Sunday, December 2, 2012

The Womens Journal ? Blog Archive ? Help, My Eyelids Have Fallen!

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Ari D. Abel, MD & Bryan D. Seiff, MD

The most common patient complaint we hear in oculofacial plastic surgery is about ?droopy eyelids?.

But what does a patient mean when he or she complains that the eyelids are ?drooping?? What treatments are available to correct this problem? And when does this ?drooping? cease to be a cosmetic concern and become a true functional problem?

In order to understand this problem and how to fix it, we must first define what is meant by ?droopy eyelids?. This complaint may mean different things to differentabel_dj13_fig1a people, and identifying a patient?s specific concern is important because the techniques for fixing these problems will differ accordingly. True ?droopy eyelids?, referred to as Ptosis in the medical literature, occur when the eyelid lifting muscle or its corresponding tendon is weakened and the lid itself hangs lower than normal (Fig 1A). Ptosis may be caused by dysfunction of the eyelid muscle or the nerve which supplies it, but is most commonly a result of wear and tear on the tendon. If the eyelid hangs low enough it may obscure the pupil, thereby affecting the patient?s peripheral vision.

abel_dj13_fig2aDermatochalasis is a condition in which the eyelid skin has thinned and lost its elasticity and subsequently hangs over the eyelashes and lid margin (Fig 2A). As this tissue thins, fat may also begin to prolapse into the upper eyelid space. Once these tissues have descended past the lid margin, they can obstruct the patient?s peripheral vision. They may also displace the eyelashes downward and cause irritation of the eye. In certain cases, this condition can be worsened by gravitational descent of the thicker eyebrow tissue, pushing the eyelid tissues even further down.

When ptosis or dermatochalasis becomes severe enough, it can obstruct the patient?s peripheral vision and begin to affect his or her daily activities. Common complaints include difficulty with driving or reading. These are more noticeable at night as ambient light levels decrease, and as compensatory forehead and accessory lifting muscles begin to fatigue. Many patients will state that they can see better when manually elevating their eyelids. In order to document these changes, photographs can be taken which demonstrate obstruction of the pupil by the eyelid or by redundant skin. In addition, visual field testing can be performed to document the degree of visual field loss. Patients that do not have any visual complaints but wish to improve the overall appearance of their eyelids may choose to undergo these procedures on an elective basis.

abel_dj13_fig2bCorrection of drooping eyelids is usually surgical. Ptosis is corrected byabel_dj13_fig1b tightening the eyelid muscle and its corresponding tendon, either through an external incision at the eyelid crease or an internal incision on the underside of the eyelid (Fig 1B). Dermatochalasis is improved by removing the redundant eyelid tissue through a lid crease incision, a procedure known as a blepharoplasty (Fig 2B). If the brow has descended and is contributing to the drooping eyelid, it can be lifted at the same time. These procedures are performed on an outpatient basis, usually under light to moderate sedation.? Patients are advised to avoid any heavy lifting or strenuous exercise for approximately one week, but may otherwise resume their normal activities, including driving, the very next day. Ice is used for several days to minimize bruising, and ointment is placed on the incisions for approximately 2-3 weeks to aid in healing. Stiches dissolve or are removed at one week.

Both Drs. Abel and Seiff are Oculofacial Plastic surgeons, meaning they specialize in the delicate tissues of the eyelid and surrounding structures.

If you think you may be a candidate for any of these procedures, or would like any information regarding other services available, they can be contacted at the
Abel Center for Oculofacial Plastic Surgery at 302-998-3220.

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Dr Abel is one of approximately 400 Oculofacial Plastic Surgeons in the United States. An Oculofacial Plastic Surgeon is Board Certified by the American Board of Ophthalmology and a Fellow of the American Society of Ophthalmic Plastic and Reconstructive Surgery. Dr. Abel is also a member of the American Academy of Cosmetic Surgery. He specializes in the treatment of eyelid, brow and other facial dysfunctions. He is skilled in the removal of tumors and the repair of ocular and facial trauma. He has many years of experience in aesthetic facial surgery, skin rejuvenation, as well as Botox and wrinkle fillers.

