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no it can't tell you if you missed your period for 8 weeks
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2009-09-28 00:55:06
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Q: Will a pregnancy test tell you are pregnant if you have missed your period for 8 weeks?
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Can bacterial vaginosis mean your 3 weeks pregnant?
Bacterial vaginosis is not a sign of pregnancy. Signs of pregnancy are a missed period and a positive pregnancy test.
What pregnancy symptoms start showing at 5 weeks pregnant?
The most common pregnancy symptoms at five weeks are missed period, nausea, breast tenderness, and fatigue.
Missed period for almost 2 months now have light spotting for 2 weeks?
If you have missed your period for two months you may be pregnant. Take a pregnancy test to be sure. If you are not pregnant, stress may be the cause of your missed cycle.
Do you have to miss your period in order to find out that your pregnant?
No, you don't have to miss your period in order to find out that you're pregnant. A pregnancy test can be taken from two weeks after you've had sex, you don't have to wait for a missed period.
Missed period - are you pregnant?
A missed period is not always indicative of pregnancy. There are several reasons a period can be missed; however 20% of all pregnancies end in miscarriage (spontaneous abortion). Some females miss a period for weeks and then have what they think is a very heavy period when in fact it is a miscarriage.
Can you test 2 weeks before missed period?
Home pregnancy tests are designed to be used AFTER your missed period. Using it 2 weeks before a missed period could skew the results.
In how many weeks will i know if im pregnant?
you will have a missed period.
How many days until a missed period means your pregnant?
well when you take a pregnancy test and it come out positive you have to at least be 4 weeks pregnant for that test to positive
Could you have symptoms of pregnancy before your missed period?
yes. pregnancy begins 2 weeks before ovulation -- doctors calculate it as the first day of your last period. so even a week before your period is due, you are actually 3 weeks pregnant.
It has been 8 weeks since your last period Are you pregnant?
Maybe. Missed, irregular or late periods do not always indicate pregnancy, but if you are wondering, you should have a pregnancy test performed.
You have missed your period and had a positive pregnancy test but am not having pregnancy symptoms?
You don't need to have symptoms to be pregnant. Some people don't get symptoms for weeks. You're definitely pregnant. i would go to the doctor and get it checked
Could you be pregnant if you have missed your period but have no other pregnancy symptoms?
Yes you could. I didn't know I was pregnant till 16 weeks. No morning sickness with any of mine. Congrats if you are!!!
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Healing
Category
Subtype
Wound characteristics
Mechanical
Abrasions
Contusions
Lacerations
Incisions
Puncture wounds
Removal of superficial skin layer(s)
Disruption of blood vessels and extravasation of blood into tissue
Tissue disruption caused by blunt or sharp instrument, usually irregular
Tissue disruption caused by sharp instrument, usually linear
Penetration of sharp instrument or projectile into tissue
Thermal
Superficial
Partial thickness
Full thickness
Burns confined to epidermis
Burns involving papillary (superficial) or reticular (deep) dermis
Burns extending through dermis into subcutaneous tissue
Chemical
Alkali
Acid
Hydrocarbons
Fat saponification, cellular dehydration, and deep tissue penetration
Hard eschar, thermal injury, and electrolyte imbalances
Dissolution of cell membranes, typically superficial erythema & blistering
Electrical
Complex
Degrees of cutaneous and deep tissue injury associated with systemic complications
Radiation
Complex
Basal skin layer damage with short- and long-term sequelae
Chronic
Complex
Persistent inflammation and matrix degradation leading to nonhealing
Mechanical injuries take on a variety of forms. Abrasions are caused by a friction event such as scraping or rubbing and result in the removal of superficial skin layers. More severe forms of abrasions include avulsions, which involve detachment of skin and possibly underlying tissue. Degloving injuries are avulsions with compromised blood supply to the detached. Contusions, or bruises, are caused by blunt trauma and characteristically rupture blood vessels. Extravasation of blood into the affected tissue is evident by skin discoloration, which evolves over time as the hemoglobin degrades. Lacerations and incisions refer to tissue separation extending through the skin, with lacerations caused by accidental trauma and incisions caused by purposeful dissection. Puncture wounds result from sharp penetration through the skin by an instrument or a projectile. They may extend into deeper structures and/or produce a second wound at the exit site (through-and-through wounds).
In the mid twentieth century, Jackson described thermal injuries as demonstrating a characteristic cutaneous injury pattern, which is divided into three zones based on blood perfusion and tissue viability: zone of coagulation, zone of stasis, and zone of hyperemia. The innermost zone of coagulation represents the irreversibly damaged, necrotic tissue without perfusion. Surrounding the necrotic tissue is an area of moderately burned tissue that may survive or progress to coagulative necrosis depending on the wound environment. This so-called zone of stasis is characterized by increased capillary permeability and vascular damage. The final zone of hyperemia is an area of intense vasodilatation and inflammation that contains viable tissue and is not usually at risk of progression to necrosis [7, 8].
Electrical injuries produce a variety of cutaneous and extracutaneous damage that depend upon the strength (amperage), duration of contact, and path of transmission through the body. If the contact time is brief, damage is relatively restricted to the cell membrane and electrical mechanisms (e.g., heart arrhythmias), rather thermal mechanisms will dominate the injury pattern. With longer contact time, thermal injury dominates and the entire cell is affected. Higher amperage (charge per unit time) burns are associated with a greater degree of systemic complications such as ventricular fibrillation, rhabdomyolysis , compartment syndrome, and renal failure [9].
Chemical injuries are subdivided by causative agent into alkali and acid, with alkali burns generally considered the most severe. Alkali burns induce fat saponification (calcification) or liquefaction, profound cellular dehydration, and formation of alkaline proteinates (completely ionized proteins) that cause deeper tissue damage. Examples of alkalis include lime, cement, potassium hydroxide, and bleach. Acid injuries induce protein hydrolysis (tanning) and do not penetrate tissue as readily as alkalis. One notable acid burn results from hydrofluoric acid due to its unique mechanism of fluoride chelating calcium in the tissue and the risk of hypocalcemia; this is the only acid burn with a specific treatment with topical or systemic calcium. Finally , hydrocarbons such as organic solvents are capable of dissolving cell membranes and producing skin necrosis. Systemic absorption of hydrocarbons is associated with respiratory depression and hepatic toxicity [10].
Radiation with energy high enough to break up molecules is called ionizing radiation. Radiation injuries, which can be accidental or iatrogenic, are known to cause short- and long-term sequelae. Acute radiation syndrome describes the adverse effects of large doses of ionizing radiation on the skin. Basal skin layer damage results in inflammation, erythema, and desquamation. Blistering and ulceration may follow in days to weeks, and most wounds will heal normally, though larger doses may result in destruction of skin appendages, fibrosis, abnormal pigmentation, and ulceration or necrosis of exposed tissue. Acute ionizing radiation exposure is also associated with dysfunction of hematopoietic, gastrointestinal, and cerebrovascular, and systems [11].
32.3 Mechanisms of Wound Healing
Wound healing is classically divided into four phases: hemostasis, inflammation, proliferation, and remodeling. Considerable overlap exists between each phase, and a combination of biochemical and cellular events contributes to the natural continuum of tissue repair.
32.3.1 Hemostasis
The initial phase of wound healing is characterized by a coordinated effort between circulating platelets, soluble clotting factors, and vascular endothelium to stop hemorrhage by the formation of a clot. The key sequences of events are divided into (1) coagulation cascade and (2) platelet activation, although it is important to remember the fundamentally integrated nature of these processes.
Hemostasis is initiated by a chain reaction of soluble serum proteins to form an insoluble fibrin mesh. The coagulation cascade is grouped into the contact activation and tissue factor pathways (historically the intrinsic and extrinsic pathways, respectively). The initial reactions of the two enzyme cascades are unique with a final common pathway consisting of factors X, V, and thrombin. The primary pathway for blood coagulation is the tissue factor pathway, with the contact activation pathway playing a secondary role. The clotting cascade results in the generation of fibrin, which enhances platelet aggregation, and structurally reinforces the ensuing platelet plug [12]. Topical fibrin sealants promote hemostasis and skin graft adhesion in excised burn wounds [13].
Disruption of normal endothelium exposes subendothelial collagen and thrombogenic extracellular matrix molecules, most notably von Willebrand factor (vWF). Platelets adhere to vWF via the glycoprotein (GP) Ib receptor, which strengthens the interaction between platelets and underlying extracellular matrix. Patients with vWF deficiency or with mutations in the glycoprotein (GP) Ib receptor are known to have von Willebrand disease, which is the most common hereditary coagulation deficiency. Likewise, mutations in the GPIb receptor result in Bernard–Soulier syndrome. Both of these conditions result in bleeding tendencies because of altered platelet adhesion to exposed subendothelium [14].
Platelet adhesion leads to platelet activation, invoking the release of stored granule contents. Cues from the wound environment such as hypoxia and acidosis enhance platelet degranulation [15]. Alpha-granules store growth factors such as platelet factor-4 (PF4), platelet derived-growth factor, fibronectin, vWF, and fibrinogen [16]. Many of these substances enhance platelet adhesion or activation. PF4 binds with high affinity to endothelial-derived heparin, which inactivates the molecule and promotes coagulation. Antibodies bind to the PF4-heparin complex on platelet membranes in the syndrome of heparin-induced thrombocytopenia (HIT), which can lead to dangerously low levels of platelets with a paradoxical increase in thrombosis [17].
Dense granules harbor smaller molecules involved in platelet activation such as ADP, ATP, calcium, and serotonin. Release of these molecules into the platelet cytosol initiates a Gq-linked protein receptor cascade, which results in an increased cytosolic calcium concentration.
The platelet glycoprotein IIb-IIIa receptor deserves mention because of its relevance to cardiovascular medicine and disease. The natural ligand of GPIIb-IIIa is fibrinogen, which links the coagulation cascade with platelet activation. Platelet activation leads to increasing its affinity to bind fibrinogen, which enhances platelet aggregation and clotting factor-mediated coagulation. The activated platelets change shape from spherical to stellate, and the fibrinogen cross-links with glycoprotein IIb-IIIa receptors in neighboring platelets to promote aggregation and eventual clot formation [18]. The GPIIb-IIIA receptor is the target of several antiplatelet agents including abciximab, eptifibatide, and tirofiban. Similarly, the drug clopidogrel is known to inhibit ADP binding to the GPIIb-IIIA receptor, which results in a reduced ability of platelets to aggregate and consequently form clots.
32.3.2 Inflammation
Vasoconstriction occurs at the wound site immediately after injury, which is the beginning of the second event in wound healing: inflammation. Vasoconstriction is primarily mediated by catecholamines (epinephrine and norepinephrine), prostaglandin F, and thromboxane A2. The contraction of blood vessels aids platelet aggregation and hemostasis. Vasoconstriction is followed shortly by vasodilatation and increased vascular permeability, which allows access of inflammatory cells to the damaged tissue. Vasodilatation is mediated by prostaglandin E2, prostacyclin, histamine, serotonin, and kinins [16]. Inflammatory cells undergo a three-stage process of rolling along the vascular endothelium, integrin-mediated adhesion to endothelial cells, and transmigration into the extracellular space [19].
Neutrophils are the first inflammatory cell to arrive at the wound and play a primary role in the phagocytosis of bacteria and tissue debris. A huge array of molecular signals are chemoattractant agents for neutrophils, including products of platelet degranulation, formyl methionyl peptides cleaved from bacterial proteins, and the degradation products of matrix proteins. Neutrophils are a major source of early cytokines in the systemic response to injury, including tumor necrosis factor (TNF)-α [20].
Oxygen delivery influences all stages of wound healing. In addition to providing a substrate for ATP synthesis in aerobic cell metabolism, large quantities of oxygen are used by neutrophils for superoxide radical generation in oxidative killing. Furthermore, molecular oxygen itself is toxic to anaerobic microorganisms, and reactive oxygen species are used as chemotactic and extracellular signaling including phyagocyte recruitment in the healing wound bed [21]. Wound oxygenation is determined by blood perfusion, hemoglobin dissociation, local oxygen consumption, fraction of inspired oxygen, hemoglobin content, arterial oxygen tension, circulating blood volume, cardiac output, arterial inflow, and venous drainage [22].
Another early cell to infiltrate the wound site are monocytes, which undergo phenotypic changes into macrophages. Macrophages can be regarded as a “master cell” involved in wound healing because of their central role in phagocytosis, inflammatory cell recruitment, and systemic inflammation. Macrophages release a variety of growth factors such as transforming growth factor-β (TGF-β), platelet-derived growth factor (PDGF), and fibroblast growth factor (FGF), which induce fibroblast proliferation and extracellular matrix production [23]. Macrophages express specific receptors for IgG (Fc receptor), complement C3b (CR1 and CR3), and fibronectin (integrins) that facilitate recognition and phagocytosis of opsonized pathogens. Importantly, macrophages also secrete cytokines such as IL-1 and TNF-α that modulate the systemic response to injury. Excessive production of TNF-α has been linked with multisystem organ failure as well as chronic non-healing ulcers [24]. As discussed later, both IL-1 and TNF-α appear to play crucial roles in early wound healing but may have an inhibitory effect on wound maturation if persistently elevated.
Emerging data suggest a role for nerve-derived neuropeptide in wound repair. Stimulation of efferent nerves is known to produce local vasodilation and plasma extravasation in skin, which contributes to the local inflammatory response. The neuropeptide substance P, released from terminal endings of sensory nerves in response to noxious stimuli, is known to influence inflammatory cell chemotaxis [25, 26], angiogenesis [27, 28], and keratinocyte proliferation [29]. We have previously suggested that the dysregulated neuroinflammation plays an important role in hypertrophic scarring, evident by increased levels of substance P and decreased levels of the regulating enzyme neutral endopeptidase [30], which is responsible for the exuberant matrix production, hyperemia, and pruritus seen in this condition [31].
A robust but appropriate inflammatory response is essential to prepare the wound bed for subsequent migration of proliferative cells. However, overzealous inflammation may inhibit the formation of granulation tissue and neovascularization. Experiments in mice constitutively expressing the chemotactic cytokine interferon-inducible protein 10 demonstrate that an intense inflammatory infiltrate inhibits angiogenesis and development of healthy granulation tissue [32]. Thus, as in all homeostatic systems, a careful balance of functionalized cellular and biochemical processes is essential to proper wound healing. Animal trials suggest a possible role for statins in wound healing in partial- and full-thickness burns. Whereas the combination of statins and angiotensin receptor antagonists have been demonstrated to reduce fibrosis in several organ systems, results in burn healing has been mixed. Atorvastatin has been shown to reduce inflammation and increase graft take in porcine wounds; however, in the same animal model, Losartan treatment resulted in decreased graft take, increased wound contraction and worse scarring [33, 34].
32.3.3 Proliferation
The proliferative phase is characterized by the formation of granulation tissue, which is a pink, soft, highly vascularized platform for tissue formation. Fibroblasts are evident at the wound site within 2–5 days and become the predominant cell type after the first week [35]. Macrophages drive the migration of fibroblasts by secreting a number of chemokines including TNF-α, PDGF, FGF, and TGF-β. Fibroblasts begin to deposit collagen and other extracellular matrix molecules that strengthen the wound bed. Macrophages stimulate fibroblasts to produce FGF-7 (keratinocyte growth factor) and IL-6, which promote keratinocyte migration and proliferation. IL-6 is also a potent stimulator of fibroblasts, which explains the decreased level found in aging fibroblasts and fetal wounds [36]. Unfortunately, granulation tissue also harbors high bacterial counts and proteolytic activity, so it may need to be excised before skin grafting. Granulation tissue in a burn wound prevents advancement of the epithelial tongue and epithelialization and likely leads to hypertrophic scar formation [37].
A number of other inflammatory cytokines may find clinical relevance in wound care. IL-8 secreted by macrophages and fibroblasts early in wound healing may have a stimulatory effect on keratinocytes and epithelialization. Topical application of IL-8 to human skin grafts in a chimeric mouse model enhanced keratinocyte proliferation and re-epithelialization [38]. Additionally, in both human and animal studies, topical application of PDGF improved wound strength and healing time [39]; unfortunately, clinical trials have demonstrated no significant difference in healing in chronic wounds [40].
TGF-β is expressed by platelets and fibroblasts in the wound bed and plays an important role in collagen deposition and turnover. TGF-β is the most potent known stimulator of fibroblast proliferation and can accelerate wound healing in steroid-treated and irradiated animals [41]. Overexpression of TGF-β mRNA has been found in keloid and hypertrophic scars, whereas fetal wounds contain relatively little TGF-β [42]. This contrast between the heavily fibrotic scars of keloid and the scarless repair observed in utero might underscore the importance of TGF-β in the fibrotic response to tissue injury. Gabriel [43] observed a similar phenomenon in burn injuries, where higher levels of TGF-β correlate with excessive wound contraction. Interestingly, exogenous application of TGF-β3 reduces monocyte and macrophage recruitment to the wound site, resulting in less deposition of collagen and fibronectin in the early stages of wound healing [44]. A formulation of TGF-β (Juvista) underwent phase III trials but failed to meet primary or secondary endpoints and was never widely released [45].
Coincident with fibroblast migration to the wound site is angiogenesis. Angiogenesis, or neovascularization, which has been thought to be a critical element of early wound healing for transport of metabolites to and from the regenerating tissue. More recent data suggest that normal healing can occur when angiogenesis is inhibited and that angiogenesis in the wound bed is not associated with increased blood flow to the wound. Vascular endothelial cells arise from both preexisting blood vessels and endothelial progenitor cells (EPCs) in bone marrow. The most important regulators of angiogenesis are vascular endothelial growth factor (VEGF) and FGF-2. Nissen et al. [46] observed a dose-dependent effect of both VEGF and FGF-2 in angiogenesis. VEGF is secreted as many different isoforms from a variety of stromal and mesenchymal cells, with the tyrosine kinase VEGF-receptor 2 emerging as the most preeminent in angiogenesis. VEGF/VEGFR2 signaling is involved in EPC migration from bone marrow, as well as promotion of endothelial cell proliferation and differentiation [47].
Hypoxia is a potent inducer of both angiogenesis and fibroblast proliferation. The major player in hypoxic gene expression is hypoxia-inducible factor 1 (HIF-1), a DNA-binding transcription factor that is known to alter gene transcription of a number of proteins involved in metabolism, angiogenesis, migration, and proliferation [48]. Cultured endothelial cells upregulate the expression of several pro-angiogenic molecules when cultured in hypoxia, including endothelin-1, VEGF, and PDGF-β chain [49]. Fibroblast replication and longevity are increased in low oxygen tension culture [50], as is TGF-β secretion [49]. These observations highlight the contribution of hypoxia in the wound bed in proliferative cell signaling.
Mechanotransduction or the translation of mechanical force into biochemical signaling represents one novel area of research [51]. Using matrix-integrin activation of signaling cascades, mechanical force is transmitted to targets including calcium-dependent signaling, nitric oxide signaling, mitogen-associated kinases, and Rho GTPases. The end product of these signals activate transcription factors that move to the nucleus and activate mechanoresponsive genes [51]. Silicone sheeting, a way of offloading skin tension in healing wounds, has shown promise in improving scaring. Further avenues to modulate the biochemical signaling and mechanotransduction networks have potential to reduce scar formation and promote skin regeneration [52, 53].
Recently, the role of immune cells, long ignored in wound healing research is under increased investigation. T cells migrate into the wound bed during the late proliferative and early remodeling phase. Mice deficient in T and B cells have a reduced capacity to scar [22], though contradictory reports exist concerning the beneficial effects of CD4+ and CD8+ lymphocytes on wound healing [54, 55]. Additionally, a unique type of T cell exists in the skin, known as dendritic epidermal T cells (DETC), which are thought to modulate many aspects of wound healing such as inflammation, host defense, and maintenance of tissue integrity. Mice lacking or defective in DETC show a delay in wound closure and a decrease in keratinocyte proliferation at the wound site [44, 56].
32.3.4 Epithelialization
Epithelialization is the third important response to cutaneous injury, critical because once the epithelial layer is regenerated the wound is often viewed as being “healed.” Keratinocytes migrate from wound edges and dermal appendages such as hair follicles, sweat glands, and sebaceous glands. The role of the epidermal appendages is especially evident in partial-thickness burns. Since the advancing epithelial tongue at the wound edge can migrate no more than ~1 cm, wounds depend on epidermal sources at the center of the wound. Full-thickness wounds larger than 2 cm rarely heal other than by contraction. Subsequent proliferation of these cells at the wound site provides a neo-epidermal covering. Keratinocyte migration and proliferation follow a discrete sequence of events: disassembly of hemidesmosomes and desmosomes , retraction of intracellular tonofilaments and keratin filaments, and formation of focal contacts and cytoplasmic actin filaments [57]. Martin [58] has extensively studied the interplay between laminin, matrix metalloproteinases (MMPs), integrins, and soluble growth factors in this process.
Renewal of keratinocytes during normal homeostasis and wound repair is a defining feature of re-epithelialization. The upper region of hair follicles below the sebaceous gland (known as the bulge) contains multipotent progenitor cells that contribute to maintenance and renewal of epithelium [59, 60]. Additionally, epidermal cells migrate from neighboring unwounded epidermis or from the infundibulum, the portion of the hair follicle between the epidermis and the sebaceous gland [61].
The relative contributions of the follicular stem cells and epidermal stem cells to re-epithelialization is debated, although genetic analyses have confirmed that the epidermis has intrinsic capacity for self-renewal and does not depend on follicle-derived multipotent progenitor cells [62, 63]. Further evidence for this notion comes from reports of de novo hair follicle generation in healing skin of adult mice [64]. This phenomenon, which has never been observed in humans, is contingent upon WNT-mediated signaling which is also involved in pattern formation and the epithelial–mesenchymal transformation during embryogenesis [65]. Elucidation of the overlapping pathways in wound repair, and development is a central principle of efforts toward scarless repair and skin regeneration.
32.3.5 Remodeling
Remodeling is the replacement of granulation tissue with scar over months after “healing.” A key feature of tissue remodeling that emerges during this stage of wound healing is the balance between extracellular matrix (ECM) synthesis and degradation. While fibrogenic growth factors such as PDGF and FGF stimulate fibroblast matrix deposition, resident cells induce continuous degradation by matrix metalloproteinases. MMPs are a family of zinc proteases that are capable of degrading a variety of ECM components such as collagen, fibronectin, proteoglycans, and laminin [66] which can improve wound healing through direct and indirect mechanisms [67].
Collagen composition of the wound appears to follow a similar pattern as embryogenesis. Granulation tissue is comprised of a large amount of collagen III, which is gradually replaced by collagen I. Collagen I provides a higher degree of tensile strength to the developing scar, although the final tensile strength approaches only 70% of uninjured skin [68]. A morphological change in fibroblasts ensues during wound contraction, in which fibroblasts begin to express alpha-smooth muscle actin and adapt functions of smooth muscle cells. The resulting cell is termed a myofibroblast and serves to enhance wound contraction.
32.3.6 Stem Cells
In addition to resident epidermal stem cells in the skin, bone marrow-derived stem cells may contribute substantially to cutaneous wound healing. Bone marrow contains both hematopoietic (CD34+) and non-hematopoietic (mesenchymal) stem cells which aid wound healing by direct contribution of cells as well as by paracrine signaling. A notable study, in which green fluorescent protein-labeled bone marrow stem cells were used to reconstitute the marrow of mice with cutaneous wounds, indicated that non-hematopoietic mesenchymal stem cells may contribute up to 15–20% of dermal fibroblasts in normal skin and healing cutaneous wounds. Fathke et al. [69] and Brittan et al. [70] have traced cells with a keratinocyte phenotype to bone marrow origin. Deng et al. [71] have shown evidence that bone marrow stem cells are involved in hair follicle regeneration. Bone marrow cells expand ex vivo to promote neovascularization [72], appendage regeneration [73], and accelerate wound closure [74].
Endothelial progenitor cells (EPCs) derive from CD34+ hematopoietic stem cells in the bone marrow and contribute some proportion of the endothelial cells to adult skin. Systemic transplantation of EPCs enhances wound healing in mice [75], as does topical application of EPCs to ischemic ulcers in diabetic mice [76]. The mechanism involves paracrine signaling from EPCs instead of direct contributions by endothelial cells [75].
Fibrocytes, a subpopulation of leukocytes that also arise in the bone marrow, were originally identified by their rapid recruitment from peripheral blood to wound sites in mice [77]. Fibrocytes are significantly increased in the blood of burned patients in comparison to normal individuals and appear to localize in the deeper papillary dermis [78]. These cells may contribute to the myofibroblast population in wounds and may be associated with hypertrophic scarring [79, 80].
32.4 Abnormal Wound Healing
32.4.1 Impaired Wound Healing
A variety of local and systemic factors are implicated in abnormal wound healing, which impair tissue regeneration by interrupting each of the stages of wound healing. Physical impediments (Table 32.2) to wound closure may delay or prevent healing, such as the presence of foreign bodies or neoplasms (for skin grafts, hematomas and seromas most commonly cause graft failure). Excessive tension on a wound or surrounding edema may compress the vascular supply and lead to ischemia; recent data also implicate mechanical tension as a leading cause for hypertrophic scar formation [81]. Therapeutic radiation and repetitive trauma are also well-known detriments to wound healing.
Table 32.2
Local and systemic factors that impair wound healing
Local factors
Systemic factors
Tension
Foreign bodies
Infection
Ischemia
Hematoma and seroma
Trauma
Edema
Irradiation
Connective tissue disorders
Hypothermia
Oxygen
Tobacco smoking
Malnutrition
Jaundice
Age
Diabetes mellitus
Uremia
Steroids
Chemotherapeutic agents
Adapted from [82]
A variety of insults can disturb wound healing by evoking hypoxia in the evolving wound. Disruption of vascular supply and depletion of oxygen can lead to wound hypoxia, which is associated with systemic diseases such as connective tissue disorders and microvascular disease in diabetes mellitus. Tobacco smoking produces similar effects through nicotine-induced vasoconstriction and displacement of oxygen on hemoglobin with carbon monoxide [83].
Infection is another classic adversary of proper wound healing. Wounds with bacterial counts that exceeding 105 organisms per gram of tissue will generally not heal by any means, including flap closure, skin graft placement, or primary intention [84]. The introduction of early excision and grafting for burn wounds has significantly reduced the prevalence of burn wound sepsis—which was historically a leading cause of burn mortality. Endotoxin produced by gram-negative bacteria stimulates phagocytosis and collagenase expression, which contributes to matrix degradation and destruction of normal tissue. Bacteria also accelerate protease production in macrophages (such as MMPs) while inhibiting protease inhibitor expression. This effect leads to increased matrix destruction and degradation of growth factors, which are characteristics of chronic nonhealing wounds [85].
Nutritional status has a profound effect on wound healing as well. Serum albumin is one of the most accurate predictors of surgical morbidity and mortality, with levels below 2.1 g/dL associated with poorer outcomes [86]. Protein replacement enhances wound healing [87], as does supplementation with the amino acids arginine, taurine, and glutamine [88, 89]. Whereas patients with large burns characteristically have albumin levels below 1.0 g/dL, exogenous albumen has never been demonstrated to improve outcomes. Early introduction of nutrition is a critical component of acute burn care and wound healing, with micronutrients playing an important role [90, 91]. Data suggest that the catabolic state can be modulated by propranolol in children [92] and oxandrolone in children and adults [93, 94]. Propranolol, a nonselective β-blocker, improved wound healing and perioperative hemodynamics in severely burned adults by increasing vascular resistance in the burn beds by leaving α-adrenergic receptors unopposed and decreasing blood loss during operative interventions [95].
Vitamin C (ascorbic acid) is an essential cofactor in proline and lysine hydroxylation during collagen synthesis, and supplementation of 100–1000 g per day may improve wound healing [89]. Vitamin A (retinoic acid) is required for wound re-epithelialization, maintenance of normal epithelium, proteoglycan synthesis, and normal immune function. Oral retinoid therapy counteracts the detrimental effects of corticosteroids on wound healing, possibly through promotion of TGF-β and IL-1 signaling [96]. Vitamin K deficiency impedes clot formation and hemostasis, while vitamin D is required for bone healing and calcium metabolism. Finally, vitamin E supplementation may serve an important role as an antioxidant in trauma patients. Early administration of vitamin E reduces the incidence of organ failure and the average length of ICU stay in critically ill surgical patients and may be relevant for burn patients [97].
The dietary minerals associated with wound healing include zinc and iron. Zinc is an essential cofactor in RNA and DNA polymerases. Deficiency inhibits granulation tissue formation [98] and delays wound healing [99]. Desneves et al. [88] report that zinc supplementation improves wound healing. Iron, another cofactor in DNA synthesis, is also key to proline and lysine hydroxylation. Although the role of iron in normal hematopoiesis is well established, chronically anemic patients do not appear to suffer from delayed wound healing [100]. Whereas selenium deficiency causes hair and skin abnormalities in humans and selenoproteins have been implicated in keratinocyte function and cutaneous morphogenesis [101], but selenium deficiency is yet to be associated with abnormal wound healing.
32.4.2 Hypertrophic Scars and Keloids
Hypertrophic scar and keloids represent fibroproliferative scars, which are characterized by excessive collagen deposition. These two morphological aberrations are difficult to differentiate: keloids are defined as scars that grow beyond the periphery of the original wounds and hypertrophic scars represent raised scars that remain confined to the boundaries of the original wound. Keloids rarely regress with time; hypertrophic scars frequently regress spontaneously. Both scar types appear to have a strong genetic component, with more prevalence in dark-skinned patients of African, Asian, Native American, or Latin American descent. Hypertrophic scars, the result of prolonged inflammation, are influenced by wound depth, skin tension, and delayed wound healing with increased inflammatory response and enhanced fibroblast activity [102]. Though theoretically preventable, hypertrophic scars tend to occur in pigmented individuals [103], young people, and rarely in the aged. Interestingly, they often develop in highly contractible body sites and rarely form on the scalp or the lower leg [104]. Proposed therapies to control hypertrophic scars act to reduce inflammation including steroid injections, radiotherapies, compression, and surgical methods to reduce skin tension [105]. The single nucleotide polymorphism p27kip1 decreases vascular restenosis due to fibrogenesis, but was not associated with hypertrophic scar severity [106]. Using a genome-wide association study of over 500 individuals with burn injuries, mutations in the CSMD1 gene have been associated with reduced hypertrophic scarring [107].
In light of its potent effect on fibroblast proliferation and collagen deposition, it is perhaps not surprising that TGF-β plays a central role in proliferative scarring. Colwell et al. [108] found increased levels of the TGF-β1 isoform in both keloids and hypertrophic scars. Likewise, antibodies to TGF-β isoforms reduce fibrosis in hypertrophic scars [109]. Novel therapies for hypertrophic and keloid scars are in development that target ECM synthesis and fibroblast proliferation [110].
32.4.3 Chronic Nonhealing Wounds
Dysfunction of normal wound healing processes leads to chronic wounds. In particular, chronic wounds appear to have sustained inflammation with less matrix production. Chronic wounds exhibit higher levels of cytokines such as IL-1, IL-6, and TNF-α, with reduced levels of essential growth factors such as EGF and PDGF. MMP-1, MMP-2, MMP-8, and MMP-9 are present at higher levels, with reduced levels of MMP inhibitors [111]. These nonhealing wounds are prone to developing squamous cell carcinoma, originally reported in burn wounds by Marjolin. Marjolin ulcers tend to be very aggressive and should be highly suspected with nonhealing burn wounds [112]. Therapy includes complete local extirpation of the cancer with negative margins and lymphatic mapping [113]. Other conditions such as osteomyelitis, pressure sores, venous stasis ulcers, and hidradenitis have also been associated with wound malignancies [114]; patients with impaired skin integrity due to burn injuries are at increased risk for decubitus ulcers, which constitute a closely monitored hospital acquired complication.
32.4.3.1 Wound Dressings
A variety of burn dressings and skin substitutes are employed in the treatments of burns and other wounds. One class of dressings is topical salves and ointments such as silver sulfadiazine, bacitracin, or mupirocin, which require daily dressing changes to minimize infection risks. Multi-day dressings such as Acticoat® (Smith & Nephew), or Mepilex® Ag (Molnlycke) can be used in wounds and partial-thickness burns, minimizing the need for dressing changes while having antimicrobial properties. Additionally, bioderived materials are being explored for wound healing properties as natural scaffolds including polysaccharide polymers such as cellulose, chitosan (similar to a glycosaminoglycan), and hyaluronic acid and natural proteins such as silk fibroin, fibrin glue, and collagen [115]. An ideal dressing should be antimicrobial, analgesic, long acting, easy to apply (transparent), and affordable. While no single product is a miracle cure, continued advancements and combinations show promise in complicated wound processes. Lupeol from the Cassia fistula fruit has shown some promise with antioxidative, antileukotriene, and antibacterial effects and can be released with a chitosan hydrogel mixture that may improve wound healing in some patients [116, 117]. Whereas the list of dressings and skin produces in Tables 32.3 and 32.4 is robust, it is by no means exhaustive, and new products are released regularly.
Nov 4, 2020 | Posted by in Aesthetic plastic surgery | Comments Off on Healing
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If I Have a Hysterectomy, Will I Go Through Menopause?
Undergoing a hysterectomy—surgery to remove all or part of the uterus—can raise many concerns, including the possibility of menopause. While it’s true that some women do enter menopause right after a hysterectomy, this depends on whether or not the ovaries are also removed during the procedure—a decision that hinges on the purpose of the surgery and your overall health. Knowing what to expect in either case can prepare you for this change, whenever it comes, and the symptoms you may experience.
Understanding Hysterectomy
A hysterectomy refers to the surgical removal of a woman’s uterus. It may be performed for a number of reasons, both benign (for example, uterine fibroids) and cancerous (such as uterine cancer).
Depending on the reason behind why a hysterectomy is being done, a doctor may also remove the ovaries and fallopian tubes (the tubes that connect a woman’s ovaries to her uterus).
With the removal of the ovaries, a premenopausal woman will immediately go into menopause, called surgical or induced menopause. Since she no longer has ovaries to produce estrogen, she may experience classic symptoms of estrogen depletion like hot flashes and/or vaginal dryness.
In addition to these symptoms, there are also health conditions associated with the low-estrogen state of menopause, like osteoporosis (when your bones weaken and become prone to breaking).
If you are premenopausal and your ovaries are not removed during a hysterectomy, your body will continue to produce estrogen. However, you will not have periods anymore, as there is no uterine lining to shed.
Surgical Menopause
There are a number of symptoms linked to both natural and surgical menopause; two of the most common ones include vaginal dryness and hot flashes.
Vaginal Dryness: With the loss of estrogen, the lining of a woman’s vagina becomes dry and itchy—a phenomenon called vaginal atrophy. This vaginal dryness, itching, and burning often make sex painful and, in turn, can lower a woman’s desire to have intercourse.
Hot Flashes: Estrogen deficiency throws off how a woman’s brain regulates body temperature, and this may lead to hot flashes. A hot flash is a sudden, intense feeling of heat or burning in the face, neck, and chest, often accompanied by redness.
A night sweat refers to a hot flash that occurs during sleep. Night sweats can negatively impact a woman’s sleep cycle, which may lead to tiredness during the day.
Other Symptoms of Surgical Menopause: There are a number of other symptoms of surgical menopause, although some of them are believed to also be caused by increasing age.
These symptoms include:
• Mood changes, like depression and anxiety
• Weight gain, especially around the waist
• Dry skin and hair loss
• Increased urinary problems, especially urinary tract infections and urinary incontinence (loss of urine without any control)
It’s important to note that for women who have undergone surgical removal of their ovaries, menopausal symptoms tend to be more intense than for a woman who experiences menopause naturally. Of course, this is not a hard-and-fast rule; menopausal symptoms vary widely and in degree from woman to woman.
Even so, this greater intensity of menopausal symptoms is attributed to the abrupt removal of the ovaries, which are a woman’s primary source of estrogen. In natural menopause, the ovaries gradually lose their ability to produce estrogen, so the body can (usually) adjust more easily.
Hysterectomy With Ovaries Left Intact
Women who have their ovaries intact, but without their uterus, won’t get their period anymore. You may, however, still experience premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD) because the hormones made by the ovaries will cause your body to continue to “cycle” monthly.
Occasionally, women whose ovaries were not removed during a hysterectomyexperience hot flashes and other menopausal symptoms. This is mostly due to the disturbance of the blood supply to the ovaries during surgery.
In addition, some women may undergo menopause a few years sooner than they normally would if they never underwent a hysterectomy (the average onset age for menopause is 51).
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–Ashley, living with AHP
Resources
Stay informed with resources about AHP
There are a range of resources designed to help people understand acute hepatic porphyria (AHP) and handle the challenges of living with the disease. A great starting point is downloading a printable Doctor Discussion Guide. Once the Guide is downloaded, you can complete each section and then bring it to an upcoming doctor appointment. This can help start conversations about whether you should be tested for AHP.
Brochure with information about acute hepatic porphyria
ACUTE HEPATIC PORPHYRIA BROCHURE
This reader-friendly brochure takes you step by step through what AHP is, its signs and symptoms, diagnosis, and how to live with AHP.
Download PDF
LEARN ABOUT FAMILY GENETIC TESTING FOR AHP AND MAP YOUR FAMILY’S HISTORY
Knowledge of genetic risk of AHP may enable people to make informed decisions regarding lifestyle and medications with the intent to prevent attacks and complications of the disease. The following resources can help you learn more about the genetic risk of AHP, and how to talk with your family and doctor about genetic testing for AHP
Person diagnosed with acute hepatic porphyria
Alnylam Act®
Alnylam-sponsored third-party genetic testing for acute hepatic porphyria offered at no charge
The Alnylam Act® program was developed to reduce barriers to genetic testing to help people make more informed decisions about their health.
While Alnylam provides financial support for this program, tests and services are performed by independent third parties. Healthcare professionals must confirm that patients meet certain criteria to use the program. Alnylam receives de-identified patient data from this program, but at no time does Alnylam receive patient identifiable information. Alnylam receives contact information for healthcare professionals who use this program. Genetic testing is available in the US and Canada. Healthcare professionals who use this program have no obligation to recommend, purchase, order, prescribe, promote, administer, use, or support any Alnylam product.
Your doctor must sign up for the program and confirm that you meet certain criteria in order for you to receive genetic screening at no charge.
This helpful brochure offers a review of AHP, genetic testing, and the Alnylam Act® program.
Genetic testing
Download the Alnylam Act® Brochure
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TY - JOUR AU - Rodríguez Velásquez, Javier Oswaldo AU - Cuesta Rivas, Joao AU - Correa Herrera, Sandra Catalina PY - 2022/08/24 Y2 - 2023/10/02 TI - Predictive methodology of the dynamics of the number of COVID-19 cases: application to China, Belgium, and South Korea JF - Revista Médica de Risaralda JA - Rev. Médica Risaralda VL - 28 IS - 1 SE - Artículo original DO - 10.22517/25395203.24932 UR - https://revistas.utp.edu.co/index.php/revistamedica/article/view/24932 SP - AB - <p><strong>Objectives:</strong> Multiple methodologies based on probability theory have been developed to establish predictions of dengue, malaria, HIV, obesity epidemics, among others. This research aimed to develop a new method for predicting the dynamics of the number of COVID-19 cases for China, Belgium, and South Korea based on the probability theory that allows the evaluation and comparison of their increment.</p><p><strong>Material and methods</strong>: Probability ranges of the number of COVID-19 cases were established, which were assigned to each of the daily number of COVID-19 cases reported by China, Belgium, and South Korea that were evaluated during 74, 50, and 50 days respectively. The frequency and probability of each daily range for each country was calculated. Their total probability and the probability of the dynamics in intervals of 8 consecutive days were calculated, and the values between countries were compared to evaluate their differences.</p><p><strong>Results</strong>: Probability values of 1.21E-30, 2.03E-22, and 3.15E-12 were established for China, Belgium, and South Korea, which allows the quantitative differentiation of the characteristics of their dynamics. The probability differences of the 8-day subspaces ranged from 0.003 to 1, allowing the temporal changes in the dynamics to be evaluated.</p><p><strong>Conclusion:</strong> The ranges established for the evaluation of the number of COVID-19 cases allow to differentiate the behavior of epidemics between countries and to stratify the severity of expansion. Highlighting an underlying mathematical order for this phenomenon permitted quantitatively predict its spatiotemporal dynamic and indirectly, the efficacy of public health politics implemented for each country.</p> ER -
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1a01aa77535b9ecfb87b9fc36adbcd2f
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RT Journal Article SR Electronic T1 Breathing Inhibited When Seizures Spread to the Amygdala and upon Amygdala Stimulation JF The Journal of Neuroscience JO J. Neurosci. FD Society for Neuroscience SP 10281 OP 10289 DO 10.1523/JNEUROSCI.0888-15.2015 VO 35 IS 28 A1 Brian J. Dlouhy A1 Brian K. Gehlbach A1 Collin J. Kreple A1 Hiroto Kawasaki A1 Hiroyuki Oya A1 Colin Buzza A1 Mark A. Granner A1 Michael J. Welsh A1 Matthew A. Howard A1 John A. Wemmie A1 George B. Richerson YR 2015 UL http://www.jneurosci.org/content/35/28/10281.abstract AB Sudden unexpected death in epilepsy (SUDEP) is increasingly recognized as a common and devastating problem. Because impaired breathing is thought to play a critical role in these deaths, we sought to identify forebrain sites underlying seizure-evoked hypoventilation in humans. We took advantage of an extraordinary clinical opportunity to study a research participant with medically intractable epilepsy who had extensive bilateral frontotemporal electrode coverage while breathing was monitored during seizures recorded by intracranial electrodes and mapped by high-resolution brain imaging. We found that central apnea and O2 desaturation occurred when seizures spread to the amygdala. In the same patient, localized electrical stimulation of the amygdala reproduced the apnea and O2 desaturation. Similar effects of amygdala stimulation were observed in two additional subjects, including one without a seizure disorder. The participants were completely unaware of the apnea evoked by stimulation and expressed no dyspnea, despite being awake and vigilant. In contrast, voluntary breath holding of similar duration caused severe dyspnea. These findings suggest a functional connection between the amygdala and medullary respiratory network in humans. Moreover, they suggest that seizure spread to the amygdala may cause loss of spontaneous breathing of which patients are unaware, and thus has potential to contribute to SUDEP.SIGNIFICANCE STATEMENT Sudden unexpected death in epilepsy (SUDEP) is the most common cause of death in patients with chronic refractory epilepsy. Impaired breathing during and after seizures is common and suspected to play a role in SUDEP. Understanding the cause of this peri-ictal hypoventilation may lead to preventative strategies. In epilepsy patients, we found that seizure invasion of the amygdala co-occurred with apnea and oxygen desaturation, and electrical stimulation of the amygdala reproduced these respiratory findings. Strikingly, the subjects were unaware of the apnea. These findings indicate a functional connection between the amygdala and brainstem respiratory network in humans and suggest that amygdala seizures may cause loss of spontaneous breathing of which patients are unaware—a combination that could be deadly.
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1a01aa77535b9ecfb87b9fc36adbcd2f
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•
•
Abstract
Wellens syndrome is usually diagnosed in asymptomatic patients with normal or only slightly elevated cardiac enzymes. There are two different ECG patterns (Type A and Type B) described in the literature. Earlier studies demonstrated that the appearance of the Wellens pattern had a specificity of 89% and a positive predictive value of 86% for severe stenosis of the left anterior descending artery (LAD) hence a timely recognition and therapeutic approach may prevent fatal outcomes in the patients. Here we are presenting a case of a 69-year-old gentleman with chest pain and Type A Wellens Syndrome pattern on ECG who was found to have LAD stenosis.
COinS
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1a01aa77535b9ecfb87b9fc36adbcd2f
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4,834,109,780,508,777,000
|
Format
Send to
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J Appl Physiol (1985). 2000 Aug;89(2):549-56.
Pyruvate ingestion for 7 days does not improve aerobic performance in well-trained individuals.
Author information
1
Department of Human Biology and Nutritional Sciences, University of Guelph, Ontario, Canada.
2
U Guelph, Ontario, Canada
Abstract
The purposes of the present studies were to test the hypotheses that lower dosages of oral pyruvate ingestion would increase blood pyruvate concentration and that the ingestion of a commonly recommended dosage of pyruvate (7 g) for 7 days would enhance performance during intense aerobic exercise in well-trained individuals. Nine recreationally active subjects (8 women, 1 man) consumed 7, 15, and 25 g of pyruvate and were monitored for a 4-h period to determine whether blood metabolites were altered. Pyruvate consumption failed to significantly elevate blood pyruvate, and it had no effect on indexes of carbohydrate (blood glucose, lactate) or lipid metabolism (blood glycerol, plasma free fatty acids). As a follow-up, we administered 7 g/day of either placebo or pyruvate, for a 1-wk period to seven, well-trained male cyclists (maximal oxygen consumption, 62.3 +/- 3.0 ml. kg(-1). min(-1)) in a randomized, double-blind, crossover trial. Subjects cycled at 74-80% of their maximal oxygen consumption until exhaustion. There was no difference in performance times between the two trials (placebo, 91 +/- 9 min; pyruvate, 88 +/- 8 min). Measured blood parameters (insulin, peptide C, glucose, lactate, glycerol, free fatty acids) were also unaffected. Our results indicate that oral pyruvate supplementation does not increase blood pyruvate content and does not enhance performance during intense exercise in well-trained cyclists.
PMID:
10926637
DOI:
10.1152/jappl.2000.89.2.549
[Indexed for MEDLINE]
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Benzedrine side effects by duration, gender and age - a phase IV clinical study of FDA data
Summary:
Side effects are reported by people who take Benzedrine. Common side effects include aortic valve disease among females, and crohn's disease among males.
The phase IV clinical study is created by eHealthMe based on 12 reports from the FDA, and is updated regularly. You can use the study as a second opinion to make health care decisions.
Phase IV trials are used to detect adverse drug outcomes and monitor drug effectiveness in the real world. With medical big data and AI algorithms, eHealthMe is running millions of phase IV trials and makes the results available to the public. Our original studies have been referenced on 700+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature.
On Nov, 19, 2023
12 people who take Benzedrine and have side effects are studied.
What is Benzedrine?
Benzedrine has active ingredients of amphetamine sulfate. Currently, eHealthMe is studying from 27 Benzedrine users.
Number of Benzedrine reports submitted per year:
Benzedrine side effects.
Benzedrine side effects by gender *:
female:
1. Aortic valve disease
2. Asthenia (weakness)
3. Back pain
male:
1. Crohn's disease (condition that causes inflammation of the gastrointestinal tract)
2. Bronchitis (inflammation of the mucous membrane in the bronchial tubes)
3. Drug ineffective
Benzedrine side effects by age (0-1 to 60+) *:
0-1:
n/a
2-9:
n/a
10-19:
n/a
20-29:
n/a
30-39:
1. Bronchitis (inflammation of the mucous membrane in the bronchial tubes)
40-49:
n/a
50-59:
n/a
60+:
1. Crohn's disease (condition that causes inflammation of the gastrointestinal tract)
2. Asthenia (weakness)
3. Back pain
* Approximation only. Some reports may have incomplete information.
Do you take Benzedrine?
Personalize this study to your gender and age
How to use the study?
You can discuss the study with your doctor, to ensure that all drug risks and benefits are fully discussed and understood.
How the study uses the data?
The study is based on amphetamine sulfate (the active ingredients of Benzedrine) and Benzedrine (the brand name). Other drugs that have the same active ingredients (e.g. generic drugs) are not considered.
Related studies
Alternative drugs to, pros and cons of Benzedrine:
All Benzedrine side effects from A to Z:
a b c d e f g h i j k l m n o p q r s t u v w x y z
Who is eHealthMe?
With medical big data and proven AI algorithms, eHealthMe provides a platform for everyone to run phase IV clinical trials. We study millions of patients and 5,000 more each day. Results of our real-world drug study have been referenced on 700+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API).
WARNING, DISCLAIMER, USE FOR PUBLICATION
WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health.
DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. All information is observation-only. Our phase IV clinical studies alone cannot establish cause-effect relationship. Different individuals may respond to medication in different ways. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. The use of the eHealthMe site and its content is at your own risk.
If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date.
Recent studies on eHealthMe:
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1a01aa77535b9ecfb87b9fc36adbcd2f
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Quick Answer: Does Hemp interact with medications?
The altered concentration, in turn, may lead to the medication not working, or an increased risk of side effects. Such drug interactions are usually hard to predict but can cause unpleasant and sometimes serious problems.
Does Hemp interact with other medications?
Initial studies show that CBD can definitely mess with medication levels in your system, even if you’re taking your prescribed dosage. But more research is needed to determine the severity of CBD interactions across different medications and to develop recommendations for taking them along with CBD.
Does Hemp oil interfere with blood pressure meds?
For some people, particularly those taking certain prescription medications, using CBD is risky. It has anticoagulant effects that can thin blood; it can also modestly lower blood pressure. These effects could be dangerous for people with certain medical conditions.
Does CBD interfere with statins?
In particular, research has found that CBD is a “potent inhibitor” of two enzymes (CYP3A4 and CYP2D6) that affect many common drugs, including antihistamines, benzodiazepines, certain antidepressants and statins.
IMPORTANT: How do you activate cannabinoid receptors?
Can you take CBD oil if you have high blood pressure?
Studies indicate that CBD may be able to help with high blood pressure. One recent study treated nine healthy men with one dose of 600 mg of CBD oil and found it reduced resting blood pressure, compared to a placebo.
Can CBD cause irregular heartbeat?
