

Happy spring, dear readers!

Weight-loss surgery worthwhile for diabetes

A recent clinical trial showed that "surgically induced weight loss leads to the remission of type 2 diabetes in the majority of obese patients," Catherine L. Keating at Monash University and others note in the medical journal Diabetes Care.
Using data from that trial, the team estimated the costs and benefits of weight-loss surgery as a way to treat type 2 diabetes.
The analysis covered 60 obese patients with diabetes diagnosed within the previous two years. Thirty were assigned to adjustable gastric banding, which reduces the capacity of the stomach, and 30 were assigned to best available medical management.
Remission of their diabetes was achieved by 22 patients (73 percent) treated surgically and 4 patients (13 percent) treated medically.
The researchers calculate that, over a two-year period, the cost of resolving one case of diabetes was $25,500 with conventional medical treatment, and $16,600 more than that with surgical therapy.
This cost is within the threshold of $50,000 - $60,000 that is usually considered acceptable from a societal standpoint.
Keating and her associates also extrapolated the costs and outcomes to the lifetime of the patients in the study.
Compared to conventional therapy, surgically induced weight loss was actually associated with health care savings, as well as with health benefits, they report.
Specifically, they calculate, "this analysis suggests that after 10 years the return on investment of surgical therapy is fully recovered through savings in health care costs."
SOURCE: Diabetes Care, April 2009.