Dr. Abel received his medical degree from Jefferson Medical College in Philadelphia, PA and completed his residency in Ophthalmology at Johns Hopkins University in Baltimore, MD. He conducted a two-year fellowship in Ophthalmic and Facial Plastic Surgery at the Albany Medical Center in Albany, NY. Dr. Abel also has a profound interest in medical missions for developing countries, which most recently included trips to India and Nepal.

Dr. Seiff is one of approximately 400 Oculofacial Plastic Surgeons in the United States. An Oculofacial Plastic Surgeon is Board Certified by the American Board of Ophthalmology and a Fellow of the American Society of Ophthalmic Plastic and Reconstructive Surgery. He specializes in the treatment of eyelid, brow and other facial dysfunctions. He is skilled in the removal of tumors and the repair of ocular and facial trauma. Dr. Seiff also has a strong interest in aesthetic care. This area of his practice includes aesthetic facial surgery, skin rejuvenation, as well as Botox and wrinkle fillers. Dr. Seiff graduated first in his medical school class at UMDNJ and completed his ophthalmology training at Cornell. He then completed his two-year oculoplastic fellowship at Univ. California-San Francisco.

Source: http://thewomensjournal.com/20121201/help-my-eyelids-have-fallen/

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Sen. Ayotte offers GOP an influential new voice (Washington Post)

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Source: http://www.businesslistingnow.com/blog/the-need-for-safety-boots-in-keeping-your-feet-protected-while-at-work/

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Saturday, December 1, 2012

An Education in Classlessness | Economics reference cell ...

Economics : Of all the people in the city of New York who should be reluctant to charge someone else with elitism, the city's richest man has to be on the top of the list. But irony has never been one of the mayor's strong suits, so there he was?the other day?with a verbal assault on Bill Perkins for, of all things, having the temerity of being a vocal critic of charters, despite having gone to the "tony" Collegiate School for his own high school education.

Here's the NY Post's (natch) account: "The Post's Dave Seifman forward some pretty choice quotes from Mayor Bloomberg going off on state Sen. Bill Perkins, a major opponent of charter schools, on his weekly WOR radio show this morning. Bloomberg jabs at the pol for attending "elite private schools" and says he's been "violently" against choice for parents."

Now's not the right time to interject a tired pot and kettle analogy, but it does take a certain amount of chutzpah to attack Perkins when the mayor probably hadn't set foot inside a public school-his kids went elsewhere obviously-until he was elected mayor. And the same goes for Chancellor Klein who, along with Bloomberg, brought absolutely zero knowledge of public education to the job?when he was elevated to his supreme commander post. And this from a man who spends all of his weekends in Bermuda!

But what's even more egregious in our view is the mayor's failure to see with any clarity what?the charter phenomenon says about his own educational effort-a point that we have already made before. Here's the Post again: "Bill Perkins is a guy who went to elite private schools, and he represents a district where most people can?t afford elite private schools, and charter schools are their opportunity to get their kids a great education," said Bloomberg. "I think the numbers are something - there?s 10,000 places this year - more places for charter schools, and there?s something like 50 or 60,000 applicants for the 10,000 places."

Now, after eight years of so-called reform-along with reams of flack touting miraculous advance-we have stampedes in poor neighborhoods to flee the public school system as fast as possible. The Post's Seifman continues to spotlight the mayor's views in a follow up story: "Bloomberg argued that charter schools promote competition, which is one reason public schools in the city are improving. "Competition is great for everybody, and it's one of those things we want to encourage, and Perkins has been violently against it, while the educators and the public and the parents want more of [it]," the mayor said."

If the Harlem clamor for choice is any indication, this kind of a competition can best be described in sports language as a blowout-and as an indictment of the failure of the overall?Bloomberg effort. Diane Ravitch's hearing testimony sheds light on the true nature of this far from healthy competition: "Some charters are as idealistic as the original vision, but many others now see themselves as competition for public schools. They want to take over public school space and replace public schools. They revel in stories about beating public schools, not helping them."