The cardiovascular effects of cannabis are not well known. Cannabis consumption has been shown to cause arrhythmia including ventricular tachycardia, and potentially sudden death, and to increase the risk of myocardial infarction (MI).
What are the negative side effects of hemp oil?
Though it’s often well-tolerated, CBD can cause side effects, such as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. CBD can also interact with other medications you’re taking, such as blood thinners. Another cause for concern is the unreliability of the purity and dosage of CBD in products.
Is hemp oil the same as CBD oil?
Hemp seed oil and CBD oil both derive from the cannabis plant. CBD oil comes from the flowers, leaves, and stems, while hemp seed oil uses extract from the seeds of the cannabis plant. Products containing hemp seed and CBD oils do not typically cause a high, since the levels of THC, if any, tend to be very low.
Does Hemp oil make you tired?
CBD does not have intoxicating properties like THC, so it won’t cause any negative effects like excessive sedation, drowsiness or feelings of fatigue.
Can CBD lower cholesterol?
CBD has been shown to improve cholesterol through its ability to regulate lipid uptake and blood pressure.
IMPORTANT: Your question: How long does hemp seed oil stay in your system?
Can you take CBD oil with cholesterol meds?
CBD-Statins Interactions
With long-term use, this could mean a risk to a patient’s health including more adverse side effects. While there is no conclusive evidence that combining CBD with statins is harmful, the aforementioned information suggests that it poses a possible health risk.
How long does it take for CBD oil to work for joint pain?
Effects may be felt within 15 to 45 minutes.
What medications does CBD interfere with?
CBD can alter the effects of other drugs
• a common blood thinner, warfarin.
• a heart rhythm medication, amiodarone.
• a thyroid medication, levothyroxine.
• several medications for seizure, including clobazam, lamotrigine, and valproate.
11.01.2021
What strain is good for high blood pressure?
Hypertension
• Hybrid. THC 27% Royal Wedding. aka Royal Wedding Cake. …
• Hybrid. THC 19% Orange Kush Breath. 4.2(11) …
• Hybrid. Terpwin Station. 4.2(13) hungry.
• Hybrid. Secret Recipe. 4.3(55) giggly.
• Indica. Gorilla OG. 4.7(3) …
• Sativa. Mountain Thunder. energetic.
• Hybrid. Copper Chem. talkative.
• Hybrid. Cherry Vanilla Cookies. 4.8(8)
How do you lower high blood pressure quickly?
Here are 17 effective ways to lower your blood pressure levels:
1. Increase activity and exercise more. …
2. Lose weight if you’re overweight. …
3. Cut back on sugar and refined carbohydrates. …
4. Eat more potassium and less sodium. …
5. Eat less processed food. …
6. Stop smoking. …
7. Reduce excess stress. …
8. Try meditation or yoga.
Run to meet life
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Can a Dental Splint or Mouthguard Really Help with TMJ Pain?
Can a Dental Splint or Mouthguard Really Help with TMJ Pain?
added on: March 31, 2024
Temporomandibular Joint Disorder (TMJ) is a condition that affects the jaw joint and the muscles surrounding it, leading to symptoms like pain, stiffness, headaches, and difficulty in jaw movement. Many individuals suffering from TMJ pain seek effective solutions to alleviate their discomfort, oftentimes without success. However, dental splints and mouthguards have gained popularity as potential treatments for TMJ pain and jaw discomfort, and may just be the right solution for you.
Understanding TMJ Pain
Before delving into the potential benefits of dental splints and mouthguards, it’s crucial to comprehend the nature of TMJ pain. The temporomandibular joint – or the TMJ – acts as a hinge connecting the jaw to the temporal bones of the skull. When this joint becomes misaligned or experiences excessive stress, it can result in TMJ pain. Common symptoms include jaw pain, difficulty chewing, clicking or popping sounds, and even headaches.
Are Dental Splints a Viable Solution for TMJ?
Dental splints for TMJ pain, also known as splint therapy or occlusal splints, are custom-made devices designed to fit over the teeth. They aim to stabilize the jaw joint and prevent excessive clenching or grinding, which are often associated with TMJ pain. These splints are typically worn during sleep, allowing the jaw muscles to relax and reducing strain on the temporomandibular joint.
In fact, research suggests that dental splints can be effective in managing TMJ pain by promoting proper jaw alignment and reducing the impact of habits like teeth grinding. However, the success of splint therapy varies among individuals, and it may not be a one-size-fits-all solution. It’s essential for individuals experiencing TMJ pain to consult with a dentist for a comprehensive assessment and personalized plan for TMJ treatment in Springfield.
Mouthguards for TMJ Pain Relief
Mouthguards, commonly associated with athletes for protecting teeth during sports activities, can also play a role in managing TMJ pain. These devices are worn over the teeth to prevent grinding and clenching. By creating a barrier between the upper and lower teeth, mouthguards help reduce the strain on the jaw joint and alleviate TMJ-related symptoms such as jaw pain or headaches.
TMJ Treatment
While dental splints and mouthguards can offer relief for some individuals, it’s crucial to recognize that they are just one component of a comprehensive TMJ treatment plan. Seeking professional guidance from a dentist experienced in TMJ disorders is essential for accurate diagnosis and personalized care.
If you’re looking for jaw pain or headache treatment in Springfield, you may just want to call your dentist, especially if nothing else has worked. Dental splints and mouthguards can be valuable tools in managing TMJ pain, but they are most effective when integrated into a comprehensive treatment plan. Always be open to talking with your dentist about any and all of your bodily symptoms, whether or not you think they’re related to dentistry. After all, they just may have the solution you’re looking for.
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Tips for faster recovery from sprained ankle
Sprained ankle prevention, sprained ankle prevention tips, sprained ankle causes, sprained ankle
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Picture this: Your school football team has made it to the finales. You have to play in the big game tomorrow but you accidentally fall and sprain your ankle. Now before you stress out in such a situation, let us tell you some expert-approved ways on how to heal a sprained ankle as soon as possible.
A sprained ankle is a common occurrence among athletes and people who routinely exercise. It is also considerably easy to prevent common foot and ankle injuries
In this article, Dr Anuj Chawla, best foot and ankle specialist in Gurgaon discusses some top tips for the prevention of ankle injuries and how to manage them.
What is a sprained ankle?
A sprained ankle happens when you hurt the ligaments in your ankles. Ligaments are flexible tissues that hold two adjacent bones together. You can sprain your ankle when you are rolling or twist it by mistake.
Common symptoms of a sprained ankle include:
• Swelling and bruising of the ankle
• Limited range of motion
• Pain and Instability
• Tender ankle
• Popping sound at the time of injury
How to heal a sprained ankle?
Athletes would understand how recurring sprained ankles are. However, this injury can also be healed comfortably. The following remedies can be applied at home if a person suffers from an ankle sprain.
Tips on how to heal a sprained ankle-
1. R.I.C.E.
The R.I.C.E approach is very popular and beneficial for a swift recovery. It is a traditional tried and tested healing method. The acronym R.I.C.E. stands for – Rest, Ice, Compression and Elevation, respectively.
Rest: If you suffer from any injury at any body part, the primary step is to give proper rest to the affected area. You should not engage in any activity that could worsen the swelling or pain.
Ice: Applying ice to the sprain has also been proved favourable in most cases. You should place an ice pack to the ankle to reduce swelling and pain. If an ice pack is not available, you can simply wrap some ice cubes around in a towel and use it.
Compression: Doctors recommend compressing the sprained ankle by using an elastic or crepe bandage. This helps in reducing the swelling and alleviates pain. It is also helpful in maintaining joint stability. While the bandage should be wrapped around firmly, you should not bind it too tight. If the bandage is excessively tight, it can obstruct blood circulation and cause numbness.
Elevation: The last step of the R.I.C.E. is to elevate the sprained ankle. Elevating the ankle helps to avoid the buildup of fluid in the joints. It is suggested that you should support the ankle by placing a pillow under it while sleeping. You should keep the ankle at an elevated level from the heart to help reduce swelling.
2. Protection
In severe ankle sprains which limit the ability of the person to walk, some form of protection is helpful to prevent worsening of the injury. Protection and immobilization can be in the form of a cast, pneumatic walker boots or ankle brace. In fact, the acronym for healing acute ankle sprain has been changed by many from RICE to PRICE so as to include protection.
3. Medicines
Non Steroidal Anti Inflammatory Drugs (NSAIDS) like ibuprofen and Voveran (diclofenac) have been proven to be of significant benefit in early healing These medicines work by reducing the pain and swelling and hence hastening the recovery.
4. Physical therapy
Exercises and rehabilitation play a paramount role in preventing stiffness, early recovery and prevention of recurrence in future. Physical therapy after an ankle sprain should be started after a brief period of rest of 5-7 days or after the plaster is removed. The rehabilitation for acute ankle sprain can be divided into 3 phases:
1. Stretching and mobilization- Gentle mobilisation of the ankle and stretching of calf muscles is started first to combat the stiffness, promote blood circulation, reduce the swelling and hence boost the process of healing.
2. Strengthening– Once the movement of the ankle is restored close to normal, strengthening of the muscles around the ankle needs to be initiated. Strengthening primarily focuses on muscles on the outer side and the front of the ankle, namely evertors and dorsiflexors respectively but it has to be done all around the ankle
3. Proprioception training- The most neglected yet the most important part of rehabilitation after an ankle sprain is prevention of recurrence. Proprioception or balance training plays an important role in this. It helps in improving the coordination between the brain and ankle without involving the eyes. Simple exercises like single leg stance with eyes open and closed can be started to improve balance training as soon as one recovers from ankle sprain.
5. Massage
You can also go to a verified healthcare provider and choose for lightweight massage. You may also do a gentle massage at home yourself.
Sprained ankle prevention tips
Besides effective management, ankle sprains can also be prevented. Since such injuries are frequent events in sports. Athletes need to learn about the prevention of ankle injuries.
Here are some useful tips to prevent foot and ankle injuries:
1. Warm-up before any sports activity – Whether you are about to participate in a marathon or hit the gym, you should always do warm up in advance. Light stretching, jogging and more are considered good warm-ups to prepare the body for a workout.
2. Wear proper footwear – The idea of playing football in heels is most bizarre. There is a variety of footwear made for their specific purposes. While playing a sport, you should wear shoes specifically designed for sports. These shoes have the right arch support that helps to prevent foot and ankle injury.
3. Replace old shoes – Even if you have the right footwear, it is important to ensure that they constantly offer the right arch support. If your sports shoes have worn out, you should replace them for the prevention of ankle injuries.
4. Avoid uneven surfaces – Everyone likes an adventure but none likes a sprained ankle. If your physical activity involves running, jumping or walking, you should avoid going to uneven surfaces. Flat surfaces help you play better and avoid injuries. Even in outdoor sports such as hiking, while you cannot completely avoid rocks and steps, you should watch out for the ones that may pose danger.
5. Do ankle exercises – Particular exercises can help to prevent foot and ankle injuries. You should include these exercises in your regular workout schedule. Some of the common exercises for ankle include:
• Ankle circle: You simply have to sit on a flat surface with your legs outstretched and move your ankles in a circular motion.
• Heel raises: This exercise requires you to stand against a wall or another support. You are required to keep your legs a few inches apart. Slowly lift your heels and stand on your toes. Hold that position for a few seconds and repeat.
6. Prevent recurrent injuries – If you have suffered from a sprained ankle earlier, your chances of hurting your ankle, again, increases. To avoid ankle sprains, you can use a tape at the sight of the previous injury or wear an ankle brace during the sporting event.
7. Choose physical therapy – A certified physical therapist would be able to help with your ankle sprain and recovery. You can choose to go for physical therapy if you have suffered from a seriously sprained ankle that may affect your physical ability or strength.
When to consult a doctor in case of a sprained ankle?
If your pain does not alleviate after implementing these tips, you should instantly seek medical support. You should consult your healthcare provider if:
• Your pain is worsening
• You are unable to walk at all
• Your swelling does not reduce
The concluding note
A sprained ankle usually heals on its own without clinical intervention. The above-given tips can help you to encourage the healing process for a quicker recovery.
To learn more about muscle and joint injuries, consult Dr Anuj Chawla, best foot and ankle specialist at the CK Birla Hospital.
Also, read: 4 Types of foot pain one should not ignore
Do you have a question?
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R allergy immunotherapy 9 3
06.01.2020| Mandi Mayers| 2 comments
r allergy immunotherapy 9 3
An exciting announcement from MDedge. Click here for more information. Pollart Dellyse. Bright atriumhealth. The evidence-based answers to these and other questions will help you to update your knowledge of allergy immunotherapy. A Good-quality patient-oriented evidence Aloergy Inconsistent or limited-quality patient-oriented evidence C Consensus, usual practice, opinion, disease-oriented evidence, case series.
• PRACTICE RECOMMENDATIONS
• Allergy and immunotherapy. - Free Online Library
• Allergy immunotherapy: Who, what, when … and how safe? | MDedge Family Medicine
• References
• Allergen immunotherapy - Wikipedia
• Immunotherapy for mosquito allergy
• Redness, swelling, or irritation right around the site of the injection is normal. These symptoms should go away in 4 to 8 hours.
PRACTICE RECOMMENDATIONS
A lot depends on how many things you're allergic to and how severe your symptoms are. Generally, allergy shots work for allergies to ommunotherapy stingspollendust mitesmold, and pet dander. Get on the phone and go to the nearest emergency room if you have shortness of breath, a tight throat, or any other symptoms that worry you after getting your shot.
EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. (9)Allergy and Clinical Immunology, National Heart and Lung Institute, Imperial College London, London, UK. (10)Section of Allergology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The lrpd.lion-wolf.ru by: 3. Golden, David BK, et al. "Venom immunotherapy reduces large local reactions to insect stings." Journal of Allergy and Clinical Immunology (): 4. Ariano, R., and R. C. Panzani. "Efficacy and safety of specific immunotherapy to mosquito bites." European annals of allergy and clinical immunology (): 5. Apr 01, · Free Online Library: Allergy and immunotherapy.(Report) by "Townsend Letter"; Health, general Allergic reaction Care and treatment Immunoglobulin E Immunoglobulins Health aspects Immunotherapy Methods.
There is another type of immunotherapy: three under-the- tongue tablets that you can take at home. Called Grastek, Oralair, and Ragwitek, they treat hay fever and boost your tolerance of allergy triggers.
Allergy and immunotherapy. - Free Online Library
During the first part of the treatment, you get doses of the allergen every day instead of every few days. Your doctor will check on you closely, in case you have a bad reaction. In some cases, you may get medicine before you get the dose of the allergen, to help prevent a reaction. They may be more risky for people with heart or lung diseaseor who take certain medications.
Allergy immunotherapy: Who, what, when … and how safe? | MDedge Family Medicine
Tell your allergist about your health and any medicines you take, so you can decide if allergy shots are right for you. Meta-analyses have found that injections of allergens under the skin are effective in the treatment in allergic rhinitis in children [3] allergyy and in asthma.
Side effects during sublingual immunotherapy treatment are usually local immunogherapy mild and can often be eliminated allergy adjusting the dosage. Potential side effects related to subcutaneous immunotherapy treatment for asthma and allergic rhinoconjunctivitis include mild or moderate skin or respiratory reactions.
Discovered by Leonard Noon and John Freeman inallergen immunotherapy is the only medicine known to tackle not only the symptoms but also the immunoyherapy of respiratory allergies.
Subcutaneous immunotherapy, also known as allergy shots, is the historical route of administration and consists of injections of allergen extract, which must be performed immunotherapy a medical professional.
References
Subcutaneous immunotherapy protocols generally involve weekly injections during a build-up phase, followed by monthly a maintenance phase that consists of injections for a period of 3—5 years.
The length of the build-up phase is dependent upon how often injections are administered, but normally ranges from three to six months. Sublingual immunotherapy involves putting drops or a tablet of allergen extracts under the tongue, which are then absorbed through the lining of the mouth. Sublingual immunotherapy has been demonstrated to be effective against rhinoconjuctivitis and asthma symptoms. Sublingual immunotherapy is used to treat allergic rhinitis, often from seasonal allergies, and is typically given in several doses over a 12 week period.
While a number of side effects have been associated with sublingual immunotherapy, serious adverse effects are very rare about 1. Oral immunotherapy OIT involves feeding an allergic individual increasing amounts of a food allergen in order to raise the threshold which triggers a reaction.
In desensitization immunotherapy the aim is to induce or restore tolerance to the allergen by reducing its tendency to induce IgE production. People are desensitized through the administration allergy escalating doses of allergen that gradually decreases the IgE-dominated response. Immunotherapy immunotherapy also creates an increase in allergen-specific IgG4 antibodies and a decrease in allergen-specific IgE antibodies, as well as diminished mast cells and basophilstwo cell types that are large contributors to allergic reaction.
Reactivity is tested using oral food challenges or with skin prick tests. However, phase 3 can be done at home.
Allergen immunotherapy - Wikipedia
In the late 19th century and early 20th century, allergic conditions were immuontherapy attracting both medical attention as an emerging public health problem and immunoyherapy interest aided by progress in biochemical techniques and the immnuotherapy of molecular and pathogenic theories.
However, the many and varied treatment approaches were very unscientific. The British physicians Noon and Freeman were the first researchers to test pollen allergen immunotherapy in humans. After the groundbreaking work by Noon and Freeman in the UK and by Cooke and colleagues in the US, allergen immunotherapy was part of mainstream medical practice for hay fever treatment immunotherapy the s.
Later, sublingual formulations were found to be effective in symptom reduction in allergic rhinitis. Sublingual immunotherapy is also found to have a better safety profile than subcutaneous immunotherapy since the local side effects caused by sublingual immunotherapy contrasted with the possible systemic events that can occur with the subcutaneous immunotherapy.
Sublingual a,lergy drops are currently commercialized and used in most European and South American countries, and in Australia and Asian countries. In most European countries, national regulations allegy marketing of allergen products allervy "named patient preparations" NPPs.
In the United States, drop formulations have not yet received FDA approval, though off-label prescription is becoming common. The use of subcutaneous immunotherapy for treatment of environmental-based allergies and asthma is well supported by the majority of national and international allergy groups such as allergy World Allergy OrganizationCanadian Society of Allergy and Immunology, European Academy of Allergy and Clinical Immunologyand the American Academy of Allergy, Asthma and Immunology.
The cost for allergen immunotherapy varies by country and administration route. There is no clear and holistic transparency across therapy forms. As of [update]oral immunotherapy's balance of risk to benefit for food allergies was not well studied. Studies involving OIT have shown desensitization towards the allergen.
However, there are still questions about longevity of tolerance after the study has ended.
r allergy immunotherapy 9 3
One approach being studied is in altering the protein structure of the allergen to decrease alleergy response but still induce tolerance. Extensive heating of some foods can change the conformation of epitopes recognized by IgE antibodies.
Immunotherapy for mosquito allergy
In fact, studies show that regular consumption of heated food allergens can speed up allergy resolution. In one study, subjects allergic to milk were 16x more likely to develop complete milk tolerance compared to complete milk avoidance. Another approach regarding changes in protein is to change specific amino acids in the protein to decrease recognition of the allergen by immunothwrapy antibodies.
Allergy Shots (Immunotherapy): Effectiveness, Side-Effects & Risks
Another approach to improving oral immunotherapy is to change the immune environment to prevent T H 2 cells from responding to the allergens during treatment. For example, drugs that inhibit IgE-mediated signaling pathways can be used in addition to OIT to reduce immune response.
2 thoughts on “R allergy immunotherapy 9 3”
1. Rudolph Ruder:
I saw one reference in the European literature from but none since. I have attached some of the questions in the archives of Ask The Expert related to mosquito allergy. In general, the quality of the materials for testing and treatment are not standardized nor consistent making the efficacy for immunotherapy unpredictable.
2. Fritz Frisk:
Allergy shots help your body get used to allergens, the things that trigger an allergic reaction. During that time, your allergy symptoms will get better and may even go away.
Add a comments
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Cognitive Behavioral Therapy
Cognitive Behavioral Therapy
If you have had therapy before, you likely have at least heard the term cognitive behavioural therapy. It is a form of therapy that treats the thoughts and evaluations that you have about yourself and the world around you. Cognitive behavioural therapy (CBT) is a very effective and useful form of therapy that can help you through many emotional and drug and alcohol addiction issues, so let’s take a look at it further, and you can see how CBT can help you.
How Does Cognitive Behavioral Therapy Work?
Cognitive Behavioral Therapy begins with the assumption that your thoughts control how you see the world, and how you feel about it. This form of therapy theorises that you learned, growing up, certain truths about the world, and internalised them as central beliefs about how things should be and how things are. Let’s look at an example to help understand this.
Imagine that you are sitting in your favourite coffee shop one afternoon, just sitting there reading a book. Without any warning, a stranger dumps a cup of coffee on your lap. You jump up and take care of yourself first, that’s just instinct. What happens next, however, is all based on those internal beliefs about life. Take a moment and ask yourself what you would feel and do? Would you be mad, and start yelling? Are you scared and looking for help? Or how about laughing at the absurdity of it all, maybe because it’s been such a hard day and this was just the final piece to an awful day that its ridiculous. Or perhaps any of a million other possible emotional combinations and reactions?
Thinking it through you can see that there are thousands of possible reactions that you could have, but what determines what you think and feel? Those internal beliefs and thoughts that happen so fast in your mind that you will not notice them without paying careful attention to what is going on inside your mind. That evaluation or thought will happen and colour how you see things and help you evaluate the situation. Following our example above, if you thought that people are threatening and the world is a dangerous place, you would probably be scared of the person who dumped coffee on you and look for help. If you had a belief structure that said that the only way to get what you want in life is to fight, you might jump up and punch the person without any question.
Cognitive behavioural therapy aims to identify and help you change those thoughts. It is a very focused and directed form of therapy which is used in alcohol rehabs that allows the therapist to work more and structure the sessions around your specific needs. Also, it is generally done as a brief form of therapy, with many lasting just 12-15 sessions, depending on individual need. Being short term, it is very focused, and will be centred on the present; very little time will be spent learning about how you grew up. Cognitive Behavioral Therapy centred treatment is about helping who you are now and helping you figure out what is helpful and healthy, and what you need to change. It is very useful in treating drug and alcohol addiction, anxiety and depression, with decades of research supporting its use as a treatment method for these conditions.
Additionally, dialectical behaviour therapy, a specialised form of Cognitive Behavioral Therapy, is evidence-based psychotherapy that uses traditional elements of CBT in partnership with other targeted approaches to treat addiction. Dialectical behaviour therapy teaches mindfulness, acceptance and distress tolerance, all skills which can be vastly beneficial during drug and alcohol recovery.
Cognitive Behavioral Therapy
One of the first things to accomplish in Cognitive Behavioral Therapy is to identify what your beliefs are about yourself and the world around you. The assessment is where the addiction therapist in the rehab will work with you to help you identify what your thoughts and beliefs are. While this sounds easy, you just talk about what you are thinking, but remember, these thoughts, these evaluations happen in a nanosecond, and you are not conscious of them. It takes time to identify what they are.
Cognitive Behavioral Therapy and Addiction Treatment
Many rehabilitation facilities incorporate CBT into an addiction treatment program. Using reframing and restructuring techniques, the addiction therapist will give you tools and activities to help first combat the unhelpful thoughts. It is a process, but changing your thoughts can be done. It involves slowing yourself down and evaluating each situation as it comes up. In other words, you act, you don’t react. The addiction therapist will teach you that by slowing down and asking yourself questions about the person, yourself, or the situation, you can often find other possible explanations, that are more in tune with reality, than the assumptions you typically make.
Cognitive Behavioral Therapy in rehab helps patients overcome drug addiction and alcoholism by:
• Helping to dismiss false beliefs and insecurities that lead to substance abuse
• Providing self-help tools to better their moods
• Teaching effective communication skills
Coping skills are another important aspect of Cognitive Behavioral Therapy. What is known about certain diseases like drug and alcohol addiction or depression, is that there are certain symptoms that just happen. They are biological in nature, and often are temporary, but require some help to get through them. That is where CBT comes in. CBT will teach you ways to cope and manage any types of distress that may happen to you. While it will be specific to you, there will be some general tips and helpful habits that they can give you so that you can start to live a healthier life overall.
Practice is also going to be a very vital part of Cognitive Behavioral Therapy as well. You can expect to have homework between sessions, as well as taking time during sessions to practice and review what you have done the past week. Change is never easy, and this kind of change takes time, effort, and most importantly, practice. Homework will be specific to you and the skills you are trying to learn. It will be practising, for example, how to come up with other possible reasons for why the person dumped coffee on your lap. Could it be an accident? Did this person think you were someone else? Were they having a seizure? It could be anything and slowing yourself down will let you see the reality of the situation and act appropriately.
Every person living under the weight of drug and alcohol addiction has unique circumstances which brought them there. Identifying and treating personal issues that prompt drug or alcohol abuse helps to reduce triggers and self-destructive behaviours.
Cognitive behavioural therapy in rehab is an amazing tool to use to learn more about yourself and why you react the way you do, and then learn to actually evaluate what you are doing to see if it fits with reality. It is well researched and can be used to treat a variety of diseases, including drug and alcohol addiction. CBT can give you back a meaningful and healthy life. Help and healing are out there for you with this.
If you know that you or a loved one is plagued with negative thoughts that fuel addictive tendencies, then CBT is a great option. However, the process of achieving freedom begins with contacting an expert to help point you in the right direction. You do not have to seek treatment alone or find a rehabilitation facility on your own. Contact us today to find a rehabilitation center near you. We can give you the key to unlock the door to a new path to life. Recovery is only a decision away.
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While eating carbohydrates early in the day provides us with the energy needed to power through training sessions and complete our daily tasks, and the evening meal containing them helps us to replace lost glycogen from our final workout for the day, consuming carbohydrates after 6:00pm (or around this period) will only lead to an unnecessary output of insulin, an anabolic hormone responsible for, among other functions, increasing fat storage.
A new German study found that when you drink 17 ounces of water (about two glasses) within a certain time frame, your metabolic rate shoots up by about 30 percent. Using these results, they estimate that by increasing your current water intake by 1.5 liters a day, a person would burn an extra 17,400 calories a year, resulting in about a five-pound weight loss.
Calories play a vital role in how much weight you will be able to lose in 10 days. Calories are the fuel for your body and to lose weight, you have to eat fewer calories than you burn off through daily activity and exercise. According to ProHealth, one pound of fat is equal to 3,500 calories. This means you will need to reduce your diet by 500 or so calories a day to shed a single pound in a week. This means you can lose about one to three pounds in 10 days.
Thе mоѕt important part іѕ tо cut bасk on sugars and starches (carbs). Thеѕе аrе thе foods thаt stimulate secretion оf insulin thе most. If уоu didn’t knоw already, insulinіѕ thе main fat storage hormone іn thе body. Whеn insulin gоеѕ down, fat hаѕ аn easier time gеttіng оut оf thе fat stores аnd thе body starts burning fats іnѕtеаd оf carbs. Anоthеr benefit of lowering insulin is thаt уоur kidneys ѕhеd excess sodium аnd water оut оf уоur body, whісh reduces bloat аnd unnecessary water weight . It іѕ nоt uncommon tо lose up tо 10 pounds (sometimes more) іn thе fіrѕt week оf eating thіѕ way, bоth body fat аnd water weight. Thіѕ іѕ а graph frоm а study comparing low-carb аnd low-fat diets іn overweight/obese women. Thе low-carb group іѕ eating untіl fullness, whіlе thе low-fat group is calorie restricted аnd hungry. Cut thе carbs, lоwеr уоur insulin аnd уоu wіll start tо eat lеѕѕ calories automatically аnd wіthоut hunger . Put simply, lowering уоur insulin puts fat loss оn “autopilot.”
COMMENTSThe opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.
To cut calories and lose weight, you have to eat right. That means no empty calories from unhealthy foods, including chips, cakes and cookies. Skip foods that contain simple carbohydrates and eliminate soda altogether. By drinking water and avoiding breads, you may reduce your caloric intake enough to lose weight. If not, opt for vegetable dishes over meat-based ones and choose non-fat dairy when you can.
Instead of subjecting yourself to another endless workout, crank up the intensity and you’ll see results faster than you ever thought possible. The results of a study conducted at McMaster University in Ontario reveal that adult male study subjects who exercised intensely for a single minute had equivalent respiratory and metabolic changes to those who worked out at a slower pace for close to an hour, so if you want to burn through that belly fat, say so long to slow and steady.
“Research has shown that [drinking caffeine] before exercise can enhance athletic performance,” Jim White, RD, ACSM, dietitian, personal trainer, and owner of Jim White Fitness & Nutrition Studios tells us in What to Drink Before a Workout for Optimal Fat Loss. Plus, a study published in the journal Sports Medicine reveals that the natural energy source can help you train stronger for longer in workouts ranging from 60 seconds to even two hours. Just remember to skip the added sugar and creamer in your coffee to avoid packing pounds onto your frame.
If you’re looking to get lean, working out before you sit down to sunny-side-up eggs and toast may be your best bet. A study in the British Journal of Nutrition found that doing cardio on an empty stomach results in significantly higher fat oxidation, or fat loss, than exercise performed after you’ve eaten. Try hitting the elliptical or Stairmaster before breakfast, and make sure to bring a small snack with you to the gym to keep your blood sugar in check. To follow up your workout, check out these 16 Post-Workout Snacks Fitness Experts Swear By.
Speaking of intervals, high-intensity interval training (otherwise known as HIIT) has been shown to be incredibly effective for weight loss. Because the workouts are so intense, you don't need to put in an hour — or even 30 minutes — at the gym. According to the American College of Sports Medicine, seven minutes is all you need to get in the best shape of your life.
Steak with avocado, anyone? Whether you're on the keto diet or not, you may wanna try this super easy dinner! 🥩 🥑⠀ ⠀ Follow these👇 directions:⠀ ⠀ 1. Rub half of the oil and seasoning of your choice onto the beef. Heat a pan to medium and cook for 2-3 mins on each side or until done to your liking. Let the beef rest for a few minutes before slicing.⠀ 2. In the meantime, wash and dry the arugula, wash and slice the tomato, and peel and slice avocado. Assemble on a plate.⠀ 3. Drizzle remaining oil and vinegar on the salad and serve steak on top.
It has to do with your hormones leptin and ghrelin.[4] Your levels get all sort of messed up and it leads to them telling your body you're hungry when you're really just tired. And to top it off, when you're sleepy, you load up on sugar, grab take out for dinner because you're tired, and skip the gym for the same reason. That's three strikes right there.
That’s because it theoretically causes a mild ketosis (yep, the basis of the keto diet), which is a fat-burning state that should make you feel less hungry. The key in being successful with a low-carb diet (especially if you’re used to a more high-carb lifestyle) is to compensate for those lost carbs with protein-rich foods, says Dr. Cheskin. That way, your volume of food stays the same, but you’re doing it healthfully rather than in a way that exacerbates your weight gain.
2. When sitting down to a meal, it should be made up of at last half vegetables(lunch and dinner, usually more fruit at breakfast time). Eat the vegetables first along with the lean protein and THEN eat the carbohydrate portion of the meal, but only if you’re still hungry. If you’re not still hungry, then don’t eat it. The starch/carbohydrate usually contains more calories than the other components in the meal, so saving it till last helps to cut unnecessary calories as most people are not still hungry by the time they finish everything else.
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5,011,628,341,612,041,000
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Immune thrombocytopenia (ITP)
Diagnosis
Your doctor will attempt to rule out other potential causes of bleeding and a low platelet count, such as an underlying illness or medications that you or your child may be taking, prior to the immune thrombocytopenia diagnosis.
The amounts of platelets can be determined via blood testing. Adults may infrequently require a bone marrow examination to rule out other issues.
Treatment
Mild immune thrombocytopenia patients might only require routine monitoring and platelet tests. Children typically get better on their own. Most individuals with ITP will require therapy at some point, as the condition frequently gets worse or is chronic.
Numerous methods of treatment are possible, such as taking drugs to increase your platelet count or having your spleen removed (splenectomy). Discuss the advantages and disadvantages of your treatment options with your doctor.
Medications
Your doctor will ask you about any over-the-counter drugs or dietary supplements you currently use to see whether you should stop using any that could impair platelet function. Aspirin, ibuprofen, and ginkgo biloba are some examples.
ITP medications include the following:
• Steroids. You’ll probably begin taking an oral corticosteroid like prednisone at the advice of your doctor. In accordance with your doctor’s instructions, you can gradually stop taking the medication after your platelet count has returned to a normal range. Because these drugs can raise your risk of infections, high blood sugar, and osteoporosis, prolonged use of them is not advised.
• Immune globulin. Your doctor might give you an injection of immune globulin if corticosteroids are ineffective. If you have serious bleeding or need to fast boost your blood count before surgery, this medication may also be utilized. Usually, the effect subsides after a few weeks.
• Medications that induce platelet production. Eltrombopag and romiplostim, two medications, assist your bone marrow in producing more platelets. These medications can make you more likely to develop blood clots.
• Other medications. By lowering the immune response that is destroying your platelets, rituximab helps you to have a higher platelet count. However, if you later decide to have surgery to remove your spleen, this medication may also lessen the effectiveness of any necessary immunizations.
Surgery
Your doctor may recommend to surgically remove the spleen due to the severity of the condition. Though it doesn’t work for everyone, this fast gets rid of your body’s primary cause of platelet destruction and raises your platelet count. Your vulnerability to infection is increased by living without a spleen.
Emergency treatment
ITP can occasionally cause serious bleeding, but this is unusual. Typically, platelet concentrate infusions are part of emergency care. Through a tube in a vein, steroids and immune globulin may also be administered.
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1a01aa77535b9ecfb87b9fc36adbcd2f
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1,745,303,794,446,299,600
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RxPharmacist
Common Checkpoint Inhibitors and Their Role in Cancer
Image: Unsplash.com
Background
Multiple medications have been discovered to target cell surface receptors. These are programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1). These receptors are specifically selected because they are important targets for cancer therapy. There are some similarities between these receptors, but there are differences to note. For example, the PD-1 receptor is expressed on T cells, B cells, monocytes, dendritic cells, natural killer T cells, and regulatory T cells. On the other hand, PD-L1 is expressed on T cells, B cells, dendritic cells, macrophages, bone marrow-derived mast cells, and a few non-immune cells.
T-cell exhaustion is commonly characterized by the presence of PD-1. PD-1 expression is found in cancers such as tumor infiltrating lymphocytes. PD-L1 is commonly overexpressed in many different types of tumors, such as tumor-associated macrophages.
To understand how PD-1 and PD-L1 work in the human body, it is best to look at each medication’s mechanism of action. The similarities between PD-1 and (PD-L1) medications are that they are monoclonal antibodies, (MAB) and are all available in an injection dosage form. The doses utilized are specific to the indication that the medication is being used for. Here, we will go into specifics to provide an overview of these medications that target cancer cells.
Medications
Nivolumab is a human IgG4 MAB and was approved by the FDA in 2014. This medication binds to the PD-1 and stops the PD-L1 and programmed death ligand-2 (PD-L2) from interacting with each other, which ultimately allows the PD-1 pathway inhibition to occur. Nivolumab is commonly indicated for:
• Melanoma
• Non-small cell lung cancer (NSCLC)
• Malignant pleural mesothelioma
• Renal cell carcinoma (RCC), hepatocellular carcinoma (HCC), and urothelial carcinoma
• Classical Hodgkin lymphoma (cHL)
• Squamous cell carcinoma of the head and neck (SCCHN)
• Esophageal, gastric, colorectal, and gastroesophageal junction cancer
• Esophageal adenocarcinoma
Nivolumab’s dose strengths are 40 mg/4 mL, 100 mg/10 mL, 120 mg/12 mL, and 240 mg/24 mL solution in a single-dose vial. The common dosages of this medication are 240 mg every two weeks and 480 mg every four weeks. It is important to be aware of the immune-mediated adverse reactions, infusion-related reactions, complications of allogeneic HSCT, and embryo-fetal toxicity associated with this medication. Multiple adverse reactions can occur such as fatigue, rash, musculoskeletal pain, nausea, vomiting, etc. Also, if it is being used with another agent, there are other adverse reactions to consider compared to when it’s being used as a single agent.
Pembrolizumab (approved by the FDA in 2014) is a human IgG4 kappa that targets the PD-1 receptor which is why it has a similar mechanism of action to nivolumab, as well as a similar adverse reaction profile. Pembrolizumab and nivolumab differ in their indications. Some pembrolizumab indications are:
• Melanoma
• NSCLC and (cHL)
• HCC, RCC, Merkel cell, cutaneous squamous cell, urothelial, and endometrial carcinoma
• Esophageal and gastric cancer
• Primary mediastinal large B-cell lymphoma (PMBCL)
• Head and neck squamous cell cancer (HNSCC)
• Microsatellite instability-high or mismatch repair deficient and colorectal cancer
• Cervical, tumor mutational burden-high (TMB-H), and triple-negative breast cancer
Typical doses in practice are 200 mg every 3 weeks or 400 mg every 6 weeks. The strengths of this medication offered are also 100 mg/4 mL (25 mg/mL) solution in a single-dose vial. The adverse effects profile is similar to nivolumab.
Atezolizumab was granted FDA approval in 2014 and is phage-derived human IgG1 MAB that blocks PDL1. This medication works by blocking the interaction between PD-1 and B7.1, but it doesn’t induce antibody-dependent cytotoxicity. Some of its indications are:
• Urothelial carcinoma
• NSCLC, SCLC, and HCC
• Melanoma
Some of the dosage forms available are 840 mg/14 mL (60 mg/mL) and 1200 mg/20 mL (60 mg/mL) solution in a single-dose vial. Routinely, doses of 840 mg every 2 weeks, 1200 mg every 3 weeks, or 1680 mg every 4 weeks are utilized in practice. It is important to be aware of the immune-mediated adverse reactions, infusion-related reactions, complications of allogeneic HSCT, and embryo-fetal toxicity which is similar to PD-1 precautions. The common adverse effects seen are fatigue, decreased appetite, nausea, and cough.
Avelumab is IgG1 human MAB anti-PD-L1. This medication was FDA approved in 2016, and is indicated for:
• Merkel cell carcinoma (MCC)
• Urothelial carcinoma (UC)
• RCC
This medication does warrant premedication and is used as needed thereafter. The common doses seen utilized are 800 mg every 2 weeks. The adverse effect profile is dependent on the indication that it is used for, but it is similar to what patients on atezolizumab experience. The common dosage form seen is 200 mg/10 mL (20 mg/mL) solution in single-dose vial.
Durvalumab is a human MAB that targets PD-L1 and was given FDA approval in 2017. Some of this medication’s indications are:
• Unresectable, Stage III NSCLC
• Extensive-stage small cell lung cancer (ES-SCLC)
• Locally advanced or metastatic biliary tract cancer (BTC)
Some of the injection dosage forms available are in a 500 mg/10 mL (50 mg/mL) and 120 mg/2.4 mL (50 mg/mL) solution in a single-dose vial. Commonly, patients receive either a weight-based dose that is dependent on their current weight, or a fixed dose of 1,500 mg every four weeks. The common adverse effects that patients experience are cough, fatigue, nausea, pneumonitis, and upper respiratory tract infections.
Table: PD-1 vs. PD-L1 Medications
Overall, when comparing PD-1 and PD-L1 medications, examining their different indications, dosage strengths, and side effect profiles can be useful in determining the right therapy for the right patient. The over-expression of PD-1 and PD-L1 in cancer cells is the reason why these receptors have been targeted in studies to identify new medication options for different cancer types. It is important to continue to stay up to date with the latest developments in literature because new and old medications are continuously being studied to find new indications and breakthrough therapies.
-Dagmara Zajac
RxPharmacist Team
References:
1. Tecentriq (atezolizumab) [prescribing information]. South San Francisco, CA: Genentech Inc; January 2022.
2. Bavencio (avelumab) [prescribing information]. Rockland, MA: EMD Serono Inc; July 2022.
3. Imfinzi (durvalumab) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; September 2022.
4. Opdivo (nivolumab) [prescribing information]. Princeton, NJ: Bristol-Myers Squibb Company; March 2022.
5. Keytruda (pembrolizumab) [prescribing information]. Whitehouse Station, NJ: Merck & Co Inc; March 2022.
6. Jiang Y, Chen M, Nie H, Yuan Y. PD-1 and PD-L1 in cancer immunotherapy: clinical implications and future considerations. Hum Vaccin Immunother. 2019;15(5):1111-1122. doi:10.1080/21645515.2019.1571892
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Uncontrolled Asthma in Children: Topic Search Strategy
Topic Search Strategy: Uncontrolled Asthma in Children
Clinical Question
A PICOT question in nursing aids on the formulation of a clinical question and thus guide the search for evidence. Notably, according to Bethany (2019), PICOT is an acronym for the population (P), intervention (I), comparison (C), outcome (O), and time (T). The members in my team were focused on the identification and evaluation of various pieces of evidence guided by the PICOT on the issue of children with hospital admissions for uncontrolled asthma. Notably, the problem of uncontrolled asthma is a profound one, especially for neonates as well as the other children and teens. According to the Centers for Disease Control and Prevention (CDC) (2019), pediatric asthma affects 4-12 percent of women, especially those in their childbearing years. Additionally, asthma in children and adolescents who are aged between 5 and 17 years is responsible for a total loss of 10 million school days each year (CDC, 2019). Moreover, the costs of caretakers for pediatric asthma is $726.1 million per year due to work absence (Engelkes et al., 2015). For children, asthma is not only detrimental to the health and wellbeing of children but can also lead to fatalities.
My PICOT question in support of the group topic is: in children and teens aged between 0-17 years (Population/patient) what is the impact of asthma education (Intervention) to expectant mothers compared to medications (Comparison) on the prevention of hospital admissions for uncontrolled asthma (Outcomes) over a one-year period (Time). As such, the purpose of the paper is to investigate the impact of asthma education and self-management strategies to the application of medications in the prevention of hospital admissions for uncontrolled asthma among neonates and teens. The comparison of the two interventions helps in the determination of the most effective one and hence lead to evidence nursing practice. Additionally, it will help in the discovery of new ways in which uncontrolled asthma can be managed, especially in children and teens.
Levels of Evidence
The level of evidence required for addressing the question enables a researcher to search for the most appropriate and quality evidence. The type of question I am asking is which intervention is more effective between the provision of asthma education and self-management interventions to the pregnant mothers and the provision of asthma medications to children in the prevention of hospital admissions arising from the condition. As such, I am seeking to compare the two therapies and determine which one should be used. The best type of evidence which can be used to answer the question is the randomized controlled trial (RCT). RCT falls under level 1 of the level of evidence (LOE), which provides studies of good quality (Dang & Dearholt, 2017). Notably, a RCT is a comparative, prospective experiment that is conducted under controlled conditions (Bhide, Shah, & Acharya, 2018). The allocation of the interventions is done in a random approach to the comparison groups. Additionally, a RCT is effective in evaluating the relationship between an intervention and outcome. A RCT is a quantitative design which we used will tell whether the use of education outweighs the adoption of pharmacological therapies in the prevention of hospital admissions from uncontrolled asthma in newborns and teens.
Search Strategy
The search for the different articles and resources which I used to respond to the clinical question was done in different databases via the use of key terms and phrases. In specific, I used search terms such as “education in the management of neonate asthma,” “self-management interventions for pediatric asthma,” “pharmacological interventions of asthma in newborns,” “effectiveness of education of expectant women in the prevention of asthma in newborns,” “education versus medications in the prevention of asthma in children and teens.” One of the key databases that I used is the Agency for Healthcare Research & Quality (AHRQ). In specific, the AHRQ database uses various quality indicators in the determination of the standards of quality healthcare and whether healthcare facilities meet those standards. Additionally, Google Scholar was used in exploring the numerous studies which have been published on the subject matter of preventing hospital admissions from uncontrolled asthma in children and teens. The AHRQ will provide the provider-level indicators which should be monitored to ensure that avoidable hospitalizations are prevented.
I made various decisions in refinement to get the required articles down to a reasonable number for review. One of those was the inclusion and exclusion criteria. In specific, the studies had to deploy randomized controlled trials. Additionally, they had to be published less than ten years ago. Furthermore, they had to be relevant to the clinical issue. Using such limits ensured that the articles were filtered with the most relevant and recently published ones being used. Using the limits ensured that the only articles which came up were those that were of high quality and could provide relevant information about the clinical issue. In my next paper and the group’s work, two articles will provide guidance. One of those is Rice et al. (2015)’s “LEAP: A randomized–controlled trial of a lay-educator inpatient asthma education program.” The other article is “Management based on exhaled nitric oxide levels adjusted for atopy reduces asthma exacerbations in children: a dual centre randomized controlled trial” by Petsky et al. (2015). The choice of these two articles is based on their ability to conduct RCTs in evaluating whether education and medications are effective in the prevention of unavoidable hospitalizations of newborns with uncontrolled asthma.
Conclusion
Evidence-based practice allows for the use of interventions which have been proven and found effective in addressing various conditions. My team focused on the identification of the interventions which could be used to prevent avoidable hospitalizations of children and teens with uncontrolled asthma. I conducted a literature search of research studies which addressed my clinical questions, which is on addressing uncontrolled asthma. The articles which could help in the clinical question were RCTs, which fall under the level I of evidence. Using such a level of evidence helped in getting quality and relevant articles. The search used key terms/phrases and was done on the AHRQ and Google Scholar databases. Two articles were chosen, which were relevant and those which provided appropriate information for the clinical issue. The proposed study will provide evidence-based practice interventions for the prevention of avoidable hospitalizations of neonates and teens with uncontrolled asthma.
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The Importance of Breathing Patterns in CFS (and Fibromyalgia) Symptoms & Recovery
by Blake Graham, BSc, AACNEM
www.nutritional-healing.com.au
September 1, 2009
I have heard about the supposed importance of breathing in chronic fatigue syndrome (ME/CFS) for many years, and never took it very seriously. Then I read an article in Alternative and Complementary Therapies journal titled “Clinical Roundup: How Do You Treat Chronic Fatigue Syndrome in Your Practice?” In the article, eight integrative/alternative medicine experts described how they treat ME/CFS.
While they come from a variety of different backgrounds, four of the eight mentioned the importance of breathing. This inspired me to look into the role of breathing in more detail. After studying this topic, I have become completely convinced that this is a very important issue.
The issues discussed here are all heavily interrelated. These relate to:
- The rate and depth of breathing,
- Dysfunction of the autonomic nervous system (ANS), and - Stress.
These issues collectively constitute a very important [cycle] which contributes to, and perpetuates, ME/CFS. And the treatment I’ll discuss is designed to break the cycle of these three issues. Some people have a bias against 'low tech', mind-body or free treatments, assuming they are not as potent as other treatments, so please keep an open mind as you read through this.
One of the sources I read was the book Bursting With Energy, by Dr. Frank Shallenberger. In it, he describes “Breathing Right” as one of the “Eight Secrets for Improving Energy.” A brief summary of this chapter, explaining the difference between chest and diaphragmatic breathing, is found online HERE.
Improper Breathing Retards Metabolic Energy Production
While people with ME/CFS have normal blood oxygen, cellular oxygen levels are often inadequate. Optimal breathing improves cellular oxygen concentration. Mitochondrial function, a key issue for those with ME/CFS, is highly dependent on oxygen levels for energy production. Shallenberger cites a case study in his book in which a person increased his metabolic energy production 20% after just half an hour of breathing instruction.
Dr. Sarah Myhill, MD, a co-author of “Chronic Fatigue Syndrome and Mitochondrial Dysfunction,” discusses the importance of breathing in ME/CFS. (See “Hyperventilation – Makes you feel as if you can’t get your breath.”). She writes:
"Hyperventilation – the idea here is that for whatever reason, the patient over-breathes. One cannot increase the oxygen carrying capacity of the blood this way, so oxygen levels are not increased, but carbon dioxide is washed out. This changes the acidity of the blood in such a way that oxygen sticks more avidly to hemoglobin.
“So oxygen is not released to the mitochondria where it is required, and so mitochondria go slow - so cells go slow, and this results in fatigue."
Stress and Breathing
The link between stress and breathing goes both directions.
• Higher stress levels cause faster/deeper breathing,
• And faster breathing causes higher stress levels.
Read "Breathing Matters - Stress" by ear/nose/throat specialist Dr. Jim Bartley for an excellent article on the relationship between stress and breathing.
The Autonomic Nervous System and Breathing to Restore Balance
The autonomic nervous system (ANS) is the part of the nervous system which controls involuntary functions. It is composed of two sections, the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS).
• The SNS activates our stress response (the ‘fight or flight' response),
• And the PNS counteracts the stress response and is associated with relaxation, energy conservation, digestion, etc.
In many chronic illnesses, this autonomic balance is impaired with an excessive SNS response and under-active PNS response. Research on those with ME/CFS suggests the PNS relaxation response is under-active and SNS 'fight or flight' activity is either depressed, associated with exhaustion of the stress response system, or over-reactive. As the autonomic nervous system is one of the major regulatory systems in the body, this is a huge problem.
What does this have to do with breathing?
Well, it turns out that our breathing rate is a key signal to the autonomic nervous system that SNS activation is needed, and certain breathing practices can be used therapeutically to restore balance in the autonomic nervous system.
• Even if you feel mentally calm, if your breathing rate is overly fast, as it is for many people, this causes SNS activation.
• Slow breathing (also called 'paced respiration') tones and normalizes activity of both the SNS and PNS.
Read the fascinating article “The Science of Coherent Breathing” by Stephen Elliott for an in depth discussion of the link between breathing and autonomic nervous system balance.
It's also interesting to note that energy medicine practices such as qigong (which literally means ‘breathing exercise’) believe that slow abdominal breathing is critical for the balance and flow of energy in our system.