But as far as Bloomberg's observation that the charter competition is in some way aiding public school improvement, where's the evidence of that? Which brings us back to the point that we made last week: "So there is obviously a perception of failure at the grass roots level. Whether this is a reality or not-and studies indicate that the charter exploits are exaggerated in the aggregate-doesn't matter. And the clamoring for, "choice," is an indictment of the current system that the media did so much to tout when it was all about mayoral control."

So what's missing from all of this trumped up outrage, is a concomitant genuine outrage at the three card monte game that the Bloombergistas have played-with Rupert and Morticia acting as the audience shills-with a gullible public. It is time to bring in the forensic accountants, and Perkins and his state senate crew should hold follow up hearings on testing fraud, unmerited teacher and administrator bonuses, and a profligate expansion of an educational bureaucracy that has failed to deliver real success even with an 80% increase in its allocation.

But that might not even be necessary if what they think is going to happen next spring actually does-new school tests that expose the naked emperor's false positives. As the NY Post reports: "Criticized for having steadily dumbed down standardized tests -- and trumpeted phantom gains -- the state Education Department says students in grades 3 to 8 taking required math and English exams starting tomorrow won't pass as easily this year. "Students are going to have to know more and do more to demonstrate proficiency on the exams," said John King, senior deputy state education commissioner."

And it will be more difficult to teach to the test: "A rising number of pupils have passed in recent years as cut scores dipped so low that some kids could randomly guess enough right answers to squeak by, experts found. State Board of Regents Chancellor Merryl Tisch and Education Commissioner David Steiner "are committed to ending the annual debate about whether our state tests have become harder or easier," King told The Post. "Doing that will require us to ensure that our tests become both less predictable and more comprehensive in terms of the number of items they test."

But, once the test fraud is exposed will it finally become clear that, as far as NYC's master of the house is concerned, "there's not much there?" Here's the Post's observation: "The sliding standards weren't revealed when Mayor Bloomberg touted dramatic spikes in state scores as a triumph of his stewardship. But the lid was blown off when federal officials found reading and math scores for New York students had remained flat on a national benchmark exam since 2007, while their scores on the state tests skyrocketed over the same period."

Education Secretary Arne Duncan, cited in Sol Stern's upcoming City Journal article, makes this telling point: ?We have to stop lying to children,? education secretary Arne Duncan said recently at a meeting of the National Governors Association (NGA).?We have to look them in the eye and tell them the truth at every stage of their educational trajectory.?

If Mike Bloomberg really wants to advance the interests of NYC school kids, he can begin by laying off the glass house?ad hominen attacks on Bill Perkins; and he can follow Duncan's advice by starting to?tell the truth-to those with an actual stake in public education-about how all of his extra funding and top down control of the educational bureaucracy has yielded a truly lackluster result. Don't expect this anytime soon, because mea culpas are conspicuously absent in the Bloomberg personality profile.

Source: http://economics-reference-cell.blogspot.com/2012/11/an-education-in-classlessness.html

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College basketball coach Rick Majerus dead at 64

Rick Majerus (Getty Images)

Anyone who has followed college basketball the past few decades probably knows a good Rick Majerus story or two.

There was the time he promised to quit at Utah if false allegations that freshman Britton Johnson had used a racial slur during the 1998 NCAA tournament turned out to be true. Or the day in 2005 when while working as an ESPN analyst, he favorably compared footage of actress Ashley Judd at a Kentucky game to watching adult videos in his hotel room. Or the introductory press conference at Saint Louis in 2007 when the school president began his speech by explaining Majerus' last name meant "great" in Latin only to have the coach correct him, telling reporters, "I think it means sausage-eater."

Examples like those of Majerus' rollicking sense of humor and larger-than-life personality are one of many reasons he'll be missed in college basketball circles. The former Utah and Saint Louis coach died Saturday at age 64, barely three months after he took a leave of absence from his job as head coach of the Billikens citing heart issues and other health concerns.

Majerus' girlfriend confirmed the news of his death to USA Today on Saturday.

The legacy Majerus leaves is as multi-layered as his personality. He was a brilliant strategist, an off-the-cuff comedian, a devoted family man and a tragic figure who battled weight issues.