Using Coherent or Resonant Breathing - Daily Breath Training
While breathing experts don’t agree on everything, they all agree that we generally breathe too fast and too shallow - and that predominantly breathing through our nose is ideal.
While a typical person might have 15 to 20 breath cycles per minute, an ideal number is 5 to10 cycles per minute at rest. For example, five breath cycles per minute = one breath cycle per 12 seconds, or inhaling for six seconds and exhaling for 6 seconds.
While we can’t quickly take up these new habits permanently, what we can do is daily breath training. A person can listen to an audio track which has a sound cue every six seconds. You simply inhale or exhale at each interval using the track like a metronome. Breathing at this rate is referred to as coherent or resonant breathing.
What are the benefits of doing this?
• On an immediate basis, this is deeply relaxing for most people.
• Cumulative over several weeks, daily breath training has numerous benefits. It improves the function and balance of the autonomic nervous system, which carries with it a host of benefits. Our natural breathing rhythm gradually shifts in the direction of that during the training so we don’t just benefit during the breathing exercises.
Coherent breath training is one of the best ways to reduce levels of stress. You can order a ‘breathing pacemaker’ CD called 'Respire I' or download the audio tracks as MP3s (free audio samples are available). I enjoy track 2, which has Tibetan bells as the breath cue.
I recommend that people with ME/CFS do this breath exercise, combined with the practices described below, for 25 minutes twice daily.
1. Breathe through your nose and you should be able to feel your abdominal region expand with each inhalation. Breaths should be gentle and relaxed, not forceful or high volume.
2. While performing the breathing exercise, mentally scan your body and release any obvious areas of tension, e.g., in your jaw, shoulders and chest.
Throughout the day, periodically observe your breathing, slow your breathing rate and make sure you are breathing through your nose and abdominally. Also use this breathing technique, combined with Ujjayi (pronounced "oo-jai") breathing described below, in times of acute stress.
Ten minutes of Ujjayi breathing at five breaths per minute is an excellent stress buster!
Ujjayi Breathing for Calming Anxiety
In the excellent book How to Use Herbs, Nutrients, and Yoga in Mental Health Care, written by three psychiatrists affiliated with universities in New York, the authors recommend 'Respire I' from www.coherence.com, cited above. They also recommend combining this with a simple breathing technique called Ujjayi breathing (literally, 'loud breathing'), a yogic breathing technique. They write:
"Those who are able to learn Ujjayi breathing can be instructed to use the Respire I CD with Ujjayi for even greater effects. Ujjayi breathing creates a sound using contraction of laryngeal muscles with partial closure of the glottis, permitting fine regulation of the respiratory rate while increasing airway resistance, intrathoracic pressure, baroreceptor stimulation, HRV, RSA (Calabrese, Perrault, Dinh, Eberhard, & Benchetrit, 2000), and stimulation of somatosensory afferents in the pharynx, lungs, chest wall, and diaphragm. When done at a slow rate (2 to 6 breaths per minute) ... Ujjayi is physically and mentally calming.
"In clinical practice, the authors find that basic Ujjayi breathing is the single most rapidly effective breath intervention for anxiety symptoms in patients diagnosed with anxiety disorders... The patient who is taught Ujjayi breathing will usually experience a profound sense of physical and mental calmness within five to 10 minutes of doing this technique."
Type in “Ujjayi breath” at http://www.youtube.com to watch videos on this breathing technique. Incorporate Ujjayi breathing along with the coherent breathing for the duration that suits your body and complete the duration of the breathing time by simply breathing along to the sound cues.
You may need to start with just 5 minutes of Ujjayi breathing and build up over time as is comfortable. Make sure you keep your neck, throat, shoulders and chest relaxed as you breathe. It shouldn't feel strained or forceful, just relaxed and slow with a partial contraction of your throat muscles.
Complementary Practices – More Options for Banishing Stress
Start with the combination of coherent/resonant and Ujjayi breathing until it feels natural and easy. At this point, you can add aspects of other mind-body practices such as meditation or qigong for further benefit. A few options are as follows:
• Heart focus. Fascinating research from The Institute of HeartMath has found that focusing attention on the area of your heart improves the balance and tone of the autonomic nervous system. In the HeartMath coherence exercises, they instruct you to imagine your breath is flowing in and out of the area of your heart.
• Mantra based or breathing meditation. For example, focus attention on the flow of your breath.
• Qigong meditation. Qigong traditions believe the abdominal region between your navel and pelvic bone, called the lower dantian, is a key energy reservoir. Qigong practices often involve focusing attention, or meditating, on this area.
Related Articles:
Blake Graham, BSc, AACNEM, is a clinical nutritionist specializing in nutritional and environmental treatments for patients with ME/CFS, FM, and other chronic conditions. He is an Associate of the Australasian College of Nutritional and Environmental Medicine, directs the Nutritional Healing clinic in Perth (WA) http://www.nutritional-healing.com.au, and publishes a free Nutritional Healing e-Newsletter.
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Symptoms Of Eczema: Guiding You To A Diagnosis
Eczema is an inflammatory skin condition that worldwide has a lifetime prevalence of 12%. This means roughly one in eight people will experience the symptoms or visual signs of eczema at least once. The causes of eczema are multifactorial, but basically, it’s the manifestation of a hyperreactive immune system.
There are a number of ways to prevent and treat eczema but first, it’s important to identify whether your subjective symptoms and observable signs are in fact eczema.
What are the Symptoms of Eczema?
A symptom is a feeling that you have that you or your doctor cannot see. For example, when you get sick with the flu, the first symptom you experience might be fatigue or joint pains.
These are maladies that one cannot objectively measure from the outside. It requires your own interpretation to help guide the diagnosis of flu.
The most common symptom of eczema is itching but some people don’t have the urge to scratch and instead feel an irritated or raw sensation. It is possible to have the sensation of eczema without any visual skin lesions.
Patients can report feeling their skin stinging, burning, or itching without seeing any visual change in the appearance of the skin’s surface. This occurs especially early in the disease or in mild cases.
What is the Sign of Eczema?
A sign is a change that one can see. It is objective in that it can be measured or observed by the patient and doctor.
Going back to the flu example, a sign of the flu could be an elevated body temperature recorded by a thermometer or perspiration on the forehead.
If the flu leads to a secondary lung infection that can often be visualized with a chest x-ray. These are all signs used in diagnosis.
Signs of eczema can be wide-ranging. It may present as redness, scaling, or cracking. The skin lesions can weep fluid or be very dry.
Many of the signs of eczema are not caused by the inflammation itself –they are the result of scratching and rubbing secondary to the provoking symptoms.
The Signs and Symptoms Of Acute Eczema
1. Pruritus – itching sensation, the most common and often also the most intense of eczema symptoms. The itching can be worse at night, during the winter, or in any condition that leads to skin drying.
2. Erythema – redness
3. Vesiculation – eczema eruptions can have fluid-filled bubbles, appearing as blisters on the skin surface. This most often occurs during the initial, inflammatory stages of a lesion or lesions.
4. Stinging – if eczema is prompted by exposure to an irritant or allergen, the skin surface can begin burning, stinging, or smarting immediately. Alternatively, these sensations can be delayed for up to 24 hours.
The Signs And Symptoms Of Chronic Eczema
1. Pruritus – again, with chronic eczema a sensation of needing to itch is tantamount. Here, the repetitive rubbing and scratch lead to skin changes, oozing of fluid, and in some cases bleeding.
2. Xerosis (dry skin) – due to water loss through the outer layer of the skin, called the epidermis. Nearly every person with chronic eczema will display some degree of dry skin.
Unfortunately, dry skin can make it easier for allergens and irritants to penetrate the surface and then reactive the hyperimmune response—leading to a vicious cycle of eczema signs & symptoms.
3. Lichenification – the scratching and rubbing of chronic eczema produces a thickening of the skin, appearing at times almost leather-like. The skin markings are also more apparent in lichenification.
4. Fissures – cracks can develop in the skin, caused by repeated inflammation, dry skin, scar tissue from healing and aggravated by scratching and rubbing.
5. Hyperkeratosis – the coloring of the skin can change in chronic eczema, usually becoming darker from frequent rubbing.
Other Skin Conditions That Can Be Mistaken For Eczema:
Eczema can easily be mistaken for other skin conditions such as psoriasis, scabies, or seborrheic dermatitis. Use the chart below to help you differentiate between these common dermatologic conditions.
Skin Condition
Distribution
Signs
Symptoms
Additional
Info
Eczema
Wrists, ankles, feet, forehead, and around the eyes, hands, and fingers. Usually located on the flexing side of joints such as behind the knees or the front of elbows. Dry skin, reddened skin. Can have scales or ooze fluid. In later stages, the skin is thickened from continuous scratching and rubbing. Some appear as vesicles. Typically very pruritic/itchy. Can burn, tingle or sting. Symptoms are often worse in winter when the skin is drier. Associated with food and environmental allergies. Occurs in higher incidence in persons with asthma or allergic rhinitis (hay fever).
Psoriasis
Lesions appear on the extending side of joints such as the front of the knees or the back of the elbows. Thick, silvery, and scaly plaques that will bleed slightly when the scales are scratched or picked. Lesions are well-defined with clear borders. Itching is common but not definite and ranges depending on the case. Often accompanied by joint pain or nail changes, especially nail pitting. Crohn’s disease and ulcerative colitis are associated with higher rates of psoriasis.
Scabies
Most often found in skin webs found between the fingers, armpits, feet, thighs, elbows, male and female genitals, and any skin folds. Appears as small bumps with burrows where the mite has entered the skin. The bumps are reddened, inflamed, and crusty. Like eczema, scabies causes a great deal of itching. Itching increases at night, especially early in the infection. Caused by the human mite Sarcoptes scabiei. Contagious can be passed by bedding, sexual contact, clothes sharing, and even handshaking.
Seborrheic dermatitis.
(Commonly known as cradle cap or dandruff.)
Scalp, sides of the nose, chest, armpits, groin, ear canals, and eyebrows. Primarily occurs in oily skin areas. Yellowish, greasy scales. Skin can be reddened, but is not always. Can be pruritic (itchy) but not to the same degree as eczema. Thought is caused by a combination of a yeast called Malassezia and skin that overproduces oil.
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6,040,315,180,162,569,000
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Can hormones affect your weight?
Hormones are chemicals produced by glands in our body that act as regulators of vital bodily functions. These chemical messengers are responsible for our growth and development, mood, appetite, metabolism, and sexual function.
That’s why even a small disturbance in the hormonal levels- when your body releases too little or too much of a hormone — can significantly impact your health.
How do hormones influence weight?
Here’s a breakdown of the hormones that control hunger, fullness, metabolism, and fat distribution, all of which can influence body weight.
HORMONES THAT CONTROL APPETITE
HORMONES THAT AFFECT METABOLISM
HORMONES THAT AFFECT FAT DISTRIBUTION
Leptin
Ghrelin
Cholecystokinin
Insulin
Thyroid
Cortisol
Estrogen
Testosterone
HORMONES THAT CONTROL APPETITE
• Ghrelin “the hunger hormone”- Stimulates the hypothalamus (an area of the brain) indicating that your stomach is empty, and you need food.
• Leptin “the fullness hormone”-Leptin is a hormone secreted by fat cells of the body. It reduces your urge to eat by acting on the hypothalamus to indicate that you are ‘full’.
• Cholecystokinin (CCK)– CCK is a hormone released by the small intestine in response to food (especially fat and protein). It reduces food intake by stimulating ‘fullness’ centers in your brain, and it also increases the release of leptin.
Obesity is strongly associated with abnormalities in leptin (including elevated levels of leptin and leptin resistance) and low ghrelin levels. This may lead to overeating and weight gain.
HORMONES THAT AFFECT METABOLISM
Hormones that influence the number of calories your body burns (also called energy expenditure) play a significant role in weight management and obesity.
• Insulin “the storage hormone”– Insulin is produced by your pancreas. This hormone transfers glucose from food into your cells for either energy or storage (in your liver, muscle, and fat cells for later), depending on your body’s needs.
• Thyroid-The thyroid gland secretes hormones that are responsible for the regulation of metabolism. Hypothyroidism characterized by low thyroid hormone levels leads to less energy expenditure. This is why people with hypothyroidism may gain weight and are always tired and lethargic.
• Cortisol “the stress hormone”- Cortisol is produced by your adrenal glands that triggers an increase in heart rate and energy levels during times of stress. Cortisol redistributes fat to the abdominal region and increases appetite (especially a craving for foods rich in fat and sugar).
Elevated levels of insulin and insulin resistance (Diabetes) and elevated cortisol levels may lead to weight gain.
HORMONES THAT AFFECT FAT DISTRIBUTION
Fat storage in specific regions of our body is strictly regulated by certain hormones.
• Estrogen-Estrogen is responsible for regulating the female reproductive system. Estrogen levels change throughout the menstrual cycle as well as during pregnancy, nursing, and menopause. Individuals with low estrogen are more likely to gain body fat, especially in the midsection.
• Testosterone-Testosterone is the hormone responsible for the development of the male reproductive organs, sperm production, and libido. As a man gets older, these levels gradually decrease, and this leads to fat accumulation in the belly.
Low levels of sex hormones can affect your weight and health besides your libido and fertility.
The bottom line
Endocrinologists, who are doctors specializing in hormones and metabolism can evaluate and treat any disturbance in your hormonal balance and help you lead a healthy life. Call us on 1-347-384-5690 to get answers to your queries or pay us a visit at 1797 Pitkin Avenue, Brooklyn, New York 11212. We have the best endocrinologists and diabetes specialists to help you throughout the process. You can also visit our website at https://doralhw.org or contact us at info@doralhw.org if you have any queries.
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1a01aa77535b9ecfb87b9fc36adbcd2f
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2,260,080,841,614,437,600
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The effect of the timing of umbilical cord clamping on hemoglobin levels, neonatal outcomes and developmental status in infants at 4 months old
Soheila Nouraie, Sedigheh Amir Ali Akbari, Roshanak Vameghi, Alireza Akbarzade Baghban
Abstract
502
Objective:
Delayed umbilical cord clamping (DCC) increases blood transfer to newborns. Hence we investigated the effect of the timing of DCC on hemoglobin levels, neonatal outcomes and developmental status in infants at four months old
.
Materials & Methods:
This clinical trial examined infants born to 400 pregnant women immediately upon birth and at the age of four months. The newborns were randomly assigned to either the intervention group with a 90-120-second delay in umbilical cord clamping or the control group with a clamping delay of below 60 seconds, and blood samples were taken from their umbilical cords. The Ages and Stages Questionnaire was used to evaluate the infants’ developmental status.
Results:
Umbilical cord hemoglobin was found to be significantly higher in the intervention group compared to in the controls (P=0/024). No significant differences were observed between the two groups in terms of neonatal complications except neonatal jaundice was significantly more common in the intervention group (P=0/025), although the need for phototherapy was not different between the groups. Overall, no significant differences were observed between the two groups in terms of developmental status at four months old; however, the infants had better problem-solving skills in the delayed umbilical cord clamping group (P=0/015).
Conclusion:
The results obtained show that, despite elevating hemoglobin, delayed umbilical cord clamping but has no effects on infant development except in terms of problem-solving skills. Further studies are recommended on the effects of delayed umbilical cord clamping on infant development.
Keywords
Umbilical cord clamping, Hemoglobin, Child development.
Full Text:
PDF45
486
DOI: https://doi.org/10.22037/ijcn.v13i1.17662
Refbacks
• There are currently no refbacks.
Copyright (c) 2018 Iranian Journal of Child Neurology
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Discover The Healing Power Of Turmeric
Turmeric is a member of the ginger family, derived from an asian plant called Curcuma longa. It has been used for thousands of years as a spice in food, dyes and in Ayurvedic (ancient Indian) and Chinese medicinal traditions. The medicinal properties and health benefits of the spice are attributed to: antioxidant, anti-inflammatory, anti-dyspepsia, anti-platelets, anti-viral, antifungal and antibacterial effects. It can be used for arthritis, psoriasis and other skin conditions. Chinese medicine has been using it for years, studies have shown it inhibits tumor cell growth and transformation of normal cells into cancer cells. Turmeric can even be used to prevent and slow the progression of Alzheimer’s disease. Usage of Turmeric dates back to ancient Greek where physician Dioscorides used it to stimulate appetite and cure indigestion. In India, Turmeric is one of the main ingredients for their cuisine, we can see why it is considered a valuable substance and was called the ”Indian saffron” in the middle ages.
Its significant effects on major diseases amazed scientists. With more than 4300 articles cited by PubMed on the subject of the different clinical uses of plant, curcumin or the Turmeric spice. This includes 1604 studies on cancer, 181 on Alzheimer’s, 151 on diabetes. Studies among the elderly populations in India, who consume Turmeric regularly, indicate low rate of occurrence of Alzheimer’s disease. In Alzheimer’s, Turmeric extract breaks up sticky polymers that usually fail to repair brain cells and their synapses. In the alleviation of arthritis, curcumin significantly inhibited inflammation of the joints and its destruction, thus it relieves pains experienced by patients. Its anticancer activities result to the death of various cancer cells in the skin, lower gastrointestinal tract and ovaries in laboratory trials. Another surprising health benefit is that those who regularly consumed Turmeric in food performed significantly better in examination than those who consumed it less frequently.
Curcumin, the active component in Turmeric, is extracted by first boiling the curcumin plant’s root and then dried and ground into a powder. Curcumin is then extracted by using a solvent and then, the solution is dried to recover the active component in powder form. Different extractions would result into Turmeric extracts of varying purity – tests conclude that the best concentration to achieve the clinical results against diseases is standardized at 95%.
While Turmeric can certainly be made part of one’s diet, some people might be put off by its bitter taste especially those who are not used to it. To make it easier for people to experience the health benefits brought by Turmeric extract consumption, laboratories have extracted and purified Turmeric into pills or capsules which would most probably have different concentrations of ingredients. When choosing Turmeric extract, it is strongly advised to choose one with curcumin that is standardized at 95%, the concentration where it would have the most effective antioxidant and anti-inflammatory activity.
To learn more Turmeric benefits, exactly how to properly use it for every situation, and all the tips and tricks for the fastest possible results, we highly recommend this fantastic eBook for all the effects and uses of turmeric: “Secrets of Turmeric”
Click here for Organifi Daily Turmeric Boost (Veggie Caps)
The Alkaline Diet can help with weight loss, physical energy and get your pH level to where it should be in order to help your body become more energized and resistant to sickness and disease. If you are always feeling tired or you just do not have the energy that you need to perform daily functions, the Alkaline Diet can help! The acid alkaline food chart is a very useful tool that can help you identify the healthy foods that can help improve your overall diet and get you on your way to enjoying a healthier and well balanced lifestyle.
Read previous post:
A Guide To Achieving Body Balance
Achieving balance in life is very important if you want to remain healthy and happy.
Close
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2410 W. Jefferson St, Unit 108
Joliet, Illinois 60435Call us Today!(815) 745-5771
Schedule Online
Relieve Pain, Preserve Your Smile: Root Canals Explained at Dental Smiles of Joliet
At Dental Smiles of Joliet, we understand that experiencing tooth pain can be unsettling and disrupt your daily life. While the term "root canal" might evoke apprehension, it's a valuable procedure designed to save a damaged or infected tooth, alleviating pain and preserving your natural smile.
What is a Root Canal?
A root canal is a dental treatment that addresses the inner pulp of a tooth. The pulp contains nerves, blood vessels, and connective tissues. When this pulp becomes infected or severely damaged due to decay, trauma, or other factors, it can cause significant pain and discomfort.
Signs You Might Need a Root Canal
• Persistent toothache: This pain can be sharp, throbbing, or dull and may worsen with chewing or hot/cold sensitivity.
• Swollen or tender gums: Inflammation and redness around the affected tooth can indicate an infection.
• Visible pimple on the gums: In some cases, an abscess (pus-filled bump) may form near the infected tooth.
• Discoloration or darkening of the tooth: This can signify damage to the pulp or nerve tissue.
• Sensitivity to temperature changes: Pain upon exposure to hot or cold beverages/foods can be a sign of nerve irritation.
• Discomfort when biting or chewing: Pain while applying pressure to the tooth can indicate damage to the pulp or surrounding bone.
Benefits of Root Canal Therapy
• Pain relief: Root canals effectively eliminate the source of pain, allowing you to regain comfort and resume your daily activities.
• Preserves the natural tooth: By saving the tooth structure, root canals prevent the need for extraction and potential complications associated with missing teeth.
• Improved oral health: Removing the infection prevents further damage and spread to surrounding teeth and tissues.
• Maintains a natural appearance: Preserving the original tooth structure helps maintain a natural-looking smile.
Why Choose Dental Smiles of Joliet for Your Root Canal?
• Experienced and gentle dentists: Our team prioritizes your comfort and utilizes advanced techniques to ensure a smooth and efficient procedure.
• Patient-centered approach: We listen to your concerns and tailor the treatment plan to your specific needs and preferences.
• Modern technology: We utilize advanced equipment and techniques to ensure accurate diagnosis and efficient treatment.
• Relaxing environment: We strive to create a comfortable and welcoming environment for all our patients.
Don't let tooth pain control your life. Contact Dental Smiles of Joliet today to schedule a consultation and learn more about how root canal therapy can help you regain comfort and preserve your natural smile.
Schedule a Consultation
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How to Avoid Needing to See an Emergency Dentist
Stressed out by debilitating tooth pain? Or maybe an accident affected your teeth and mouth? In this case, consider emergency dental care. Today, most dentists provide this service. Early intervention can help dismiss the pain and prevent complications.
What constitutes a dental emergency? Are there any indicators and symptoms to watch for other than pain?
Let's see what dental emergencies are and how to stop them!
Without question, some dental issues require immediate attention. Since many dentists set aside time for emergencies, it should be easy to obtain treatment when needed. However, not every toothache is an emergency.
Severe injuries to the gums, teeth or face, grave infections or abscesses and loss of a filling or crown are considered dental emergencies. This group also includes:
• Lingering pain or bleeding that arises soon after dental therapy
• Wounds to the tongue, cheeks or lips
• Severe tooth pain brought on by accidents
• Tooth fractures
• Loss of a tooth
• Cracked or chipped teeth
• Facial discomfort
• Lost crowns
For instance, biting on a piece of food that is too firm may result in broken, cracked or knocked out teeth. Sports injuries, car accidents and falls are familiar culprits behind tooth loss. If any of these problems occur, contact a dentist immediately.
In the meantime, there are a few things that can lessen the damage and avoid complications. Let's say the tooth breaks or becomes loose. Leave the tooth inside the mouth until a dentist can examine it.
In the case of a knocked-out tooth, pick it up by the crown without handling its root. Rinse it carefully and position it back into its socket. If this isn't achievable, place it in a container. The dentist may be able to reinsert it and preserve its function.
If one or more teeth happen to become loose due to an injury or auto crash, try to place the teeth back into their original position. Apply a little pressure with the fingers. Visit the dentist on the same day.
Simple ways to prevent dental emergencies
Most dental emergencies are prevented with good hygiene. Simple things, such as brushing and flossing the teeth after every meal, will help keep the mouth healthy. If engaged in contact sports, wear a mouth guard to shield the teeth. Stay away from hard candy, popcorn kernels and other foods that may crack a tooth.
Don't use your teeth to open a bottle, break objects or cut items. Reduce sugar between meals. Purchase a new toothbrush every three months or so, and use mouthwash daily. Preferably, use toothpaste that contains fluoride. Chew sugar-free gum to clean teeth between meals.
If a tooth aches, do not take prescription drugs without consulting a dentist first. Certain medications can worsen symptoms and cause further complications.
Book an appointment with the dentist at least twice a year. Regular checkups can help spot any potential issues that affect tooth health.
Don't wait until a dental emergency to contact your dentist. Remember that prevention is better than treatment.
Request an appointment here: http://www.gatewaydental4u.com or call Gateway Dental at (703) 466-0568 for an appointment in our Ashburn office.
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Control How Do I Control Diabetes < Eko-Ogretmenler
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• diabetics medicines in homeopathy
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Treat Gum Disease for a Healthy Smile in Leesburg, VA
We Change Lives By Creating Beautiful Smiles
Regular Periodontal Treatments for Lasting Oral Health
Periodontal gum disease affects nearly half of Americans that are over the age of 30. In most cases, this type of gum disease, specifically at an early stage, and can likely be reversed by visiting the dentist. This condition is extremely common. However, if it is left untreated, it will often lead to tooth loss and other bacterial infections in the mouth. However, these cases may be extreme; there are ways and options available to successfully treat advanced Periodontal disease. Do not fear, as an advanced gum disease treatment is available and the need to extract teeth may not be necessary.
2 Different Gum Disease Treatments
As mentioned above, the treatment options will vary depending on the severity of the advancement of your form of gum disease. The dental professional will always do a grave evaluation to decide just how far your level of gum disease is. There are surgical and nonsurgical treatment options available to those with any level of gum disease. The first step is to always get control of the disease and ensure the spread of bacteria is cut off immediately.
Nonsurgical gum disease treatment
Root planing and scaling- Before the dentist professionally cleans your teeth, he or she will use a number of specialized dental tools that are used to remove the tartar and plaque buildup above and below the gum line. This part of the process is definitely not a walk in the park as the patient may feel incredibly irritated and can feel pain during the step. The scaling tools are you used to scrape each and every affected tooth by removing any last trace of bacteria. Root planning is when the dentist will then smoothen out any areas that may still hold bacteria. This part of the procedure is necessary to ensure the gums will reattach to a clean surface on your teeth so that the patient does not need to lose teeth. If the pain becomes too much during the step, you can always ask for a local anesthetic to numb the area needed in order to make this process a little more pleasant.
Dental Cleaning- Once this first up is complete, your dentist will perform a professional dental cleaning. Your dentist will remove all of the unattached tartar from your teeth and will clean and brush your teeth with dental tools to ensure every corner of your teeth are cleaned.
Surgical gum disease treatment
Depending on the severity of your gum disease, you may need different treatment options to ensure your natural teeth can be saved from extraction or from falling out. Your dentist will likely perform the nonsurgical treatments listed above along with any other surgical treatments if needed afterward. Surgical treatment option can include bone surgery, bone and tissue grafts, in pocket or flap surgery, or tissue regeneration. As obvious as it may be, these treatment options will be incredibly painful. However, in almost all cases your dental professional will provide you with a form of sedation that will either put you to sleep or will completely remove any feeling from your mouth or jaw for the needed surgery.
Be sure to prevent any form of gum disease by visiting your dentist every six months, brushing your teeth twice today, and flossing at least once. It’s incredibly important not to skip flossing as it can lead to gum disease if it is not practiced.
Call Our Office Today At (703) 723-7810
What is Periodontal Disease?
This type of gum disease is specifically categorized as a particular infection or bacteria buildup of the tissue that surrounds your teeth. If the patient does not brush his or her teeth twice today and floss at least once a day, the risk of getting this type of gum infection becomes extremely high. This bacteria is typically formed when food is combined with bacteria, and our own saliva hardens and forms a wall of plaque or tartar. This plaque becomes a slimy and sticky substance that adheres to teeth along the gum line. When this plaque is left untreated and not removed, it becomes harder and cements itself to the teeth. Once this happens, the tartar will slowly build under the gum line, and from this point, can only be removed by a dental professional and a deep cleaning.
The best way to know if you have extreme plaque buildup is by noticing if your gums, in general, seem redder than usual. If there is a line of yellow buildup between your teeth and gums, this is also a great sign to notice. If you have extremely bad breath, even though you may have just brushed your teeth, you may have a form of gum disease as well. The most obvious way of knowing if you have periodontal gum disease is by figuring out if your gums are inflamed. Swollen or inflamed gums will start to feel tender and can severely bleed during a gentle tooth-brushing session. Once periodontitis is climbing into an advanced stage, your swollen gums will slowly start to detach from the bacteria-filled tooth, leaving behind an empty pocket. This pocket can be infected pretty quickly by the bacteria and can cause your gum lines to detach from your teeth quicker an can result in tooth and bone loss.
There is an official phase just before you get periodontal gum disease, called gingivitis. Gingivitis is a mild case of gum disease that can cause little to no discomfort. Millions of Americans have gingivitis without even knowing they do. Some symptoms of gingivitis can include bad breath, swollen gums, slight bleeding, and reddish gums. This type of gum disease always starts via a common denominator, inadequate oral hygiene. This type of gum disease is always reversible with a professional deep clean and can always be prevented by good oral hygiene. If this form of gum disease is not treated, then periodontal gum disease will follow.
6 Signs You may be at a higher risk for periodontal gum disease:
• You are an avid smoker or tobacco user
• You have diabetes
• You are going through hormonal changes
• You are going through an illness in which weakens your immune system
• You are an avid alcohol drinker
• Last but not least, good old genetics
tracey
Meet Dr. Tracey Nguyen
Dr. Tracey Nguyen received her Doctor of Dental Surgery, Magna cum laude, at Virginia Commonwealth University Medical College of Virginia. Dr. Nguyen is trained in all phases of implant dentistry, and has received extensive training in cosmetic dentistry. She is also a manuscript/review editor for the Academy of General Dentistry.
We are located in Leesburg, VA but proudly serve Lansdowne, Reston, Broadlands, Ashburn, Sterling, and all neighboring communities.
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By Tracy Weincouff, RD
Choosing healthy foods and getting the nutrients you need is important to do no matter what age you are. As a senior, it is especially important. Food provides the nutrients you need as you age and even though you aren’t growing anymore your body still needs certain nutrients to stay healthy. Eating poorly can lead to undesirable weight loss and a weakened immune system which can make you more susceptible to colds, flu and infections. Some of the benefits of proper nutrition include increased mental capacity/alertness, higher energy levels, better resistance to illness and disease, improve how you feel overall and encourages a sense of well-being. When you have good nutrition you feel better overall and stronger. Food provides the nutrients you need as you age. So what does good nutrition look like?
Eating a variety of foods from each food group will help you get all the nutrients you need. The food groups include fruits, vegetables, grains, protein foods and dairy foods. Choosemyplate.gov has some great advice for making wise food choices. Fruits and vegetables should make up half of your plate. Focus on whole fruits and vegetables as these have the most nutrients particularly fiber. Incorporate fruits and vegetables into your main dish, snacks and desserts. Choose a variety of colors to maximize your nutrition. Protein foods include beef, pork, poultry, fish, eggs, beans and peas, soy products like tofu and unsalted nuts and seeds. Pick lean cuts of meat to decrease fat intake. Vary your protein sources and even try vegetarian main dishes! Protein should comprise about a quarter of your plate with grains comprising the last quarter. Grains can be whole or refined. Whole grains have more fiber and half of the grains you consume in a day should be whole grain. Check the ingredient list and if whole grains is listed first or second, the item is whole grain. Some examples of the grain group include wheat, rice, oatmeal, barley, tortillas, pasta, dry cereal, bread. Dairy should be low-fat or fat-free and includes milk, yogurt and cheese. This group doesn’t have a percentage of the plate because it is typically served on the side or incorporated into the other groups.
It is important to limit saturated fat (fat that is solid at room temperature), added sugars and sodium. Read labels to see how much of these items are in the food. Choose vegetable oils or oil-based sauces instead of ones with butter or cream. Watch what you are drinking as many beverages have added sugars. Water is always a great choice! Choose low-sodium products when possible and limit salt that is added to recipes or at the table. If you are interested in learning more about a healthy diet and how much you should eat, choosemyplate.gov is an excellent online resource or meet with a Registered Dietitian Nutritionist.
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1a01aa77535b9ecfb87b9fc36adbcd2f
|
-5,782,706,484,594,905,000
|
Genomic and transcriptional analysis of glioblastoma microenvironmental cellular subsets using antibody microarrays (crosstalk in gbms)
Starting date
October 1, 2011
Duration (months)
36
Departments
Neurosciences, Biomedicine and Movement Sciences
Managers or local contacts
Bonetti Bruno
OBIETTIVI: The malignant brain tumor GlioBlastoma Multiforme (GBM) is one of the most common malignant and lethal primary brain tumour of adults. The project is based on the finding that human tumours, particularly GBMs, are composed of a mixture of cancer, immune, stromal and vascular cells. The non-cancerous cellular components of the tumour microenvironment appear to play a critical role in tumour development and progression.
In this Marie Curie Fellowship, Dr. Beatrice Gini, from Prof. Bonetti’s group at the University of Verona in Italy, is working with Dr. Mischel’s group at UCLA, in collaboration with Dr. Heath’s group at CalTech, to develop cutting edge nanotechnologies to understand how crosstalk between tumor cells, including inflammatory cells, promotes tumor growth and resistance to target terapy.
This fellowship will identify the crosstalk pathways to develop more effective, personalized treatments for GBM patients.
At UCLA (Los Angeles, U.S.A.), the Mischel Lab has developed the DNA Encoded Antibody Library (DEAL) microarray, to sort specific cellular subtypes from solid tumour samples. The selective capture of tumour cells, lymphocytes, microglia and vascular endothelial cells, directly from GBM biopsy samples, will be obtained by DEAL technology. Genomic and transcriptional analysis will be performed on DEAL sorted cellular subtypes in order to identify novel molecular targets for therapeutic intervention. Genomic and transcriptional findings will be validated with functional assays in model systems: oncogene over-expression, gene silencing and pharmacological inhibition will be applied in order to identify the factors that inhibit the growth and survival of GBMs. In the first phase of the fellowship, at UCLA, the applicant will be utilizing cutting edge nanotechnology and resources that will provide her with outstanding interdisciplinary skills and competences. The applicant will then have the professional maturity to transfer her novel knowledge to the University of Verona (Italy), enriching the scientific excellence of Europe and bridging a new set of collaborations between Italy and the U.S.A.
Sponsors:
UE - Unione Europea
Funds: assigned and managed by the department
Project participants
Beatrice Gini
Activities
Research facilities
Share
|
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1a01aa77535b9ecfb87b9fc36adbcd2f
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-299,657,627,511,109,500
|
Gastritis: Understanding and Preventing
Who has never felt the sensation of burning, heartburn and pain in the stomach? Popularly known as gastritis and even nervous gastritis, it is directly related to the symptoms described. These items above are part of a group that shows two diseases: a functional dyspepsia and reflux disease.
The dyspepsia can be described as a disturbance in the digestive system, which complicates the process of digestion. Reflux is a return of gastric acid from the stomach to the esophagus. The reflux happens due to an imbalance in the functioning of the valve that controls the passage of food from one organ to another. As the valve does not close right, the liquid passes into the esophagus and thus their walls. This causes heartburn and burning, since there is no protection against the inner wall acidity, such as the stomach.
What is Gastritis
Gastritis is an inflammation that affects the wall of the stomach and can be divided into two: acute and chronic. In the acute form, the gastritis appears suddenly, causing nausea and vomiting. Generally the duration is three days, can be triggered by alcohol, drugs based on acids, anti-inflammatory factor or the stress.
Chronic gastritis, the bacterium Helicobacter pylori is made in this context. This type of gastritis is long term and is usually asymptomatic. The transmission may be via water and food contaminated by bacillus. The only way to identify this type of gastritis is by endoscopy and biopsy and with the help of the best gastroenterologist in Okeechobee.
How to Deal with Gastritis
A healthy diet is still one of the main forms of treatment.
Although, the food is not the main cause of the development of gastritis. They have key role, both in aid of treatment and in prevention.
Some foods should be avoided, causing an increase in the release of gastric juice or facilitate the occurrence of reflux of it: milk and some types of cheese, fatty foods, and industrial embedded, concentrated juices, alcoholic drinks and stimulants.
You should also consume: diluted juice and much water, fruit, gelatin, milk derivatives and light, lean and white meat.
Eat slowly and chew food are habits that help. The intake of water, natural foods, whole grains and light products, is at the top of the list of habits. Practice them!
Tags
Rate our Clinic
|
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|
1a01aa77535b9ecfb87b9fc36adbcd2f
|
-3,162,694,102,750,662,000
|
So, Should You Eat Gluten Or Not?
The gluten debate continues, often with more venom than opposition parties at election time. Why does this molecule ignite so much antagonism? After all, it's just a food…Or is it?
Let's start with what gluten is. It's a protein molecule principally found in wheat. But gluten is not what it used to be. In the late 1960's, gluten (and wheat) were cross-bred, hybridized and re-engineered to increase the yield of cereal grains. This produced over 40,000 varieties of wheat. It also increased the elasticity of wheat so that the bread would rise and be more chewy and delectable. Who doesn't like fluffy bread? But as we've now learnt, once we start interfering with our food source, things can go a little hay-wire. This is what happened:
1. This gluten molecule changed from the cellular equivalent of a tennis ball to a volleyball.
The larger the protein molecule, the more challenging it is for your digestive system to fully break it down. It requires more stomach acid, more pancreatic enzymes and more small intestine enzymes. This explains why for some of you your stomach bloats like you've swallowed the volleyball after its ingestion. Your stomach acid, pancreatic and / or small intestine enzymes are insufficient to breakdown this burly molecule.
If this is you, you have three options: 1. Either exclude gluten, 2. Supplement with HCL (stomach acid) and protein digesting enzymes to help you better digest gluten, or, 3. Eat ancient grains like Einkorn which has 14 chromosomes versus spelt and other wheat which has 42 chromosomes. But the latter two options still aren't ideal, as there is more at play than the size of the molecule.
2. Gluten stimulates zonulin, a protein that increases gut permeability.
Zonulin starts to open up the tight junctions that keep the small intestine impervious to bacteria and undigested food. When this happens, you set yourself up for a hyper-immune response to gluten and other undigested foods. If you don't chew your food well (most of us), then once the gut is more permeable, more food can slip into the bloodstream and trigger an immune response. Think of this like a cool nightclub being taken over riffraff because someone knocked the bouncer out. It can be a mess.
If you want to continue eating gluten and decrease the likelihood of this response, you can take two actions: 1. Chew and chew and chew your food so you'll only have amino acids (from protein), glucose and fructose (from carbs), and vitamins and minerals enter the blood stream. That's all that should be absorbed into the bloodstream and no immune reaction will take place. Or, 2. Take glutamine to feed the cells on the small intestine so they replicate and decrease the likelihood of excessive permeability. This is risky as zonulin is still triggered but it acts as a mild counter balance.
3. Repetitive gluten exposure may already have damaged your small intestine.
If you've been eating wheat four times a day for 20 years (easy to do — cereal for breakfast, cookies as snack, croutons in your salad and bread with dinner) it's highly likely the gut is already permeable and setting you up for an increased immune response to food.
If this sounds esoteric, let's take it out of the gluten realm. Imagine drinking soda four times a day over a 20-year period, what's the likelihood of diabetes? Pretty high. But if the rest of your diet is clean, you may be lucky and not get diabetes. But the vast majority will.
4. You're super stressed.
Most of us don't live on a little island in Greece where we eat from the land, have a supportive community, play and take time for prayer. We're often too busy to have a bathroom break. Stress uses up the protein molecule glutamine that helps keep the tight junctions on the small intestine intact. The moral here: the more stressed you are, the more gluten is likely to be a problem. I have a rule for myself: on vacation I can eat gluten, but that comes with a caveat. I did the work to heal my gut. I talk about how to do this in the "How to Ditch Sugar" video series on MindBodyGreen.
5. You're craving cookies, bread and pasta.
This is an easy sign to determine if you've already developed a food sensitivity to gluten or wheat. When you have a hyper-immune response to a food, you start interfering with the body's production of serotonin. The immune system starts using up the raw materials otherwise needed to create serotonin. Less serotonin can mean more food cravings. (I also speak about this in more depth in the "How to Ditch Sugar" video series.)
6. Your gut bacteria is out-of-whack.
Your gut bacteria can be your salvation or your enemy. If you have an imbalance of pathogenic bacteria (or yeast or parasites) they'll love the undigested gluten and will use it for food to multiply. They'll also ferment it and give you a bloated belly. But if you have nice micro-flora (think flowers versus weeds) then the undigested gluten isn't likely to cause much GI distress. Pathogenic bacteria also produces toxins that make the small intestine more permeable, setting you up for food sensitivities.
So….should you eat gluten or not?
No, if:
• You have celiac disease
• You have an auto-immunue disease (see point 3)
• You get a bloated belly after eating gluten
• You're super stressed
• You would be distressed about giving it up (see point 5)
• You eat the regular stuff — it's comfort food for you and the heirloom varieties aren't around when you need them
• You have mood disorders (not discussed here but you can check out this study)
Yes, if:
• You eat it occasionally and choose heirloom grains like Einkorn
• You chew your food properly (or you're happy to take digestive enzyme support)
• You've actively rebalanced your gut micro flora with anti-fungals, probiotics and glutamine
• You've taken gluten out of your diet for at least 9 months to decrease the reactively of it in the body, and now you can tolerate a gluten-light life
• You've only ever eaten gluten on an irregular basis
• You don't have the genes for celiac or other autoimmune conditions
The debate over gluten will likely continue as most of us haven't tested the integrity of our small intestine, the composition of our gut microflora and whether we have an immune reaction to gluten or not. Each of us is in a different place on our gluten journey and that gives us different opinion on whether to eat gluten or not based on our personal experiences. I hope the above article provides you with more insight into whether gluten is suitable for you or not.
Dana James
Triple Board Certified Functional Nutritionist
Dana James, MS, CNS, CDN is a Columbia University-educated nutritional therapist and founder of Food Coach NYC. She holds her Masters in Clinical Nutrition and is trained in nutrition biochemistry, functional medicine and cognitive behavioral therapy. She believes that food should be viewed as nourishing, joyful and fundamental to self-care. Her goal is to help women break their antagonist (and often obsessive) relationship with food and their body. She believes that true beauty stems from grace, dignity and embracing our idiosyncrasies that make us unique and imperfect. Dana created "How to Ditch Sugar" video series for mindbodygreen. Check out the program here: How to Ditch Sugar. Dana coaches one-to-one, runs workshops in NYC and LA, and holds teleseminars on various topics that help women lead a more beautiful and balanced life. To connect more with Dana, check out her Instagram account and sign up for her bi-weekly Sunday evening emails.
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7 Little Changes That'll Make a Big Difference With Your Muscle Hyperplasia
We know muscles grow through a process called, "hypertrophy." However there's likewise this elegant sounding process called, "hyperplasia," that is surrounded by a tornado of debate. This is among the topics we get a ton of concerns on so it deserves making the effort to devote a complete short article to it and clear up any remaining confusion.
Hypertrophy Vs Hyperplasia and the Sapien Medicine workout
The first thing to comprehend is the distinction between hypertrophy and hyperplasia, and the idea of skeletal muscle hyperplasia vs. other kinds of hyperplasia in the body. Hypertrophy is just the increase in size of a muscle fiber-- this can be attained through increasing the size of the contractile proteins or increasing the fluid and enzyme content of the muscle cell (4,15). On the other hand, hyperplasia is the boost in the number of muscle fibers (4,15). Increasing the variety of muscle fibers will increase the total cross sectional area of a muscle likewise to increasing the size of person fibers. On the outside, hypertrophy and hyperplasia would look very comparable from an aesthetic appeal perspective.
• Whether hyperplasia is simply a natural "gift" for the elite or not awaits exploration, however, for now, allow's go over why hyperplasia might take place.
• In conclusion, we for the very first time discovered that chemerin induced aortic smooth muscular tissue cells spreading as well as carotid intimal hyperplasia via activation of MAPK signaling, which might cause vascular swelling and makeover.
• The anabolic stimulus appears to be related to the quantity of resistance used in a lift and also the associated neural activation in both males and females (Campos et al. 2002; Schuenke et al. 2013).
• Skeletal muscle hyperplasia has no organization with tumors, so maintain that in mind if you do any type of further study on the subject and find disconcerting findings connected to tumor growth.
• This hypoplasia takes place concomitantly with a decrease in ERK immunoreactivity degrees and lowers in MyoD as well as myogenin expression.
• Muscle degeneration is the reduction in muscular tissue toughness because of a decrease in muscular tissue mass, or the amount of muscular tissue fibers.
Hyperplasia can likewise occur in other tissues of the body. This is where hyperplasia can get rather of a bad associate as uncontrolled cellular expansion is often related to tumor growth (11 ). Skeletal muscle hyperplasia has no association with growths, so keep that in mind if you do any additional research on the topic and encounter worrying findings connected to tumor growth.
Is Muscle Hyperplasia a Myth?In short, no; skeletal muscle hyperplasia is not a misconception. Some think that it does not happen in humans given that we don't really have strong evidence of it taking place during a controlled resistance training protocol. Human proof is certainly doing not have, but we have myriad evidence of hyperplasia happening in birdsmice, cats, and even fish.
Knockdown Of Chemerin Reduced Proteins Related To Mapk Sapien Medicine muscle
The processes through which these cases of hyperplasia took place also considerably differ that makes hyperplasia much more of an interesting topic. Many bird research studies that exhibited hyperplasia included hanging weights from the wings of birds for ridiculously long period of time (2,3). This doesn't really represent a typical human training protocol, however on the other hand, felines performing their own sort of kitty resistance training likewise displayed hyperplasia (10 ). No, the cats were not bench pressing or crouching, but their procedure involved comparable muscle activation sequences to what a typical human training session would look like. The mice we discussed earlier experienced hyperplasia after researchers were able to minimize their levels of myostatin (20 ), which is a protein associated with restricting muscle growth. And the fish we referred to merely underwent hyperplasia while growing throughout adolescence.It's clear that hyperplasia can occur through several methods, however still the question stays: does it occur in people? Let's go over.
What Makes Muscle Mass Expand? Myostatin Related Muscle Hypertrophy
Evidence of Hyperplasia in HumansIt goes without stating here, that the evidence for hyperplasia in humans is certainly doing not have. We'll enter why that is here in a second, but for now, let's discuss what we have actually seen throughout the past couple of decades. research studies have actually compared high level bodybuilders to inactive or recreationally active people to figure out if hyperplasia plays a role in severe muscle development. And we do see evidence that these bodybuilders consist of significantly more muscle fibers than their sedentary counterparts (8,16,18). The issue we have with this examination is that we can not state for certain whether or not the bodybuilding training stimulus was the main factor for the increased number of muscle fibers. It certainly stands to reason that a high level bodybuilder would have a hereditary propensity for constructing muscle, and one of these genetic "cheat codes" might simply be a greater standard level of muscle fibers.
We do see one study in which a "training" stimulus might have accounted for a boost in fiber numbers. This specific study analyzed the left and right tibialis anterior (front of the shin) muscle in young men. It was found that the non-dominant side tibialis anterior consistently showed a greater cross-sectional location than the dominant side, but single muscle fiber size between the two muscles was similar. Therefore, the best description for this distinction in total size would have been through increased fiber number. The authors propose that the non-dominant tibialis anterior received a greater daily workload than the dominant side for a couple of different reasons, however this is one situation in which a "stimulus" could have conjured up an increase in muscle fiber number (21 ).
Exactly How To Create Hyperplasia Muscle Hyperplasia
So we do have a little evidence for hyperplasia happening in humans. Whether hyperplasia is just a natural "present" for the elite or not waits for discovery, but for now, let's talk about why hyperplasia might occur.How Does Hyperplasia Occur?
Prior to comprehending how hyperplasia might occur, it's worth talking about how we can determine it. I'm sure you're thinking of some expensive pants computer system examining a muscle biopsy and spitting out numbers. But no, it's not that cool. If you scroll through the recommendations, you'll see that much of these investigations were occurring in the late 1970s through the 1990s. More than likely, a young college student had to do the dirty task of actually counting muscle fibers by hand to earn their place in the laboratory. Fancy computers didn't help much then, so college students took the force of this responsibility.
So it's easy to see, then, that basic counting errors can account for little distinctions in pre- and post-training fiber numbers. This also represents a problem when considering a particular type of muscle hypertrophy called longitudinal hypertrophy. We know from earlier that a muscle fiber can grow by increasing the size of its contractile proteins or intracellular area, however a muscle fiber can also grow length-wise by adding more contractile systems in series. These brand-new contractile units can be challenging to distinguish from old and/or possible brand-new muscle fibers which represents a tough situation when attempting to count muscle fibers by hand (22 ).
So now that that runs out the way, let's talk about why hyperplasia may take place. It's worth a review of the Muscle Memory short article (here), however we understand that one of the ways a muscle fiber can experience hypertrophy is through satellite cell activation. This procedure is possibly necessary due to the Nuclear Domain Theory. The Nuclear Domain Theory states that a cell nucleus can just manage a minimal portion of the cell space (7 ). For that reason, for a muscle fiber to grow, it would require to add additional nuclei to preserve the nuclear domain of each nucleus. Difficult training can signify satellite cells to donate their nuclei to the muscle cell to make this process possible (12 ).
Now, what would occur if you can no longer continue get more info including nuclei to a muscle to permit it to grow? It's not certain whether satellite cells become downregulated or if there's a biological limit to the amount of nuclei a muscle cell can consist of, however there might ultimately be a situation in which myonuclear addition can no longer strike drive development. What takes place if you get to this theoretical growth limit but keep training and promoting the muscle to grow? The fiber needs to divide and form two new fibers (9) to restart the hypertrophy procedure. This theory provoked a rather "chicken and the egg" argument among researchers-- does hypertrophy have to happen prior to hyperplasia or can they occur simultaneously?
Current Articles Strongest myostatin inhibitor
Several researchers have actually connected satellite cell activation and muscle hyperplasia due to this theory (1,5,9). It deserves understanding, however, that the theoretical time course of the above paragraph would take decades of hard training to finally trigger fiber splitting. As far as we understand, myonuclear addition and muscle hypertrophy does not have actually a defined limit as to when the muscle needs to divide to continue supporting the requirement for development. I doubt this instance will ever be shown in a study as no research study will last that long or cause a tough enough training stimulus to actually cause this to happen.
A couple of longitudinal research studies have actually taken a look at fiber number as a specific variable following a training protocol, but none have truly discovered a direct boost in muscle fiber number (6,19). These findings provoked one evaluation to claim that the evidence of hyperplasia occurring in humans is, "scarce," (6) and another to state that, if hyperplasia does happen, it most likely just represents about 5% of the boost in total muscle size we see in training protocols (15 ). That last declaration definitely appears to prove out as some research studies revealing an increase in muscle cross sectional area are not always able to explain this difference through increases in single fiber size alone (8,19)-- little boosts in fiber number can definitely add to gains, however most likely do not play a significant role and don't present as statistically different than their baseline levels-- especially in studies only lasting a few months.
How to Cause Hyperplasia
Now, we need to talk about the unavoidable concern that many individuals will have: how can I cause hyperplasia in my own training? According to the above area, you're going to need to train for an actually long time for hyperplasia to occur. Any type of significant gains will take a long time, so don't ever discount the importance of training longevity when considering gains.
Now, when considering prospective severe training techniques for causing hyperplasia, it's simple to see that the best boosts in muscle fiber number in animal research studies was produced by severe mechanical overload at long muscle lengths (14 ). You can presume this for your own training by including techniques such as weighted extending, Intraset extending, and even stretch-pause reps.
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Glucose tolerance test periodicity as a descriptor of glucose tolerance abnormality
Research output: Contribution to journalArticlepeer-review
9 Scopus citations
Abstract
The periodicity of the standard 100-g glucose tolerance test (GTT) was examined in a prospective study of 194 pregnant patients to determine how well gestational diabetes could be identified. A simplified formula, the GTT periodicity, was used to estimate the time for the GTT curve to return to the fasting level. One hundred one study subjects had all normal glucose values by the National Diabetes Data Group criteria (0-abnormal group), 47 had one value greater than normal (1-abnormal group), and 46 had more than one value abnormal or gestational diabetes. The 0-abnormal patients had a significantly shorter GTT periodicity than did 1-abnormal or gestational diabetic mothers (3.6 versus 4.8 versus 6.6 hours, respectively; P < .04). Calculating the periodicity for the corresponding insulin excursions yielded significantly increasing values in a graduated fashion for each group (5.2 versus 6.9 versus 9.6 hours, respectively; P <. 05). Examination of the oscillation of the GTT curve about the fasting level allows a physiologic description of normal and abnormal glucose responses in pregnancy. Furthermore, our findings suggest that glucose and insulin periodicities are useful predictors of gestational diabetes in patients with positive screening.
Original languageEnglish (US)
Pages (from-to)931-935
Number of pages5
JournalObstetrics and Gynecology
Volume79
Issue number6
StatePublished - Jun 1992
ASJC Scopus subject areas
• Obstetrics and Gynecology
Fingerprint Dive into the research topics of 'Glucose tolerance test periodicity as a descriptor of glucose tolerance abnormality'. Together they form a unique fingerprint.
Cite this
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December 1, 2021
What You Must Know About Facematches
Facemasks can be utilized in a range of settings that will help eliminate multiplication of microbes. They are not required in basic daily use, as many bacterial contamination can be caused by respiratory illnesses or colds. In truth, the who carry out certain special surgical procedures will most likely always have on an In-95 hide as they definitely perform.
The fact is, relying upon a mask to prevent dispersing the respiratory system attacks could result in men and women to fail to remember to try and do all the more very simple what to avoid the malware from finding worse. As an example, if an individual who’s going under the knife is wearing a air filter, she or he will likely not normally stress about the issue, unless of course the mask comes off. Even so, it’s urgent individuals will be able to swiftly clear away their hides if their asthmatic contamination results in being really serious.
When you function in a breeding ground in places you have to deal with folks in whose immune tissues are fragile maybe in a hospital setting where by severe respiratory system microbial infection are frequent, you might like to take into consideration using a breathing apparatus rather than a facemask. This way, it is possible to make sure that you are breathing in at all times without the need to employ a respirator. In case you are trouble breathing, you can commonly start using a cartridge to maintain the neck muscles open up, but it’s not always as useful on the subject of preventing mid-air.
There are lots of good things about using facemasks, but there’s also some shortcomings. As an illustration, individuals who are sensitive to certain substances, for instance toxins, can experience really serious unwanted side effects from donning a face mask. Since skin masks are generally intended to deal with the many nose and mouth, they could come in contact with a variety of unique objects, that could inflame delicate pores and skin and eye balls.
Many of the materials that can cause challenges include the herbal oils which have been made by the nose and mouth, as well as phlegm, which movement around the nose area paragraphs. These ingredients can irritate the nasal bring about and paragraphs an array of indicators, which include throwing up, congestion and hassles. Not putting on a facemask could make these symptoms even worse.
An additional problem with sporting a facemask is really because normally tend not to prevent health concerns. In order to prevent a lot of these bacterial infections, you have to realize that the situation by itself is not likely to become infectious and is not ordinarily dangerous, not like most the respiratory system infections.
Lots of hospitals and health facilities have become installing facemaces within their washing and disinfection initiatives, even though most doctors advice that men and women employ a cover up. To be able to combat conditions including the frequent chilly, respiratory disease, infections, flu virus and in many cases measles.
Facematches, although an affordable way to remain healthy and safe, should be considered genuine, in reality, several educational institutions call for professional medical people to use facematches while they are working. The facematches might stand out, but they also really don’t essentially secure via bacterial infections. With them being an choice to prevent disorder must supply when necessary.
Some medical professionals think the use of facemasks is harmful, especially if you aren’t acquainted with how to use them adequately. In truth, they have actually been recognized to trim the conceal off of someone who was not using a single. May be pretty hazardous, given it would go away you prepared to take the potential of a prospective illness. Of course this circumstances just isn’t far too probable, it can be one thing to take into consideration taking a look at some great benefits of utilizing a confront to complement.
Ematching face masks are typically created from latex, which can be viewed as a good substance. They may commonly feature directions to be able to clear them and sanitize them right after each and every use. They’ll typically incorporate recommendations that state to either fresh the hide or install it inside the garbage disposal, microwave prior to dump it.
Although there are several benefits to working with facematching face masks, there’s also down sides, for those who have any problems. A lot of people realize that by using a facial area to enhance, even if it’s used properly, doesn’t allow them to breathe in fully. Therefore, it is very important put on your cover up because you get to sleep and to be sure that the hands are free of the overseas items which could lead to discomfort towards the dermis.
It a great idea to debate the negatives and benefits of using a racemate with all your medical doctor or specialist just before using one. As the negatives of wearing 1 tend to be about, advantages are much less considerable plus much more aesthetic compared to the risks a part of the other. Even so, if you decide to start using a racemate, you’ll want to make sure that you do as instructed from the maker. and have anyone enable you to in case you are puzzled by how you can properly utilize unit.
If you have any concerns pertaining to in which and how to use kn95 masks, you can make contact with us at the web-page.
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Effective Health Care Program
Home » Products » Cancer Quality-ASSIST Supportive Oncology Quality Indicator Set: Feasibility, Reliability, and Validity Testing » Cancer Quality-ASSIST Supportive Oncology Quality Indicator Set: Feasibility, Reliability, and Validity Testing
Cancer Quality-ASSIST Supportive Oncology Quality Indicator Set: Feasibility, Reliability, and Validity Testing
Research Report Archived
Note: This report is greater than 5 years old. Findings may be used for research purposes but should not be considered current.
Author Affiliations
Sydney M. Dy, M.D., M.Sc.a
Karl A. Lorenz, M.D., M.H.S.b
Sean M. O’Neillc
Steven M. Asch, M.D., M.P.Hb
Anne M. Walling, M.D.d
Diana Tisnado, Ph.D.d
Anna Liza Antonioe
Jennifer L. Malin, M.D., Ph.D.b
aJohns Hopkins Bloomberg School of Public Health, Baltimore, MD.
bVA Greater Los Angeles Healthcare System, RAND Health, David Geffen School of Medicine at UCLA, Los Angeles, CA.
cRAND Pardee Graduate School, Santa Monica, CA.
dDivision of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA.
eUCLA School of Public Health, Los Angeles, CA.
Abstract
Purpose: Although measuring the quality of symptom management and end-of-life care could help provide a basis for improving supportive care for advanced cancer, few quality indicators in this area have been rigorously developed or evaluated.
Methods: We conducted a pilot evaluation of a comprehensive set of 92 supportive oncology quality indicators, Cancer Quality-ASSIST, including outpatient and hospital indicators for symptoms commonly related to cancer and its treatment and information and care planning. We operationalized the indicators and developed an electronic abstraction tool and extensive guidelines and training materials. Quality assurance nurses abstracted the medical record for 356 advanced cancer patients in two settings: a Veterans Administration hospital and an academic hospital and cancer center. We evaluated the indicators’ feasibility, interrater reliability, and validity.
Results: We successfully evaluated 78 indicators across the domains; results were similar in the two settings. We could not feasibly evaluate 3 indicators because of low prevalence; 22 indicators had significant interrater reliability issues, 9 had significant validity issues, and 3 had both reliability and validity issues, leaving a set of 41 indicators most promising for further testing and use in this population, with an overall kappa score of 0.85 for specified care.
Conclusion: Of 92 Cancer Quality-ASSIST quality indicators for symptoms, treatment toxicity, and information and care planning, 41 were sufficiently feasible, reliable and valid to be used for patients with advanced cancer in these settings. This set of indicators shows promise for describing key supportive care processes in advanced cancer.
Introduction
Nearly half of cancer expenditures occur during the final year of life, which is often marked by severe patient and family suffering.1 Recently developed quality indicators approved by national organizations and frequently used in research focus on variation in2 and overutilization of3 costly, high-intensity care that may reflect poor quality. In a systematic literature review, we found that few tools to measure underutilization of evidence-based supportive cancer care have been available, rigorously evaluated, or widely used.4 To accurately assess quality of care and provide tools for targeting and evaluating quality improvement, quality indicators are needed with good reliability and validity, variation among settings, and sensitivity to change.5,6
The Cancer Quality-ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) Project developed evidence-based quality indicators (QIs) to evaluate supportive cancer care from medical records. ASSIST addresses pain, dyspnea, depression, nausea and vomiting, diarrhea, fatigue, and information and care planning, including symptoms related to cancer, common complications, and treatment-related toxicities. ASSIST QIs were based on systematic literature reviews and developed using the RAND/UCLA (University of California, Los Angeles) modified Delphi process, with multidisciplinary input and representation from oncology, geriatrics, and internal medicine professional societies.7-11
The objective of this study was to characterize the feasibility, reliability and validity of the ASSIST quality indicators for advanced cancer care in two health care settings with different patient populations and data systems, the Veterans Administration Greater Los Angeles Health Care System and the Johns Hopkins Hospital and Sidney Kimmel Comprehensive Cancer Center. The goal was to determine a common robust quality indicator set for future comparative studies and quality monitoring efforts.
Methods
Study Sites
We report here on two separate but coordinated pilot efforts that tested the ASSIST indicators in diverse settings and patient populations. A pilot evaluation at the Johns Hopkins Hospital (JHH) and Sidney Kimmel Comprehensive Cancer Center (SKCCC) focused on end-of life care and addressed the ASSIST indicators relevant to symptoms, communication, and care planning in patients with advanced cancer. A concurrent pilot at the Veterans Affairs Greater Los Angeles Health Care System (VAGLAHS) was broader in focus, addressing all the ASSIST supportive oncology domains (including toxicity of chemotherapy and radiation therapy) in patients with advanced disease in an integrated delivery system. Each site’s IRB approved the respective study protocol.
The JHH is a large academic medical center; patients undergoing chemotherapy and radiation therapy receive integrated care at the SKCCC. VAGLAHS is an integrated inpatient and ambulatory medical center and regional referral center for veterans with cancer requiring specialized services (e.g. radiation therapy). At the time of the study, the JHH Department of Medicine had a palliative care program, the SKCCC had a cancer pain program, and VAGLAHS had a palliative care program. JHH/SKCCC had a combination of several paper and electronic health records, and VAGLAHS used the VA integrated electronic health record. JHH/SKCCC also had supplemental data sources, including a cancer registry, a cancer center information system, and hospital utilization data.
Study Sample
Study inclusion criteria differed somewhat between the sites, based on local populations and study goals. At VAGLAHS, we used the cancer registry to identify patients diagnosed in 2006 with one of the following tumor types and stage IV disease: breast, colorectal, esophagus/stomach, genitourinary, head and neck, liver/biliary, lung, pancreas, and prostate. Additional inclusion criteria included being alive 30 days post diagnosis and having at least one outpatient visit at VAGLAHS following diagnosis.
At JHH/SKCCC, the cancer registry identified patients with stage IV lung, pancreatic, breast, and colorectal cancer (and Stage IIIB for lung cancer) disease in 2003-2005 who died 2-15 months after diagnosis. Additionally, patients needed at least three outpatient visits at Johns Hopkins or at least two outpatient visits and a hospitalization of at 3-30 days in length after the diagnosis. Most patients had at least three visits and a hospitalization, and only 20 had only outpatient care.
Quality Indicators
The ASSIST indicators address supportive care, symptom management, and information and care planning needs of cancer patients, and were developed following a systematic literature synthesis.7-10 A panel of multidisciplinary international leaders from oncology, palliative care, geriatrics, primary care, nursing, and social work evaluated the initial indicator set for validity and feasibility using the RAND appropriateness method, resulting in a revised set of 92 indicators. Indicators use an "If-then" statement, which is represented as a ratio with "if" as the denominator and "then" as the numerator:
Quality Indicator = # patients who received the specified intervention
______________________________________
# patients for whom the intervention was indicated
The numerator describes the care that should be provided. The denominator identifies the patient population to whom the care should be provided. For an individual patient, the indicator could have a value of "pass" or "not pass"; for the population, the range of values is 0-1. For example, the ASSIST quality indicator "IF a cancer patient is receiving a long-acting opioid for cancer pain, THEN he or she should also be prescribed a short-acting opioid for breakthrough pain," is expressed as
The number of patients receiving a short and long-acting opioid
_______________________________________________
The number of cancer patients receiving a long-acting opioid
Data Sources
We developed a detailed medical record abstraction instrument to collect the data elements for scoring each indicator and detailed abstraction guidelines, which were customized to the abstraction process used at each site, including a Microsoft Access-based abstraction tool. To balance the need to abstract detailed information and the time and cost of abstraction, each site specified abstraction windows for the different indicator domains. At JHH/SKCCC, nurses abstracted data from up to 3 cancer-related outpatient visits, including the first 2 visits and last visit. At VAGLAHS, nurses abstracted data from up to 3 months of visits (mean 10, SD 7) for symptom management and up to 12 months for information and care planning. For the patients’ last cancer-related hospitalization, both sites abstracted the first 3 days of the hospitalization for symptom management, and the entire hospitalization for information and care planning. At JHH/SKCCC, after abstracting 148 medical records, we concluded that we had an adequate sample to evaluate the reliability and validity for inpatient symptoms since these indicators were relevant to all patients, and we stopped abstracting this inpatient symptom data only for the remainder of the patients.
At VAGLAHS, following a week-long training and one-week pilot, three experienced nurse abstractors abstracted the electronic medical record (EMR) from the VA Computerized Patient Record System (CPRS), from June – September 2008. At JHH/SKCCC, following similar training, a nurse project manager and three professional nurse abstractors from Delmarva, a Quality Improvement Organization (QIO), abstracted records from July – September 2008. We held regular meetings with abstractors at each site and weekly conference calls with investigators from both sites to ensure shared understanding of the guidelines, and developed a shared abstraction FAQ (Frequently Asked Questions).
Assessment of Feasibility, Reliability and Validity
We assessed feasibility in three ways: during tool development, qualitatively during abstraction, and, during analysis, by evaluating how many patients were eligible for indicators. While developing the tool and guidelines, we excluded indicators at each site irrelevant to the setting or population or infeasible to operationalize or abstract. We modified several indicators at one or both sites to improve feasibility of abstraction and/or analysis. Abstractors took notes on feasibility, including abstraction time and difficulties in finding information or reliably determining a data element, and impressions of abstraction. Finally, we excluded indicators for low prevalence if too few patients were eligible by the denominator n (<3% at VAGLAHS and n=5 at the JHH/SKCCC).
To assess inter-rater reliability (IRR), all nurses at each site abstracted a sample of records (5%, n=8 at VAGLAHS and 4%, n=9 at JHH/SKCCC). At VAGLAHS, we assessed validity by physician implicit review (JLM or KAL) of records of cases that failed quality indicators. At JHH/SKCCC, we assessed validity by comparing nurse abstraction to a physician investigator (SMD) gold standard abstraction for the 9 record IRR sample, and assessed quality control by comparing nurses’ assessments and nurse-physician agreement.
Analyses
We calculated observed agreement and the kappa statistic for indicator eligibility (denominator) and, conditional on eligibility, the care specified by the QI to evaluate IRR. Although no standard for minimum reliability of a quality indicator exists, high reliability is desirable if indicators are intended for accountability or quality improvement.12 We considered IRR to be inadequate when the kappa statistic was < 0.8 for eligibility (denominator) or < 0.6 for care specified by the QI (numerator).13 When possible, we modified initial indicator specifications to determine if reliability could be improved.
Results
Patient characteristics are shown in Table 1; age and ethnicity were relatively similar across the 2 sites, but VAGLAHS patients were almost all male, included more types of cancer, and only half were decedents. Of the total set of 92 Cancer Quality-ASSIST indicators, we excluded three because they were duplicative of other indicators, and 9 because either the data elements were not routinely in the medical record or we concluded that they would require excessive abstraction time. We also excluded 3 indicators not applicable to the sample or setting (e.g. care during stem cell transplant). One included indicator (for pain screening) was split into 2 indicators (inpatient and outpatient). We therefore attempted to abstract 78 and 47 of the 92 quality indicators in the VAGLAHS and JHH/SKCCC study samples, respectively (the JHH/SKCCC study did not include chemotherapy or radiation therapy indicators). The mean abstraction time at JHH/SKCCC was approximately 2.5 hours for patients with a hospitalization and at VAGLAHS was 2.3 hours. Of the successfully evaluated indicators, 22 had inadequate reliability (kappa <0.8 for eligibility or <0.6 for adherence), 9 inadequate validity, and 3 both inadequate reliability and validity in these settings (examples in Table 2). Finally, we excluded 3 indicators that did not meet prevalence criteria in at least one site (8 indicators at JHH/SKCCC did not meet prevalence criteria).
The 41 indicators that met our criteria for feasibility, reliability and validity include 10 of the 15 indicators for pain, 2/5 for depression and psychosocial distress, 7/15 for nausea and vomiting, 2/5 for anorexia and weight loss, 5/8 for fatigue and anemia, 2/3 for diarrhea, 6/8 for dyspnea, 1/5 for delirium, 1 for rash, and 5 for information and care planning (Table 3). Overall kappa was 0.87 for eligibility and 0.86 for specified care; we were also able to calculate individual kappa scores for 9 of the indicators, which ranged from 0.73 – 1.0.
Discussion
In this pilot study of the 92 medical-record based Cancer Quality-ASSIST supportive oncology quality indicators, following development and implementation of an abstraction tool, use of trained abstractors, and analysis of quantitative and qualitative abstraction results, including interrater reliability, 41 met strict criteria for feasibility, reliability and validity for advanced cancer across two clinical settings. These indicators represent all domains of the original ASSIST set except mucositis, insomnia, and fever/neutropenia.
Most quality indicators are adopted and published without rigorous development or evaluation despite evidence that these methods improve validity and risks and misallocation of resources from inappropriate implementation.1 Although several related medical record-based indicator sets addressing different domains or settings have been evaluated,14 including the PEACE Palliative Care Quality Measurement project for hospice and palliative care,15 ASCO (American Society for Clinical Oncology) QOPI (Quality Oncology Practice Initiative) for oncology outpatient care,16 and the VHA set for critical care,17 none has undergone this rigorous development and evaluation process. This study demonstrates the importance of evaluation, since only approximately half the ASSIST indicators, already rigorously developed through a systematic review and expert panel process, met criteria in these pilot tests.
Thirty-seven indicators did not meet our criteria for reliability (n=22), validity (n=9), both reliability and validity (n=3) or prevalence (n=3) in these settings. Most indicators did not meet criteria due to reliability issues. The subjective nature of symptoms and inconsistent documentation augment the challenge of obtaining clinical data manually from records. QIs assessing symptoms and communication are very different from those assessing discrete, concrete events like fecal occult blood testing followup by colonoscopy. For example, absence of symptom(s) was often documented with non-specific language, such as "Appears comfortable," limiting both reliability and validity. However, the indicators might perform differently in other settings. All of these criteria may be affected by documentation practices, practice patterns, site of care (e.g. inpatient vs. outpatient), as well as disease and patient characteristics (which may affect the prevalence of a condition). For example, obtaining records from prior sites of care such as nursing homes in order to assess whether an advance directive was appropriately communicated was not feasible with our settings or resources. However, a similar quality indicator was successfully implemented in a study of quality of care for vulnerable community-dwelling older patients, which obtained medical records from primary care and specialist providers, acute care hospitals, skilled-nursing facilities, and home health agencies.18
Different documentation practices can affect performance for indicators dependent on documentation. However, the Cancer-ASSIST indicator set includes only indicators where experts agreed that poor documentation by itself constituted poor quality of care, because lack of documentation could cause gaps in care processes or communication. For example, lack of documentation about care planning conversations may affect other providers’ ability to effectively address urgent end-of-life decisions. Nevertheless, we found that variation in documentation practices sometimes limited indicators’ reliability. For example, we could not reliably abstract newly-identified moderate to severe pain in ambulatory care in our settings. However, a recent study in patients dying in the hospital found that pain score documentation in inpatient standardized nursing notes was reliable for pain indicators.19 Electronic medical records (EMRs) hold promise for improving the feasibility of data collection for quality assessment, although much of the detailed clinical information in EMRs remains in free text fields which still require abstraction. Potential solutions include natural language processing, structured templates for documenting these issues, and obtaining symptom information directly from patients, potentially with automatic capture in a related database.
An ideal supportive care indicator system should include multiple approaches to quality assessment. Routine symptom screening and recording could improve capacity to evaluate outcomes. Some types of indicators difficult to operationalize in this study, such as symptom followup, may require additional collection of specific outcome data, similar to 48-hour pain followup in hospice.20 Carefully-evaluated available claims-based indicators can be helpful for regional quality evaluation or in databases (e.g., managed care) that cross clinical settings, although their focus is on aggressiveness of care.3 Issues such as communication and spiritual care are challenging to standardize in documentation, and indicators from the patient and family perspective may be needed for these domains and to evaluate the patient’s experience.21,22 Registry-based measures, such as in the CMS (Center for Medicare Services) PQRI (Physician Quality Reporting Initiative)23 or cancer registries, can be another method of measuring quality. These approaches vary in feasibility, cost of obtaining data, validity, usefulness at different points in the clinical trajectory, and how well they reflect current evidence. Advancing clinical evidence, changes in routine clinical data capture, and evaluation of efficient strategies that combine process-outcomes and different report perspectives (e.g, patient and family) will eventually define integrated quality assessment approaches.
This study has several limitations. Although the overall reliability of this indicator set is high, not all indicators were triggered frequently enough for full individual reliability or validity assessment. Further evaluation of these indicators requires better methods for identifying eligible patients (e.g., spinal cord compression), or these rarer quality issues may be better addressed using other methods, such as event reporting. The use of trained nurses experienced in abstraction may have increased reliability beyond what might be expected in community settings. Further refinement of the indicators, abstraction tool, and training guide, and focusing on the subset of indicators with acceptable reliability and validity, could potentially improve some indicators’ performance.
Documentation and the use of EMR use may also differ in other settings, which could either improve or limit these indicators’ performance depending upon the situation. These two urban academic centers shared many features, including relatively coordinated cancer care, a teaching environment and strong support services. However, there were also important differences, including their organizational structures (private vs. VA hospital), the patient populations they serve, and the presence of a strong hospital-wide palliative care program only at the VA at the time of the study, which may have affected the level of documentation. Despite these differences, reliability and validity results were similar across almost all indicators. Not all common malignancies were well-represented in this study (e.g., breast cancer), and further evaluation of these indicators in different cancer types is needed. Although the review times for this initial evaluation were lengthy, their purpose was to determine which indicators had the best potential for reliability and validity; abstraction with a smaller number of indicators would be less time-consuming.
In summary, this report presents the first evaluation of a comprehensive supportive oncology quality indicator set, developed for face validity with clinician experts through a rigorous process of systematic review and expert panel consensus, and evaluated for feasibility, reliability, and validity in two sites. This robust set of quality indicators can be used to evaluate the quality of supportive and end-of-life care for patients with advanced cancer and to identify areas for quality improvement efforts. Future research should evaluate which indicators are critical to efficient and effective quality measurement in these domains and have the greatest correlation with desired patient outcomes.
References
1. Lorenz KA. Promoting efficiency and quality in the Hummer health care system. J Clin Oncol 2007;26:5664-5665.
2. Wennberg JE, Fisher ES, Stukel TA, et al. Use of hospitals, physician visits, and hospice care during last six months of life among cohorts loyal to highly respected hospitals in the United States. BMJ 2004;328:607.
3. Earle CC, Landrum MB, Souza JM, et al. Aggressiveness of cancer care near the end of life: is it a quality-of-care issue? J Clin Oncol 2008;26:3860-3866.
4. Lorenz KA, Lynn J, Dy S, et al. Quality measures for symptoms and advance care planning in cancer: a systematic review. J Clin Oncol 2006;24:4933-4938.
5. McGlynn EA, Asch SM. Developing a clinical performance measure. Am J Prev Med 1988;4:14-21.
6. National Quality Forum. Measure Evaluation Criteria. Available at: http://www.qualityforum.org/docs/measure_evaluation_criteria.aspx.
7. Lorenz KA, Dy SM, Naiem A, et al. Quality Measures for Supportive Cancer Care: The Cancer Quality-ASSIST Project. J Pain Symptom Manage 2009;37(6):943-964.
8. Walling A, Lorenz KA, Dy SM, et al. Evidence-based recommendations for information and care planning in cancer care. J Clin Oncol 2008;26:3896-3902.
9. Dy SM, Asch SM, Naeim A, et al. Evidence-based recommendations for cancer pain management. J Clin Oncol 2008;26:3879-3885.
10. Dy SM, Asch SM, Naeim A, et al. Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea. J Clin Oncol 2008;26:3886-3895.
11. Naeim A, Dy SM, Lorenz KA, et al. Evidence-based recommendations for cancer nausea and vomiting. J Clin Oncol 2008;26:3903-3910.
12. Quality Measurement and Health Assessment Group (QMHAG), Center for Medicare and Medicaid Services. Measure evaluation criteria and subcriteria descriptions. Adopted from NQF Final Evaluation Criteria. Available at: http://www.hsag.com/mms.
13. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1997;33:159-174.
14. Pasman HR, Brant HE, Deliens L, et al. Quality indicators for palliative care: A systematic review. J Pain Symptom Manage 2008;38(1):145-156.
15. The Carolinas Center for Medical Excellence. Palliative Care Quality Measures Project (PEACE). Available at: http://www.qualitynet.org/dcs/ContentServer?c=MQParents&pagename=Medqic%2FContent%2FParentShellTemplate&cid=1228695715754&parentName=Topic.
16. Jacobson JO, Neuss MN, McNiff KK, et al. Improvement in oncology practice performance through voluntary participation in the Quality Oncology Practice Initiative. J Clin Oncol 2008;26:1893-1898.
17. Nelson JE, Mulkerin CM, Adams LL, et al. Improving comfort and communication in the ICU: a practical new tool for palliative care performance measurement and feedback. Qual Saf Health Care 2006;15:264-271.
18. Wenger NS, Solomon DH, Roth CP, et al. The Quality of Medical Care Provided to Vulnerable Community-Dwelling Older Patients. Ann Intern Med 2003;139:740-747.
19. Walling AM, Asch SM, Lorenz K, et al. Quality of end of life care in the hospital. J Gen Intern Med 2009;23:153-154.
20. Connor SR, Tecca M, Lund Person J, et al. Measuring hospice care: The National Hospice and Palliative Care Organization National Hospice Data set. J Pain Symptom Manage 2004;28:316-328.
21. Teno JM, Clarridge B, Casey V, et al. Validation of Toolkit After-Death Bereaved Family Member Interview. J Pain Symptom Manage 2001;22:752-758.
22. Finlay E, Shreve S, Casarett D. Nationwide veterans affairs quality measure for cancer: the family assessment of treatment at end of life (FATE). J Clin Oncol 2008;26:3838-3844.
23. American Medical Association Physician Consortium for Performance Improvement. Consortium Measures. Available at: http://www.cms.hhs.gov/pqri.
Tables
Table 1. Patient characteristics
Johns Hopkins Veterans Affairs Greater Los Angeles
N N=238 N=118
Age, mean (SD) 60.5 (12.0) 65.9 (9.9)
Female 125 (52.5%) 2 (2%)
Race/Ethnicity Caucasian 155 (65%) 73 (62%)
African American 76 (32%) 36 (30%)
Other 7 (2%) 9 (8%)
Cancer Type Breast 6 (3%) 1 (1%)
Colorectal 28 (12%) 15 (13%)
Esophagus/stomach 10 (8%)
Genitourinary 8 (7%)
Head and neck 27 (23%)
Liver/biliary 4 (3%)
Lung 132 (55%) 27 (23%)
Pancreas 72 (30%) 6 (5%)
Prostate 20 (17%)
Died during study period 100% 55 (49%)
Table 2. Examples of quality indicators with significant issues with feasibility, reliability or validity in these settings
Indicator Issue
Measure not feasible IF a patient with head and neck cancer is undergoing radiation treatments THEN midline radiation blocks and three-dimensional radiation treatments should be used Use of blocks not documented in radiation oncology notes
IF a patient with advanced cancer has an advance directive/DNR and the patient receives care in a second venue, THEN the advance directive/DNR should be present in the medical record at the second venue or documentation should acknowledge its existence, its contents, and the reason that it is not in the medical record Challenging to obtain records from different settings
Measure not reliable IF a patient is diagnosed with cancer, THEN s/he should be screened for depression within 1 month following the diagnosis Inadequate reliability for specified care (numerator, kappa=-0.29); variability in documentation for mood assessment
IF a patient with cancer has new fatigue, THEN there should be an assessment within 1 month of the initial documentation of fatigue for either insomnia or depression No patients eligible with original specification. Alternate specification dropping "new": inadequate reliability for indicator eligibility (denominator, kappa=0.3); variability in documentation indicating absence of fatigue
IF a patient is newly known to have advanced cancer after a surgery, diagnostic test, or physical exam, THEN a discussion including prognosis and advance care planning should be documented within 1 month or a reason why such a discussion did not occur Inadequate reliability for specified care (numerator, kappa=0.56); challenging to identify content of discussions from documentation
Measure not valid IF a hospitalized patient has a change in his/her pain regimen to treat severe, sustained cancer pain THEN there should be an assessment of whether or not the change in treatment reduced the pain within 4 hours Challenging to identify severe sustained pain, time medication administered and time of pain assessment. Time of documentation may not reflect the time of assessment
IF a patient with advanced cancer has documentation of dyspnea despite treatment with non-opioid medications or underlying causes, THEN they should be offered opioids within one month or there should be documentation of contraindications to opioid therapy Requires experienced clinician to distinguish dyspnea refractory to treatment with non-opioid medications; elements necessary to identify eligible patients often not well documented
IF a cancer patient has a positive screening for pain THEN the provider should assess the likely etiology/ies of the pain Etiology of pain often indirectly addressed rather than directly linked to pain evaluation, especially when related to cancer
Table 3. Quality indicators that met criteria for feasibility, reliability, and validity in these settings
Indicator Criteria
Only one indicator met criteria at JHH/SKCCC but not at VAGLAHS: IF a patient with cancer over the age of 65 or with advanced disease is admitted to the hospital THEN cognitive status should be evaluated within 48 hours of admission (100% agreement).
Pain If a cancer patient has a cancer-related outpatient visit then there should be screening for the presence or absence and intensity of pain using a numeric pain score
IF a cancer patient is admitted to a hospital then there should be screening for the presence or absence of pain
If a patient with cancer pain is started on a long-acting opioid formulation, then a short-acting opioid formulation for breakthrough pain should also be provided
If a patient with cancer pain is started on chronic opioid treatment then he/she should be offered either a prescription or nonprescription bowel regimen within 24 hours or there should be documented contraindication to a bowel regimen
If a patient's outpatient cancer pain regimen is changed, then there should be an assessment of the effectiveness of treatment at or before the next outpatient visit with that provider or at another cancer-related outpatient visit
If a patient has advanced cancer and receives radiation treatment for painful bone metastases then he/she should be offered single-fraction radiation OR there should be documentation of a contraindication to single-fraction treatment
If a cancer patient has new neurologic symptoms or findings on physical examination consistent with spinal cord compression then he/she should be treated with steroids as soon as possible, but within 24 hours or a contraindication to steroids should be documented
If a cancer patient has new neurologic symptoms or findings on physical examination consistent with spinal cord compression then a whole-spine magnetic resonance imaging (MRI) scan or myelography should be performed as soon as possible, but within 24 hours OR there should be documentation of why an MRI scan was not appropriate
If a cancer patient has confirmation of spinal cord compression on radiologic examination, then radiotherapy or surgical decompression should be initiated within 24 hours or a contraindication for such therapy should be documented
If a cancer patient is treated for spinal cord compression then there should be follow-up of neurologic symptoms and signs within 1 week after treatment is completed
Depression and Psychosocial Distress If depression is diagnosed in a cancer patient, then a treatment plan for depression should be documented
If a patient with cancer is treated for depression, then response to therapy should be documented within 6 weeks
Nausea and Vomiting If a patient with cancer undergoing moderately or highly emetic chemotherapy or with advanced cancer affecting the gastrointestinal tract or abdomen is seen for a visit in a cancer-related outpatient setting, then the presence or absence of nausea or vomiting should be assessed at every visit
If a patient with advanced cancer affecting the gastrointestinal tract or abdomen is admitted to a hospital, then the presence or absence of nausea or vomiting should be assessed within 24 hours
If a patient with cancer is undergoing chemotherapy treatment with a high acute emetic risk, then a 3-drug regimen including single doses of a 5-HT3 receptor antagonist, dexamethasone, and selective neurokinin-1 receptor blocker should be given immediately prior to chemotherapy
If a patient with cancer is undergoing chemotherapy treatment with a moderate acute emetic risk, then a 2-drug regimen including a 5-HT3 receptor antagonist and dexamethasone should be given immediately prior to chemotherapy
If a patient with cancer reports nausea or vomiting on admission to the hospital, then within 24 hours potential underlying causes should be assessed
If an inpatient with cancer has nausea or vomiting, then within 24 hours of the initial report of nausea and vomiting, the patient should be offered a change in therapy
If an outpatient with cancer not receiving chemotherapy or radiation is treated for nausea or vomiting with an antiemetic medication, then the effectiveness of treatment should be evaluated before or on the next visit to the same outpatient site
Fatigue/Anemia If a cancer patient is seen for an initial visit or any visit while undergoing chemotherapy at a cancer-related outpatient site, then there should be an assessment of the presence or absence of fatigue
If a known cancer patient is newly diagnosed with advanced cancer, then there should be an assessment of the presence or absence of fatigue
If a patient with cancer is found to have anemia with a hemoglobin <10 g/dl, then the presence and severity of anemia-related symptoms (e.g. fatigue, dyspnea, and lightheadedness) should be evaluated
If a patient with cancer is found to have severe, symptomatic anemia (hemoglobin <8 g/dL),then transfusion with packed red cells should be offered to the patient within 24 hours
Anorexia/Weight loss If a patient presents for an initial visit for cancer affecting the oropharynx or gastrointestinal tract or advanced cancer at a cancer-related outpatient site, then there should be an assessment for the presence or absence of anorexia or dysphagia
If a cancer patient is treated with an appetite stimulant for anorexia, then there should be an assessment before or on the next visit to the same outpatient site of whether or not there was an improvement in anorexia
If a cancer patient is treated with enteral or parenteral nutrition, then there should be an assessment prior to starting nutrition that there was difficulty maintaining nutrition due to significant gastrointestinal issues and that expected life expectancy was at least one month
Dyspnea If a patient with cancer reports new or worsening dyspnea, then there should be documentation of cause or of investigation of at least one of the following: hypoxia, anemia, bronchospasm or chronic obstructive pulmonary disease, pleural effusion, tumor obstruction of bronchi or the trachea, pneumonia, or pulmonary embolism
If an outpatient with primary lung cancer or advanced cancer reports new or worsening dyspnea, then they should be offered symptomatic management or treatment directed at an underlying cause within one month
If an inpatient with primary lung cancer or advanced cancer has dyspnea on admission, then they should be offered symptomatic management or treatment directed at an underlying cause within 24 hours
If a patient with cancer in the hospital is treated for dyspnea, then there should be an assessment within 24 hours that the treatment was effective in relieving dyspnea OR that a change in treatment for dyspnea was made
If a cancer patient has dyspnea and a malignant pleural effusion, then they should be offered thoracentesis within 1 month of the initial diagnosis of the effusion, or other treatment (e.g., diuresis) should result in a reduction in the effusion or symptomatic dyspnea
If a cancer patient with a malignant pleural effusion undergoes thoracentesis, then there should be a repeat assessment of dyspnea within one week
Treatment-Associated Toxicities
Diarrhea If a patient with cancer is undergoing chemotherapy and has diarrhea then in order to classify the diarrhea as complicated or uncomplicated all of the following should be assessed: · history of onset and duration,· number of stools and stool composition, and· at least one of the associated symptoms[fever, dizziness, abdominal pain/cramping, nausea/vomiting, decreased performance status, sepsis, fever, bleeding, or dehydration]
If a patient with cancer is undergoing chemotherapy with a high risk (>10%) of chemotherapy-induced diarrhea then an antidiarrheal agent should be prescribed on or before treatment is initiated
Delirium IF a hospitalized patient with cancer over the age of 65 or with advanced cancer has delirium THEN there should be an assessment for the presence or absence of at least one of the following potential causes and their association with delirium: medication effects, central nervous system disease, infection, or metabolic processes
Skin Rash If a patient with cancer who is being treated with agents that block epidermal growth factor receptors (EGFR), then the presence and severity of skin rash should be evaluated within 1 month after starting the treatments and at each visit
Information and Care Planning If a patient with advanced cancer dies an expected death, then there should be documentation of an advance directive or a surrogate decision maker in the medical record
If a patient with advanced cancer dies an expected death, then s/he should have been referred for palliative care prior to death (hospital-based or community hospice) or there should be documentation why there was no referral
If a patient with advanced cancer is admitted to the ICU and survives 48 hours, then within 48 hours of ICU admission, the medical record should document the patient's preferences for care or attempt to identify them
If a patient with advanced cancer is mechanically ventilated in the ICU, then within 48 hours of admission to the ICU, the medical record should document the patient's preference for mechanical ventilation or why this information is unavailable
If a patient with cancer undergoes chemotherapy, then prior to chemotherapy, s/he should be informed about the risks and benefits of treatment, including likely symptoms and side effects, and whether the treatment intent is curative or palliative
Journal Publications
Dy SM, Lorenz KA, O'Neill SM, et al. Cancer Quality-ASSIST supportive oncology quality indicator set: feasibility, reliability, and validity testing. Cancer 2010;116:3267-75.
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How Does Sleep Affect Your Body?
Published 31 May 2018, 11.30 am
Sleep is an essential part of your health and well-being. It is equally essential as a healthy diet and regular exercise. Research shows that getting enough sleep every night helps protect your physical and mental health as well as improve your quality of life. There are a number of key important outcomes from getting continual, adequate, and restful sleep:
Improved mental health
Lack of adequate sleep often leads to forgetfulness, irritability, and tiredness. Restorative sleep helps your brain regenerate and function properly. A good night sleep allows your body to remove dead blood cells and brain cells to clear pathways for newer synapses that help you maintain maximum cognitive brain function.
A healthy heart
According to research conducted by the University of Warwick, getting less than 6 hours of sleep over
an extended period increases your chances of heart failure by 48% and suffering from stroke by 15%. This is because sleep deprivation disrupts biological processes like blood pressure, inflammation, and glucose metabolism.
Weight
Lack of sleep increases chances of obesity. Sufficient sleep helps your body sustain a healthy balance of the production of the hormones responsible for making you feel hungry and full. When you deprive your body of sleep, it produces more ghrelin which ultimately increases your appetite. If you stay awake for longer hours, your body will need more energy to help you stay up longer. Therefore, you tend to eat more.
Immune system
If you consistently skimp on needed rest, the chances are that you fall sick often becomes higher. Sleep deprivation weakens the immune system. It makes you more prone to catching colds and flu. When you sleep, your body creates disease fighting hormones to fight off diseases and infections. Hence, if you do not sleep enough, you restrict your body’s ability to create these substances leaving you more prone to any virus or bacteria you encounter. Recent research also shows that sufficient sleep will help you get more preventative benefits from vaccines.
Healthier skin
Sleep is food for your body, brain, and skin. Poor sleep can cause chronic skin conditions and make
your skin age faster. However, when you get sufficient sleep, your body produces new collagen that helps prevent skin sagging, which in turn leads to fewer wrinkles. Also, a good night sleep will give your skin sufficient time to recover from ultra violet light exposure.
In case you are experiencing difficulty falling asleep, here are a few tips to help you snooze.
• Adopt a regular sleep/wake cycle
• Avoid alcohol, big meals, and smoking before bedtime
• Exercise regularly
• Do not nap for too long or too late in the day
Sleep is a vital part of maintaining overall wellness in so many ways. It can make an enormous impact on the quality of your life. Hence, it is important that you prioritize getting adequate and consistent sleep every night.
If you feel stressed, have anxiety, trouble sleeping, or any emotional distress, please contact us today at Novus Anti-Aging Center and we will be happy to get you back on track.
WebToMed Medical Website Design
Medical Website Design and Internet Marketing by www.webtomed.com
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1a01aa77535b9ecfb87b9fc36adbcd2f
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7,098,836,916,948,684,000
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Skip to main content Skip to navigation
Chromium-plated insufflator
An insufflator pumps carbon dioxide into the peritoneal cavity (the abdomen) to provide an "optical space" which permits examination of the abdominal contents. Carbon dioxide is used to distend the abdomen as it is very soluble in blood and easily exhaled through the lungs. The presence of carbon dioxide distends the abdomen increasing the difficulty of spontaneous breathing, thus increasing the need for mechanical ventilation and close monitoring of the patient as compared to traditional surgeries.
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Tuesday, September 21, 2021
General
Spinal And Processes Body Functions
Spinal is mostly brought on by wear-and-tear modifications within the spine related to aging. In extreme instances of spinal cells on the injury space and, more importantly, by modifications molecules that repress the translation of target mRNA. To grasp the mechanisms underlying gene alterations following SCI, we analyzed the microRNA expression patterns at different time factors following rat spinal cord damage. Start by mendacity on your stomach, together with your toes hips distance apart.
If find more information doing the plank in your forearms, attempt to maintain your forearms utterly parallel (like train tracks). Now flex your feet so your toes are braced towards the flooring and your heels are pointing toward the ceiling. Lift your torso and legs off the flooring so you are supporting your weight with solely your forearms and toes. Try to keep your tailbone slightly tucked to prevent your back from arching.
If you happen to discover that you’re starting to feel any ache in the lower again or you might be getting drained, you can place your knees on the flooring for assist. Try to hold for 60 seconds and remember to keep drawing your belly button in. The spinal system in our physique are present the totally different course of carried out with train and common maintenance of yoga tips and one other means of services is considered one of an important maintain the part of physique which is completed body. It has a large impact on the way the rest of our physique functions.
Therefore, this can be very and approach of one other manner of therapy which is give the right manner of health and outcomes important to maintain work on energy with the muscles across the spine so as to maintain your body wholesome. Different approach of body remedy companies with muscles, and the core of your body, is one among the primary steps in the direction of improving the health of your spine. You can think of the “well being” of your spine by thinking of your posture.
As in every part else, persistence and perseverance will additional you to your targets in a more effective approach instead of rushing issues. Once you are able to stroll a few steps in a gradual method, try utilizing different muscles of your body. Move your trunk, bend your knees a bit, transfer as in the event you have been going to jump, get the feeling of floating.
The concept is to be relaxed on the slackline and walk like a feline would, that’s to say, in a graceful and relaxed manner. Don’t overlook to breathe! Breathing deeply while slacklining helps so much, similar to yoga. Make it a meditative follow and take a deep breath, stroll a couple of steps, then exhale fully.
However, don’t get tense trying to carry the air in your lungs. just click the next site ought to really feel natural and relaxed. Take breaks from time to time. Slacklining makes use of muscles that most individuals don’t use. Once your legs and arms get drained, take a break and then start once more. Highly recommended Resource site may additionally really feel some type of psychological exhaustion after you try slacklining for a couple of hours.
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Dental Implant Reviews Tijuana
How Can I Avoid Dental Implants?
There are a variety of alternative tooth restoration methods that are less expensive and do not require implants. Although these techniques can help restore lost tooth volume but they can only offer an interim solution. In addition, they could cause more harm than good, like damage to the enamel of the teeth and gum disease that leads to loose teeth and cavities. Fortunately, proper regenerative care can help restore gum health and avoid the need for dental implants.
Sugary foods
When it regards dental implants it is essential to avoid eating drinks and foods high in sugar. They can cause damage to the implants as well as your natural teeth. Also, you should avoid certain sauces, such those used on your steak. Drink plenty of water instead to keep your mouth clean and hydrated.
Candies and sweets with sugar are likely to adhere to the surface of the implant and cause it to fail, resulting in an infection. After undergoing dental implant surgery, it’s crucial to avoid eating sweet foods as well as hard food. They can cause mouth irritation which could lead to an unfavorable situation.
If you’re wondering about the foods to avoid after dental implants, consult your dentist. He or she can provide more information. You can even get an appointment for free. By calling your Cumberland dentist, you can ask about post-implant treatment. Additionally, your dentist may have some suggestions to prevent infections that can occur after dental implants.
It is important to avoid eating sticky, hard or acidic food items following dental implant surgery. All of these can disrupt the healing process of implants. Hot and acidic foods can also influence the healing process of soft tissue around the implant. After recovering from dental surgery, it is essential to stay clear of soda and other beverages that contain sugar. Those foods contain sugar and can lead to further complications.
It’s okay to indulge in soft, chewy foods however it is important not to consume too much sugar. These include muffins, cakes, as well as pies. Although they may seem innocent at first, they could cause damage to your dental implant. To avoid this from happening, you must clean your teeth frequently.
Smoking
While dental implants are extremely effective for improving dental function, smoking can negatively impact the effectiveness of dental implants. Combining smoking and dental implant treatment can increase the risk of failure. Dental Associates of New England can help you understand the risks and complications of dental implants treatment. This guide explains the reasons why smoking should be avoided by patients who undergo dental implant therapy.
Stop smoking cigarettes if considering dental implants. Smoking restricts blood flow and increases the chance of complications. Stop smoking for a minimum of two months and quit smoking one week prior to the surgery. This will allow your body to heal quicker and allow for the initial stages of the process of osseointegration.
Smoking also affects the immune system, which makes implants less secure. Additionally, smoking affects the tissues in the mouth like the gums and teeth. This can lead to tooth decay and stains on your teeth. It could also cause gum disease, and increase the chances of implant failure.
Smokers also have a higher risk of developing peri-implantitis. It is caused by the accumulation of bacteria around the implant’s base. It causes irritation to the gums as well as the bone around the implant, which weakens the osseointegration bonds. Implants that are dental may fail due to bone loss.
If you are considering having dental implants, it is crucial to quit smoking cigarettes as soon as you can. While it’s not always feasible to completely quit smoking the best option is to cut down on the amount of cigarettes you smoke. Smoking less cigarettes will greatly enhance the efficacy of dental implants, and will also boost your overall health.
High-intensity exercise
Although dental implants have an success rate of 95% percent, they carry certain dangers. They could result in the implant failing. These risks can be minimized by a dentist who makes recommendations before dental implant surgery. Patients should stay away from vigorous exercise for a minimum of 48 hours following surgery and should avoid vigorous movements. Also, they should make sure to rest more and avoid heavy lifting for a minimum of a week.
Although it is tempting to workout immediately after waking up after receiving dental implants, a high-intensity exercise routine could increase blood flow to the surgical site which could cause a delay in the healing process. Patients should consult their dentist to determine when they are permitted to exercise or engage in other strenuous activities. Each patient’s healing process will be different, and some may be able to exercise in just a few days, whereas others might need to wait several weeks or even months. Patients must listen to their bodies and stay away from exercise until their dentist has cleared them.
While physical activity and exercise are essential to a person’s overall health However, many people might not be aware of the potential dental dangers involved. Exercise that is intense should be restricted to the duration of a couple of hours per week. During this time, patients should avoid eating snacks with high sugar content. Additionally, they should continue brushing their teeth after consuming sugary snacks.
Gum disease
Gum disease can be prevented in numerous ways. One of them is proper dental hygiene. This will help you avoid the swelling, red, and bleeding gums that can happen after dental implants. Keeping your gums healthy is crucial to protect the implants as well as your remaining teeth. It will preserve your new teeth for years to come.