Majerus amassed a career record of 517-215, taking Ball State, Utah and Saint Louis to the NCAA tournament a total of 11 times and leading the 1998 Utes on an improbable run to the national title game. Along the way, he built a reputation as an Xs-and-Os mastermind, more comfortable turning a group of lightly recruited players into a formidable team than coaching at a "Cindy Crawford program" as he often referred to the North Carolinas and Dukes of the world.

Majerus might have accomplished even more in basketball were it not for health concerns caused by his weight issues and love of food.

In his first season at Utah in 1989, he underwent coronary bypass surgery six games into the season. He later left the Utah program in 2004 after being hospitalized again for heart problems earlier in the year.

When Majerus took a leave of absence at Saint Louis in August, the school initially did not rule out the possibility he would return to coach the Billikens for the 2013-14 season. As the weeks went by, however, and reports surfaced that Majerus' condition had worsened, it became clear that he had coached his final game.

What's especially tragic about Majerus' death is that he was vibrant and in good spirits this time a year ago.

With the death of his beloved mother behind him and no major health problems of his own, Majerus seemed rejuvenated last season. He was in great spirits as the Billikens cracked the top 25 for the first time in his tenure, made the NCAA tournament and even thumped Memphis before falling in the Round of 32.

During one press conference in Anaheim after Saint Louis had just defeated Villanova in the semifinals of the 76 Classic, a jovial Majerus hammed it up with reporters as though he didn't have a care in the world.

He bemoaned the lack of an authentic custard stand in Southern California. He told stories of his players white water rafting and cliff jumping in the Ottawa River. And he kidded that "there would have been the first tsunami ever in a river" if he had joined them.

Quips like that are one of the ways Majerus will be remembered. It's just extremely sad he won't be around to make a few more of them.

Source: http://news.yahoo.com/blogs/ncaab-the-dagger/rick-majerus-master-strategist-larger-life-personality-dies-030332642--ncaab.html

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Panetta: US to fight al-Qaida in Afghanistan for years

By NBC News staff and wire reports

WASHINGTON --?Al-Qaida fighters are still trying to make inroads into Afghanistan, Defense Secretary Leon Panetta said Thursday, cautioning that battling the group would be a core U.S. mission there for years to come.

?The goal here is an enduring presence,? he told reporters at the Pentagon.

Panetta made the comments as the United States weighs how large a military force to keep in Afghanistan when the NATO combat mission ends in 2014, ending a war that, at that point, will have stretched for more than 13 years.

The United States currently maintains approximately 66,000 troops in Afghanistan, but the residual force may number less than 10,000. President Barack Obama could decide in the coming weeks, although no deadline has been set.

As Taliban regroup, victims battle for 'free' Afghanistan

Panetta said fighting the core al-Qaida group to prevent it from re-establishing a haven in Afghanistan was "going to be the fundamental thrust of the (counter-terrorism) effort."

A narrow focus could help limit the size of the mission.

"Although we clearly have had an impact on (al-Qaida's) presence in Afghanistan, the fact is that they continue to show up and intelligence continues to indicate that ... they are looking for some kind of capability to be able to go into Afghanistan, as well," Panetta said Thursday.

PhotoBlog: Relentless Afghan conflict leaves traumatized generation

?That?s something we just have to be continually vigilant in terms of protecting against,? he added.

/

More than ten years after the beginning of the war, Afghanistan faces external pressure to reform as well as ongoing internal conflicts.

A U.S. defense official, speaking to Reuters on condition of anonymity, estimated there were still only about 100 al-Qaida militants in Afghanistan.

But Jeffrey Dressler, an Afghanistan expert at the Washington-based Institute for the Study of War, said looking only at al-Qaida fighters -- as opposed to those who ally with them -- carried enormous risks.

Meet Afghanistan's first female rapper

"I think the mistake that we've made all along is too narrowly defining the threat," Dressler said.

'Enablers'
Beyond counter-terrorism, Panetta said the post-2014 U.S. presence in Afghanistan would also need to have a "train-and-assist mission" to further develop the Afghan Army.