Brushing your teeth after each meal is a great method to remove food particles as well as plaque. It is also important to floss regularly to remove food particles and plaque from between your teeth. Regular visits to the dentist are suggested to keep your teeth in good condition. During these visits, your dentist may recommend a procedure referred to as a scale-and-polish. This procedure is designed to remove plaque and food particles from the gumline. Gum disease can also be caused by smoking, so it is important that you quit smoking before you get dental implants.
In addition to regular dental hygiene It is also important to visit a periodontist in order to ensure that your mouth is healthy enough to be able to receive implants. While most dentists are trained to treat periodontal diseases however, not all of them are qualified. It is possible to stop the disease from getting worse and to help patients get implants.
Gum disease can lead to serious issues. Gum disease may lead to tooth loss. If not treated the condition could cause an infections of implants and cause significant damage.
Smoking can interfere with healing.
Smoking cigarettes can hinder the healing process of dental implants. This is because nicotine blocks the gums from receiving oxygenated blood, which is necessary for the growth of cells and for repair. This can cause a significant delay in the healing process and eventually affect the performance of dental implants. Gum disease can also be caused by smoking cigarettes.
It is vital to be honest about your smoking habits with your dentist. Smoking is a leading cause of death and illness in the UK. About 78,000 people die each year due to smoking-related diseases. Many more suffer from smoking-related illnesses like stroke, heart disease, pneumonia, and many other cancers.
While some people can have dental implant surgery, others shouldn’t smoke for at minimum one week before the procedure. It is essential to follow the directions of your dentist during the time of recovery. This includes limiting your eating habits, smoking, drinking, and alcohol consumption. In addition to this, you should limit your consumption of caffeine, alcohol, and nicotine, as these can interfere with the healing process.
Smoke from cigarettes can cause irritation to the oral tissues and damages salivary glands. The absence of saliva will weaken the gums and bone which support dental implants. Nicotine also reduces blood flow to the area. Without enough blood flow and oxygenation these tissues will not be able to heal. The immune system is also affected by smoking cigarettes.
There are many reasons that smoking cigarettes may hinder the healing process of dental implants. Tobacco smoke, for example reduces the amount of oxygen in the bloodstream, which is vital for the growth of bone. It also weakens the immune system, making it difficult for gums and teeth to heal properly.
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High-throughput analysis of single cell transcriptomes case study
Cells
Traditionally, gene expression experiments are undertaken on samples containing millions of cells. While this allows the identification of differentially expressed genes and transcripts in distinct cell populations, many subtle differences between cells in the same sample can be overlooked. Recent advances in high-throughput cell separation and transcriptomic analysis techniques has spawned the burgeoning field of single cell transcriptomics, which allows much more detailed analysis of gene expression.
The R2C2 technique delivers highly accurate, full-length transcripts.
At the University of California, Santa Cruz, Dr. Christopher Vollmers and his team are using single-cell transcriptomics to investigate gene expression in B cells. As Dr. Vollmers points out: ‘Each B cell makes a unique antibody transcript, so you really have to go at the single cell level to understand what B cells do’ 1.
In order to obtain full-length transcripts, which is a significant challenge when using short-read sequencing technology, the team developed a novel amplification strategy, which, when combined with the long reads delivered by nanopore sequencing, provided highly accurate, full-length reads. This Rolling Circle to Concatermeric Consensus (R2C2) method allows the generation of a consensus sequence for each transcript, thereby increasing base accuracy (Figure 1).
Utilising this technique allowed transcriptome analysis of 96 individual B cells, delivering over 400,000 full length cDNA reads with a median base accuracy of 94%2. Using an updated version of their Mandalorion data analysis pipeline, these reads could be used to identify high-confidence RNA transcript isoforms. A key finding of their study was that many of the B cells analysed, which were obtained from a healthy individual, express isoforms of the CD19 gene that lack the epitope targeted by CAR T-cell therapy — a discovery which may have significant implications in cancer treatment. This finding would not have been possible using short-read sequencing or without single-cell analysis.
According to the team: ‘The R2C2 method generates a larger number of accurate reads of full-length RNA transcript isoforms than any other available longread sequencing method’ 1. They further comment that they: ‘...believe that R2C2 has the potential to replace short-read RNA-seq and its shotgun approach to transcriptome analysis entirely, especially considering the […] wide release of the high-throughput PromethION sequencer’ 2.
human fig 7.PNGFigure 1: Schematic of the R2C2 method. Following cDNA circularisation, rolling circle amplification creates multiple joined copies of the transcript. After sequencing, each read is split into its constituent subreads which are then aligned to generate an accurate consensus sequence. Figure courtesy of Dr. Christopher Vollmers, University of California, Santa Cruz.
This case study is taken from the human white paper.
Download the human genetics white paper
References
1. Vollmers, C. Improving MinION read accuracy to enable the high-throughput analysis of single cell transcriptomes. Presentation. Available at: https://nanoporetech.com/resource-centre/ improving-minion-read-accuracy-enable-highthroughput-analysis-single-cell [Accessed: 1 August 2018]
2. Volden, R. et al. Improving nanopore read accuracy with the R2C2 method enables the sequencing of highly-multiplexed full-length single-cell cDNA. Proc Natl Acad Sci U S A. doi: 10.1073/pnas.1806447115 (2018).
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> Hints > FAQs
FAQs
You'll find lots of your questions answered in this section. This information is based on my scientific research coupled with real people's experiences.
When you read The Don't Go Hungry Diet, you will have many "aha" moments as your questions about permanent weight loss are answered.
To read a FREE sample of my book The Don't Go Hungry Diet now, click here.
How is the Don’t Go Hungry Diet different from conventional diets?
Is there anything I can’t eat on the Don’t Go Hungry Diet?
How fast will I lose weight on the Don’t Go Hungry Diet?
What is the Famine Reaction?
What is the Fat Brake?
I’m struggling to lose the last 5 kilos. Any tips?
Why do this slower diet when I could lose 1 kg a week on another one?
How does the Don’t Go Hungry Diet compare to higher protein diets?
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Help! I gained a kilo in a week!
I already eat healthily and exercise, so why aren't I losing weight?
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What the experts say...
"Dr Amanda, Long time no write/hear. A lot has happened diet-wise since we last communicated. I have LEARNED. Never before have I dieted *for life*. Diets for me in the past have always been a means to an end. Your book has taught me many things. Mainly that a diet and the way we eat is a permanent thing, and secondly HOW to listen to my body when it's hungry and when it's full. At the beginning of this process my immediate goal was to quickly lose weight. This has evolved into a desire to lose weight, but at my body's pace. As a result, I am continuing to lose weight, but I've removed the time frame. My *long term* target is 80 kg, and in time, I believe I will achieve this. Once again, I thank you for your wise and sensible advice from one of the best books on the subject in print! Matthew P.S. Attached is my progress, kept updated since my last contact. I have now lost 11.5 kilos since I started your program nine months ago. "
- Matthew, Bahrs Scrub, QLD
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Home WelfareGeneral well-being Why do I have low vitamin D
Why do I have low vitamin D
by Alivia Nyhan
Published: Last Updated on
Many people believe that they do not suffer from a vitamin D deficiency because they regularly consume foods fortified with this nutrient. However, this is not the case and suffering from a low level of vitamin D in the body is a fairly common disorder. There are very few foods with adequate therapeutic levels of this substance, and those fortified do not have the necessary amount to cover what your body demands.
Also, many people believe that vitamin D, also known as calciferol, is a pervasive and accessible substance to acquire, but this is not the case either. It is a steroid hormone that is not easily found in food, but sun exposure is the primary way to obtain it.
The primary function of calciferol is to help absorb calcium and maintain a balance with phosphorus. If you discovered a deficiency of this substance in your body and wonder why you have low vitamin D, at FastlyHealwe want to offer you some details.
Little sun exposure
Generally, during the winter, you do not encounter frequent sun exposure, which can be a possible answer if you wonder why you have low vitamin D. This can also happen if you are one of the people who are without have much exposure to the sun throughout the year, such as the elderly or those who have a disability who cannot go out frequently, among others.
Although overexposure to the sun can cause significant damage to your body, especially to your skin, if you do not have adequate protection, lack of exposure to the sun can also cause damage, such as having a low level of vitamin D in the body. 10 to 15 minutes in sunlight is enough since this light intervenes so that provitamin D and part of the cholesterol is transformed into vitamin D.
A bad diet
If you eat a diet with an absence of foods such as meatfish, or different dairy products, for example, if you are a vegetarian, you become more prone to suffer from vitamin D deficiency.
In addition, if you are one of the people with this type of diet, you could suffer from other disorders because they have not only a low level of vitamin D in the body but also other essential nutrients for you to be healthy in shape.
Digestive diseases
If you maintain a proper diet and still your vitamin D level is low, you may suffer from a digestive disease since many of them have, as a consequence, poor absorption of the nutrients that are integrated into the food you eat.
This is the case of liver failure and pancreatic damage, among other disorders. You must always undergo regular medical checks to detect any changes in time and carry out the appropriate treatment.
Other pathologies
If you are still wondering why I have low vitamin D, other pathologies could cause this disorder, such as osteoporosis, hypothyroidism, obesity, cancer, alcoholism, and chronic kidney failure.
These pathologies have numerous symptoms, and the deficiency of vitamin D in your body is one of them. This is why it is essential always to keep diseases under control
What causes a lack of vitamin D?
Some of the following diseases can develop when you have a low level of vitamin D in your body:
• Dental cavities.
• Colon, prostate, or breast cancer.
• Intestinal inflammation
• Bone deformations, mainly in children.
• Osteoporosis.
• Weak bones in children are called rickets.
Symptoms of vitamin D deficiency
The main symptoms of vitamin D deficiency that you may observe are:
• Sores in the mouth
• Lack of vision
• Swelling in the joints
• Sleep disorders.
This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.
If you want to read more articles similar to Why do I have low vitamin D, we recommend that you enter our Wellbeing category .
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Sciatica – Sydney chiropractor discusses some common myths
leg painSciatica, probably one of the most common self diagnoses I hear in practice! For the most part people inaccurately use the term “sciatica” to describe any pains that occur in the lower back and radiate into the leg. True sciatica, is the result of compression and or irritation of the spinal nerves either as they exit the low back or further down where they form a bundle (the sciatic nerve) passing through the pelvis into the back of the leg. Sciatica can be a combination of pain, pins and needles, numbness and or weakness in the affected leg and can be on one or both sides.
There are a multitude of other reasons why someone may get back and leg pain!
These include though not limited to injuries to the muscles, joints and supporting structures of the spine, pelvis, hips and lower legs.
Injuries that we commonly see in practice that are mistaken for sciatica are:
1) Hip Bursitis
2) Hamstring tendonitis
3) Recurrent Gluteus medius strain with active trigger point referral
4) Lumbar facet joint sprain
5) Sacroiliac sprain and/or instability
6) Foot and ankle injuries such as plantar fasciitis and Achilles tendonitis
Each injury requires a different management strategy for a full and proper recovery to occur. So when low back and leg pain present a full evaluation and proper diagnosis is the most important step before pursuing any particular type of treatment.
Here are some other distinctions that need to be made about true sciatica:
1) Can occur with or without back pain
2) Occurs in the back of the leg. Pain in the front of the leg has nothing to do with the sciatic nerve.
3) Is commonly caused by disc herniation
4) Is less commonly caused by compression by the muscles in the pelvic region
At Better Health we have a very experienced team of chiropractors, physiotherapists and podiatrists ready to review your case and make sure you get the right sort of care for your particular problem. If you would like further help with your sciatica please contact us on 9518 0722.
Yours in Better Health
Dr Andrew Richards Principal Chiropractor Better Health
Dr Andrew Richards (Chiropractor)
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Seasonal Affective Disorder
Depressive disorders is a discouraging situation that people ought to attempt to learn how to consider significantly in to get better. It can trigger severe Psychological and bodily aspect effects. A lot of details are accessible concerning depressive disorders. You can select from organic remedies, therapy, and prescription medicines amongst other ways for your plan for treatment to fight depressive disorders. Beneath is an post to assist you in Discovering the most efficient way to deal with your depressive disorders, and make it a factor of the past.
Attempt to keep your regular degree of socialization. Depressive disorders might prevent you from attempting to do your regular actions. In spite of this, remaining sociable is essential to defeating depressive disorders. Continue your regular actions. Shying from your regular actions will only worsen your depressive disorders.
Steer clear of environment, that will end up in a unfavorable cycle of depressive disorders symptoms. Over-analyzing your unfavorable ideas and emotions can have the exact same effect. Transferring your focus on the strengths of your existence While motivating other people to do the exact same can have a severe impact on your general condition of thoughts.
When attempting to deal with depressive disorders, discovering some new pastime or curiosity can be helpful. Keep your existence filled with pursuits and actions, or else it might result in depressive disorders. Attempt some factor you have usually desired to do, for example dancing, artwork or skydiving. No issue what, the secret is to keep in thoughts that new pursuits can help you deal with your depressive disorders.
A lengthy bathtub is generally effective in soothing you, if you really feel at a loss for your depressive disorders. Relaxing in the bathtub hearing soft, soothing songs, or studying your preferred guide can help much ,you really feel better. The hotter the water, the more enjoyable. Your muscle tissue will really feel great, so operate the bathtub as warm as you can securely tolerate.
You need to keep in thoughts that you’re in control of your ideas. Consider away the term stressed out from your whole vocabulary. The term has unfavorable associations and implications, and results in poor emotions and ideas. Remember, phrases have energy, and stressed out is an effective term. Use key phrases like “sensation poorly”, or “not my greatest”, to consider away some of the energy from your emotions.
Decorate your the place to find be as positive and pleased as you can. This will trigger you to normally really feel better your self.
Depressive disorders can be brought on by numerous fundamental factors, and you ought to make your greatest work in attempting to figure out what these fundamental factors are, for your personal depressive disorders. It will be quicker to deal with your emotions if you know very well what leads to them.
You need to look for help from a expert if you are struggling with depressive disorders or even program sadness. They will be in a position to correctly identify you, and determine if you will need any type of medication. They also have the capability to let you know precisely what proper diagnosis of depressive disorders is unpleasant to you.
It is vital that you have a knowledge of precisely what depressive disorders is. Depressive disorders isn’t only psychological, but it is bodily as well. This amounts in your thoughts are restricted by extra amounts of tension and anxiety. This can even make you really feel more stressed out.
Medicines for example, anti-depressants are recommended for depressive disorders, as this promotes the thoughts to step-up its manufacture of this. There are also a quantity of organic techniques which can improve you. Looking after your bodily requirements is the greatest factor you can do to remedy depressive disorders.
Make certain you consume sufficient, and consume wholesome, and well balanced meals. In addition, you ought to bodily exercise, and participate in effective bodily exercise during the day time so that you’re exhausted at evening, and can go to mattress at a sensible hour. Restrict your use of caffeine, which is a stimulant, so that you rest sufficient. Finally, if you’re stressed out, you ought to probably steer clear of Alcoholic beverages. Alcoholic beverages is a depressant, so you need to be cautious of it , if you’re currently sensation is slow or stressed out.
http://www.bipolar4lifesupport.co
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Skip to content
Why Does Rogaine Cause Hair Loss? (Expert Answers)
⌚️ Got only 60 seconds?
Increased hair loss, one of the most publicized side effects of minoxidil, is often the result of hair follicles rapidly moving through the hair growth cycle and shedding before an anagen phase. This is normal as it is part of the mechanism in how minoxidil works.
We also recommend that you watch this video:
Related Questions
1Does Rogaine Make Your Hair Fall Out?
Rogaine can cause a form of temporary hair loss called minoxidil-induced telogen effluvium. Your hair cycles through four stages of growth: anagen, the growing phase. catagen, transition phase.
2Can Rogaine Make Hair Loss Worse?
The short answer is, no, your Rogaine treatment is not causing you to lose more hair than before, and it will not make it worse than it would be in the future. To understand why it’s not causing your hair loss to get worse, let’s take a look at what Rogaine is and how it works.
3How Long Does Hair Fall Out After Starting Rogaine??
How long does Minoxidil Shedding last? Minoxidil shedding (increased hair loss after using Minoxidil) typically only occurs at the beginning of your treatment. Research shows that minoxidil shedding starts 2-8 weeks after beginning the treatment. After that, the shedding is usually seen to subside.
4Why You Shouldn’T Take Rogaine?
Stop using this medication and tell your doctor right away if you have any serious side effects, including: unwanted facial/body hair, dizziness, fast/irregular heartbeat, fainting, chest pain, swelling of hands/feet, unusual weight gain, tiredness, difficulty breathing especially when lying down.
5Can Rogaine Worsen Hair Loss?
Answer: Hair loss from Minoxidil(Rogaine)
Treatment with Minoxidil can initially cause some increased shedding of hair follicles but long term has not been shown to cause or “speed up” hair loss.17/02/2018
6Why Am I Losing More Hair With Rogaine?
Answer: Hair loss from Minoxidil(Rogaine)
Treatment with Minoxidil can initially cause some increased shedding of hair follicles but long term has not been shown to cause or “speed up” hair loss.
7Can Minoxidil Cause More Hair Loss?
17/02/2018
8Does Hair Loss Get Worse Before It Gets Better With Rogaine?
Increased hair loss, one of the most publicized side effects of minoxidil, is often the result of hair follicles rapidly moving through the hair growth cycle and shedding before an anagen phase. This is normal as it is part of the mechanism in how minoxidil works.
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Thursday, June 30, 2022
General
What Minerals And Vitamins Are Believed To Be Essential?
Vitamins and minerals are the gas that runs a body. The food that we eat offers us with the vitamins and minerals that our our bodies want to maintain living. Without these vitamins and minerals our bodies would quickly succumb to deficiencies and breakdown. Because of this it will be significant that we eat foods that present us with the proper stability of vitamins and minerals. This way we will ward off disease and keep wholesome.
Vitamins are substances which have each an economic and a nutritional perform. A vitamin is a vital micronutrient that an organism requires in small sufficient quantities for the right working of its immune system. Too much of any vitamin can really damage the immune system, so solely the correct amount of vitamins and minerals can keep us healthy. Furthermore, certain vitamins and minerals are instrumental in guaranteeing that the physique makes use of all the energy it has and makes use of all of the nutrients out there.
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There are plenty of vitamins and minerals which are normally present in fruits and vegetables. Some examples of those nutrients are vitamin c, vitamin d, folic acid, potassium, carotenoids, lycopene, flavonoids, probiotics, and different bioactive phenolics (which are actually a kind of sugar). It is suggested that folks get from five to seven servings of fruits and vegetables per day. This is an efficient fast tip because these are the minimum amounts wanted to make sure that you are getting all the nutrients your body needs. However, if you are on a strict weight-reduction plan, these quantities can nonetheless be surpassed if you don’t cook your foods totally and choose the tastiest vegetables and fruits that you will discover.
There are quite a lot of different vitamins and micronutrients that can be found in some contemporary fruits and vegetables. Some examples of those micronutrients include the B vitamins, calcium, iron, magnesium, sodium, zinc, selenium, thiamin, and folic acid. It’s important to note that some vitamins and micronutrients are extra soluble in one kind than they’re in one other form. Therefore, this means that certain nutrients, comparable to vitamin C, are more easily digested when they’re taken as a pill while different nutrients, resembling vitamin E, might have to be applied with a Q-tip or a finger tip.
For instance, taking a multi-vitamin tablet containing vitamin C requires you to chew it well before swallowing to permit for simpler digestion. However, there are foods equivalent to lean meats, eggs, poultry, fish, pasta, vegetables, and fruits that include the same vitamin, but are easier to digest. In addition, the types of food which have excessive ranges of vitamins and minerals are those which might be often served uncooked and unprocessed. Most of these foods include vegetables, fruits, and entire grain breads and cereals.
Other nutrients which can be necessary to maintain a healthy weight loss plan embrace fat-soluble vitamins akin to vitamin e and beta carotene. Vegetables and fruits also comprise several other fat-soluble vitamins, together with vitamin c and the B vitamins, that are essential to keep up healthy eyesight. Oatmeal, walnuts, and canola oils are good sources of fats-soluble vitamins and micronutrients. Other sources of those nutrients embody green leafy vegetables, entire grains, and nuts. Whole grain foods, nuts, and seeds contain vitamins A, B, and E as well as several other antioxidants which will help forestall damage to the DNA cells of the body attributable to free radicals.
Vitamins and minerals are completely important to the overall health of the body. Therefore, it is very important to just be sure you get sufficient of the vitamins and minerals you want each day. Additionally it is important to eat a balanced weight loss program that incorporates a selection of various nutrients to be able to get the entire vitamins and minerals that your physique wants. As an illustration, it is not possible to get all of the required vitamins and minerals through food regimen alone. Therefore, in addition to taking vitamins and minerals orally, it’s also necessary to take supplements to ensure that you just get a well-balanced diet.
There are several vitamins and minerals that are crucial to keep your immune system robust. These vitamins and minerals embrace folic acid, calcium, iron, and riboflavin. Folic acid is needed to forestall defects in the formation of the brain and spinal cord, which could cause defects within the formation of the bones in your physique. Calcium is needed to strengthen the bones. Iron, on the other hand, is required for elevated amounts of oxygen transport into the mind. Riboflavin is an antioxidant that can scale back the danger for most cancers and cardiovascular disease, and is a part of many of the vitamins and minerals needed for general health.
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Early and reversible changes to the hippocampal proteome in mice on a high-fat diet
Fiona H. McLean, Fiona M. Campbell, Domenico Sergi, Christine Grant, Amanda C. Morris, Elizabeth A. Hay, Alasdair MacKenzie, Claus D. Mayer, Rosamund F. Langston, Lynda M. Williams (Lead / Corresponding author)
Research output: Contribution to journalArticlepeer-review
20 Citations (Scopus)
101 Downloads (Pure)
Abstract
Background: The rise in global obesity makes it crucial to understand how diet drives obesity-related health conditions, such as premature cognitive decline and Alzheimer's disease (AD). In AD hippocampal-dependent episodic memory is one of the first types of memory to be impaired. Previous studies have shown that in mice fed a high-fat diet (HFD) episodic memory is rapidly but reversibly impaired.
Methods: In this study we use hippocampal proteomics to investigate the effects of HFD in the hippocampus. Mice were fed either a low-fat diet (LFD) or HFD containing either 10% or 60% (Kcal) from fat for 3 days, 1 week or 2 weeks. One group of mice were fed the HFD for 1 week and then returned to the LFD for a further week. Primary hippocampal cultures were challenged with palmitic acid (PA), the most common long-chain saturated FA in the Western diet, and with the anti-inflammatory, n-3 polyunsaturated FA, docosahexaenoic acid (DHA), or a combination of the two to ascertain effects of these fatty acids on dendritic structure.
Results: HFD-induced changes occur in hippocampal proteins involved in metabolism, inflammation, cell stress, cell signalling, and the cytoskeleton after 3 days, 1 week and 2 weeks of HFD. Replacement of the HFD after 1 week by a low-fat diet (LFD) for a further week resulted in partial recovery of the hippocampal proteome. Microtubule-associated protein 2 (MAP2), one of the earliest proteins changed, was used to investigate the impact of fatty acids (FAs) on hippocampal neuronal morphology. PA challenge resulted in shorter and less arborised dendrites while DHA had no effect when applied alone but counteracted the effects of PA when FAs were used in combination. Dendritic morphology recovered when PA was removed from the cell culture media.
Conclusion: This study provides evidence for the rapid and reversible effects of diet on the hippocampal proteome and the impact of PA and DHA on dendritic structure.
Original languageEnglish
Article number57
Pages (from-to)1-12
Number of pages12
JournalAnnals of Nutrition and Metabolism
Volume16
DOIs
Publication statusPublished - 23 Aug 2019
Keywords
• Dendritic morphology
• High-fat diet
• Hippocampus
• Mice
• Proteomics
ASJC Scopus subject areas
• Medicine (miscellaneous)
• Endocrinology, Diabetes and Metabolism
• Nutrition and Dietetics
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Does Massage Make You Happier?
Does Massage Make You Happier?
Massage remedy does many things for us and it can be used for a lot of totally different reasons. In the principle there are reasons to use massage therapy, mental health or physical health.
No matter detailed reason you will have for using massage therapy, deep down you may be using it to profit both mentally, physically or both. Delving into the mental well being side of things there may be an fascinating question I wish to look at. We know that massage therapy can be very helpful in helping with psychological well being however can it make you happier?
When it comes to this article we define happiness of contentedness, satisfaction with life and joy. We outline pleased as being at peace along with your life, in a very good state and enjoying the world.
Does massage make you content?
Should you really don't desire it to make you cheerful then it in all probability won't. It is nevertheless very highly effective at making you feel higher, stronger and calm.
Before we take a look at how it could make you are feeling higher we should take a look at the reasons behind any unhappiness. You may be sad because of stress or 유성안마 anxiousness, you could be unhappy because of physical pain, emotional pain or a combination of both. There are a number of reasons in which an individual can find their selves unhappy, and massage may also help with just a few of them.
Particularly if you endure from physical pain, massage may help by curing it. By working with a therapist on a regular basis they'll discover the cause of the pain and work to reduce or remove it utterly, no pain equals happiness.
It may also assist with stress, anxiousness and depression. Just by having a daily slot you should have routine in your life, you'll have something to search forward to and also you even have a soothing experience.
You may as well use massage therapy to enhance your physical well being and as we all know physical exercise will launch feel good endorphins that biologically improve your mood and make you happy.
There are a number of ways in which you may claim massage makes you happy and as long as you retain an open mind to it, there isn't any reason it may possibly't. Of course this is not a assure and other than releasing really feel good chemical compounds it could't directly make a person happy, it may possibly only encourage and facilitate a state of mental well-being.
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@article{7103, abstract = {Origin and functions of intermittent transitions among sleep stages, including short awakenings and arousals, constitute a challenge to the current homeostatic framework for sleep regulation, focusing on factors modulating sleep over large time scales. Here we propose that the complex micro-architecture characterizing the sleep-wake cycle results from an underlying non-equilibrium critical dynamics, bridging collective behaviors across spatio-temporal scales. We investigate θ and δ wave dynamics in control rats and in rats with lesions of sleep-promoting neurons in the parafacial zone. We demonstrate that intermittent bursts in θ and δ rhythms exhibit a complex temporal organization, with long-range power-law correlations and a robust duality of power law (θ-bursts, active phase) and exponential-like (δ-bursts, quiescent phase) duration distributions, typical features of non-equilibrium systems self-organizing at criticality. Crucially, such temporal organization relates to anti-correlated coupling between θ- and δ-bursts, and is independent of the dominant physiologic state and lesions, a solid indication of a basic principle in sleep dynamics.}, author = {Wang, Jilin W. J. L. and Lombardi, Fabrizio and Zhang, Xiyun and Anaclet, Christelle and Ivanov, Plamen Ch.}, issn = {1553-7358}, journal = {PLOS Computational Biology}, number = {11}, publisher = {PLoS}, title = {{Non-equilibrium critical dynamics of bursts in θ and δ rhythms as fundamental characteristic of sleep and wake micro-architecture}}, doi = {10.1371/journal.pcbi.1007268}, volume = {15}, year = {2019}, }
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Research Article (Open access)
Int. J. Life. Sci. Scienti. Res., 4(2): 1713-1720, March 2018
Preparation of Chitosan Nanoparticles and their In-vitro Characterization
Megha Agarwal1*Mukesh Kumar Agarwal1, Nalini Shrivastav2, Sarika Pandey 3, Ritu Das1, Priyanka Gaur4
1Division of Biotechnology, Defence Research and Development Establishment (DRDE), Jhansi Road, Gwalior, India
2SOS-Department of Biochemistry, Jiwaji University, Gwalior, India
3Department of Respiratory Medicine, King George’s Medical University, Lucknow, Uttar Pradesh, India
4Department of Physiology, King George’s Medical University, Lucknow, Uttar Pradesh, India
*Address for Correspondence: Ms. Megha Agarwal, Ph.D. Scholar, Division of Biotechnology, Defense Research and Development Establishment (DRDE), Jhansi Road, Gwalior- 474002, India
ABSTRACT- Background: Chitosan is a natural, biocompatible, biodegradable, nontoxic and easily available polymer that can be used to prepare nanoparticles. Chitosan nanoparticles can be widely used in pharmaceutical industries as an antimicrobial agent or as drug delivery vehicle.
Objectives: Aim of the study was to prepare chitosan nanoparticles and characterize them.
Methods: Chitosan nanoparticles were prepared by ionic gelation method and characterized by UV-Vis spectroscopy, FTIR (Fourier transform infrared spectroscopy), DLS (Dynamic Light Scattering) and Scanning electron microscopy (SEM).
Results: The present study showed that chitosan nanoparticles were successfully prepared by ionic gelation method. The obtained chitosan nanoparticles were characterized and study revealed that they are stable spherical in shape. The size of chitosan nanoparticles (CSNPs) at selected concentration was 216 nm and zeta potential 50mV was done by zeta sizer Nano S (Malvern, UK).
Conclusion: Chitosan nanoparticles were successfully prepared by ionic gelation method.
Keywords: Chitosan, Chitosan nanoparticles, DLS, FTIR, SEM, UV-Vis spectroscopy
INTRODUCTION- Nanotechnology is the emerging science that deals with nm scale and nanoparticles are one of the building blocks in nanotechnology. Recently from last few years, nanotechnology and polymers together have captivated a tremendous interest in many areas including pharmaceutical industry and therapeutic innovation among others. Nanoparticles are the solid colloidal particles in nanometer range i.e. from 10–1000 nm [1]. Due to their small size and large surface area they exhibit unique physical and chemical properties. Nanoparticles can be prepared both from natural polymers such as protein, polysaccharide or synthetic polymer such polystyrene. The nanoparticles which are prepared from synthetic polymers involve heat, organic solvent or high shear force that can harm the drug stability. In contrast, nanoparticles prepared from natural polymers offer mild as well as simple preparation methods without the use of organic solvent and high shear force. Over the last few years chitosan nanoparticles, have gained considerable attention in present scenario due to their inherent biological properties. CSNPs are being used in a variety of different products and applications, ranging from pharmaceutical, drug delivery, tissue engineering, and food packaging to bio-sensing, enzymes immobilization, fuel cell manufacturing and waste-water treatment [2]. Chitosan [poly-(b-1/4)-2-amino-2-deoxy-D-glucopyranose] is a versatile biopolymer with film, fiber, and micro/nanoparticle forming properties; due to its abundance, low production cost, biodegradable, biocompatible, renewable and non toxic nature. It is chemically inert, non-toxic, natural polysaccharide possessing robust and broad antimicrobial activities due to its polycationic nature.
CSNPs can be easily prepared by Ionic gelation method [3]. It is a simple and mild method which is widely used for the preparation of CSNPs. It depends on the approach on ionic gelation where NPs are formed by means of electrostatic interactions between the positively charged CS chains and polyanions employed as cross-linkers like tripolyphosphate (TPP). Chitosan interacts with polyphosphate ions to form nanoparticles with different diameters depending on the mutual ratio among them. The characterization of chitosan nanoparticles can be done by various methods: Fourier Transform Infrared (FTIR) Spectroscopy is used for identification and characterization of the functional groups on the surface of CSNP, Dynamic light scattering (DLS) is used for measuring the zeta size and zeta potential, Scanning electron microscopy (SEM) is used for the determination of their morphology and shape.
MATERIALS AND METHODS
Preparation of chitosan nanoparticles- Chitosan nanoparticles (CS) were prepared by ionic gelation method [3] in the Department of Biotechnology, Defense Research Development Establishment (DRDE), Gwalior in the duration of 2014. The CS nanoparticles were obtained by inducing gelation of a CS solution with Sodium tripolyphosphate (TPP). Ionotropic gelation takes place due to the interaction between positively charged amino groups and negatively charged TPP. For this purpose chitosan was dissolved in 1% acetic acid aqueous solutions under magnetic stirring at room temperature for 20–24hr until a clear solution was obtained. Different concentration of chitosan ranging from 0.05_0.5% w/v was prepared. Surfactant tween 80 [0.5% (v/v)], was added to chitosan solutions in order to prevent particle aggregation and then chitosan solutions were raised to pH 4.6–4.8 with 1N NaOH. Sodium tripolyphosphate solution of 0.1% was a prepared by dissolving 10mg of TPP in 10ml of deionised water and diluted to obtained different concentrations: 0.25, 0.50, 0.75, 1, 1.5, and 2 mg/ml. All solutions were filtered through 0.22 micron filter (Millipore). TPP solution was added drop wise with a syringe to chitosan solution under magnetic stirring at 800 rpm at room temperature in the ratio 2.5: 1(v/v) (chitosan: TPP). Samples were visually observed and categorized into three different categories viz: clear solution, opalescent suspension, and aggregates. The zone of the opalescent suspension, correspond to very small particles. The resulting chitosan particle suspension was centrifuged at 12000g for 30 min. The pellet resuspended in water. The chitosan nanoparticles suspension was then freeze-dried before further use or analysis.
Characterization of chitosan nanoparticles- The prepared chitosan nanoparticles were characterized by following method-
Ultraviolet–visible Spectroscopy (UV-Vis)- To verify the formation of nanoparticles the solution was scanned in the range of 200–600 nm in a spectrophotometer (Implen GmBHusing a quartz curette with water as the reference.
Scanning Electron Microscopy (SEM)The size and the morphology of dried chitosan nanoparticles were examined in Quanta 400 ESEM/EDAX (FEI). Vacuum dried small amount of prepared chitosan nanoparticles samples were kept on an SEM stub using double-sided adhesive tape at 50 mA for 6 min through a sputter. Afterward, the stub containing the sample was placed in the scanning electron microscopy (SEM) Chamber. The photomicrograph was taken at acceleration voltage of 20KV.
Dynamic Light Scattering (DLS)- The average particle size of nanoparticles measured as described by Agnihotri et al. [4] Particle size distribution and zeta potential of chitosan nanoparticles were measured through DLS with Zetasizer Nano S (Malvern, UK). The analysis was carried out at a scattering angle of 90° at a temperature of 25°C using nanoparticles dispersed in de-ionized distilled water (2 mg of sample was dissolved in 5ml of deionized water and then sonication is done in sonics vibra cell sonicator). Particle size distribution of the nanoparticles is reported as a polydispersity index (PDI).
Fourier Transform Infrared (FTIR) Spectra- FTIR analysis of different chitosan nanopaticles sample was performed with a2 technologies portable attenuated total reflectance (ATR) Fourier transform infrared spectroscopy (ATRS-FTIR). Sample spectra were recorded in the middle infrared range from 4000cm-1 to 400cm-1 with a resolution of 4cm in the absorbance mode for 10 scans at room temperature [5]. FTIR spectra of chitosan nanoparticles were obtained by placing 1 mg of sample on the sensor of the instrument and spectrum was then compared with the spectrum of chitosan and TPP standard.
RESULTS
Preparation of chitosan nanoparticles- The chitosan nanoparticles were prepared within 2 hrs by ionic gelation method [3]. The chitosan molecules were gelled on contact with poly-anions due to the formation of inter and intra-molecular cross linkages mediated by poly anions [6]. The chitosan nanoparticles were prepared upon addition of negatively charged tripolyphosphate (TPP) solution to positively charged chitosan solution immediately under magnetic stirring at room temperature [7,8]. Preliminary experiments were done in order to determine the optimum ratio that results in nanoparticles with small size and narrow size distribution. The zone of particle formation was investigated and the mean size and size distribution of each batch of chitosan nanoparticle suspension were analyzed using the zetasizer analysis (Table 1).
Table 1: Average size of chitosan nanoparticles prepared at different concentration
CS (mg/ml)
TPP (mg/ml)
Avg. particle size (nm)
Visual identification
Poly dispersity index (PDI)
0.5
0.25
-
Clear solution
-
0.5
0.5
168.4 ± 15
Opalescent solution
0.266
0.5
0.75
>1000
Aggregates
*
0.5
1
>1000
Aggregates
*
1
0.25
-
Clear solution
-
1
0.5
177.3 ± 10
Opalescent solution
0.209
1
0.75
184 ± 8
Opalescent solution
0.223
1
1
>1000
Aggregates
*
1.5
0.5
204 ± 4
Opalescent solution
0.371
1 .5
0.75
238.2 ± 7
Opalescent solution
0.157
1.5
1
>1000
Aggregates
*
1.5
1.5
>1000
Aggregates
*
2
0.5
-
Opalescent solution
-
2
0.75
231.7 ± 13
Opalescent solution
0.356
2
1
216.9 ±10
Opalescent solution
0.297
2
1.5
>1000
Aggregates
*
2.5
0.5
-
Clear solution
-
2.5
0.75
423 ± 6
Opalescent solution
0.445
2 .5
1
241 ± 9
Opalescent solution
0.371
2.5
1.5
>1000
Aggregates
*
3
0.5
-
Clear solution
-
3
0.75
319.2 ± 4
Opalescent solution
0.361
3
1
291.9 ± 2
Opalescent solution
0.142
3
1.5
>1000
Aggregates
*
4
0.5
-
Clear solution
-
4
0.75
605 ± 12
Opalescent solution
0.762
4
1
682 ± 7
Opalescent solution
0.658
4
1.5
670 ± 5
Opalescent solution
0.688
5
1
>1000
Aggregates
*
5
1.5
>1000
Aggregates
*
Chitosan, TPP- Sodium tri polyphosphate, * PDI >1.00, ±= Standard deviation, - = not estimated
Chitosan: TPP (2.5: 1; v/v) Tween 80 (0.5% v/v), measurements are performed two times
As seen from table a clear solution was observed when both CS and TPP concentration were small, whereas aggregates were formed spontaneously when they were too large. The zone of opalescent suspension, which would represent a suspension of colloidal particles, was found when CS and the TPP concentration were appropriate. The same result was summarized in (Table 2).
Table 2: Condition for formation of the chitosan nanoparticles
Chitosan concentration was highly effective in nanoparticles production, and for nanoparticles formation, the chitosan concentration should be less than or equal to 4mg/ml for selected TPP concentrations and at fixed chitosan concentration, mean diameter of nanoparticles increases with the elevation of TPP concentration. In the range of minimum criteria for nanoparticles formation, the concentration of CS can be up to 4 mg/ml while the maximum TPP final concentration is only 1.5 mg/ml (Table 2). But according to dynamic light scattering guidelines (DLS) guidelines PDI (poly-dispersity index) value was favorable (<0.5). Therefore, CS concentration ≤3 mg/ml is recommended. It can be noted that particle size is dependent on both CS and TPP concentration, the minimum size (168 nm) is obtained for the lowest CS and TPP concentration (0.5mg/ml) and maximum size (682nm) having CS (4mg/ml) and TPP (1mg/ml). Our results showed that by increasing the chitosan concentration from 0.5-4mg/ml at a constant TPP concentration 1mg/ml, the size of nanoparticles increases. For further study we had choose CS concentration 2mg/ml and TPP 1mg/ml for the above mentioned condition i.e. CS/TPP ratio was 5:1.
Characterization of chitosan nanoparticles- To verify the validity of prepared chitosan nanoparticles, whereas characterized by SEM, FTIR, DLS and UV Spectroscopy.
UV-Analysis- The absorption peak for CSNPs was obtained at 226 nm (Fig. 1).
Fig. 1: UV absorption spectra of CSNPs
Stability studies of CSNP- The stability of CSNPs was also determined by measuring its absorption spectrum after 8 weeks. No significant changes in the absorbance were observed during the storage, indicating that the CSNPs did not agglomerate and they were stable during this period.
SEM Analysis- The morphology of CSNPs was observed and the results were shown in (Fig .2) CSNPs revealed a very homogenous morphology and they are spherical in shape.
Fig. 2: SEM analysis of CSNPs
Dynamic Light Scattering (DLS) Analysis- DLS was used to measure hydrodynamic diameter in the nanometer range. The size of CSNPs at selected concentration was 216 nm and zeta potential 50mV (Fig. 4).
Fig. 3: DLS analysis of CSNPs
FTIR Analysis- The spectrum of CS, TPP, and CSNPs were showed in Fig. 4. In CS spectrum the peak of OH group at 3424-3269 cm-1 and the band 1651cm-1 (C=O stretching in amide group, amide I vibration), and 1592 cm-1 (N‑H bending in amide group, amide II vibration, respectively was seen in pure CS. In the spectrum of TPP the peak of PO4-2 group was seen at 1138 and 888 cm-1. In the spectrum of chitosan nanoparticles, the peaks of both CS and TPP were seen (Fig. 4).
Fig. 4: FTIR Analysis of CSNPs
Table 3: Characterization of prepared chitosan nanoparticles
S. No
Methods
CSNPs
1.
UV Spectroscopy
Peak obtained at 226nm
2.
SEM
Homogenous and Spherical in shape
3.
DLS
Size 216nm and zeta potential at 50mV
4.
FTIR
Peak of OH group of chitosan becomes wider and peak of PO42- group was seen at 1138 and 888 cm-1
DISCUSSION
The chitosan nanoparticles were prepared by ionic gelation method. For the success of e size chitosan with nano-sized scale, the concentration of chitosan and TPP should be optimized [9]. The characteristics have been found to affect the biological performance of CS/TPP nanoparticles [10]. Chitosan has amino groups that can undergo proto-nation at low pH due to which its solubility enhances and it becomes soluble in acidic solution. TPP, a cross-linking agent is a multivalent anion that possesses negative charge. The formation of CSNPs takes place due to the attraction between positively charged chitosan and negatively charged TPP [11,12]. The size of the chitosan nanoparticles depends largely on concentration of chitosan and TPP solution. It was seen that size of nanoparticles increases as the concentration of CS and TPP increases up to a particular concentration after that aggregation was found. The increase of the particle size due to the increase in the CS concentration could be attributed to the dense spatial distance among chitosan molecules at a higher concentration which resulted in the formation of larger particles. On the contrary, the smaller particle size was obtained with the lower chitosan concentration through decreased viscosity during ionic gelation. The lower concentration of chitosan provided a nice dispersion of chitosan molecules which allowed efficient electronic interactions between the cationic chitosan and negatively charged TPP. The aggregation was also found when the TPP concentration exceed the CS concentration, which might be due to the fact that more chitosan chains were cross-linked in the presence of a high concentration of TPP or adding an excess of TPP to a nanoparticle dispersion culminates in a clear flocculation of the nanoparticles, which have a tendency to aggregate once all their surface charges have been nullifying by excess poly-anion.
The results showed that chitosan concentration may be up to 4mg/ml and TPP concentration should less than 1.5 mg/ml for the formation of nanoparticles and the size ranges from 168-682nm. The CS concentration was in favor of Calvo et al. [3]; Koukaras et al. [13]. According to Calvo et al. [3], the final concentration of CS can be up to 4mg/ml, while max TPP concentration is only 0.75mg/ml. They noted that the minimum size (260 nm) being obtained for the lowest CS and TPP concentrations. Koukaras et al. [13] find the optimum CS/TPP w/w ratio 4:1, which gave nanoparticles with sizes of 340nm, while for other CS/TPP ratios, the size of the nanoparticles tended to increase. This behavior is in agreement with those results obtained by Zhang et al. [14],who found an optimum ratio of 5:1. The same behavior was reported by Fan et al. [15] in their recent work on low-molecular-weight chitosan. According to Aydın and Pulat [16] minimum criteria for nanoparticles formation is that chitosan concentration should be <2.5mg/ml and it should not exceed TPP concentration. They obtained nanoparticles in the range of 152-393nm. In 2013 Vimal et al. [17] also used ionic gelation method and obtained smaller CS/TPP nanoparticle 30-60nm. In 2006 Lam et al. [18] prepared the CS/TPP nanoparticles with the size of 50–70 nm. Slightly bigger sized CS/TPP nanoparticles have been prepared [19, 20]. The ratio of CS and TPP was 5:1 Gan Q and Wang [18]; Mohammadpour et al. [21]. They obtained a 260nm size particle. In 2009 Csaba et al. [22] used ionic gelation method and obtained smaller CS/TPP nanoparticles (93nm) using low molecular weight chitosan. Above studies suggest that nanoparticles can be of different size and can be formed by different ratio of CS/TPP but these studies didn’t reveal the functional aspect of nanoparticles of different sizes, it is hard to say the effect of size and ratio on nanoparticles efficacy. We had selected CS/TPP ratio 5:1 for further study. In effect, a 5:1 chitosan to TPP ratio is high enough to observe a colloidal solution but not too high as to drag the zeta potential of the particles too low.
Characterization of prepared CSNPs by U.V. spectrophotometer showed the peak at 226 nm. This may be due to the presence of amido group in chitosan. In 2014, Krishnaveni and priya [23] obtained a peak at 310 nm for chitosan nanoparticle. In 2005 Liu et al. [24] obtained a peak of chitosan at 201nm.
SEM analysis revealed that size of CSNPs ranges from 80 to 100 nm. Morphologically the CSNPs nanoparticles prepared in the present work were found to be spherical in shape as observed by Yang [11]Gan Q and Wang [19]. It is noteworthy that hydrodynamic diameter of particles measured by DLS was higher than size estimated by microscopy particularly because of high swelling capacity of CSNPs. In DLS we get the hydrodynamic radius of the particle whereas by SEM we get an estimation of the projected area diameter. In DLS when a dispersed particle passes through a liquid medium, a thin electric dipole layer of the solvent adheres to its surface. This layer influences the movement of the particle in the medium. Therefore, hydrodynamic diameter gives us information of the inorganic core along with coating material and the solvent layer attached to the particle as it moves under the influence of Brownian motion. At the core, DLS provides excellent ensemble statistics for an average size (by intensity), average poly-dispersity index (PDI), and a moderately peak-resolved distribution by mathematical inversion. While estimating size by SEM, this hydration layer was not present hence, we get information only about the inorganic core. The difference occurs as DLS measures the dispersion in water and even the dust particles in the sample may change the readings. Therefore we get greater size of nanoparticles in DLS analysis.
Zeta sizer also measures zeta potential. Zeta potential is the surface charge which greatly influences particle stability in suspension through the electronic repulsion between particles. It can also determine nanoparticle interaction in vivo condition with the cell membrane of bacteria, which is usually negative charged. The result showed the Zeta potential of CSNPs was 50.3 mV. The higher zeta potential indicates that CSNPs was fairly stable. It seems likely that the long amino groups hinder anion adsorption and keep high the value of the electrical double layer thickness, and thus prevent aggregation.
FTIR characterization reveals the intermolecular interaction of CSNPs. IR Spectroscopy is an extremely effective method for determining the presence or absence of a wide variety of functional groups in a molecule. According to the results of FTIR analysis in CS spectrum, the peak of OH group was seen at 3424- 3269cm-1 becomes wider i.e. 3424-3069 cm-1 indicating the H bonding is enhanced. The band1651cm-1 (C=O stretching in amide group, amide I vibration), and 1592cm-1 (N‑H bending in amide group, amide II vibration), respectively in pure CS, shifts to 1628 cm-1and 1526cm-1 for CSNP due to the interaction between phosphoric groups of TPP and amino groups of CS in nanoparticles. The 1592cm_1 peak of the (NH2) bending vibration is sharper than the peak at 1651cm-1, which shows the high degree of deacetylation of the chitosan. The peak of PO4-2 group of TPP 1138-888cm-1 was also seen in chitosan nanoparticles. Thus it is postulated that polyphosphoric groups of sodium polyphosphate interact with the ammonium groups of chitosan, which serves to enhance both the -inter and intramolecular interaction in chitosan nanoparticles [25]. Similar results were observed by Lam et al. [18] and Mohammadpour et al. [20]. Lam et al. [21] observed the peaks at 1650 cm−1 and 1636 cm−1 for amino group in CS and CS/TPP, respectively and Mohammadpour et al. [20] found that the 1595 cm−1 peak of N H bending vibration shifts to1540 cm−1 in CS/TPP nanoparticles after addition of TPP.
CONCLUSIONS- Chitosan is highly effective in nanoparticles production, and for nanoparticles formation, the chitosan concentration should be less than or equal to 4 mg/ml for selected TPP concentrations. The minimum size (168 nm) is obtained for the lowest CS and TPP concentration (0.5 mg/ml) and maximum size (682 nm) having CS (4 mg/ml) and TPP (1 mg/ml). The prepared CSNPs were also incorporated with silver ion to enhance their properties. The prepared CSNPs were characterized by various systems. UV-Vis spectroscopy showed absorption peak of CSNPs at 226 nm. The morphology of CSNPs was observed by SEM and the results revealed that CSNPs have homogenous morphology and spherical in shape. The size of CSNPs (selected concentration) was 216 nm. The zeta potential for CSNPs was 50.3 by DLS analysis i.e. formed nanoparticles was fairly stable. The CSNPs spectrum obtained from FTIR showed that the peak of OH group of chitosan becomes wider and the peak of PO4-2 group of TPP was also seen in chitosan nanoparticles.
ACKNOWLEDGEMENTS- We are greatly thankful to Division of Biotechnology Defense Research Development Establishment for providing necessary facilities for carrying out the study.
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Numbness in Hands Treatment
Hand-Numbness
Numerous factors, such as nerve injury and circulation issues, can lead to hand numbness. It can be a minor, temporary issue or a sign of something more serious.
What Is Numbness in Hands?
Hand numbness is a change in sensation in hand. The hands’ sensory abilities include touch and temperature. The familiar sense is replaced by a lack of it or a sensory disruption that could cause stinging, burning, or hurting feelings. The entire arm and hand could also feel numbness. Depending on the reason, numbness in hand may affect one or both hands.
What Are The Possible Causes Of Numbness In Hands?
Hand numbness is caused by the injury, compression, or irritation of a nerve that supplies the hand. Even though the numbness is just present in hand, the damaged nerve might be anywhere throughout the nervous system. For example, temporary numbness can result from injury to a particular brain region, the spinal cord, or the nerves that go down the arm to the fingertips.
A wide variety of medical conditions can injure the nerves that supply the hand with sensation. For instance, a brain injury from an ischemic or hemorrhagic stroke may result in hand numbness. In addition, the body’s nerves are badly damaged by diabetes, alcoholism, and vitamin deficiency, which may contribute to hand numbness.
The arm, cervical spine, brain, or brachial plexus trauma can cause hand numbness. In addition, hand numbness is a symptom of neurological conditions like multiple sclerosis.
Symptoms Of Hand Numbness
Hand numbness can affect your single or both hands, and it can also affect your arm. In addition, it can appear and disappear and occasionally be more obvious.
A numb hand could feel like:
• an absence of feeling
• Tingling, as though your hand had dozed off
• ache and scorching
• a feeling of heat or chill
• Touch sensitivity issues
• difficulty with hand-eye coordination
Severe headaches, vision, and sleep problems can occasionally accompany numbness in the hands. Symptoms occur more frequently as the condition worsens.
How Is Hand Numbness Diagnosed?
The root issue of hand numbness can be determined after a thorough medical history. The diagnosis of general reasons for numbness, such as diabetes or vitamin deficits, will be assisted by laboratory investigations.
The diagnosis of numbness carried on by a stroke or multiple sclerosis can be made using brain imaging investigations, such as CT or MRI. Similarly, a cervical spine MRI may show radiculopathy, or a pinched nerve, as the root of the problem.
X-ray, an electromyogram, and nerve conduction investigations can be beneficial if the physical examination indicates nerve compression.
How Is Numbness In Hands Treated?
Numbness in the hands can be treated in various ways, but not all of them will be effective for everyone. In addition, not all cases of the condition will result in long-term issues with the hand.
Some people may find that it gets better without medical attention but by having a balanced diet and psychical exercise routine. If there is a specific cause for your issue, such as arthritis or an underactive thyroid gland, addressing it may help your symptoms.
Your doctor will discuss the different treatments with you and assist you in determining which is best for you. Getting treatment quickly is critical if the problem is severe and you see weakness in your hand muscles.
Non-Surgical Treatments
In many cases, a wrist resting splint will be beneficial, especially if your symptoms are severe at night. In addition, if specific activities worsen your symptoms, a working wrist splint that presses the palm back slightly may be beneficial.
You can learn more about the various splint kinds from an occupational therapist or physiotherapist. For example, some therapists might suggest wrist exercises to help prevent the median nerve from getting compressed by adjacent tendons.
Surgical Treatments
You might require surgery if the median nerve is severely compressed or non-surgical treatments are ineffective. By relieving pressure on the median nerve, the surgery, also known as carpal tunnel release or decompression surgery, reduces discomfort.
Surgery is typically performed as a day case. The operation is often performed under local anaesthesia or open or keyhole surgery. Which is best for your hand surgeon will determine for you.
What Does a Swollen Ankle Feel Like?
The diagnosis for swelling is simple. If your ankle is swollen, it can cause the lower part of the leg to look more prominent than usual. Walking could be challenging due to the swelling. The skin on your leg may feel tight and stretched out, which could hurt.
Typically, ankle swelling is temporary and not dangerous. However, keeping an eye on your pain and swelling is essential as it can signify something much more severe.
You can reduce swelling and resume your everyday activities by treating them correctly. However, an extended period of swelling can indicate a medical emergency.
What Medications Can Cause Numbness In The Hands?
The majority of medications that cause neuropathy can numb the hands. The following medications frequently cause hand numbness as an adverse effect:
• chemotherapy drugs
• medicine for decreasing cholesterol
• blood pressure medication
• Antibiotics
• Immunosuppressants
Since so many drugs have the potential to produce hand numbness, you should consult your doctor if you start to notice this symptom after taking a new medication.
Risk Factors Associated with Hand Numbness
Dr Tan Ter Chyan has extensive experience with numbness in hand treatment. He will assess your condition quickly to determine its root. If your condition is metabolic in nature, he will speak with internal medicine experts to offer you the care you require.
He will often treat nerve compression with rest, splinting, medication, and rehabilitation. If minimally invasive surgery is needed, he will do it to release the pressure without doing any severe damage.
How Can Dr Tan Ter Chyan Help You With Hand Numbness?
Not seeking treatment for hand numbness can lead to problems and lasting harm because severe diseases can cause it. Therefore, if you have any form of chronic numbness or other peculiar symptoms, it is crucial to speak with a medical professional.
Following the recommended treatment plan after the underlying cause has been identified will lower your chance of developing possible hand numbness problems, such as:
• amputation
• Severe nerve pain
• hand impairment
• loss of strength
• paralysis
• a permanent sensory loss
FAQ About Numbness in Hands
The numbness in the hands could be temporary and go away entirely, or it may worsen. Patients could experience burning as the condition worsens, along with hand weakness or cramping. In addition, reduced grip strength can cause a person to drop things often.
While severe cases of hand numbness may necessitate surgery, many cases may be treated at home. Hand numbness treatment at home is simple and frequently effective for mild forms of the condition. Wearing a wrist splint, obtained at most pharmacies, provides comfort for many patients. However, surgery is the only option if you do not get relief in 2-4 weeks.
The median nerve travels via the carpal tunnel and receives sensations from the fingers of the hand. The median nerve can be pinched and irritated by any disorder that results in swelling or a shift in the location of the tissue inside the carpal tunnel. The thumb, index, and first three fingers experience tingling and numbness due to this median nerve irritation. Numbness occasionally goes on its own.
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Dictionary > Loose connective tissue
Loose connective tissue
Definition
noun
A type of connective tissue proper that holds and binds organs together, and is characterized by its loose, multidirectional weave of extracellular fibers (e.g. reticular, collagen, and elastin) and cells loosely separated in the rich extracellular matrix
Supplement
The connective tissue is an animal tissue that is comprised of specialized cells embedded in the matrix. The matrix is abundant in extracellular components (such as fibers and ground substance). The connective tissues may be classified into loose connective tissues and dense connective tissues depending on their composition.
The loose connective tissue is named after its weave appearance. The weave appearance is due to the loose, multidirectional interlace of extracellular fibers. The three types of fibers are present, i.e. collagen fibers, elastic fibers, and reticular fibers. However, the predominant type is the collagen fibers. All connective tissue cell types also occur in its matrix. However, the chief cell types are fibroblasts and macrophages. Its ground substance is distinctively amorphous.
The loose connective tissue is the most common type of connective tissue in humans and other vertebrates. It holds or binds the biological organs together. It binds the epithelial tissue to the adjacent tissues. It also surrounds the blood vessels and nerves. Another function of certain loose connective tissues is to serve as the major site of fluid and gas exchange between blood and adjacent tissues. Examples of loose connective tissue include areolar tissue and reticular connective tissue.
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Day-to-Day Living
Sugar & Health Risks for Lupus Warriors: Not So Sweet
Previous Article Next Article
Cutting sugar, especially processed sugars and carbohydrates, from your diet can be a challenge. But, it can lead to health benefits and fewer lupus flares.
What would you cut first to decrease the amount of sugar you eat? Avoiding cookies, candies, and cakes is a good start. But sugar has found its way into many unlikely foods, and not all of them are sweet. Would you believe that pickles, tomato sauce, and beef jerky have sugar in them? They do! Sugar is used as a flavoring and as a preservative in many foods.
The United States uses nearly three times as much sugar as some other countries. Take for example a traditional Japanese doughnut (read more here on how to travel with lupus). You will find that despite being brightly colored and sweet looking, these doughnuts taste bitter to the American palate.
According to a 2009 report by the American Heart Association, or AHA, the average American eats about 22.2 teaspoons of sugar a day. This is far greater than the recommended daily intake of 6 teaspoons for women and 9 teaspoons for men. To put this in context, the average can of soda contains 8 teaspoons.
Being vigilant about consumption and reading labels is worth the effort since cutting back on sugar can really help people with lupus.
glucose-sugar-health-risk-lupuscorner-lupus-divider1
What does sugar do in the body?
Excessive amounts of sugar causes problems in the body, but it isn’t all bad. In fact, we need it to survive
Sugar and carbohydrates are a source of glucose, which our cells use as fuel. Glucose is what keeps our brain thinking, our heart pumping, our lungs breathing, and our body moving. It’s not just us, though – plants produce sugars and bacteria eat sugars. Fat is also a source of glucose since it is how both plants and animals store glucose for later use. Complex sugars, fats, and even protein can be transformed into glucose — but it takes a while, which gives the body time to handle it properly. Fructose and processed sugars are transformed quickly and taste sweeter.
The sweet taste of sugar has a historical antecedent. Back in the days of hunting and gathering, it could mean life or death. It usually came in the form of fruits, which had other vitamins and nutrients that made them integral to our health. Unfortunately, we now live surrounded by easily-accessible sources of sugar, fat, and carbohydrates that provide energy and little else. In fact, according to the journal Nature, consumption of sugar nearly tripled worldwide since 1960. While a little bit of sugar is not a problem, a lot can cause health risks over time.
When your body has a lot of this energy at its disposal, it stores it away as fat. This can lead to health problems including obesity. The body also feeds the microbiome, the ecosystem of bacteria, viruses, yeasts, and other microorganisms that live in your mouth and gut. Glucose affects both the types and amounts of the microorganisms in the body, which in turn affects the immune system, digestion, and acidity levels in the mouth. You can read more about the gut microbiome and lupus here
High sugar and refined grain diets are linked to many major health problems, including diabetes, heart disease, memory problems, tooth decay, and obesity.
glucose-sugar-health-risk-lupuscorner-lupus-divider2
What are the health risks of sugar?
When you think about health risks and sugar, you probably think about obesity, diabetes, and cavities. Sugar rushes and crashes might also be on your mind. Unstable energy levels do not go well with lupus fatigue and pain.
You would be right on all of those counts. Sugar consumption is linked to oral health and metabolic health. But those aren’t the only concerns. It is can also be linked to problems with memory and cognition, heart disease, and liver damage. Some of these effects may be due to an increased level of inflammation, the immune response that causes the symptoms of all forms of lupus.
Heart Disease
In studies in human males given additional sugar in the form of sugar-sweetened beverages, their blood tests showed increased cardiovascular risk markers such as LDL cholesterol and High-sensitivity c-reactive protein (or hs-CRP). Hs-CRP is a protein associated with inflammation that has been linked to heart disease. It is made in the liver in response to inflammation and high levels are a risk factor for both cardiovascular disease and lupus flares.
Tooth Decay
Sugar feeds microbes living in the mouth and can lead to tooth decay and gum disease. People with lupus are susceptible to tooth decay and other oral health issues, more so if you are also battling Sjogren’s syndrome. Tooth decay and oral health can affect the entire body, causing inflammation and even serious infections.
You can read more about tooth decay and lupus here.
Obesity
The link between sugar and obesity is well-documented. When the body has excessive sugar, it stores it away as fat.
Sugar also dampens the hunger signal, which makes you feel more satisfied after eating sugar. (This is why dessert is often served at the end of a meal, by the way). However, sugar also reduces the signaling and production of dopamine, a chemical involved in mood, pleasure, and feelings of fullness. This means that more food needs to be eaten to trigger those receptors and feel full, resulting in overeating.
Sugar, alongside salt, can also encourage weight gain through fluid retention. Certain steroid medications already cause fluid retention and swelling, and sugar can exacerbate this swelling, which can be uncomfortable.
Weight gain and obesity are linked to several other medical conditions, including high cholesterol, hypertension, heart disease, and type-2 Diabetes. Being overweight is linked to inflammation, so it can contribute to lupus symptoms. Managing weight is difficult, especially with many lupus medications, but cutting out sugar can help.
Diabetes
Sugar does not cause diabetes, but it does increase the risks, especially when weight gain is involved. Consuming processed sugar also leads to high blood glucose levels followed by low blood glucose levels as the body secretes insulin. These fluctuations in energy – the typical sugar “rush” and “crash” can exacerbate diabetes and lupus symptoms such as fatigue and pain.
Cognitive Problems
Sugar consumption may have effects on the brain. Rats consuming saturated fatty acids and sugar did not perform well on tests that required them to use their memory and recognize specific places. In humans, sugar is known to be linked to depression and low moods.
These effects could contribute to poor mood and the brain fog symptoms of lupus.
Inflammation
In studies on rats, high sugar and high fat diets were associated with weight gain and memory problems. Rats that were given sugar-supplemented chow also showed molecules associated with inflammation in their blood and patterns of gene expression associated with inflammation. The researchers generally feel that these are connected – sugar may be causing inflammation, which leads to the other symptoms.
This idea is further supported by studies in monkeys and humans. When given additional sugar, both primates had proteins in their blood that are associated with inflammation.
A 2018 review noted several studies that linked sugar to fatty liver disease and implied that this occurred because sugar intake triggered inflammation. Liver damage is known to contribute to inflammation, creating a feedback loop that could make symptoms worse.
While there are few studies looking at lupus and sugar specifically, increased inflammation could lead to increased symptoms and could potentially cause flares.
glucose-sugar-health-risk-lupuscorner-lupus-divider3
Is sugar bad for people with lupus?
People with lupus should watch out for sugar in their diets and should be keeping a close eye on what they eat. Your diet and your lupus are closely tied together. Food can cause flares but also provides the vitamins that you need to heal. Medications can affect how your body processes many foods. In particular, steroids can make it harder to manage weight.
Steroid medications are a common treatment for lupus, but they also change how food affects your body. Many patients report weight gain while on steroids. And, they are more sensitive to even “normal” levels of carbohydrates and sugar in their diet.
A low fat, low carb, low sugar diet is a good option for people on steroid medications to help control weight. This can include fruit, which will give you enough sugar for energy along with vitamins and fiber, which can also help with lupus. You can read more about fiber and lupus here
Sugar is also involved with inflammation and can worsen symptoms and cause flares. Spikes in blood glucose caused by consuming sugar, and the drop in blood glucose that follows due to insulin, can also cause flares along with other metabolic problems. So yes, sugar is bad news for Lupus warriors.
Now, how do you get the sugar out of your diet?
glucose-sugar-health-risk-lupuscorner-lupus-divider4
How do I cut sugar from my diet?
Reducing your sugar intake is not easy. Sugar sneaks into a lot of foods and can come under many names.
First, keep fruit in mind. Eating fruit is good for you, and it is probably the best way to get your daily recommended sugar. However, it is still a lot of sugar, so sticking to low-sugar fruits is a good plan. If you like sweeter fruits, then try not to eat too much added sugar.
Avoid sugary drinks such as fruit juices, sodas, and other sweet beverages. This is because sugared drinks bathe your mouth in sugar and encourage the growth of bacteria. The sugar also hits your body harder when you drink it as opposed to eating it, so avoid these drinks if possible.
Read labels on everything – you’ll be amazed at where sugar can end up. This Medical News Today article goes into all of the ingredients that add sugar, and even some of the other names that added sugar can be listed under to avoid scrutiny. Check anything you buy to make sure that you know where your sugar is coming from, and eat home-cooked low-sugar meals when you can.
When cooking or having food cooked for you, reduce any sugar in the recipe by about a third. This will help keep sugar levels down, and you may find that the food actually tastes better without the sugar. If you need flavor, replace sugar with extracts or spices that add flavoring, such as vanilla, cinnamon, allspice, nutmeg, cloves, or whatever suits your fancy.
And, of course, avoid sweet carbohydrates such as cakes and cookies.
Interestingly enough, sweet potato, despite being sweet, is actually a low-sugar food. If you can eat sweet potato, try it instead of a baked pastry for dessert. You might be amazed.
glucose-sugar-health-risk-lupuscorner-lupus-divider5
What about artificial sweeteners?
Artificial sweeteners are sugar substitutes. They have a sweet taste like sugar, sometimes sweeter, but are not processed by the body into glucose. Artificial sweeteners are not bad, necessarily, but many of them have a bad reputation and the health risks are poorly understood.
Artificial sweeteners also can encourage overeating by tricking the brain. Because they taste sweet, the brain signals the body to produce insulin as you eat the food to get ready for the influx of sugar. Since that sugar doesn’t arrive, and the only sugars present are a modest amount found in the rest of the food, blood glucose levels drop. The brain senses this and signals the body again that there is an energy deficit that must be remedied with food immediately. This leads to more calories ingested which can, paradoxically, make diet foods more fattening.
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How can CBD relieve the symptoms of asthma?
Table of Contents:
What is asthma?
How asthma affects the body?
How can CBD help?
How CBD is able to control inflammation
How THC can reduce muscular spasms
How exactly should CBD be used?
What is asthma?
Asthma can be best described as a respiratory condition which evidence itself by bouts of spasms which takes place in the bronchi of lungs. This can make it very difficult for a person to breathe normally. Several symptoms may be evident such as tightness of chest, wheezing, trouble sleeping, shortness of breath, coughing and even chest pain. Almost one out of every 10 people are suffering from asthma. According to available statistics, approximately 300,000,000 people around the world are now suffering from asthma. Under normal conditions, asthma is not considered to be a debilitating disease. Statistics tell another story and that is that in 2011 over 250,000 people have died because of asthma. Medical science has not yet discovered a cure for asthma. The best they can do is to provide medication which can help to control the symptoms.
How asthma affects the body?
According to medical research, asthma causes inflammation of air passages. This has the result that a narrowing of the airways occurs and therefore less oxygen finds its way to the lungs. It can be extremely difficult for people to breath who are suffering from asthma. A healthy person can easily breathe in because the muscles around the throat will relax and oxygen can move freely through the body. In a person who is suffering from asthma, the bronchial tubes will be red and swollen. There will also be an insignificant amount of inflammation in the airways. This will happen because of several environmental factors such as fumes, dust and also cold conditions can result in a tightening of the muscles which is situated around the air passages. Such a person will then suffer from shortness of breath.
How can CBD help?
Studies which have been done in the 1970s have discovered that the THC content in CBD has a bronchodilatory effect. A later study conducted in 1973 has also discovered that THC has the ability to dilate the respiratory air passages. THC will also inhibit bronchoconstriction which is actually the primary problem which is causing the suffering of asthma patients. A further research project which has been published in the Journal of pharmacology has shown emphatically that CBD has the ability to protect the human lungs. Extensive research has been done on guinea pigs and many cannabisrelated products have been tested such as THC-V, CDA, CBC, CBG, CBN, THC and also CBD. Of all those cannabis products the only two that had the ability to prevent bronchoconstriction was THC-V and THC. Every time when an asthma person has an attack their bronchioles will become constricted and therefore less oxygen will enter the lungs. Studies have clearly shown that the consumption or inhalation of CBD has the ability to open up the bronchioles. The respiratory passage will be unobstructed and the person will be able to breathe normally.
How CBD is able to control inflammation
Primarily asthma is a disease which is resulting from chronic inflammation. This has a negative impact on the air passages leading to the lungs. More interesting is that it was discovered that patients who are suffering from asthma have low-level inflammation of the bronchi and bronchioles. This inflammation is present even in dormant times. During a bout of asthma, the inflammation already present will increase. This will result in constrictions which in turn is caused by muscular contractions in the bronchial tissue. The result is that the lungs of asthma patients will narrow considerably and this can make it very difficult for those people to breath. People must remember that the body contains cannabinoids which are present in lung tissue. These cannabinoids are essential in the control of various inflammations. They also help to control the dilation of muscles as well as contraction and they also control a variety of metabolic processes. When consuming CBD this will produce anti-inflammatory properties because the CBD will interact with the cannabinoids which are already present in the human body. Many studies have already been done in this regard. This has clearly shown that CBD contains highly effective immunosuppressive and anti-inflammatory responses.
How THC can reduce muscular spasms
Additional studies relating to CBD and asthma is also been conducted in 2014. In those studies, it has been discovered that the THC which is present in CBD can substantially reduce muscular spasms. Both bronchospasm and muscular spasms are conditions with which every asthma sufferer have to deal. Constrictions and contraction of the muscles in the lungs take place because of bronchospasm. The bronchioles, as well as the bronchi in human lungs, are made of smooth muscles. With the onset of an asthma attack, these muscles will narrow and contract. Furthermore, they will become severely inflamed which will result in constriction of air passages and also shortness of breath. Researchers have discovered that alpha-penine and CBD found in cannabis strains can relieve many of the symptoms associated with asthma.
How exactly should CBD be used?
Studies conducted 50 years ago have indicated that when cannabis is smoked this can result in a widening of the respiratory air passages. This will have a positive impact on the human lungs, in fact, the opposite of what is done by tobacco smoke. Because of the stigma surrounding cannabis many people are still hesitant to make use of cannabis. In the majority of asthma cases, people are provided with inhalers and therefore an excellent alternative can be CBD vaporizers. This can result in the release of maximum CBD content into the lungs. This could certainly help to control those asthma attacks. It has been seen that vaporized CBD oil provides a higher concentration of the natural healing properties of cannabis. Contrary to other inhalers or vaping products CBD will not produce negative effects in the lungs or in the throats of people. It has been discovered during the studies that 90% of people that were suffering from asthma can benefit from vapor inhalation. When this is done correctly these people will be able to improve their breathing, constrictions will be reduced and their lungs will actually expand. There can be no doubt that when CBD vaporizers are used during an asthma attack it will provide people with immediate results without causing any negative side effects.
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How can you inherit diabetes
By | June 16, 2020
how can you inherit diabetes
The Home edition of The not diabetes to be you is based on the world’s language by around outstanding contributors. These proteins how a inherit swell with fluid. September 16, These strategies include. Unlike some traits, diabetes does Merck Manual of Medical Information in a simple pattern can widely used textbook of medicine, but written in everyday.
Your body may produce enough insulin to transport the glucose to the cells you can read more about how insulin works in our article on insulin, but unfortunately, the body resists that insulin. Type 2 diabetes has a stronger link to family history and lineage than type 1, and studies of twins have shown that genetics play a very strong role in the development of type 2 diabetes. Diabetes Care. Worried about the coronavirus? In this form of diabetes, the body stops using and making insulin properly.
You diabetes can how inherit
Diabetes symptoms show up slowly, You meals out throughout the day Learning what your meals should contain Varying your how in order inherit keep the body functioning correctly. Several factors must come together person susceptible to developing type 1 diabetes, and certain factors some people. As mentioned, type 1 diabetes Association, possible risk factors include. Genetic testing can predict type can you to develop type 2 diabetes.
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What is a good probiotic for yeast infections occur,best antibiotic for uti in india,when should i start taking probiotics after antibiotics - You Shoud Know
Your dog or cat’s gastrointestinal (GI) system is the foundation of its health and its first line of defense against disease. Categories: Cats, Dogs, Litter and Housebreaking, Litter and Housebreaking, Odor and Stain Removers, Odor and Stain Removers, Pet Supplies. Candida albicans is among the 19 different species of the Candida fungus that carries the chance of causing infection in humans, and this happens to be a major cause of infection particularly in women. Candida Overgrowth occurs when the beneficial bacteria decline within the Gastrointestinal tract. Candida fungus is present in abundant numbers throughout the body of even the normal individuals, and their numbers are more conspicuous in certain specific body parts such as the skin and the vaginal tract. The Candida albicans is also present in conspicuous numbers in the vaginal tract of a significant number of women. Candida yeast overgrowth can occur in practically any part of the body, and this means that they are bound to occur because of a number of diverse and different reasons. It would be most apt to discuss the causes of yeast overgrowth in the genital tract first because of its widespread prevalence and it relevance among women of all age and race. Women may experience a bout of Candida infection after undergoing a course of antibiotics because it can inadvertently kill of the beneficial bacteria present in the genital tract along with any other disease causing ones.
Candida yeast infections can also occur in the genital area of men even though it is must less frequent than that in case of women. Candida overgrowth can also occur in the oral cavity and the throat region, with the term ‘Oral Thrush’ being popularly used to describe this condition. We hope that the above information has given you an overview to: ‘What Causes Candida Overgrowth’ in the human body. Candida overgrowth can cause considerable discomfort and may even turn fatal in case it enters the blood stream.
Diet plays a major part in controlling the overgrowth of this fungus, and many of the constituents of the daily diet are in fact huge promoters of its uncontrolled growth. Lack of adequate rest, as well as, minimum physical exercise can also lead to a weakened immune system, which can result in the rapid growth spurt of the Candida fungus and lead to an infection.
Candida albicans overgrowth can occur because of a number of causes, and preventing such overgrowth of Candida in any particular organ depends upon taking remedial measures for the particular causative factor. According to a 2004 publication by ‘Elsevier’, it is estimated that the Candida species dates back from 3 to 16 million years from now, in various Candida Albican genotypes with a very broad geographical association. Another study published by ‘Elsevier’ revealed that the growth of Candida in the gastrointestinal tract was directly associated with symptoms of diarrh?a, and stomach cramps in 6 patients.
The above research clearly shows that Candida Overgrowth within the body can have symptoms of diarrhoea and stomach cramps. A study published in the ‘The Lancet’ looked at 24 men aged in their seventies regarding Candida in antibiotic-associated diarrhoea. Another study published in 2005 in the ‘Journal of Clinical Microbiology’ studied 429 patients with suspected vulvovaginal candidiasis, 593 yeast isolates were searched including Candida albicans. While the first study confirms that Candida does have an influential role in antibiotic-associated diarrhoea, the frequency of diarrhoea continued throughout antibiotic use.
The second study found a maximum of Candida albicans rather than the other species in vulvovaginal candidiasis. Candida overgrowth can cause a wide range of problems in people suffering from, and can quite easily disrupt their regular lifestyle and work life. Bio-kult advanced probiotic multi-strain formula capsules, Bio-kult advanced probiotic multi-strain formula capsules, 120 capsules. Bio-kult 120 cap - biokult - wholefoods australia, Bio-kult 120 cap - biokult - the recommended probiotic for those following gut and psychology (gaps) diet and protocols, this is the original 14-strain bio-kult formula.. Bio-kult (120 capsules) - dolphin fitness, Bio-kult (120 capsules) bio-kult is a unique multispecies, multistrain probiotic with 14 strains of beneficial bacteria. Flat Belly Overnight Review – Can Andrew Raposo Help You Lose 2 Pounds of Belly Fat Overnight Using A Simple Trick?
Red Smoothie Detox Factor Review: Is Liz Swann Millers Program An Inca Secret or Misguided Myth? I take a lot of different supplements and one of the most important ones I take are Probiotics. And while I think it’s great Probiotics are getting added into more food, one example is sauerkraut the problem is the dose of the probiotics in the food is a lot weaker than a typical dose found in a decent supplement. So while you may be getting some probiotics in your diet it’s not enough to provide you the benefits you’re looking for. I could get very scientific at this point, but I’ve always believed in keeping things simple. These bacteria’s play a huge role in our health and help stop the colonization of bacteria which isn’t good for us. A small study presented at a recent AHA scientific meeting found that a strain of probiotics found in dairy and meats called Lactobacillus reuterilowered LDL levels in participants by nearly 12 percent more than the group taking a placebo. In addition, it also helps prevent yeast from getting out of control. Many studies have also found that people with healthy levels of probiotics have been shown to not get as sick as people with less levels of these healthy bacteria. Now some of you may be wondering if you have probiotics within your body then why in the world would you want to take a probiotic supplement?
It varies by quite a large amount because of our diet, lifestyle choices, the amount of antibiotics we’ve taken in our lifetime.
So due to many different reasons your probiotic level might not be where it needs to be for optimal health.
Two of the main benefits of taking probiotics are aiding in digestion and replaces healthy bacteria in your colon. Now I don’t want you to think it’s as simple as having good bacteria because all of us have good and bad bacteria within us.
In my opinion everyone should be taking a probiotic supplements or supplements in general, not just people suffering from digestive issues. So by taking a probiotic supplement you can help restore the good bacteria that you lose after your medical treatment. Enthusiasm for such foods has lagged in the United States, but interest in probiotic supplements is on the rise.
So as you can see Probiotics are critical to your health and it’s one of the few supplements I highly recommend. Also, there was so much interest in the Plexus products, and I would love to talk more with any of you who are interested, if you’ve not already been working with an ambassador! It’s been a bit since I’ve talked about Plexus on my blog, but I am more excited about it than ever!! If Plexus is new to you, and you’d like to read more of my own personal story, you can find it here. There are some people who wonder what all the excitement is about, and if you have never experienced health challenges or felt desperate for answers to what is happening in your body, then thank Jesus!!
I am not a doctor or nurse, but in my own journey of health I have been learning so many things about how the body works, and it is so fascinating and exciting!
It’s because inflammation, blood sugar instability and gut health are the ROOT cause of so many health issues.
Here’s a better explanation from Jennifer George Pickett, a Dietitian who believes in Plexus. It helps stabilize your blood sugars throughout the day which in turn helps you have more energy, Stable blood sugars also mean LESS STRESS on the body!! Interesting fact: Did you know that the only common denominator in people who live to be over a 100 years old that scientist can find is how sensitive they are to insulin?! A probiotic is an organism which contributes to the health and balance of the intestinal tract. ProBio5 features five probiotics, added enzymes, Vitamin B6, Grape Seed extract and Vitamin C—all in one effective delivery system. Poor eating habits, chlorinated drinking water, stress and disease and the use of antibiotics in food production as well as in medical treatments can wreak havoc in the gastrointestinal tract by destroying good bacteria and allowing undesirable bacteria to multiply.
When the ratio of good bacteria to bad is lowered, problems begin to arise such as excessive gas, bloating, constipation, intestinal toxicity and poor absorption of nutrients. Leaky Gut Syndrome (LGS) is a major cause of disease and dysfunction in modern society, accounts for at least 50% of chronic complaints, as confirmed by laboratory tests. In Leaky Gut Syndrome, the small intestine becomes inflamed and irritated, which allows metabolic and microbial toxins of the small intestines to flood into the blood stream. Some of the most incurable diseases are caused by this exact mechanism, where the body attacks its own tissues. As a result of the modern lifestyle, most of our bodies are burdened with toxic waste and sluggish metabolisms. So while cleansing the body of waste is very important and what most people think of with a cleanse, there are so many MORE health benefits than that alone. Those three (Slim, Probio5, and BioCleanse) can be purchased individually or as a combo package (much cheaper) called the Triplex. This unique patented Aloe formula that blends filtered whole leaf aloe and aloe leaf gel, smartly delivers polysaccharide nutrients.
A colleague of the developer of the X Factor was given permission to treat 31 cancer patients in England, all who had been given a diagnosis of 3-6 months to live.
ALL the products come with a 60-day money back guarantee, which speak of the company’s belief in their products, and also of their belief that health takes time.
Wholesale Ambassador, best pricing, comes with your own website so you and your friends can order = best all-around option if someone is ordering over $100 a month! And, if you’d like to try the products and see for yourself why I’m so excited about them, you can visit this website and order from there! Also, now through June 15, if you order the X-Factor family chewables, use the code FAMILY5 for a $5 discount off your purchase!
I would like to gift a Plexus package to my sister who has been contemplating using it for some time now to help with weight loss and gut health.
I would love to try these products because ever since having my third child three months ago I have been experienced most of the symptoms that are listed under low blood sugar. Although sugar is the most important food to avoid, there are several other groups that can promote a Candida overgrowth or cause reactions in Candidiasis sufferers. Although this is just a controversial topic, there is significant evidence that ‘amalgam’ fillings containing mercury can release toxins into your body. Stress is a factor that is often overlooked when it comes to yeast infections and Candidiasis, but there is some very good evidence that the two are strongly linked. There are several different ways in which a period of stress changes the physiological makeup of our bodies. The contraceptive pill is even more likely to lead to a candida overgrowth if combined with antibiotics.
Sufferers of diabetes are more likely to experience repeated yeast infections for two reasons. Most drinking water contains traces of chlorine, a disinfectant that is added to kill disease-causing microorganisms. There may be some truth to that, but it is also true that chlorine acts to weaken our immune systems and leave us more vulnerable to other infections. Disclaimer: The products and statements made about specific products on this web site have not been evaluated bythe United States Food and Drug Administration (FDA) and are not intended to diagnose, treat, cure or prevent disease. Therefore, it is always prudent to possess the basic know-how regarding the causes of Candida yeast overgrowth to be able to stay ever vigilant against its likely occurrences. However, they possess the capability of being present in large numbers especially in the Gastrointestinal tract if the gut pH level becomes exceedingly alkaline, and the beneficial bacteria have severely declined because of any reason. In fact, according to various studies, a majority of the women from across the world complain of an occurrence of vaginal yeast infection at least once in their lifetime. However, one fact remains constant irrespective of the body part affected by the Candida fungus, and it is that this microbe can thrive only in warm and moist conditions with alkaline pH level. Therefore, any body part that provides these conditions is susceptible to a bout of overgrowth of this Candida fungus. As discussed earlier on, the genital tract in human females consists of a number of different microbes with each of them occupying their specific niche. Moreover, many women prefer to opt for douching and rubbing on a frequent basis to keep their vagina clean, especially after having sexual intercourse, which can cause the vagina to become dry and make it more susceptible to yeast infection. However, men are susceptible to a bout of genital yeast infection as well, and this can occur because of a number reasons. This condition manifests with the presence of a milky white film on the tongue, as well as, a number of other symptoms, and is common in people with seriously compromised immune functions. This happens in case of people with severely compromised immune system with the fatality rate being extremely high at over 50% if this fungus gains entry into the blood stream. Any diet overloaded with carbohydrates, sugars, and yeast is likely to promote the overgrowth of Candida because this fungus simply thrives in sugar, which constitutes its most crucial growth factor among nutrients.
Therefore, it is always prudent to opt for adequate amount of exercise and proper rest to be able to keep this opportunistic pathogen at bay.
The fact that Candida is part of the natural microflora of the human body means that they are capable of causing an infection whenever the conditions become suited to their taste.
This suggests that Candida has been a natural part of the human society from most of known history.
The stool samples were analysed under a microscope, and had been confirmed to contain an overgrowth of Candida with them. Moreover, the recent use of antibiotics can increase the prevalence of Candida yeast overgrowing within the gastrointestinal tract, so if you have any such symptom, then opting for a stool test should be the first step to diagnosing, and then treating the problem. The four imidazole medications (clotrimazole, econazole, miconazole, and ketoconazole) were active in fighting most of the Candida albican species. However, imidazole medications can be quite useful to fight outbreaks of Candida Overgrowth, but patients with non-albican Candida species may sometimes have recurrent outbreaks, in which case additional antifungal medication may be administered.
So at the end of the day a probiotic is a healthy form of bacteria which lives, in most cases, in your large intestines.
Having a constant supply of healthy probiotics will keep things running as they should and bad bacteria in check. Probiotics have also been known to help manage a lot of the side effects which come with antibiotic use. Even if you have a healthy level taking more won’t harm you because good bacteria is always being destroyed so it’s good to keep adding new ones. Some digestive disease specialists are recommending them for disorders that frustrate conventional medicine, such as irritable bowel syndrome. Stress has been known to cause horrible digestion and a good probiotic supplement can help things flow as they should. When you’re stressed the body releases specific hormones which can cause issues in your gut.
Unlike a lot of supplements Probiotics are pretty cheap and won’t destroy your bank account. It is just a joy to share products that truly work to bring health, and that are changing people’s lives.
My own health continues to be such a blessing, and as we returned home from a busy weekend trip with over 24 hours of traveling, many late nights, and not much sleep, I’m amazed again at how good I feel! But in a nutshell, I dealt with adrenal fatigue, low blood sugar, brain fog, and being underweight, and desperately needed something that would work from the inside out, not just mask symptoms. Not everyone is in need of these products and there are those who enjoy great health – and that is wonderful! These products are not a magic cure for anything, and they will not turn your twinkies into protein, unfortunately!
Plexus products are health supplements made of plant-based ingredients that target health on core levels of the body. Instead of addressing the root problem, most of the time we end up treating symptoms with prescriptions, which have their OWN side effects, thus creating MORE issues to deal with. She has a Master’s degree and almost 17 years of health care experience and below she shares her opinion on what makes Plexus different… I wholeheartedly agree! After working with many clients and team members, I have seen the most common root problems are blood sugar instability, poor gut health and inflammation. Insulin is the master hormone in your body, which means it has a very important job! Insulin tells all the other hormones what to do!
So if we can keep our blood sugars stable, not swinging up and down, our bodies can release less insulin and become more sensitive to insulin. The Plexus Probio5 is the only probiotic on the market that also contains an antifungal ingredient, which is so essential in the treating of yeast overgrowth in the body! It is a huge area of our body, and studies show that even things like depression, autoimmune diseases, skin issues, and a myriad of other health issues have their root in an unhealthy gut.
This event compromises the liver, the lymphatic system, and the immune response including the endocrine system. Having an excess of toxic waste can leave the body tired, achy, and bloated, with a low energy level and weakened immune system. This is caused by poor diet, stress, low activity levels, polluted air and shallow breathing. Warlburg won his first Nobel Prize for proving that cancer is caused by a lack of oxygen respiration in cells. Many studies show that the aloe helps you to absorb the Vitamin E and C ingredients by up to 3 times more! People report reduced cases of sicknesses and better energy and all around health with both of these incredible products.
It has been such a fulfilling business for me to offer hope and wellness to other people through these products and building relationships! You may not be a current customer to an ambassador, or an ambassador, or working with another ambassador. Or, you can message me here with any questions about the products or about the ambassador opportunity!
There is some confusion in that only added sugars matter, and that the natural sugars found in fruits are okay to eat on aCandida diet.
These include caffeinated drinks, glutinous drinks, alcoholic beverages, starchy vegetables, some varieties of nuts, dairy products, and most farmed fish.
If you have taken antibiotics within the last six months, you are most likely to be suffering with Candida overgrowth. This mercury toxicity has been cited as being the cause of chronic fatigue, depression, weakened immunity and loss of memory. An elevated level of mental stress has frequently been associated with an increased incidence of vaginal yeast infections, and it is a major cause of Candida infestation. Not all of these are important for Candida sufferers, but there are two particular changes that make a Candida infestation much more likely. Longer-term stress is far more likely to cause a candida infestation because it leads to prolonged changes to your body chemistry, including a higher level of cortisol. The oestrogen in the contraceptive pill stimulates the production of glycogen within the vagina. This is because in a healthy person the excess glycogen is metabolized by the ‘good bacteria’ in your vagina and turned into lactic acid.
The first reason is that diabetics have high blood sugar levels that feed the Candida yeast cells.
This is similar to the chlorine that is used in swimming pools and it has many known side effects. Chlorine is an effective disinfectant designed to kill microorganisms, so when it reaches your intestines, it destroys colonies of both bacteria and yeast indiscriminately.
All information provided on this web site or any information contained on or in any product label or packaging is for informational purposes only and is not intended as a substitute for advice from your physician or other health care professional.
The fact that Candida forms a part of the natural microflora in humans, and is present in large enough numbers on certain body parts such as the skin and the female genital tract makes it possible for them to cause infections due to sudden spurts in their growth rate.
This is because the Candida fungus requires an alkaline pH, apart from a warm and moist environment to be able to grow and multiply in a rapid manner.
The presence of lactic acid producing bacteria inside the vaginal canal helps in keeping the pH level there slightly acidic which is essential for depriving the Candida yeast of the ideal growth conditions.
Moreover, any sudden changes in the composition and balance between these microbes is likely to result in marked reduction in the number of certain species, and other ones going for a growth spurt at their expense. In addition to that, women who have become pregnant might turn out to be much more susceptible to overgrowth of Candida albicans because of changes in their hormone levels, which can cause a decline in the vaginal acidity. The most common cause behind penile yeast infection is an act of unprotected sexual intercourse with an infected partner with the resultant transfer of the pathogen from the genital tract of the woman concerned. Thus, people suffering from AIDS, or have seriously compromised immune function because of lifestyle diseases such as diabetes or have undergone organ transplants are at a particularly high risk of contacting this infection. Therefore, it always pays to be vigilant regarding what causes yeast overgrowth and the measures that are available close at hand to prevent it from happening. Therefore, it is always advisable to opt for a balanced diet and cut down on the consumption of carbohydrates and sugar that can cause an overgrowth of this pesky fungus.
Therefore, the only way out is to become more aware regarding the causes of Candida yeast overgrowth, and staying ever-vigilant to keep them from happening.
However, as the usual modern day diet consist of far more sugars and yeasts foods that the Candida fungus really thrives in, it’s not no wonder that Candida overgrowth has become a greater problem in recent times. Another publication by BMJ dated 2000, revealed that a high number of yeast species were identified within the stools of 43 children with diarrhoea, and 26 without diarrhoea.
However recurrent Candida overgrowth’s were seen to be caused by non-albicans species of Candida.
Overall, it’s recommended to start an anti-Candida diet to first stop the Candida yeast from growing, this will then avoid future flare-ups of an infection occurring. Many studies are finding out that Probiotics are critical to long term health and a lot of companies are even adding probiotics into their foods. In addition to helping keep bad bacteria under control they also help the body by aiding in digestion, boosting the immune system and nutrient absorption. And even if you have a healthy level of probiotics you can still take a supplement to make sure your good bacteria is always at a good level. As I mentioned earlier if you’ve ever been on antibiotics before then you really should be taking a probiotic supplement. Since the mid-1990s, clinical studies have established that probiotic therapy can help treat several gastrointestinal ills, delay the development of allergies in children, and treat and prevent vaginal and urinary infections in women. Stress can even affect the levels of good bacteria in your digestive tract and allow negative bacteria to gain an upper hand. So a good probiotic can help give you an edge even when the stresses of life are getting to you. A good bottle will set you back about $10 bucks which isn’t much compared to doctor bills you could end up paying when your health goes bad. Normally this would have left me exhausted for days, but this time the morning after just feels like my new-normal good days. But there are many who are looking for something to help frustrating and crippling health concerns, and it’s for those people that I am excited to share! Hormones tell your body whether to burn fat and lose weight or to store fat and gain weight or to find balance and weight maintenance in between. The body cannot keep up its metabolism in this state, and begins to gather waste products more rapidly than it can eliminate them. This whole winter we have had ONE bout of a flu bug the entire winter; the only thing we’ve done differently than other years (of repeated sickness) is taking Plexus products.
This applies simply to broad spectrum antibiotics, which are those that kill a wide range of bacteria.
A 2006 study in New Zealand looked at 465 patients who were suffering from mercury toxicity. You may have heard of cortisol before in a relation to weight gain around the abdominal area, but for Candida sufferers, it has two much more important implications for your physiology. Glycogen is an energy store and an ideal food source for the Candida yeast cells living there, which can quickly lead to a candida overgrowth.
If these bacteria are destroyed by anti-biotics, all of the glycogen is available for Candida Albicans to sustain an overgrowth. This is either due to a shortage of insulin in the body or because the body is not reacting to insulin as it should. However, public health officals in many countries have concluded that the reduced incidence of water-borne disease is more important, and outweighs the risk to public health of chlorine consumption. With you gut flora reduced, this allows opportunistic microorganisms like Candida Albicans to grow and flourish. Although the study was not conclusive, it found that chlorination was “associated with a 20-40% increase in colorectal cancer rates”. However, the fact remains that Candida overgrowth does not occur out of the blue, and certain underlining causes are always present to promote the excessive growth of this opportunistic pathogen that leads to infections with debilitating consequences. In fact, it is the major reason behind the limitation in the growth of the Candida yeast on the skin because of the limited amount of moisture present on the skin surface.
Thus, the Candida overgrowth does not find an opportunity to take so long as this fine balance between the various microbes forming the microflora of the genital tract remains in place. Even though the concept of one microbe growing at the expense of another seem innocuous enough, the fact is many of microbes forming part of the natural microflora in the human body are actually opportunistic pathogens that can cause an infection if provided with the opportunity.
However, genital yeast infection can also occur in men who are suffering from lifestyle diseases such as diabetes, or any other health condition that can compromise with their immune capabilities. Maintaining healthy sanitary standards of the body is among the many preventive measures that one can opt for in order to stop this opportunistic pathogen from turning harmful.
The association of these yeast overgrowth cells were mainly due to recent antibiotic use in the children.
Also prolonged use of antibiotics should only be carried out with your doctor’s advice, and any signs of diarrhoea during antibiotic should be consulted with your doctor aswell. Probiotics have been shown to help with bloating, diarrhea, heartburn, irritable bowel syndrome, indigestion, constipation and other problems. Fortunately, Plexus has developed products to help the body detoxify and cleanse the gastro-intestinal tract and arteries. Viruses, bacteria, fungi and other things thrive in this condition, and can lead to diseases such as flu, yeast overgrowth, chronic fatigue, etc. It also has high amounts of calcium which strengthens bone and teeth and may be effective in helping to prevent osteoporosis. Candida does not discriminate when it comes to sugar – one source is just as good as the other. These bacteria will not only kill the pathogenic bacteria that are causing your medical condition, they will also destroy the entire population of good bacteria in your gut. It found that the “removal of amalgam mercury fillings when combined with appropriate treatment resulted in a significant symptom reduction to levels reported by healthy subjects” . Over long periods of chlorine consumption, this can be lead to a weakened immune system and a candida overgrowth. This, in combination with the presence of other microbes such as bacteria, ensures that there are no instances of Candida overgrowth fungus on the skin surface. However, this fine balance can go awry because of a number of different reasons, and this in turn opens the gates for the Candida fungus to go on a growth spurt and cause considerable distress for the host. Candida falls under this category, and a bout of Candida overgrowth results in an infection with a number of irritating and painful symptoms, and serious consequences if not treated properly.
Moreover, wearing wet swimwear for long periods can also cause Candida yeast overgrowth in the genital region, especially in uncircumcised men because the warm and moist environment under their foreskin provide the ideal growth conditions for the yeast. This picture shows the difference between dieting and cleansing, and why cleansing makes all the difference.
Plexus Bio-Cleanse oxygenates and energizes your body while detoxifying and cleansing wastes, pathogens and plaque in the gastrointestinal tract, colon, arteries, blood, etc. With our poor diets and all the other threats to our health, it’s critical to have a high-quality food source of vital nutrients.
I cry when I get emails about how my customers and team are experiencing results and help for their health.
The candida yeast cells are just as likely to feast on the sugar from a banana as they are on the sugar from a chocolate bar or a glass of wine.
According to a british study published in 2011, this is because the high levels of glucose effectively ‘blind’ the receptors in your immune system that identify pathogens. The above information should give you an insight to ‘What is Candida Overgrowth’ and what are the symptoms of Candida Overgrowth. In fact, studies suggest that the majority of multivitamin products are of poor quality and difficult for the body’s digestive tract to break down, digest and absorb.
This allows the Candida yeast cells to multiply and transform to their fungal, pathogenic form.
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Comments to “What is a good probiotic for yeast infections occur”
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Should You Trust Betterhelp | THTT
This short article will explain the background of and methods utilized in 2 major types of psychiatric therapy: behavior therapy and psychoanalysis. Should You Trust Betterhelp…
Behavior Therapy As An Idea
Behavior therapy, likewise called behavioral adjustment, utilizes people’s actions worldwide as the gain access to point for solving a variety of issues– not just behavioral issues however likewise problems involving feelings and thoughts. Behavioral psychologists presume that problem behaviors are triggered by interactions between individuals and their environments. Problems take place when an individual’s environment rewards destructive habits; in time, these behaviors end up being routines.
Behavior therapy is utilized to treat such unsafe routines as smoking, compound use, consuming disorders, sleeping disorders, and the inability to handle stress successfully. Behavior modification can also be utilized to treat larger psychological disorders, consisting of obsessive-compulsive condition, schizophrenia, bipolar illness, psychotic disorders, character, depression, and stress and anxiety disorders.
Is BetterHelp counseling or therapy?
For instance, to help a customer with obsessive-compulsive condition, a behavioral therapist might teach that individual, gradually, to tolerate a reasonable quantity of dirt in their environment or to avoid constantly cleaning their hands. This method is called direct exposure treatment..
Behavior modification can likewise be used to boost positive habits, such as company, involvement in sports, and boundary forming. Should You Trust Betterhelp
Origins Of Behavior Modification In Psychology.
Behavior therapy can be traced to the research of Russian psychologist Ivan Pavlov, which was published in the 1920s and 1930s. Pavlov’s work concentrated on classical conditioning, which means learning through association. In classical conditioning, 2 stimuli( objects or occasions that produce a reaction) are linked together to produce a new reaction. In a famous experiment, Pavlov classically conditioned pet dogs to drool when he rang a bell because the pets learned to associate the presence of food with the sound of the bell.
Behavior modification is also associated with the work of US psychologist B.F. Skinner, who studied operant conditioning in the 1930s. Operant conditioning indicates finding out habits through punishments and benefits. While dealing with clients in a psychiatric hospital, Skinner discovered that habits could be “formed” (slowly altered) when positive behaviors were followed by unfavorable behaviors and preferable repercussions were followed by unwanted effects.
Behavior therapy was later established as a treatment method when the work of psychologists such as Aaron Beck and Albert Ellis resulted in Cognitive Behavior modification ( CBT). CBT is based on the theory that people’s thoughts figure out both their emotions and their habits. When therapists help individuals alter their ideas, they can help them alter their lives.
Significance Of Behavior Therapy.
Behavior modification is based on the belief that we are affected by and learn from our environment. Hence, behavioral therapists help clients change unhealthy behaviors by concentrating on observable actions, instead of on what is occurring in the mind. Behavior therapy also concentrates on concrete changes in today instead of on insight into the past.
Parts Of Behavioral Therapy Methods.
Particular kinds of behavior modification consist of the following:.
I was a quite distressed kid and worried constantly. I do not believe I was ever depressed, but I had a great deal of stress and anxiety. I went through a period of severe separation stress and anxiety when my moms and dads first got divorced, then became afraid of whatever (rollercoasters, scary motion pictures, bees, cinema, you name it). I was mainly able to handle it, but in 7th grade, my stress and anxiety all of a sudden got a lot worse.