Kevin Frayer / AP

In southern Afghanistan, the focus of the U.S. war effort, nearly all the Afghan soldiers are foreigners too. Photographer Kevin Frayer shows these soldiers in a series of portraits.

He also said the United States would need to provide "enablers" -- specialists who perform tasks such as destroying landmines or treating the injured -- to support U.S. forces.

Obama calls 10 service members in Afghanistan to offer thanks

Panetta declined to offer any estimate for the size of the force, saying that is "exactly what's being discussed" now.?

Reuters contributed to this report.

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Source: http://worldnews.nbcnews.com/_news/2012/11/30/15563017-panetta-us-foresees-enduring-presence-to-fight-al-qaida-in-afghanistan?lite

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New patient-friendly way to make stem cells for fight against heart disease

ScienceDaily (Nov. 29, 2012) ? Scientists have discovered a patient-friendly and efficient way to make stem cells out of blood, increasing the hope that scientists could one day use stem cells made from patients' own cells to treat cardiovascular disease. Their research was published November 30 in the journal Stem Cells: Translational Medicine.

The study, funded by the British Heart Foundation (BHF), Medical Research Council (MRC) and Wellcome Trust, outlines a way for scientists to get the cells they need to make induced pluripotent stem (iPS) cells (3) from a routine blood sample. Previously scientists have struggled to find an appropriate type of cell in the blood that can be turned into a stem cell, and often make iPS cells from skin or other tissues, which can require a surgical procedure, like a biopsy.

Dr Amer Rana and his colleagues at the University of Cambridge grew patients' blood in the lab and isolated what are known as 'late outgrowth endothelial progenitor cells' (L-EPCs) to turn into iPS cells. The iPS cells can then be turned into any other cell in the body, including blood vessel cells or heart cells -- using different cocktails of chemicals. Scientists use these cells to study disease, and ultimately hope to grow them into tissue to repair the damage caused by heart and circulatory diseases.

Dr Amer Rana, of the University of Cambridge, said of the research: "We are excited to have developed a practical and efficient method to create stem cells from a cell type found in blood. Tissue biopsies are undesirable -- particularly for children and the elderly -- whereas taking blood samples is routine for all patients.

"Researchers can freeze and store the blood cells, and then turn them into iPS cells at a later stage, rather than having to transform them as soon as they are sourced, as is the case for other cell types used previously. This will have tremendous practical value -- prolonging the 'use by date' of patient samples."

Shannon Amoils, Research Advisor at the BHF, said: "iPS cells offer great potential -- both for the study and potentially the future treatment of cardiovascular diseases. As iPS cells are made from the patient's own tissue, they can be used to study diseases and hopefully one day to repair damaged tissue without being attacked by the body's immune system.

"Being able to efficiently produce iPS cells using cells from a blood sample will make it easier for researchers to push this technology forward. But there are still many hurdles to overcome before this kind of technique could be used to treat patients."

Dr Paul Colville-Nash, regenerative medicine Programme Manager at the MRC, said: "iPS cell technology offers an exciting new approach to building lab-based models of disease, which can be used to understand illness and test new drugs, as well as the possibility for cell replacement therapy in the longer term. Being able to produce iPS cells from an easy to obtain source such as blood should further support the rapid progress being made in this field and enhance the application of this technology to the fight against human disease."

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The above story is reprinted from materials provided by University of Cambridge. The original story is licensed under a Creative Commons license.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. Imbisaat Geti, Mark L. Ormiston, Foad Rouhani, Mark Toshner, Mehregan Movassagh, Jennifer Nichols, William Mansfield, Mark Southwood, Allan Bradley, Amer Ahmed Rana, Ludovic Vallier, Nicholas W. Morrell. A Practical and Efficient Cellular Substrate for the Generation of Induced Pluripotent Stem Cells from Adults: Blood-Derived Endothelial Progenitor Cells. Stem Cells Trans Med, November 29, 2012 DOI: 10.5966/sctm.2012-0093

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Source: http://feeds.sciencedaily.com/~r/sciencedaily/health_medicine/heart_disease/~3/Pl76K0JR3b4/121129232652.htm

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