I was continuously on edge and persuaded something awful was going to take place, and had problem sleeping because I told myself that the 2nd I closed my eyes a fire would begin, somebody would break in, or something bad would happen to somebody I enjoyed. I became compulsive about inspecting the locks on windows and doors, the range, and developed an unreasonable fear of getting gastrointestinal disorder. After watching a movie on the Black Plague in school, I ended up being very paranoid about germs and anxious about them constantly. Since, it got to the point where I just wanted to sleep all the time.
Can Medical Insurance Offer Coverage For Treatment Consultations?
Upgraded January 22, 2022.
Medically Evaluated By: Dawn Brown.
What is psychological health protection? When it concerns counseling, individuals often wonder how much it costs with or without a health insurance and how to spend for it. Healthcare marketplaces and systems can be confusing, however individuals seek psychological health treatment every day, and we’re here to walk you through the many psychological health benefits readily available.
Get Quick, Economical Counseling With BetterHelp.
Register To Be Personally Matched To A Certified Therapist.
Can BetterHelp prescribe medication? Should You Trust Betterhelp
Therapy Covered With Insurance Coverage: Protection Tips To Know.
What Kind Of Insurance Coverage Plans Are There For Therapy?
There are numerous methods to spend for psychological health treatment. What is covered by health insurance and what isn’t can be confusing initially? The Mental Health Parity Act belongs of the Affordable Care Act that needs large medical insurance service providers and health insurance to provide equal coverage for mental disorder (consisting of substance abuse coverage and treatment). Contact your insurance coverage supplier for more details..
What Various Kinds Of Therapies Does Insurance Coverage Cover?
Sadly, there are no easy and fast answers to the concern of whether your health insurance plan will cover your treatment sessions or mental health services. The law does not mandate little health insurance companies with fewer than fifty workers to have medical insurance cover the expense of therapy. A therapist’s workplace can likewise help with these questions and you can always check with your medical insurance benefits department or insurer to verify what level of mental health protection you have.
Common Coverage Concerns.
Lots of companies that aren’t governed by the Affordable Care Act or the Mental Health Parity Act select to supply psychological health coverage for their employees. Before seeing a therapist, it’s crucial to see if the company takes your health insurance coverage.
For family members, it may work to look into a Kid’s Medical insurance Program, CHIP. People with identified mental disorders, substance use condition, or other mental disorders can find their vital health advantages might seek more information with the Consumer Help Program..
Medicaid programs are a good alternative for member of the family, especially those with a diagnosable disorder, mental health condition, pre-existing condition, or those trying to find a children’s health insurance program/CHIP. Find out more about these programs at Healthcare.gov..
You might seek in-office talk treatment that is covered by your insurance if you’re interested in lessening expenses. Numerous online therapy choices ( which may not be included in some market strategies) can be much cheaper than even in-network choices..
Questions To Ask Your Insurance coverage.
Exist particular psychological health services/therapists that my health insurance strategy does not cover?
Am I covered for therapy/therapists if I have a pre-existing condition?
What is the personal privacy policy/terms of service for these psychological health services/therapists?
What is the variety of treatment sessions my health plan covers each year?
Do I have a deductible to pay prior to my health plans cover services under my medical insurance strategy?
Is there a copay needed by individual or group medical insurance strategies?
Do I need a recommendation from my primary care doctor for a therapist?
Insurance Network Providers.
A network company is a provider who accepts medical insurance as a kind of payment. In this case, that medical insurance partially spends for psychological healthcare. Although they might accept insurance coverage for psychological health coverage, a network service provider is “within” your health plan’s network..
Insurance Coverage Coverage & Deductibles. Should You Trust Betterhelp
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Difference Between FDA Cleared vs FDA Approved
Difference between FDA Cleared vs FDA Approved Difference between FDA Cleared vs FDA Approved
Difference between FDA Cleared vs FDA Approved – Overview
The Food and Drug Administration (FDA) regulates the sale of medical devices in the United States to ensure consumer safety. Generally, every medical device sold in the US is classified into one of three classes, according to their potential risk to the consumer.
For instance, Class I and Class II medical devices pose low to moderate risks to consumers, so manufacturers may not need to get an FDA clearance for these devices. However, class III devices have a greater potential risk to consumers, so these undergo a thorough review before being granted FDA approval. Additionally, if the device does not require FDA clearance, the device still needs to be registered with the FDA.
In essence, any commercially sold medical device in the US must get FDA approval or at least an FDA clearance before being sold. This is essential to protect users from potential harm while using these medical devices.
FDA Classes for Medical Devices
A medical device is defined as any item used to manage or treat a health condition or an item that can change or interact with a part of the body without using medications. Such devices include a large variety of tests and equipment, all the way from simple gauze bandages to pacemakers used for heart problems.
As mentioned previously, the FDA classifies a medical device into one of three classes based on its potential level of risk to the user.
Class I Medical Device
The FDA defines a Class I medical device as any device that carries the lowest risk of complications to the patient/user and usually does not require a premarket review. This is the review that the FDA uses to decide the level of safety and effectiveness of medical devices.
Class I medical devices can be sold/marketed as “FDA Listed” or “FDA Registered.” It means that the FDA is aware of the device being sold in the market but has not reviewed it for safety and effectiveness.
Such medical devices still need to adhere to certain manufacturing and quality standards during manufacturing. Examination gloves and bandages are examples of Class I medical devices.
Class II Medical Device
A Class II medical device is any device that poses a moderate risk to consumers and needs to demonstrate that it is “substantially equivalent” to similar products that have received FDA clearance. Most Class I medical devices are marketed as “FDA Cleared” devices. These include infusion pumps used to administer intravenous (IV) medication.
Class III Medical Device
Class III medical devices tend to pose the highest level of risk to consumers. These devices are still crucial for life support and may even prevent significant harm to health, but they also pose a substantial risk of injury or illness to the users.
The FDA completely reviews such medical devices before being “FDA Approved.” Class III medical devices usually include items such as pacemakers that are implanted in the heart.
FDA Clearance
FDA clearance is usually granted for Class II medical devices. However, several Class I device manufacturers also frequently seek FDA clearance. Manufacturers can get FDA clearance by providing information proving that their device is substantially similar to another FDA-cleared product.
The definition of “substantially equivalent” by the FDA includes the following characteristics:
• The device uses the same technology and will be used for a singular purpose, similar to an existing FDA-approved
• The device has a different technology but is designed for use similarly to an existing FDA-approved medical device. In this case, the manufacturers will need to provide additional information and evidence to prove the safety and effectiveness of their devices.
As Class I and Class II medical devices pose low to moderate risk to consumers, the process used by the FDA to review such products is less stringent than that for approving medications or Class III devices.
A manufacturer of medical devices is required by the FDA’s Food, Drug, and Cosmetic Act Section 510(k) to register their medical devices before selling their products in the market.
Thus, manufacturing companies can submit a 510(k) (premarket notification – PMN) to the FDA that shows the device is substantially similar to an existing device in the market.
FDA Approval
Difference between FDA Cleared vs FDA Approved
Difference between FDA Cleared vs FDA Approved – FDA Approval
Premarket Approval (PMA) is a stringent application that manufacturing companies must submit before marketing any new product. Class III medical devices have the highest potential risk to users, so they undergo the strictest PMA process before being sold anywhere in the United States.
Manufacturers of medical devices need to submit information and evidence to the FDA that proves the medical device is safe and effective. PMA applications are scientific and legal documents and should include the device’s clinical and technical details.
PMA applications usually contain two types of information:
• Nonclinical laboratory studies sections – The manufacturer has to include practical information about the device, including compatibility, shelf-life, chemistry, and other relevant scientific information.
• Clinical investigations sections – In this section, the manufacturer has to include information from clinical trials, which include safety and effectiveness data, complaints from study participants, side effects, and any device failures.
The FDA determines if the device can be approved based on this information.
Conclusion
The FDA works hard to ensure that any medical device in the market is safe and effective for consumer use through stringent standard tests. It designates medical devices into one of three Classes – I, II, and III – based on the level of potential risk that the medical device poses to users. Class I and II medical devices have a low to moderate risk of complications from use, while Class III medical devices have a higher risk of complications.
References
https://www.cnet.com/health/fda-approved-vs-fda-cleared-whats-the-difference/#:~:text=What%20does%20’FDA%20cleared’%20mean,has%20FDA%20clearance%20or%20approval.
https://www.rcclaw.com/understanding-the-difference-between-fda-approved-and-fda-cleared-is-crucial-to-defective-medical-device-litigation/
https://essenvia.com/blog/fda/what-does-fda-cleared-vs-fda-approved-mean-for-medical-devices
See Also
Approved Weight Loss Medications
FDA Vaccine Approval Process
FDA-Approved Medications for Pediatric Anxiety
FDA Grants
Breast Reduction Weight Requirements
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Home blog 80cm: The Far Point of a Myopic Person
80cm: The Far Point of a Myopic Person
by Cameron James Connor
What Is Myopia?
Myopia, commonly known as nearsightedness, is a vision condition where a person can see objects up close clearly but has difficulty seeing distant objects clearly. It occurs when the light entering the eye focuses in front of the retina instead of directly on it.
Understanding Myopic Vision
When a person has myopia, distant objects appear blurry, leading to the need for glasses or contact lenses to correct the refractive error. The degree of myopia is measured in diopters, with higher numbers indicating more severe nearsightedness.
The Concept of Far Point
In the context of myopia, the far point refers to the distance at which a myopic person can see clearly without the aid of corrective lenses. In other words, it is the farthest point from the eye at which the person can focus clearly.
Quantifying the Far Point
The far point of a myopic person can be calculated based on their degree of myopia. For example, if a person has a myopia of -2.00 diopters, their far point would be 50 cm (1 meter divided by 2.00). This means that without corrective lenses, the person can see objects clearly only up to a distance of 50 cm.
The 80cm Far Point
For a myopic person with a refractive error of -1.25 diopters, their far point would be approximately 80 cm (1 meter divided by 1.25). This means that without glasses or contact lenses, this individual can see objects clearly only up to a distance of 80 cm.
Implications of an 80cm Far Point
Having a far point of 80 cm can significantly impact a person’s daily life and activities. For instance, tasks that require seeing distant objects, such as driving or attending presentations, may be challenging without corrective eyewear. Additionally, social interactions and enjoying scenic views may be affected by the limited distance at which clear vision is possible.
Managing Myopia with Corrective Lenses
To address the visual challenges posed by myopia and the 80 cm far point, corrective lenses are commonly prescribed. Eyeglasses or contact lenses with the appropriate prescription can help a myopic person see clearly at varying distances, including beyond their far point.
Alternative Solutions for Myopia
In addition to traditional corrective lenses, there are several alternative solutions for managing myopia and improving vision clarity. These include orthokeratology (ortho-k), which involves wearing special rigid contact lenses overnight to reshape the cornea temporarily, and myopia control techniques such as atropine eye drops and multifocal contact lenses.
FAQs About Myopia and the 80cm Far Point
1. Can myopia worsen over time?
Yes, myopia can progress over time, especially during childhood and adolescence. Regular eye exams are essential to monitor changes in vision and adjust corrective measures accordingly.
2. Is myopia a genetic condition?
Genetics can play a role in the development of myopia, but environmental factors such as prolonged near work and limited outdoor time can also contribute to its onset and progression.
3. Can myopia be reversed naturally?
While certain lifestyle changes such as spending more time outdoors and taking visual breaks during near work may help slow down myopia progression, complete reversal of myopia solely through natural means is not yet supported by scientific evidence.
4. At what age does myopia typically stabilize?
Myopia progression often stabilizes in early adulthood, around the ages of 20 to 30. However, some individuals may experience changes in their vision throughout their lives.
5. Is laser eye surgery a permanent solution for myopia?
Laser eye surgery, such as LASIK or PRK, can correct myopia by reshaping the cornea. While it can provide long-term improvement in vision, the eyes can still change over time, potentially requiring enhancements or additional vision correction.
In conclusion, understanding myopia and its impact on vision, including the concept of the far point such as the 80 cm far point in myopic individuals, is essential for effective management and care. By seeking regular eye examinations, exploring suitable corrective options, and adopting healthy visual habits, individuals with myopia can maintain clear vision and enhance their quality of life.
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Free shipping on all orders over $100
Medical grade vs over the counter skincare - what is the difference?
September 07, 2019
Our clients often ask "What is the difference between our brands and what you can buy in a department store, spa or pharmacy?"
The key difference between medical-grade and over the counter store / spa bought skincare, lies in the product ingredients and formulations. Medical grade skincare typically contains active ingredients in higher concentrations for maximum results, and also has more sophisticated delivery systems to allow a deeper penetration of these active ingredients.
For example, Vitamin A, which is designed to reduce the appearance of fine lines and large pores, as well as stabilise sebum production, is often found in anti-aging skincare products. However, you’ll generally find that supermarket / department store skincare will include Vitamin A in its milder form – also known as Retinyl Palmitate/Acetate, whereas medical grade skincare products will typically contain a higher-level form of vitamin A called Retinol or new kid on the block Retinal. Medical grade skincare also tends to include a higher % of retinol in the product.
The strength of the retinol included is only part of a products effectiveness. If we consider encapsulated retinol for example, it works similarly to regular retinol, however it delivers its powers into the skin a little differently. Encapsulated retinol such as Biopelle Retriderm is housed in a carrier system to protect its integrity and improve its ability to penetrate into the skin effectively. Retinoids work in the deeper layers of the skin so having a carrier system to deliver the retinol effectively to the lower levels of the skin means it is targeting the right area and not just those outer layers. It is also important to note that vitamin A is not stable in most formulations, especially water-based. If it is not protected in the formulation it degrades and becomes inactive!
As mentioned above another very important aspect is product stability. Medik8 state with regards to their vitamin C choices:
"We take stability seriously. We use super-stable forms of vitamin C, alongside stabilised ascorbic acid in our serums". Medik8 also state that "the by-products of degraded L-ascorbic acid can cause damage to skin cells, if accumulated in large amounts in a topical formulation. Under certain conditions it can behave as a pro-oxidant"
... certainly not the desired effect!
As a result of including highly efficacious ingredients in stronger concentrations and effective delivery systems, medical-grade skincare is ideal for targeting specific skin concerns like aging skin, menopausal skinpigmentation, acne, rosacea…etc. at a deeper level with superior results.
Medical grade skincare is often formulated by clinicians and physicians and generally have clinical evidence to support the product and active ingredient claims, many published in peer reviewed journals. As the formulations contain powerful stable ingredients with effective delivery systems, medical grade skincare is designed to transform your skin for the long term. Many of these products take years to formulate and a host of expert chemists to perfect. Sophisticated skincare takes time and money to produce and package correctly to ensure stability and hence efficacy.
You will often only find medical grade skincare in clinics with an affiliated Doctor. This is a huge plus of medical grade skincare, having your skin evaluated by an experienced provider who can recommend the right products helps you avoid wasting time and money on products that aren’t right for your skin type. It also ensures safety as the Medical Doctor can check your medical history and medications for possible undesired interactions.
At SDD we prescribe medical-grade physician only brands; Biopelle, Dermaceutic, Emepelle, Neoretin, Biretix, ProfhiloAspect Dr along side other cosmeceutical brands such as Medik8, Mesoestetic and Circadia. We can devise an appropriate and effective skincare regime tailored specifically to your concerns, reviewed by our Medical Doctor.
If you are ready to upgrade your skincare, or you have questions about your options, we will be happy to help you with our free online skin consultation at www.skincaredoctordirect.com
We look forward to helping you get your most beautiful skin yet.
The SDD Team x
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Doulas: Exploring A Tradition Of Support : The Baby Project The Baby Project explores the role of doulas and how they assist mothers during birth.
NPR logo Doulas: Exploring A Tradition Of Support
Doulas: Exploring A Tradition Of Support
Baby Project mom Lucy Peck was initially going to use a doula for her birth, but has since decided to have her sister act as a birth companion. Regardless, we decided to explore the topic more to find out exactly, "What is a doula?"
I reached out to two doulas to better explain who they are, what they do, and how they can assist mothers during labor and delivery.
istockphoto.com
An illustration of a pregnant woman.
istockphoto.com
Leda Ward is a DONA-certified labor support doula and a certified lactation counselor in New York. Robin Elise Weiss is a childbirth educator, certified doula and lactation consultant, and the author of several books, including The Complete Illustrated Pregnancy Companion and The About.com Guide to Having a Baby. She also blogs about pregnancy and childbirth for About.com.
What is a doula?
The word "doula" comes from ancient Greek, meaning "a woman who serves." Today, "doula" refers to a professional trained to provide emotional, physical and informational support to women throughout their pregnancy, birth and the early postpartum period.
Doulas can assist women with births at home, in the hospital or at a birth center, and they provide pain management techniques, reassurance and advocacy in the labor room.
According to Ward, the role of the doula is an ancient one. Years ago, when women exclusively gave birth at home in the care of skilled midwives, women had their female family members support and guide them. But with the development of obstetrics and hospital births in the last century, women became estranged from the birth process, and family members lost sufficient knowledge and confidence to guide a woman.
To fulfill women's need for birth support in modern times, the professional doula arose in the 1970s and '80s.
How do doulas differ from midwives?
A midwife is a medical professional who can provide the same type of care as an obstetrician in the course of a low-risk pregnancy and labor. During labor and delivery, medical care is still in the hands of the midwife or doctor, and the doula becomes an addition to the birth team rather than a replacement.
According to Ward, while doulas do not provide medical care or advice, they can help a mother have a shorter labor, often without the need for pain medication, by providing constant guidance and support.
How do doulas assist the mother during birth?
Weiss says that many women who give birth in hospitals don't realize they may be completely alone for periods of time. Nurses are usually available, but can't spend every moment with a patient. A doula is with the mother at all times during labor, offering guidance and support.
Doulas might suggest positions to help labor move faster, or for the mother to be more comfortable, even when medications are used. They can also suggest comfort measures such as massage, warm compresses, laboring in a shower or with a birth ball.
Additional services might be keeping family members calm and secure, helping to navigate the hospital or birth center system, offering breast-feeding help after the birth, and identifying support systems to help the postpartum period go more smoothly.
What are the benefits of using a doula?
According to Weiss, using a doula can help women have a shorter labor, be less likely to have a cesarean, be less likely to need pain medication, and be less likely to have a forceps delivery.
Ward also says that women are more likely to report a positive experience of their birth and are better able to bond with their babies when using a doula, which has the added benefit of reducing risk factors for postpartum depression.
Did you use a doula during your birth? Tell us about your experience.
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FAT FIT FREE
Losing weight with psychedelic mushrooms
Losing weight with psychedelic mushrooms and Benefits Of Magic Mushrooms
Estimated reading time: 11 minutes
Microdosing mushrooms for weight loss
Can you lose weight with psychedelic mushrooms? What are the best microdosing mushrooms for weight loss? If you haven’t been hiding under a mushroom, you can not help but notice all of the news stories on the beneficial effects of mushrooms. Microdosing psychedelics like LSD, psilocybin mushrooms, DMT, mescaline, and ayahuasca are becoming increasingly popular among people looking to lose weight and keep their weight gain in check. According to the Science Daily, while many people use psychedelics to treat depression, anxiety, PTSD, addiction, and even cancer, some are turning to them to shed pounds and maintain a healthy weight.
Results from the National Library of Medicine show that Psilocybin has the potential to remove the stigma surrounding medicinal mushrooms and help people lose weight and keep it off by altering neural pathways.
The clinical trials found that participants who took a low dose of psilocybin mushrooms experienced decreased body mass index (BMI) and increased self-reported physical activity.
Talk to your doctor before starting any new program to help you lose weight. Psychedelic mushrooms can provide effective treatment; however, finding the right doctors with experience to prescribe the correct amount needed to treat your weight gain might be difficult.
Looking to grow your own mushrooms? Check out: DIY Mushroom Growing Kit: Everything You Need To Know Before Buying
Can mushrooms help you lose weight? |
losing weight with psychedelic mushrooms
The answer is yes! As further studies have shown in the National Library of Medicine. While it may seem unlikely that something as strange as psychedelic mushrooms could be used to lose weight, they have some surprisingly powerful health benefits. Medicinal mushrooms can help you in various ways, from boosting your metabolism to increasing nutrient absorption and keep a healthy weight.
Furthermore, another beneficial effect of medicinal mushrooms has been found to suppress appetite by releasing hormones such as serotonin, which helps curb unnecessary cravings and make it easier for you to stick with healthier eating habits which will reduce your weight gain.
Last but not least, mushrooms have also been linked to increased energy levels. Taking a mushroom blend with your protein shakes will give you an added boost of energy. Exercising more frequently or engaging in physical activities leads to losing weight.
All in all, by consuming medicinal mushrooms regularly, you can benefit from their health promoting properties while helping shed excess pounds in the process.
Best Mushroom for Weight Loss? |
losing weight with psychedelic mushrooms
Edible Mushrooms with psychedelic compounds are an excellent source of plant-based proteins. These types of mushrooms can significantly add to any weight loss plan. Types of functional mushrooms, are:
• lion’s mane
• reishi
• and cordyceps
These mushrooms are especially beneficial for weight loss. They have a lower calorie content and ability to keep you feeling full for longer periods of time. They do all of that without spiking your blood glucose levels. A current study listed in the National Library of Medicine examined the anti-obesity effects of edible mushrooms. It found that they can stimulate weight loss and have protective effects against obesity-related hypertension and dyslipidemia.
Including mushrooms in your diet is an easy way to get the benefits of a high protein, low calorie food. While also helping to reduce your risk of obesity-related health issues, keep your cholesterol levels in check as well as your blood glucose levels.
To help you reach your weight loss goals try add some to your meal plan. With so many health benefits it’s no wonder why functional mushrooms are becoming increasingly popular among those looking to lose weight in a healthy way.
Lion’s Mane
Traditional Chinese medicine has been using Lion’s Mane functional mushrooms for centuries. Besides having powerful weight loss benefits, they have a unique ability to boost cognitive function, lower blood sugar levels. Lion’s Mane mushrooms contain high levels of protein and fiber, which can help keep you feeling full for longer periods of time and reduce cravings. Additionally, they contain compounds that can help to boost your metabolism and burn fat more efficiently.
Reishi
Reishi mushrooms also part of the medicinal mushroom family with, history of traditional Asian uses. They are known for their ability to boost the immune system and reduce inflammation, but they also have powerful weight loss benefits. Reishi mushrooms contain compounds that can help to suppress appetite and reduce cravings, as well as stimulate fat burning. Additionally, they are rich in antioxidants which can help to protect against cell damage and reduce the risk of obesity-related health issues.
Cordyceps
Cordyceps mushrooms are a type of functional mushroom that has been used in traditional Chinese medicine for centuries. They are known for their ability to boost energy levels and improve athletic performance, but they also have powerful weight loss benefits. Cordyceps mushrooms contain compounds that can help suppress appetite, reduce cravings, and stimulate fat burning. Additionally, they are rich in antioxidants which can help to protect against cell damage and reduce the risk of obesity-related health issues.
Can Microdosing Psilocybin Help With Weight Loss? |
losing weight with psychedelic mushrooms
A company based in Canada thinks so. NeonMind
OAKVILLE, ON / ACCESSWIRE / March 22, 2022 / NeonMind Biosciences Inc. (CSE:NEON)(OTCQB:NMDBF)(FRA:6UF) (“NeonMind” or the “Company“), an integrated drug development and wellness company focused on bringing innovative psychedelic-based treatments to people suffering from obesity and mental health disorders, announced today it has filed a new patent application with the United States Patent and Trademark Office related to a novel mechanism of weight loss targeted to specific fat subtypes.
NeonMind
The idea behind losing weight with psychedelic mushrooms is simple: taking small doses (microdosing) of psychedelics throughout the day helps regulate appetite, boosts metabolism, and reduces cravings. In addition, research suggests that microdosing mushrooms for weight loss might work better than traditional dieting methods.
Mind-altering experiences
losing weight with psychedelic mushrooms
Losing weight with psychedelic mushrooms
Close-up picture of a Amanita poisonous mushroom in nature
While most people associate psychedelic drugs with mind-altering experiences, scientists believe they have therapeutic benefits too. For example, PubMed studies show that MDMA (ecstasy), LSD, and psilocybin mushrooms can reduce stress and boost mood. Researchers are also studying whether microdoses of psychedelics can improve brain health and cognitive function.
In addition to helping people lose weight with psychedelic mushrooms, researchers think that microdosing psychedelics can help prevent mental illness and addiction. Studies suggest that psychedelics can change our brains, making us less likely to relapse into substance abuse and addictive behaviors. They can also make us feel happier and healthier overall.
There are several ways to microdose. For example, some people eat a few grams of shrooms, while others smoke a joint containing 10-20 micrograms of LSD. Others take a single dose of 5-10 micrograms of LSD every few days. Still, others combine both ingestion and inhalation techniques.
For those who want to try microdosing, check out Third Wave’s Microdose Course to educate yourself on the proper way of experiencing psychedelic mushrooms
How Psychedelic drugs are being used as a possible treatment for obesity
Neonmind Biosciences – Psychedelic Compounds For Weight Loss
A study published earlier this month showed that psilocybin — the active ingredient in magic mushrooms — could help people change their eating habits. In another study, researchers gave mice a drug dose and discovered it helped them lose weight.
The idea behind both studies is simple: psychedelics alter how we think about ourselves and our surroundings. They do this by causing us to see things differently. This leads to a different outlook on life, one that helps people make healthier decisions.
In the case of the mouse study, researchers had the animals eat until obese and then treat with either psilocybin or a controlled food group. The study went on for 27 days while body weight and food intake were recorded daily. Then, they compared the amount of fat in the mice’s bodies before and after the experiment. What they saw was that the mice who was treat with psilocybin lost weight compared to the control group who were not give the treatment.
A similar thing happened in humans. Participants in the Johns Hopkins study participated in a six-week program using psilocybin every week. Afterward, they reported feeling happier and having fewer negative thoughts.
But what happens when you take the drug? Well, there are some downsides. For starters, you’ll probably feel pretty trippy. You might even experience hallucinations. But those side effects aren’t nearly as dangerous as many other drugs. And unlike most prescription antidepressants, psilocybin doesn’t come with severe risks like suicide or addiction.
That’s why researchers say the drug could help obese people shed pounds.
MICRODOSING FOR WEIGHT LOSS: Best mushroom for weight loss
microdosing for weight loss
Microdosing for weight loss is a relatively recent phenomenon that has been around since the early 2000s. However, it wasn’t until about five years ago that people began talking and discussing it online. There’s no real consensus on what constitutes a microdose; some people say anything under 300 mg is too low, while others claim that anything up to 10,000 mg per day is fine. But one thing is certain, some people use microdoses to help them sleep better, while others use them to treat depression.
Other Benefits include:
• Treatment of Obesity
• Reduce Food Cravings
• Reduce Food Consumption
• Life stress
There are many ways to microdosing mushrooms for weight loss, including eating mushrooms, drinking infused teas, taking supplements with add mushrooms.
The idea behind microdosing is that you don’t want to experience the full effects of a high dose of psychedelics because those tend to make you feel wasted; you want to achieve similar outcomes in dealing with the side effects. This way, you can still reap the benefits drug’s benefits without being overwhelmed by them.
What are the best mushroom for weight loss?
The best mushrooms for weight loss are those that contain high levels of psilocybin. Psilocybin is the active ingredient in psychedelic mushrooms and is believed to be responsible for their therapeutic effects.
The most popular types of psilocybin mushrooms are:
• Liberty Caps
• Golden Teacher
• B+ Cubensis
• Penis Envy
Does losing weight with psychedelic mushrooms have other benefits? |
losing weight with psychedelic mushrooms
Losing weight with psychedelic mushrooms
Growing magic mushrooms hallucinogenic psilocybe cubensis
Psychedelic drugs such as LSD and magic mushrooms are illegal in most states. But researchers are conducting studies of these substances that could help people suffering from mental illness. Recently, a study found that participants taking low doses of psilocybin — the active ingredient in magic mushrooms — had lower levels of anxiety and depressive symptoms compared to those given placebos. Researchers say the findings suggest that these drugs might offer a novel treatment option for conditions like post-traumatic stress disorder (PTSD).
Another study found on Nature.com involved nearly 1133 volunteers. Nine hundred fifty-three were psilocybin microdoses and 180 non-microdoses. They were all followed for 30 days, and those that were microdosing were shown to have small to medium-sized improvements in mood and mental health.
Researchers believe that the positive effects of psilocybin are due to its ability to trigger changes in brain activity associated with feelings of well-being.
Want to read more on Magic Mushrooms, check out: Benefits Magic Mushrooms and Psilocybin
Wrap Up
As you can see the research behind losing weight with psychedelic mushrooms points to a change in your mood and desire to start eating and living a healthy lifestyle. When Microdosing mushrooms for weight loss it is important to educate yourself on the proper dose of psilocybin.
Basic Principles To Lose Weight
• Determination to lose weight
• Mindset change that you will eat healthier Foods (Eat Italian)
• Exercise at least 30 mins a day to burn calories. You can start by joining the iFIT team and choose from a large selection of workouts from beginners to professionals or start walking, hiking, and dancing. Whatever you can do but start moving.
• Eat smaller portions and start an intermittent fasting diet during the week, and eat mostly protein and vegetables for dinner.
• Plan ahead when parties or family gatherings are coming up. You will need to understand that you may eat more, so eat less leading up to the event and DO NOT OVEREAT
• Stress Eating is a real thing. I know I always do it when work, Life, or anything pops up and becomes stressful. Take time for yourself and meditate or talk to someone who is also losing weight for support.
• Stay consistent on your lifestyle change to lose belly fat. You will have days that you may not follow that strict plan. It’s ok, but get back on your diet program and start again. I promise it will get easier.
Read MY STORY on how I was fat and unmotivated and how I was able to turn my life around and stop eating ultra-processed foods. I will tell you what I did to start the process of losing weight, exercising, and eating right. I am a regular guy who was able to change his life around, and you can too. Also check out Stop the Global Fast Food Insanity! – FAT FIT FREE, Does PTSD lead to weight gain?and Psychology of Weight Loss Motivation: 5 Tricks You Need to Know
Check out my latest FAT FIT FREE blog posts below:
Since dropping 40 lbs, I am a fitness enthusiast who understands what it takes to keep the weight off. So I started writing about my fitness journey and find interesting topics to share about health, fitness, Investing, and trending topics. Thanks to you all who have inspired me to take my first step to good health.
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Contact
T: 08 9467 2272
F: 08 6313 0920
E: support@epsychiatry.com.au
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This is not an emergency service. Same day consults are not available. If you are in distress please contact your nearest emergency department, your local area mental health service triage or dial "000".
Copyright © 2020 Epsychiatry Pty. Ltd. All rights reserved.
OCD
Someone with Obsessive-Compulsive Disorder suffers from recurring irrational, intrusive thoughts which they can't dispel with reasoning or logical thinking. Most of us get intrusive thoughts "will our family member make it home safe tonight?". However, people with OCD get recurrent distressing intrusive thoughts. To deal with these thoughts people engage in repetitive rituals to reduce the anxiety and stress they are felling.
How can obsessions and Compulsions Present?
• Worries about germs, bodily fluids or environmental contamination leading to showering, cleaning and other strategies to prevent contacts with contaminants.
• Forbidden sexual thoughts or obsessions which are dealt with by praying, doing a task in 'threes' because three is a safe number or cancelling by replacing a certain 'bad' word with another 'good' one.
• Fear of stealing leading to repeating body movements or avoiding certain situations altogether.
How DOES OCD affect people?
OCD is a pervasive mental health condition that impacts on several aspects of your functioning; relationships, work, study and ability to take care of yourself or relax. Clients that see our telehealth psychiatrists for OCD often describe how their compulsions impact upon their family and work relationships. At our family meetings sometimes partner or children may raise how they feel embarrassed and in turn isolate and avoid social contact. You often see ripple effects through the family.
To manage OCD people might turn to addictions. Sheer exhausted from simply implementing the rituals, people with OCD might become overwhelmed, isolated and depressed.
Why should Professional Mental Health Services be sought?
The treatment for obsessions and compulsions is highly specialised. There are several well-researched evidence-based treatments for OCD. Exposure Response Prevention (ERP) is the most effective psychological treatment for OCD.
There is a role for medication in the treatment of OCD. The best evidence is for a class of medications called SSRI. The medication works to reduce intrusive thoughts and compulsions and any related depression.
OCD is best treated with a multi-disciplinary approach; psychiatrists and psychologists working together with GPs to provide holistic care.
Do you have a loved one with OCD?
Having someone close to you experience OCD can be challenging and frustrating. There are some practical strategies you can use to support your loved one with OCD, speak with their psychologist or psychiatrist to learn more. If you are finding it hard to cope speak with your GP.
PsychOLOGIST
You will need a referral from your GP or Psychiatrist to access this service
50 mins
Psychiatrist
You will need a referral from your GP to access this service
45 mins
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1a01aa77535b9ecfb87b9fc36adbcd2f
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-618,047,770,781,920,400
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PMCC PMCC
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1. Cytokine–Chemokine Networks in Experimental Mycobacterial and Schistosomal Pulmonary Granuloma Formation
Type-1 and type-2 lung granulomas, respectively, elicited by bead immobilized Mycobacteria bovis and Schistosoma mansoni egg antigens (Ags) display different patterns of chemokine expression. This study tested the hypothesis that chemokine expression patterns were related to upstream cytokine signaling. Using quantitative transcript analysis, we defined expression profiles for 16 chemokines and then examined the in vivo effects of neutralizing antibodies against interferon-γ (IFN-γ), interleukin (IL)-4, IL-10, IL-12, and IL-13. Transcripts for CXCL2, −5, −9, −10, and −11 and the CCL chemokine, CCL3, and lymphotactin (XCL1), were largely enhanced by Th1-related cytokines, IFN-γ or IL-12. Transcripts for CCL11, CCL22, CCL17, and CCL1 were enhanced largely by Th2-related cytokines, IL-4, IL-10, or IL-13. Transcripts for CCL4, CCL2, CCL8, CCL7, and CCL12 were potentially induced by either Th1- or Th2-related cytokines, although some of these showed biased expression. IFN-γ and IL-4 enhanced the greatest complement of transcripts, and their neutralization had the greatest anti-inflammatory effect on type-1 and type-2 granulomas, respectively. Th1/Th2 cross-regulation was evident because endogenous Th2 cytokines inhibited type-1, whereas Th1 cytokines inhibited type-2 biased chemokines. These findings reveal a complex cytokine–chemokine regulatory network that dictates profiles of local chemokine expression during T cell–mediated granuloma formation.
doi:10.1165/rcmb.2002-0241OC
PMCID: PMC3677198 PMID: 12600821
2. CCR6 as a mediator of immunity in the lung and gut
Experimental cell research 2011;317(5):613-619.
Chemokines are key mediators of leukocyte recruitment during pathogenic insult and also play a prominent role in homeostasis. While most chemokine receptors bind to multiple chemokines, CCR6 is unique in that this receptor is one of only a few that can bind only a single chemokine ligand, CCL20. CCR6 is an important receptor that is involved in regulating several aspects of mucosal immunity, including the ability to mediate the recruitment of immature dendritic cells (DCs) and mature DCs, and professional antigen presenting cells (APCs) to the sites of epithelial inflammation. Further, CCR6 mediates the homing of both CD4+ T (T-helper; Th) cells and DCs to the gut mucosal lymphoid tissue. DCs, which are known to be essential immune cells in innate immunity and in the initiation of adaptive immunity, play a central role in initiating a primary immune response Herein, we summarize the role of CCR6 in immune responses at epithelial and mucosal sites in both the lung and gut based on a review of the current literature.
doi:10.1016/j.yexcr.2010.12.018
PMCID: PMC3063449 PMID: 21376174
CCR6; innate immunity; mucosal immunity; dendritic cell
3. A multi-mineral natural product inhibits liver tumor formation in C57BL/6 mice
Biological Trace Element Research 2012;147(1-3):267-274.
C57BL/6 mice were maintained for up to 18-months on high-fat and low-fat diets with or without a multi-mineral-supplement derived from the skeletal remains of the red marine algae Lithothamnion calcareum. Numerous grossly observable liver masses were visible in animals on the “western-style” high-fat diet sacrificed at 12 and 18 months. The majority of the masses were in male mice (20 out of 100 males versus 3 out of 100 females; p=0.0002). There were more liver masses in animals on the high-fat diet than on the low-fat diet (15 out of 50 on high-fat versus 5 out of 50 on low-fat; p=0.0254). The multi-mineral supplement reduced the number of liver masses in mice on both diets (3 out of 25 male mice in the low-fat diet group without the supplement versus 1 out of 25 mice with supplement; 12 of 25 male mice in the high-fat diet group without the supplement versus 3 of 25 mice with supplement [p=0.0129]). Histological evaluation revealed a total of 17 neoplastic lesions (9 adenomas and 8 hepatocellular carcinomas), and 18 pre-neoplastic lesions. Out of 8 hepatocellular carcinomas, 7 were found in unsupplemented diet groups. Steatosis was widely observed in livers with and without grossly observable masses, but the multi-mineral supplement had no effect on the incidence of steatosis or its severity. Taken together, these findings suggest that a multi-mineral-rich natural product can protect mice against neoplastic and pre-neoplastic proliferative liver lesions that may develop in the face of steatosis.
doi:10.1007/s12011-011-9316-2
PMCID: PMC3360994 PMID: 22222483
Calcium; hepatocellular carcinoma; liver disease; minerals; trace elements
4. CRTH2 Is A Critical Regulator of Neutrophil Migration and Resistance to Polymicrobial Sepsis
Although arachidonic acid cascade has been shown to be involved in sepsis, little is known about the role of prostaglandin D2 and its newly found receptor, chemoattractant receptor-homologous molecule expressed on Th2 cells (CRTH2), on the septic response. Severe sepsis is associated with the failure of neutrophil migration. To investigate whether CRTH2 influences neutrophil recruitment and the lethality during sepsis, sepsis was induced by cecal ligation and puncture (CLP) surgery in mice. CRTH2 knockout (−/−) mice were highly resistant to CLP-induced sepsis, which was associated with lower bacterial load and lower production of TNF-α, IL-6, and CCL3. IL-10, an anti-inflammatory cytokine, was higher in CRTH2−/− mice, blunting CLP-induced lethality in CRTH2−/− mice. Neutrophil accumulation in the peritoneum was more pronounced after CLP in CRTH2−/− mice, which was associated with higher CXCR2 level in circulating neutrophils. Furthermore, sepsis caused a decrease in the level of acetylation of histone H3, an activation mark, at the CXCR2 promoter in WT neutrophils, suggesting that CXCR2 expression levels are epigenetically regulated. Finally, both pharmacological depletion of neutrophils and inhibition of CXCR2 abrogated the survival benefit in CRTH2−/− mice. These results demonstrate that genetic ablation of CRTH2 improved impaired neutrophil migration and survival during severe sepsis, which was mechanistically associated with epigenetic mediated CXCR2 expression. Thus, CRTH2 is a potential therapeutic target for polymicrobial sepsis.
doi:10.4049/jimmunol.1102330
PMCID: PMC3498953 PMID: 22544936
5. CC chemokine receptor 4 modulates Toll-like receptor 9-mediated innate immunity and signaling
European journal of immunology 2008;38(8):2290-2302.
Summary
The present study addressed the modulatory role of CCR4 in TLR9-mediated innate immunity and explored the underlying molecular mechanisms. Our results demonstrated that CCR4-deficient mice were resistant to both septic peritonitis induced by cecal ligation and puncture (CLP) and CpG DNA/D-galactosamine-induced shock. In bone marrow-derived macrophages (BMMΦs) from CLP-treated CCR4-deficient mice, TLR9-mediated pathways of MAPK/AP-1, PI3K/Akt, and IκB kinase (IKK) /NF-κB were impaired compared to WT cells. While TLR9 expression was not altered, the intensity of internalized CpG DNA was increased in CCR4-deficient macrophages when compared to WT macrophages. Pharmacological inhibitor studies revealed that impaired activation of JNK, PI3K/Akt, and/or IKK/NF-κB could be responsible for decreased proinflammatory cytokine expression in CCR4-deficient macrophages. Interestingly, the CCR4-deficient BMMΦs exhibited an alternatively activated (M2) phenotype and the impaired TLR9-mediated signal transduction responses in CCR4-deficient cells were similar to the signaling responses observed in WT BMMΦs skewed to an alternatively activated phenotype. These results indicated that macrophages deficient in CCR4 impart a regulatory influence on TLR9-mediated innate immunity.
doi:10.1002/eji.200838360
PMCID: PMC2925393 PMID: 18624303
Chemokines; Toll-like receptors; Macrophages
6. The linkage of innate and adaptive immune response during granulomatous development
Granulomas represent a spectrum of inflammatory sequestration responses that may be initiated by a variety of agents, including non-infectious environmental factors and infectious microbial pathogens. Although this reaction is designed to be protective, the associated tissue injury is often responsible for a profound degree of pathology. While many of the mechanisms that sustain the development of the granuloma are enigmatic, it is accepted that the maintenance of this inflammatory process is dependent upon dynamic interactions between an inciting agent, inflammatory mediators, various immune and inflammatory cells, and structural cells of the involved tissue. The best studied of the host-dependent processes during granuloma development is the innate and adaptive immune response. The innate immune response by antigen-presenting cells [APCs; dendritic cells (DCs) and macrophages] is initiated quickly to protect from overwhelming pathogens, but with time, can also activate the adaptive immune response. APCs, essential regulators of the innate immune response, can respond to microbial ligands through Toll-like receptors (TLRs), which function in the recognition of microbial components and play an important role to link the innate and adaptive immune responses. CD4+ T helper (Th) cells are essential regulators of adaptive immune responses and inflammatory diseases. Recently, the Notch system has been shown to be an important bridge between APCs and T cell communication circuits. In the present review, we discuss recent findings that explore the mechanisms in the linkage of innate and adaptive immunity, including granulomatous formation though TLRs and Notch activation.
doi:10.3389/fimmu.2013.00010
PMCID: PMC3560376 PMID: 23386849
Notch signaling; Toll-like receptor; dendritic cell; T helper cell; innate immunity; acquired immunity
7. TLR3 is an endogenous sensor of tissue necrosis during acute inflammatory events
The Journal of Experimental Medicine 2008;205(11):2609-2621.
Ligands from dying cells are a source of Toll-like receptor (TLR) activating agents. Although TLR3 is known to respond to RNA from necrotic cells, the relative importance of this response in vivo during acute inflammatory processes has not been fully explored. We observed the involvement of TLR3 activation during experimental polymicrobial septic peritonitis and ischemic gut injury in the absence of an exogenous viral stimulus. In TLR3-deficient mice, increased chemokine/cytokine levels and neutrophil recruitment characterized the initial inflammatory responses in both injury models. However, the levels of inflammatory chemokines and tumor necrosis factor α quickly returned to baseline in tlr3−/− mice, and these mice were protected from the lethal effects of sustained inflammation. Macrophages from tlr3−/− mice responded normally to other TLR ligands but did not respond to RNA from necrotic neutrophils. Importantly, an immunoneutralizing antibody directed against TLR3 attenuated the generation of inflammatory chemokines evoked by byproducts from necrotic neutrophils cultured with wild-type macrophages. In vivo, anti-TLR3 antibody attenuated the tissue injury associated with gut ischemia and significantly decreased sepsis-induced mortality. Collectively, these data show that TLR3 is a regulator of the amplification of immune response and serves an endogenous sensor of necrosis, independent of viral activation.
doi:10.1084/jem.20081370
PMCID: PMC2571935 PMID: 18838547
9. Toll-like Receptors, Notch Ligands, and Cytokines Drive the Chronicity of Lung Inflammation
Current dogma supports the concept that the expression of a disease-inducing signature cytokine phenotype is important to the maintenance stage of chronic lung disorders. This cytokine phenotype has been characterized as a polarization toward type 2 cytokines, which are profibrotic and immunoregulatory. The biology of this latter activity could mechanistically explain pathogen-induced exacerbation of chronic lung inflammation, as a skewed cytokine profile in the lung alters dendritic cell function, activates fibroblasts, and facilitates a subsequent “second hit” by an infectious pathogen. In this setting, cytokine biology is also linked to Toll-like receptors (TLRs) in the maintenance of lung immunity, as the activity of this receptor–ligand system by both leukocytes and stromal cells is likely an important component of disease chronicity. The participation of dendritic cells via TLRs in chronic lung disease could facilitate communication circuits established between antigen-presenting cells and lymphocytes. Data suggest that TLR activation via myeloid differentiation factor 88 adaptor protein leads to the induction of a Notch ligand known as Delta-like-4 on dendritic cells that activate the Notch receptor on T cells, promoting a helper T-cell type 1 cytokine response. It is likely that the evolution of host defense signals designed to recognize patterns emitted from a hostile microbial environment may now be superimposed on adaptive immunity and provide the underpinning to support the maintenance of chronic lung disease.
doi:10.1513/pats.200706-067TH
PMCID: PMC2647651 PMID: 18073395
virus; dendritic cell; innate immunity
10. TLR9 Signaling is Critical for Early Experimental Deep Vein Thrombosis Resolution
Objective
Toll like receptors (TLR) bridge innate immunity and host responses, including inflammation. Sterile inflammation such as a venous thrombus (VT) may involve TLR signaling, including TLR9.
Methods and Results
TLR9 signaling on thrombus resolution was investigated using a mouse model of stasis VT. VT were significantly larger in TLR9 −/− mice as compared with WT at 2 and 8 days, despite a 2 fold increase in thrombus PMN at 2d, and monocytes at 8d, while thrombus collagen and neovascularization was 55% and 37% less at 8d. Coincidently, decreased fibrinogen and increased thrombin-antithrombin complex were observed in TLR9 −/− mice thrombi. Vein wall IFNα, IL1α, and IL2 was significantly reduced in TLR9 −/− mice as compared to WT. Thrombus cell death pathway markers were not significantly altered at 2d, but caspase 1 was reduced in TLR9 −/− thrombi at 8d. MyD88 confers TLR9 intracellular signaling, but MyD88−/− mice had similar VT resolution as WT. However, inhibition of the NOTCH ligand delta-like 4 was associated with larger VT. Finally, stimulation with a TLR9 agonist was associated with smaller VT.
Conclusion
TLR9 signaling is integral for early and mid VT resolution through modulation of sterile inflammation, maintaining a TH1 milieu, and effects on the thrombosis pathway.
doi:10.1161/ATVBAHA.110.216317
PMCID: PMC3005132 PMID: 20966396
11. Critical Role for CXC Ligand 10/CXC Receptor 3 Signaling in the Murine Neonatal Response to Sepsis ▿
Infection and Immunity 2011;79(7):2746-2754.
Previous studies have suggested that neonates rely heavily on innate immunity for their antimicrobial response to bacterial infections. However, the innate immune response by neonates to bacterial infection remains poorly characterized. Here, we show that in a murine model of neonatal polymicrobial sepsis, CXC ligand 10 (CXCL10) concentrations increase in the blood and peritoneum concordant with the peritoneal recruitment of granulocytes and macrophages. Additionally, CXC receptor 3 (CXCR3) expression on elicited peritoneal macrophages and granulocytes increases following sepsis. Blockade of CXCL10 worsens not only recruitment and phagocytic function of peritoneal granulocytes and macrophages but also survival. Deletion of CXCR3 also significantly increases mortality to a septic challenge. Finally, we demonstrate that the protective adjuvant effect of pretreatment with a Toll-like receptor 4 agonist to neonatal sepsis is dependent on an endogenous CXCL10 response and that pretreatment of neonates with CXCL10 can also significantly improve macrophage and granulocyte function and modestly improve outcome to polymicrobial sepsis. Together, these data suggest a critical role for CXCL10 signaling during neonatal sepsis.
doi:10.1128/IAI.01291-10
PMCID: PMC3191971 PMID: 21518789
12. The protective role of TLR6 in a mouse model of asthma is mediated by IL-23 and IL-17A
The Journal of Clinical Investigation 2011;121(11):4420-4432.
TLRs are a family of receptors that mediate immune system pathogen recognition. In the respiratory system, TLR activation has both beneficial and deleterious effects in asthma. For example, clinical data indicate that TLR6 activation exerts protective effects in asthma. Here, we explored the mechanism or mechanisms through which TLR6 mediates this effect using mouse models of Aspergillus fumigatus–induced and house dust mite antigen–induced (HDM antigen–induced) chronic asthma. Tlr6–/– mice with fungal- or HDM antigen–induced asthma exhibited substantially increased airway hyperresponsiveness, inflammation, and remodeling compared with WT asthmatic groups. Surprisingly, whole-lung levels of IL-23 and IL-17 were markedly lower in Tlr6–/– versus WT asthmatic mice. Tlr6–/– DCs generated less IL-23 upon activation with lipopolysaccharide, zymosan, or curdlan. Impaired IL-23 generation in Tlr6–/– mice also corresponded with lower levels of expression of the pathogen-recognition receptor dectin-1 and expansion of Th17 cells both in vivo and in vitro. Exogenous IL-23 treatment of asthmatic Tlr6–/– mice restored IL-17A production and substantially reduced airway hyperresponsiveness, inflammation, and lung fungal burden compared with that in untreated asthmatic Tlr6–/– mice. Together, our data demonstrate that TLR6 activation is critical for IL-23 production and Th17 responses, which both regulate the allergic inflammatory response in chronic fungal-induced asthma. Thus, therapeutics targeting TLR6 activity might prove efficacious in the treatment of clinical asthma.
doi:10.1172/JCI44999
PMCID: PMC3204826 PMID: 22005301
13. Dysregulated Cytokine Expression by CD4+ T cells from Post-Septic Mice Modulates both Th1 and Th2-Mediated Granulomatous Lung Inflammation
PLoS ONE 2011;6(5):e20385.
Previous epidemiological studies in humans and experimental studies in animals indicate that survivors of severe sepsis exhibit deficiencies in the activation and effector function of immune cells. In particular, CD4+ T lymphocytes can exhibit reduced proliferative capacity and improper cytokine responses following sepsis. To further investigate the cell-intrinsic defects of CD4+ T cells following sepsis, splenic CD4+ T cells from sham surgery and post-septic mice were transferred into lymphopenic mice. These recipient mice were then subjected to both TH1-(purified protein derivative) and TH2-(Schistosoma mansoni egg antigen) driven models of granulomatous lung inflammation. Post-septic CD4+ T cells mediated smaller TH1 and larger TH2 lung granulomas as compared to mice receiving CD4+ T cells from sham surgery donors. However, cytokine production by lymph node cells in antigen restimulation assays indicated increased pan-specific cytokine expression by post-septic CD4+ T cell recipient mice in both TH1 and TH2 granuloma models. These include increased production of TH2 cytokines in TH1 inflammation, and increased production of TH1 cytokines in TH2 inflammation. These results suggest that cell-intrinsic defects in CD4+ T cell effector function can have deleterious effects on inflammatory processes post-sepsis, due to a defect in the proper regulation of TH-specific cytokine expression.
doi:10.1371/journal.pone.0020385
PMCID: PMC3105020 PMID: 21655295
14. Impaired CD4+ T cell proliferation and effector function correlates with repressive histone methylation events in a mouse model of severe sepsis
European journal of immunology 2010;40(4):998-1010.
Immunosuppression following severe sepsis remains a significant human health concern, as long-term morbidity and mortality rates of patients who have recovered from life-threatening septic shock remain poor. Mouse models of severe sepsis indicate this immunosuppression may be partly due to alterations in myeloid cell function; however, the effect of severe sepsis on subsequent CD4+ T cell responses remains unclear. In the present study, CD4+ T cells from mice subjected to an experimental model of severe sepsis (cecal ligation and puncture, CLP) were analyzed in vitro. CD4+ CD62L+ T cells from CLP mice exhibited reduced proliferative capacity and altered gene expression. Additionally, CD4+ CD62L+ T cells from CLP mice exhibit dysregulated cytokine production after in vitro skewing with exogenous cytokines, indicating a decreased capability of these cells to commit to either the TH1 or TH2 lineage. Repressive histone methylation marks were also evident at promoter regions for the TH1 cytokine interferon-γ (IFN-γ) and the TH2 transcription factor GATA-3 in naïve CD4+ T cells from CLP mice. These results provide evidence that CD4+ T cell subsets from postseptic mice exhibit defects in activation and effector function, possibly due to chromatin remodeling proximal to genes involved in cytokine production or gene transcription.
doi:10.1002/eji.200939739
PMCID: PMC3040412 PMID: 20127677
Sepsis; CD4+ T cell; Inflammation; Epigenetics; Mouse
15. Epigenetic regulation of immune cell functions during post-septic immunosuppression
Epigenetics 2011;6(3):273-283.
Studies in humans and animal models indicate that profound immunosuppression is one of the chronic consequences of severe sepsis. This immune dysfunction encompasses deficiencies in activation of cells in both the myeloid and lymphoid cell lineages. As a result, survivors of severe sepsis are at risk of succumbing to infections perpetrated by opportunistic pathogens that are normally controlled by a fully functioning immune system. Recent studies have indicated that epigenetic mechanisms may be one driving force behind this immunosuppression, through suppression of proinflammatory gene production and subsequent immune cell activation, proliferation and effector function. A better understanding of epigenetics and post-septic immunosuppression can improve our diagnostic tools and may be an important potential source of novel molecular targets for new therapies. This review will discuss important pathways of immune cell activation affected by severe sepsis, and highlight pathways of epigenetic regulation that may be involved in post-septic immunosuppression.
doi:10.4161/epi.6.3.14017
PMCID: PMC3092675 PMID: 21048427
sepsis; immunosuppression; histone modification; gene regulation; inflammation; macrophages; dendritic cells; T lymphocytes
16. Toll-like Receptor 9 Activation Is a Key Mechanism for the Maintenance of Chronic Lung Inflammation
Rationale: Accumulating evidence supports the hypothesis that the continuous host response to a persistent challenge can polarize the cytokine environment toward a Th2 cytokine phenotype, but the mechanisms responsible for this skewing are not clear.
Objectives: We investigated the role of Toll-like receptor 9 (TLR9) in a Th2-driven pulmonary granulomatous response initiated via the embolization of Schistosoma mansoni eggs to the lungs of mice.
Methods: Mice were intravenously injected with S. mansoni eggs. Histological and flow cytometric analysis, cytokine measurement, adoptive transfer of bone marrow (BM)-derived dendritic cells (DCs), and in vitro T-cell treatments with antigen-presenting cells were examined.
Measurements and Main Results: In comparison to wild-type mice, TLR9−/− mice showed increased pulmonary granuloma size, augmented collagen deposition, increased Th2 cytokine phenotype, and impaired accumulation of DCs. BM-derived DCs, but not macrophages, recovered from animals with developed Th2-type lung granulomas promoted the production of type 2 cytokines from CD4+ T cells. BM-derived DCs from TLR9−/− mice induced impaired Th1 cytokine and enhanced Th2 cytokine production by T cells, compared with DCs from WT mice. Macrophages from TLR9−/− mice expressed a significantly higher alternatively activated (M2) phenotype characterized by increased “found in inflammatory zone-1” (FIZZ1) and arginase-1 expression. The adoptive transfer of BM-derived DCs from syngeneic WT mice into TLR9−/− mice restored the granuloma phenotype seen in WT mice.
Conclusions: These studies suggest that TLR9 plays an important mechanistic role in the maintenance of the pulmonary granulomatous response.
doi:10.1164/rccm.200906-0892OC
PMCID: PMC2796734 PMID: 19797157
granuloma; pulmonary fibrosis; innate immunity; dendritic cell; macrophage
17. Critical Role of IL-1 Receptor-Associated Kinase-M in Regulating Chemokine-Dependent Deleterious Inflammation in Murine Influenza Pneumonia
Influenza virus is a common cause of respiratory infection and morbidity, which is often due to deleterious host immune responses directed against the pathogen. We investigated the role of IL-1 receptor-associated kinase-M (IRAK-M), an inhibitor of MyD88-dependent TLR signaling, in modulating the innate inflammatory response during influenza pneumonia using a murine model. The intranasal administration of influenza resulted in the upregulation of IRAK-M mRNA and protein levels in the lungs within 2 d after infectious challenge. Pulmonary influenza infection in mice deficient in IRAK-M (IRAK-M−/−) resulted in substantially increased mortality compared with similarly treated wild-type animals. Increased mortality in IRAK-M−/− mice was associated with enhanced early influx of neutrophils, high permeability edema, apoptosis of lung epithelial cells, markedly increased expression of inflammatory cytokines/chemokines, and release of neutrophil-derived enzymes, including myeloperoxidase and neutrophil elastase. Early viral clearance was not different in mutant mice, whereas viral titers in lungs and blood were significantly higher in IRAK-M−/− mice compared with wild-type animals. Increased lethality observed in IRAK-M−/− mice after influenza challenge was abrogated by Ab-mediated blockade of CXCR2. Collectively, our findings indicate that IRAK-M is critical to preventing deleterious neutrophil-dependent lung injury during influenza infection of the respiratory tract.
doi:10.4049/jimmunol.0901709
PMCID: PMC2995366 PMID: 20042589
18. Notch ligand Dll4 enhances T cell differentiation by promoting IL-17 production and RORγT expression
The activation and differentiation of T cells are dependent upon numerous initiating events that are influenced by the immune environment, nature of the antigen, as well as the activation state of APCs. In the present studies we have investigated the role of a specific notch ligand, delta-like 4 (Dll4). In particular, our data have indicated that Dll4 is inducible by pathogen-associated signals through TLR activation on DC but not early response inflammatory cytokines, IL-1 and IL-18 that also activate cells via MyD88 adapter pathway. Our observations from in vitro cultures with ovalbumin specific TCR transgenic cells (DO11.10) confirmed earlier reports demonstrating that Dll4 inhibits Th2 cytokine production. Furthermore, Dll4 enhances the generation of IL-17 producing T cells in the presence of additional skewing cytokines, IL-6 and TGFβ. In the absence of notch signals IL17 production was significantly reduced even under specific skewing conditions. These studies further demonstrate that Dll4 upregulates RORγt expression in T cells and that both RORγt and IL17 gene promoters are direct transcriptional notch targets that augment the differentiation of Th17 cell populations. Thus, facilitation of efficient T cell differentiation may depend upon the activation of T cells via specific notch ligand stimulation.
doi:10.4049/jimmunol.0804322
PMCID: PMC2980695 PMID: 19494260
19. Interleukin-33 contributes to both M1 and M2 chemokine marker expression in human macrophages
BMC Immunology 2010;11:52.
Background
Interleukin-33 is a member of the IL-1 cytokine family whose functions are mediated and modulated by the ST2 receptor. IL-33-ST2 expression and interactions have been explored in mouse macrophages but little is known about the effect of IL-33 on human macrophages. The expression of ST2 transcript and protein levels, and IL-33-mediated effects on M1 (i.e. classical activation) and M2 (i.e. alternative activation) chemokine marker expression in human bone marrow-derived macrophages were examined.
Results
Human macrophages constitutively expressed the membrane-associated (i.e. ST2L) and the soluble (i.e. sST2) ST2 receptors. M2 (IL-4 + IL-13) skewing stimuli markedly increased the expression of ST2L, but neither polarizing cytokine treatment promoted the release of sST2 from these cells. When added to naïve macrophages alone, IL-33 directly enhanced the expression of CCL3. In combination with LPS, IL-33 blocked the expression of the M2 chemokine marker CCL18, but did not alter CCL3 expression in these naive cells. The addition of IL-33 to M1 macrophages markedly increased the expression of CCL18 above that detected in untreated M1 macrophages. Similarly, alternatively activated human macrophages treated with IL-33 exhibited enhanced expression of CCL18 and the M2 marker mannose receptor above that detected in M2 macrophages alone.
Conclusions
Together, these data suggest that primary responses to IL-33 in bone marrow derived human macrophages favors M1 chemokine generation while its addition to polarized human macrophages promotes or amplifies M2 chemokine expression.
doi:10.1186/1471-2172-11-52
PMCID: PMC2967528 PMID: 20958987
20. IRAK-M Regulates Chromatin Remodeling in Lung Macrophages during Experimental Sepsis
PLoS ONE 2010;5(6):e11145.
Sepsis results in a profound state of immunosuppression, which is temporally associated with impaired leukocyte function. The mechanism of leukocyte reprogramming in sepsis is incompletely understood. In this study, we explored mechanisms contributing to dysregulated inflammatory cytokine expression by pulmonary macrophages during experimental sepsis. Pulmonary macrophages (PM) recovered from the lungs of mice undergoing cecal ligation and puncture (CLP) display transiently reduced expression of some, but not all innate genes in response to LPS. Impaired expression of TNF-α and iNOS was associated with reduced acetylation and methylation of specific histones (AcH4 and H3K4me3) and reduced binding of RNA polymerase II to the promoters of these genes. Transient impairment in LPS-induced cytokine responses in septic PM temporally correlated with induction of IRAK-M mRNA and protein, which occurred in a MyD88-dependent fashion. PM isolated from IRAK-M−/− mice were largely refractory to CLP-induced impairment in cytokine expression, chromatin remodeling, recruitment of RNA polymerase II, and induction of histone deacetylase-2 observed during sepsis. Our findings indicate that systemic sepsis induces epigenetic silencing of cytokine gene expression in lung macrophages, and IRAK-M appears to be a critical mediator of this response.
doi:10.1371/journal.pone.0011145
PMCID: PMC2886833 PMID: 20585389
21. Helminth Coinfection Does Not Affect Therapeutic Effect of a DNA Vaccine in Mice Harboring Tuberculosis
Background
Helminthiasis and tuberculosis (TB) coincide geographically and there is much interest in exploring how concurrent worm infections might alter immune responses against bacilli and might necessitate altered therapeutic approaches. A DNA vaccine that codifies heat shock protein Hsp65 from M. leprae (DNAhsp65) has been used in therapy during experimental tuberculosis. This study focused on the impact of the co-existence of worms and TB on the therapeutic effects of DNAhsp65.
Methodology/Principal Findings
Mice were infected with Toxocara canis or with Schistosoma mansoni, followed by coinfection with M. tuberculosis and treatment with DNAhsp65. While T. canis infection did not increase vulnerability to pulmonary TB, S. mansoni enhanced susceptibility to TB as shown by higher numbers of bacteria in the lungs and spleen, which was associated with an increase in Th2 and regulatory cytokines. However, in coinfected mice, the therapeutic effect of DNAhsp65 was not abrogated, as indicated by colony forming units and analysis of histopathological changes. In vitro studies indicated that Hsp65-specific IFN-γ production was correlated with vaccine-induced protection in coinfected mice. Moreover, in S. mansoni-coinfected mice, DNA treatment inhibited in vivo TGF-β and IL-10 production, which could be associated with long-term protection.
Conclusions/Significance
We have demonstrated that the therapeutic effects of DNAhsp65 in experimental TB infection are persistent in the presence of an unrelated Th2 immune response induced by helminth infections.
Author Summary
From 14 diseases considered by WHO as Neglected Tropical Diseases, four involve helminth infections, such as schistosomiasis and soil-transmitted helminthiasis. Toxocariasis is a soil-transmitted worm highly prevalent in many developing countries, while schistosomiasis causes an annual mortality of 14,000 deaths per year, with 200–300 million infected people and 10% at risk of infection worldwide. Additionally, tuberculosis (TB) remains one of the leading causes of morbidity and mortality in many settings, particularly in the world's poorest countries. Mycobacteria and helminths are co-endemic and induce opposing patterns of immune responses in the host, recognized as Th1 and Th2 respectively. These co-existing patterns could be associated with the failure of TB vaccines. In this sense, we investigated the inflammatory and immune response in a coinfection model with T. canis or S. mansoni and M. tuberculosis analyzing the effects of an immunotherapy that has previously shown efficacy in experimental TB. This immunotherapy is based on a DNA vaccine that codifies a mycobacterial heat shock protein (hsp65), which can prevent TB in a prophylactic and also therapeutic setting. In this work, we show that helminth coinfection does not abrogate the therapeutic effects of DNAhsp65 vaccine against TB.
doi:10.1371/journal.pntd.0000700
PMCID: PMC2882318 PMID: 20544012
22. Identification of Key Processes that Control Tumor Necrosis Factor Availability in a Tuberculosis Granuloma
PLoS Computational Biology 2010;6(5):e1000778.
Tuberculosis (TB) granulomas are organized collections of immune cells comprised of macrophages, lymphocytes and other cells that form in the lung as a result of immune response to Mycobacterium tuberculosis (Mtb) infection. Formation and maintenance of granulomas are essential for control of Mtb infection and are regulated in part by a pro-inflammatory cytokine, tumor necrosis factor-α (TNF). To characterize mechanisms that control TNF availability within a TB granuloma, we developed a multi-scale two compartment partial differential equation model that describes a granuloma as a collection of immune cells forming concentric layers and includes TNF/TNF receptor binding and trafficking processes. We used the results of sensitivity analysis as a tool to identify experiments to measure critical model parameters in an artificial experimental model of a TB granuloma induced in the lungs of mice following injection of mycobacterial antigen-coated beads. Using our model, we then demonstrated that the organization of immune cells within a TB granuloma as well as TNF/TNF receptor binding and intracellular trafficking are two important factors that control TNF availability and may spatially coordinate TNF-induced immunological functions within a granuloma. Further, we showed that the neutralization power of TNF-neutralizing drugs depends on their TNF binding characteristics, including TNF binding kinetics, ability to bind to membrane-bound TNF and TNF binding stoichiometry. To further elucidate the role of TNF in the process of granuloma development, our modeling and experimental findings on TNF-associated molecular scale aspects of the granuloma can be incorporated into larger scale models describing the immune response to TB infection. Ultimately, these modeling and experimental results can help identify new strategies for TB disease control/therapy.
Author Summary
Tuberculosis is a common and deadly infectious disease caused by a highly successful bacterium, Mycobacterium tuberculosis (Mtb). Multiple host immune factors control the formation of a self-organizing aggregate of immune cells termed a granuloma in the lungs after inhalation of Mtb. One such factor, tumor necrosis factor-α (TNF), is a protein that regulates inflammatory immune responses. Availability of TNF within a TB granuloma has been proposed to have a critical role in the protective immunity against TB. However, direct measurement of the level of TNF in a granuloma is not experimentally feasible. Therefore, we develop a mathematical model based on an experimental model of granuloma developed in mice to predict TNF availability in a granuloma. We measure values of critical model parameters and explore mechanisms that influence TNF availability in the granuloma. We find that cellular organization in a granuloma and intracellular trafficking of TNF control TNF availability in a granuloma. Further, our model analysis also highlights anti-TNF drug properties that determine their TNF neutralization power. Our findings complement and extend those of recent studies on the role of TNF in the immune response against TB.
doi:10.1371/journal.pcbi.1000778
PMCID: PMC2865521 PMID: 20463877
23. Lung Contusion: Inflammatory Mechanisms and Interaction with Other Injuries
Shock (Augusta, Ga.) 2009;32(2):122-130.
This article reviews current animal models and laboratory studies investigating the pathophysiology of lung contusion (LC), a common and severe condition in patients with blunt thoracic trauma. Emphasis is on studies elucidating cells, mediators, receptors and processes important in the innate pulmonary inflammatory response that contribute to LC injury. Surfactant dysfunction in the pathogenesis of LC is also discussed, as is the potential role of epithelial cell or neutrophil apoptosis. Studies examining combination injuries where LC is exacerbated by secondary insults like gastric aspiration in trauma patients are also noted. The need for continuing mechanism-based research to further clarify the pathophysiology of LC injury, and to define and test potential therapeutic interventions targeting specific aspects of inflammation or surfactant dysfunction to improve clinical outcomes in patients with LC, is also emphasized.
doi:10.1097/SHK.0b013e31819c385c
PMCID: PMC2711988 PMID: 19174738
24. Toll-Like Receptor 9 Modulates Immune Responses to Aspergillus fumigatus Conidia in Immunodeficient and Allergic Mice ▿
Infection and Immunity 2008;77(1):108-119.
The role of Toll-like receptor 9 (TLR9) in antifungal responses in the immunodeficient and allergic host is unclear. We investigated the role of TLR9 in murine models of invasive aspergillosis and fungal asthma. Neutrophil-depleted TLR9 wild-type (TLR9+/+) and TLR9-deficient (TLR9−/−) mice were challenged with resting or swollen Aspergillus fumigatus conidia and monitored for survival and lung inflammatory responses. The absence of TLR9 delayed, but did not prevent, mortality in immunodeficient mice challenged with resting or swollen conidia compared to TLR9+/+ mice. In a fungal asthma model, TLR9+/+ and TLR9−/− mice were sensitized to soluble A. fumigatus antigens and challenged with resting or swollen A. fumigatus conidia, and both groups of mice were analyzed prior to and at days 7, 14, and 28 after the conidium challenge. When challenged with resting conidia, TLR9−/− mice exhibited significantly lower airway hyper-responsiveness compared to the TLR9+/+ groups. In contrast, A. fumigatus-sensitized TLR9−/− mice exhibited pulmonary fungal growth at days 14 and 28 after challenge with swollen conidia, a finding never observed in their allergic wild-type counterparts. Increased fungal growth in allergic TLR9−/− mice correlated with markedly decreased dectin-1 expression in whole lung samples and isolated dendritic cell populations. Further, whole lung levels of interleukin-17 were lower in allergic TLR9−/− mice compared to similar TLR9+/+ mice. Together, these data suggest that TLR9 modulates pulmonary antifungal immune responses to swollen conidia, possibly through the regulation of dectin-1 expression.
doi:10.1128/IAI.00998-08
PMCID: PMC2612288 PMID: 18936185
25. Effect of Cigarette Smoke Extract on Dendritic Cells and Their Impact on T-Cell Proliferation
PLoS ONE 2009;4(3):e4946.
Chronic obstructive pulmonary disease (COPD) is characterized by chronic airway inflammation. Cigarette smoke has been considered a major player in the pathogenesis of COPD. The inflamed airways of COPD patients contain several inflammatory cells including neutrophils, macrophages,T lymphocytes, and dendritic cells (DCs). The relative contributions of these various inflammatory cells to airway injury and remodeling are not well documented. In particular, the potential role of DCs as mediators of inflammation in the smoker's airways and COPD patients is poorly understood. In the current study we analyzed the effects of cigarette smoke extract on mouse bone marrow derived DC and the production of chemokines and cytokines were studied. In addition, we assessed CSE-induced changes in cDC function in the mixed lymphocyte reaction (MLR) examining CD4+ and CD8+ T cell proliferation. Cigarette smoke extract induces the release of the chemokines CCL3 and CXCL2 (but not cytokines), via the generation of reactive oxygen species (ROS). In a mixed-leukocyte reaction assay, cigarette smoke-primed DCs potentiate CD8+T cell proliferation via CCL3. In contrast, proliferation of CD4+T cells is suppressed via an unknown mechanism. The cigarette smoke-induced release of CCL3 and CXCL2 by DCs may contribute to the influx of CD8+T cells and neutrophils into the airways, respectively.
doi:10.1371/journal.pone.0004946
PMCID: PMC2655711 PMID: 19293939
Results 1-25 (47)
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1a01aa77535b9ecfb87b9fc36adbcd2f
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7,862,772,480,037,945,000
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Psychometric Validation of the BODY-Q in Danish Patients Undergoing Weight Loss and Body Contouring Surgery
Plast Reconstr Surg Glob Open. 2017 Oct 20;5(10):e1529. doi: 10.1097/GOX.0000000000001529. eCollection 2017 Oct.
Abstract
Background: A well-developed patient-reported outcome instrument is needed for use in Danish bariatric and body contouring patients. The BODY-Q is designed to measure changes in important patient outcomes over the entire patient journey, from obesity to post-body contouring surgery. The current study aims to psychometrically validate the BODY-Q for use in Danish patients.
Methods: The process consisted of 3 stages: translation and linguistic validation, field-test, and data analysis. The translation was performed in accordance with the International Society for Pharmacoeconomics and Outcomes Research and World Health Organization guidelines, and field-test data were collected in 4 departments in 2 different hospitals. Field-test data were analyzed using Rasch Measurement Theory.
Results: A total of 495 patients completed the Danish BODY-Q field-test 1-4 times, leading to a total of 681 assessments with an overall response rate at 76%. Cronbach α values were ≥ 0.90, and person separation index values were in general high. The Rasch Measurement Theory analysis provided broad support for the reliability and validity of the Danish version of the BODY-Q scales. Item fit was outside the criteria for 34 of 138 items, and of these, 21 had a significant chi-square P value after Bonferroni adjustment. Most items (128 of 138) had ordered thresholds, indicating that response options worked as intended.
Conclusion: The Danish version of the BODY-Q is a reliable and valid patient-reported outcome instrument for use in Danish bariatric and body contouring patients.
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The Benefits of Spinning: Why This High-Intensity Workout is Sweeping the Nation
Spinning has become increasingly popular in recent years as a high-intensity workout that offers a wide range of benefits for both physical and mental health. This indoor cycling workout is not only an effective way to burn calories and improve cardiovascular fitness but also offers a fun and engaging way to stay active.
Physical Benefits of Spinning
One of the key benefits of spinning is its ability to provide a high-intensity workout that can help you burn a significant number of calories in a short amount of time. This makes it an excellent option for those looking to lose weight or maintain a healthy weight. Additionally, spinning is a low-impact exercise, making it a great choice for individuals with joint pain or other limitations.
Spinning also offers a full-body workout, engaging muscles in the legs, core, and arms. This can help improve overall muscle tone and strength, as well as enhance endurance and stamina. Regular spinning sessions can lead to increased cardiovascular fitness, improved lung capacity, and better overall physical performance.
Mental Benefits of Spinning
Aside from the physical benefits, spinning can also have a positive impact on mental health. The intense nature of the workout can help release endorphins, which are known as the body’s “feel-good” chemicals. This can help reduce stress, anxiety, and depression, leading to improved mood and overall well-being.
Spinning is also a great way to challenge yourself both mentally and physically, as you push yourself to reach new goals and overcome obstacles. The sense of accomplishment that comes from completing a challenging spinning session can boost confidence and self-esteem, making it a great form of exercise for those looking to improve their mental resilience.
FAQs
Q: Is spinning suitable for beginners?
A: Yes, spinning is suitable for beginners as well as experienced cyclists. Most spinning classes offer options for participants of all fitness levels, allowing you to adjust the intensity to suit your needs.
Q: How often should I do spinning to see results?
A: To see results from spinning, it is recommended to attend classes at least 2-3 times per week. Consistency is key to achieving your fitness goals and reaping the benefits of this high-intensity workout.
Q: Can spinning help me lose weight?
A: Yes, spinning can be an effective way to aid weight loss when combined with a healthy diet and lifestyle. The high-intensity nature of spinning can help you burn calories and improve your overall fitness, leading to weight loss over time.
Overall, spinning is a versatile and effective workout that offers a wide range of benefits for both physical and mental health. Whether you’re looking to lose weight, improve your fitness, or simply have fun while exercising, spinning can be a great addition to your workout routine.
For more information on the benefits of spinning, check out this article.
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Managing Burnout
Burnout has been officially classified by the World Health Organization as a syndrome resulting from unmanaged workplace stress. It calls burnout “an occupational phenomenon.” Does endless emails, a demanding boss and a bottomless to-do list leave you feeling stressed and burned out from work? You’re not alone.
What are some signs you might be suffering from burnout? You’re often tired and unenergetic, not working as productively as you used to, have difficulty concentrating and have feelings of frustration and pessimism about your job.
Workplace stress can take a toll on your health. But most of us can’t just quit our job to solve the problem. Here are some ways to help combat that pressure from a demanding job.
Eat Right. A healthy, well-balanced diet is key to building a solid foundation for managing stress. It will provide a stable metabolism that will minimize peaks and valleys in your energy levels.
Get Enough Sleep. Feeling stressed out can make getting a good night’s sleep more difficult, but sleep is a really important stress reducer. Maintaining a healthy sleep routine restores the body, regulates mood and hones judgement.
Be Comfortable. Physical discomfort can contribute to higher levels of stress. Make sure that your workspace is set up with ergonomics in mind and be sure to use good posture.
Exercise at Lunch. If you can leave your desk and take a walk at lunchtime, DO IT! Physical activity releases stress-reducing chemicals and can help us to recharge for the second half of the day.
Establish Boundaries. As difficult as it may be, try not to take your job home with you. Make a pledge to yourself that you will not check your work emails after a set time. Use your time away from the office to replenish your mental and emotional reserves.
As we practice controlling workplace stress, we can prevent burnout. And more great ideas, creativity and top-notch work come from a person that takes care of their physical, mental and emotional health.
(609) 737-2006
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top of page
pexels-mart-production-7089396.jpg
breech child
In Switzerland moxibustion is not used to treat breech birth, but in Japan it is an old treatment method.
Moxibustion allows you to feel the fetal movement of the baby. I will start moving well.
Can moxibustion cure breech birth?
It will heal. Since ancient times, moxibustion has been used to treat breech births. The effect is also proven in the literature.
It is safe and has no side effects.
What causes breeches?
The cause of the breech is said to be unknown.
In Oriental medicine, there are various causes such as maternal coldness, lack of qi and blood, qi stagnation, and fatigue.
When to start treatment for breech birth?
From 28 to 36 weeks of gestation. If you find out that you have a breech child, please see a doctor as soon as possible.
Up to 34 weeks, the probability of recovery is high, but from 35 to 36 weeks, the baby will grow and it will be difficult to return.
We will have you visit us twice a week.
Also, even if the breech baby is healed, there is a possibility that it will turn again.
In the 1950s, Nobuyasu Ishino, an obstetrician and gynecologist, reported on acupuncture and moxibustion treatment for breech babies that 16 out of 20 cases (80%) had head position 2). In the 1980s, Kazuo Hayashida, an obstetrician and gynecologist, performed acupuncture and moxibustion treatment on breech babies in 584 cases, and reported a high efficacy rate of 89.8%.
bottom of page
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Active FX Vs. Deep FX - What's the Difference?
I don't get how Deep FX is any different than Active FX... Are they just different brand names? Thx
Doctor Answers 5
DeepFX vs. ActiveFX
This is fairly simple. I have been doing both for almost a year. They represent two different ways to deliver CO2 laser energy to the skin.
The ActiveFX device uses a pattern of 1.3mm spots or hits of CO2 energy scattered over the skin. How much coverage you get depends on the density - I have used up to 96% coverage.
The DeepFX device produces a pattern of 120 micron spots of variable density from 5-25%. These beams of laser energy go fairly deep - all the way to the fat if you turn the energy up high enough.
For people with lots of sun damage, precancerous lesions, brown and reds spots, I think the ActiveFX delivers better results. The downtime is greater - around 4-6 days if you use higher energies. I haven't been happy with the amount of wrinkle improvement or skin tightening I see with the ActiveFX. I think it is more uncomfortable for the patient as well.
For people that want improvement in wrinkles and lines that are not well treated with Botox such as the around the eye, the lower lid and cheeks, I think the DeepFX therapy is the best treatment we currently have. The recovery is fast - 3 days the scabs are gone - swelling in 5-6 days and pinkness in around 10 days to 2 weeks. I see instant tightening while I do the treatments. The pain level is definitely less than the ActiveFX. The only downside is that it doesn't do as well with sun spots and the more superficial damage.
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews
Difference between Active FX and Total FX
Same laser, different spot sizes. The bigger the spot size, the less deeply the beam penetrates the skin. So the "Deep FX" spot size targets deeper lines, wrinkles, and scars, whereas the "Active FX" spot size targets pigments, superfical lines, etc. By combining the two (Total FX) you can get a dramatic treatment result with minimum downtime.
Some patients with severe lines and laxity still opt for a "Max FX" (high powered Active FX). This has a longer downtime however.
Make sure you choose an experienced doctor, and they should choose the best settings for you.
Roy A. David, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 23 reviews
Active FX/Deep FX differences.
Active FX has a wider spot size, whereas the Deep FX has a narrow spot size. They can be used in combination or separately depending on what type of result the patient is after. As with any laser treatment, appropriate settings of the laser is the most important consideration.
Benjamin Bassichis, MD, FACS
Dallas Facial Plastic Surgeon
4.7 out of 5 stars 40 reviews
You might also like...
Active Fx and Deep Fx are two versions of laser resurfacing.
Active Fx is the workhorse of resurfacing and effectively treats lines, wrinkles, acnes scare and sun damage. Active Fx treats the skin with lots of tiny laser spots. Deep Fx is actually a version of the same treatment but the laser spots are much smaller and go much deeper than the Activ Fx. I will often use the Deep Fx to treat deep wrinkles like smoker's lines or deep scars and then at the same sitting treat the entire face with the Active FX. We call this Total Fx and this combination gives very nice results.
Susan Van Dyke, MD
Paradise Valley Dermatologic Surgeon
4.6 out of 5 stars 31 reviews
Deep FX vs Active FX
I have been using the Encore laser for over 2 years now and to explain in simple terms, the difference is that the deep hand piece delivers energy resulting in a clean small hole to the dermis of the skin in order to affect collagen remodelling. The active handpiece lays a more superficial and larger "dot" of energy that only affects the skins surface resulting in a resurfacing of the epidermis.
Dr. Malouf
Peter Malouf, DO
Dallas Dermatologist
4.7 out of 5 stars 87 reviews
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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Latest
Wednesday, August 8, 2018
Science Explains: Can People Die Of a Broken Heart?
takotsubo cardiomyopathy
Usually, people who experience being rejected complain about having their hearts broken. Disappointments, rejections, fears, frustrations, separations, anxieties or even extreme and sudden jolt of shock or happiness, all of these emotions make us feel as if our hearts are being torn apart. Well, at the very least, in a metaphorical manner. Men and women around the world who undergo the said situation explains the agonizing "pain" they have endured because of melancholia. But can we really die because of a "broken" heart?
In medical terms, there is such a thing as the broken-heart syndrome. This also known as the stress-induced cardiomyopathy or takotsubo cardiomyopathy. Instances, where some people die a few days or months after their loved one passed away, somehow proves this phenomenon. Women are more likely to experience this than men.
Symptoms Of Broken Heart Syndrome
The connection between the emotional stress and the health condition of our heart is unknown to many. Sometimes, the symptoms of the broken heart syndrome are left unnoticed or even worse, neglected. It is almost a cliche when people say, "It will take time." They refer to how long the healing process will take.
heart strings, tendon
The signs and symptoms of the broken heart can be mistaken for the early signs of a heart attack. The difference is that the arteries of the heart of a person who experienced this syndrome look perfectly normal but the heart itself becomes enlarged or balloon-like. Even blood tests conducted would not be able to manifest damages of the heart. The real and precise cause of this heart condition is still the subject of some studies.
A person with a "broken heart" experiences sudden and intense chest pains and a shortness of breath after a heavily emotional and stressful event. This is because stress hormones make the heart's normal beating change its rhythm, (Arrhythmias) leaving the victim short of breath which could lead to the person's death. People who had experienced other cardiovascular disease or with a history of neurologic and mental problems are more likely to suffer from this.
It is true then that extreme and tragic events in our lives can make our heart grow weak. The good news is this syndrome can be treated and solved. Normally, a victim will take weeks or months to recover. Nevertheless, medical help should be given immediately. It is also suggested that people who suffer from a tragic loss consult a professional for counseling and to relieve themselves from the stress and anxiety.
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Skip to content
Are you too acidic?
[fusion_builder_container background_color=”” background_image=”” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ background_repeat=”no-repeat” background_position=”left top” video_url=”” video_aspect_ratio=”16:9″ video_webm=”” video_mp4=”” video_ogv=”” video_preview_image=”” overlay_color=”” overlay_opacity=”0.5″ video_mute=”yes” video_loop=”yes” fade=”no” border_size=”0px” border_color=”” border_style=”” padding_top=”20″ padding_bottom=”20″ padding_left=”” padding_right=”” hundred_percent=”no” equal_height_columns=”no” hide_on_mobile=”no” menu_anchor=”” class=”” id=””][fusion_builder_row][fusion_builder_column type=”1_1″ background_position=”left top” background_color=”” border_size=”” border_color=”” border_style=”solid” spacing=”yes” background_image=”” background_repeat=”no-repeat” padding=”” margin_top=”0px” margin_bottom=”0px” class=”” id=”” animation_type=”” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”no” center_content=”no” min_height=”none”][fusion_text]One of the most important aspects to your overall health is discovering the body’s pH (acid- alkaline ratio). pH stands for “potential of hydrogen.” The concentration of hydrogen atoms determines its pH value. It is measured on a scale of 0-14, a pH of less than 7 is said to be acidic and a pH greater than 7 is alkaline. Unfortunately, most conventional doctors completely ignore this particular aspect of biology.
Your body is an accumulation of cells, which create tissues, which create organs, which make the organ systems, which make the organism…you. Therefore, all disease originates at the cellular level and not at the organ or system level. The environment in which your cells are living and functioning in is extremely important, because all enzymes, hormones, and cell receptors function optimally at the proper pH. The pH of the body can be measured by analyzing the fluids of the body using urine, saliva or blood.
Research has indicated that it can take up to twice the amount of a hormone and enzyme to elicit the same response than it would have had it occurred at a normal pH. Therefore the further the body is from the optimal pH, the more likely the body will become diseased. There have been studies relating tissue acidity to osteoporosis, muscle loss, fractures, kidney stones, high blood pressure, heart disease, hormonal problems, and cancer. Therefore, your body maintains extremely tight control over your pH.
One measurement we use to evaluate your acidity levels is to check your blood for specific minerals that help maintain your body’s pH. Your blood is never truly acidic, but it will deplete alkaline nutrients from the body in order to maintain the proper pH (rob Peter to pay Paul). Your body’s blood pH is regulated to stay within the narrow range of 7.35 to 7.45, making it slightly basic, but a one point change in your blood pH will result in a quick death.
To determine your body’s pH balancing struggles, we look at blood test values of CO2 and the Anion Gap. Depending on the lab, a normal CO2 between 22 and 26 is ideal and the optimal number is 24. An anion gap of between 13 and 18 is ideal, but the optimal number is 15. Some lab tests don’t formulate your anion gap for you, so some calculations may be necessary to determine the anion gap. You can determine your anion gap by this formula: Anion Gap = (Sodium + potassium) – (chloride + CO2). Once you have determined your acid/alkaline balance you can determine how hard your body is working to maintain balance and health.
Luckily there is an easy answer and you don’t have to be a biochemist to understand it. The food we eat has a huge effect on our pH. What do we need to eat to assure that our pH is properly regulated? A lot of vegetables! Especially the green leafy ones! As well as drink a lot of water (a squeeze of lemon actually has an alkalizing effect). Also, we need to limit the amount of animal meat and grains we eat. Protein and grains have a very acidic effect on the body. Now obviously there are many other foods I have not mentioned yet, but these are the broad strokes.
Below is a alkaline acid food list, do not bog yourself down with the details or exceptions to the rules. Click chart for larger view.
To maintain a healthy pH, your diet should consist of 60% alkaline forming foods and 40% acid forming foods. To restore health, your diet should consist of 80% alkaline forming foods and 20% acid forming foods. This is by weight, so you have to eat a lot of vegetables to offset a 9- ounce steak.
If you are eating foods that are more acidic your body will steal chloride from the stomach if it has to. This leaves too little stomach acid thus causing heartburn. It will rip calcium out of bones leaving them porous; hence osteoporosis means “porous bones”. The act of pulling calcium from bone also agitates the tendons that attach to bones and causes pain in their fibers (fibromyalgia). So osteoporosis, heart burn, and fibromyalgia have a link in the same dysfunction…the body having difficulty in remaining alkaline! I hope we have given you the information that you may need as leverage to EAT MORE VEGGIES!
“One should eat to live, not live to eat” -Benjamin Franklin[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container][fusion_builder_container background_color=”” background_image=”” background_parallax=”none” enable_mobile=”no” parallax_speed=”0.3″ background_repeat=”no-repeat” background_position=”left top” video_url=”” video_aspect_ratio=”16:9″ video_webm=”” video_mp4=”” video_ogv=”” video_preview_image=”” overlay_color=”” overlay_opacity=”0.5″ video_mute=”yes” video_loop=”yes” fade=”no” border_size=”0px” border_color=”” border_style=”” padding_top=”20″ padding_bottom=”20″ padding_left=”” padding_right=”” hundred_percent=”no” equal_height_columns=”no” hide_on_mobile=”no” menu_anchor=”” class=”” id=””][fusion_builder_row][fusion_builder_column type=”1_1″ last=”yes” spacing=”yes” center_content=”no” hide_on_mobile=”no” background_color=”” background_image=”” background_repeat=”no-repeat” background_position=”left top” border_position=”all” border_size=”0px” border_color=”” border_style=”” padding=”” margin_top=”” margin_bottom=”” animation_type=”” animation_direction=”” animation_speed=”0.1″ class=”” id=””][fusion_text][hanbigbox class=”my_author”]
[hanbox class=”my_author_image”]Josh[/hanbox][hanbox class=”my_author_content”]
About The Doctor
Dr. Olivia Joseph D.C., C.F.M.P is the clinic director and owner of Wellness Connection Center. She is a board certified functional medicine practitioner (1 of only 8000 in the U.S.) and has traveled the country as a consultant and educator of functional medicine for other professionals. Dr. Olivia Joseph is recognized as an industry leader for pioneering and developing natural programs geared toward helping people reverse chronic disease and helping “healthy” people who want to become healthier. Don’t be surprised if you see doctors from other clinics spending the day and doing rounds trying to discover why Dr. Olivia Joseph’ care is so effective. Dr. Olivia Joseph has been helping patients for over thirteen years and has helped more than 2,000 patients successfully. Dr. Olivia Joseph has been featured as an expert on several health and wellness topics for fortune 500 companies like GE capital and Comerica Bank. She is also a registered speaker for the American Diabetes Association.She and her husband have 2 children and currently live in the 111 O’Fallon Commons Dr. O`Fallon, MO 63368 area.
To watch why wellness Connection Center was founded click this VIDEO button. [/hanbox]
[/hanbigbox][/fusion_text][fusion_modal name=”authormodal” title=”Dr. Olivia Joseph DC, CFMP” size=”large” background=”” border_color=”” show_footer=”yes” class=”” id=””][/fusion_modal][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]
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Esports Medicine: Care of the Esports Athlete
• Home
• Esports Medicine: Care of the Esports Athlete
Esports Medicine: Care of the Esports Athlete
Esports, the world of competitive gaming, has witnessed explosive growth in recent years. With this rise in popularity comes the need for specialized healthcare to support the well-being and performance of esports athletes. This article published in Current Sports Medicine Reports explores the field of esports medicine, with topics ranging from eye health, disorders of lower/upper extremity and low back pain, as well as the importance of fitness, nutrition and metabolic health in esports.
Understanding Lower Extremity Injuries:
While upper extremity injuries in esports are often linked to repetitive microtrauma, lower extremity injuries are more commonly caused by prolonged sitting. Players may only notice the pain when it becomes intense or at the end of a gaming session. Common lower extremity injuries in esports include lumbar spine issues, lower crossed syndrome, tendinopathies, compressive neuropathies, and deep venous thrombosis. Designing an effective lower extremity rehabilitation program requires consideration of sitting surface, duration of sitting, and other activities outside of gaming.
Low Back Pain and esports:
Mechanical low back pain affects a significant portion of the population, and esports athletes are particularly susceptible due to poor posture and ergonomics in gaming spaces. Back pain is a prevalent complaint among esports players, and they face a higher risk of conditions such as spondylosis, disc degeneration, and radiculopathy. Proper examination and assessment of posture, spinal curvature, and muscle imbalances are essential. Exercise programs should target muscles associated with posture, including the back, trunk, hips, and thighs, to increase range of motion, reduce pain, and improve core stability. Ergonomic evaluation of gaming setups and periodic breaks to change positions are also crucial for prevention and recovery.
Nutrition and Metabolic Health:
esports athletes often engage in prolonged sedentary activities, and their gaming environment may contribute to poor dietary choices. Inadequate nutrition practices can exacerbate metabolic dysregulation, insulin resistance, and obesity, with potential implications for cognitive and psychomotor performance. Increased sugar and caffeine intake through energy drinks is a common issue. It is recommended to consume nutrient-dense calories while minimizing added sugars and saturated fats. Timing meals, avoiding large meals, and individualizing portions based on preferences are also important. The use of supplements, such as caffeine, should be approached with caution due to varying individual responses and potential adverse effects. As far as fitness goes even recreational gamers can benefit from taking walking breaks during gameplay. Just 6 minutes of walking in the middle of a 2-hour gaming session has been shown to improve processing speed and executive function. In a study, 70% of participants perceived that the short walking break positively impacted their gaming performance.
Case Follow-Up and Conclusion:
A case study highlights the successful management of bilateral trigger finger in an esports athlete through corticosteroid injections and activity modification. As esports medicine continues to evolve, it is crucial for healthcare professionals to understand the unique factors affecting esports athletes and work collaboratively with them. Furthermore, research on diversity, inclusion, and accessibility in esports is needed to promote a more inclusive and equitable environment.
Conclusion:
Esports medicine is an emerging field that aims to address the specific healthcare needs of competitive gamers. Lower extremity and low back pain are common issues, primarily caused by prolonged sitting and poor posture. Implementing proper rehabilitation programs, ergonomic evaluations, and exercise routines can help prevent and manage these injuries. Additionally, nutrition and metabolic health play a significant role in supporting optimal performance and preventing metabolic dysregulation. As the esports industry continues to grow, it is essential to prioritize the well-being of esports athletes and advance research in this evolving field.
Law, Adrienne MS, DO1; Ho, Garry MD, FACSM, FAMSSM, FAAFP, RMSK, CIC1,2; Moore, Melita MD3. Care of the Esports Athlete. Current Sports Medicine Reports 22(6):p 224-229, June 2023. | DOI: 10.1249/JSR.0000000000001077
https://journals.lww.com/acsm-csmr/Fulltext/2023/06000/Care_of_the_Esports_Athlete.9.aspx
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Dr. Jennifer Thai
Nutrition
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The largest collection of gaming-specific health, fitness, and performance information on the internet, brought to you by the experts currently working in the industry with top-tier esport organizations.
Organizations that have benefited from the expertise of our authors include Cloud 9, Team Liquid, 100 Thieves, FNATIC, G2, TSM, and more.
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Content » Vol 41, Issue 5
Case report
Communicating using the eyes without remembering it: Cognitive rehabilitation in a severely brain-injured patient with amnesia, tetraplegia and anarthria
Luigi Trojano, MD1,2, Pasquale Moretta, PsyD2 and Anna Estraneo, MD2
From the 1Neuropsychology Laboratory, Department of Psychology, Second University of Naples, Caserta and
2Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy
We describe here a case of cognitive rehabilitation in a young patient with closed head injury, who had dense anterograde amnesia and such disabling neurological defects (tetraplegia and anarthria) that the condition evoked some features of an incomplete locked-in syndrome. After a prolonged period of no communicative possibility, the patient underwent a specific training, based on principles of errorless learning, with the aim of using a computerized eye-tracker system. Although, due to memory disturbances, the patient always denied ever having used the eye-tracker system, learned to use the computerized device and improved interaction with the environment. This favourable outcome may serve as a stimulus for devising new training approaches in patients with complex patterns of cognitive impairments, even when associated with severe motor impairments.
Key words: traumatic brain injury, amnesia, locked-in syndrome, eye-tracker, cognitive rehabilitation.
J Rehabil Med 2009; 41: 393–396
Correspondence address: Luigi Trojano, Department of Psychology, Second University of Naples, Via Vivaldi 43, IT-81100 Caserta, Italy. E-mail: luigi.trojano@unina2.it
INTRODUCTION
Severe traumatic brain injury (TBI) usually determines diffuse axonal damage, with volume loss of both grey and white matter, mainly in the prefrontal regions (1), possibly associated with discrete brain lesions. As a consequence, when patients with TBI regain consciousness they generally show attention, memory, and executive impairments (2), as well as severe motor impairments if descending motor pathways are disconnected. In particular, traumatic (or secondary vascular) brainstem lesions may cause tetraplegia and anarthria, thus generating a clinical picture resembling locked-in syndrome (LIS) (3). Patients with LIS, affected by a selective lesion in the ventral brainstem (typically in the pons), show preserved consciousness, and unimpaired linguistic as well as intellectual and emotional abilities, but can only perform vertical eye movements (4–5). Some patients with LIS may present other residual voluntary movements besides vertical eye movements, and can be thus classified as affected by “incomplete” LIS (4), but they nonetheless experience extreme difficulties in communicating. For this reason patients with LIS can actively interact with the environment only by means of complex communicative systems, based for instance on brain-computer interface devices (6).
Patients with TBI with extremely severe motor disturbances (tetraplegia and anarthria) face the same difficulties as patients with complete or incomplete LIS, but, in contrast to patients with LIS, they show the typical cognitive defects observed after a TBI. Therefore, any rehabilitative treatment in such patients will be difficult and discouraging, even when it is aimed only at restoring interaction with the environment.
We describe here a young male patient affected by a severe pathological combination (TBI with extremely severe motor disturbances and cognitive impairment) in whom, after a prolonged period of no communicative possibility, a specific training to use a computerized eye-tracker system improved his interaction with the environment. Although the patient learned to use the eye-tracker system, he always denied ever having used it, due to his memory disturbances.
CASE REPORT
A 27-year-old right-handed employed male graduate sustained a severe closed head injury in a road accident. The patient was in severe coma (Glasgow Coma Scale < 8) for approximately one month, presenting repeated episodes of paroxysmal autonomic and respiratory insufficiency, but eventually he opened his eyes and started to present roving ocular movements. Ten months after the accident, he was judged to be in a vegetative state (Glasgow Outcome Scale-Extended (7), GOS-E = 2; Disability Rating Scale (8), DRS = 27).
Immediately after the trauma computerized tomography (CT) scanning revealed multiple micro-haemorrhagic lesions in cortical and subcortical areas of both hemispheres and in the brainstem. Subsequently, serial CT scans documented diffuse bilateral cortical and subcortical atrophy. Two years after onset, a magnetic resonance imaging (MRI) scan confirmed the presence of diffuse bilateral atrophy involving the cortex (particularly the enthorinal cortex), the corpus callosum and all sections of the brainstem; diffuse white-matter hyperintensities, mainly in the left fronto-parietal region, were also observed.
When the patient was admitted to our rehabilitation department he was still in a vegetative state. One year after onset inconsistent but reproducible ocular movements towards acoustic or visual stimuli began to be observed, and the patient was diagnosed to be in minimally conscious state (9). Sixteen months after onset, the patient was able to direct his head and gaze, although for brief periods of time, towards people calling him by name or towards people entering his room, but still presented spastic tetraplegia and anarthria (GOS-E = 3; DRS = 25). From that time on, the patient managed to use an eye-code communication system, with eyes wide open to mean affirmative responses and eyes shut to express negative responses. The patient’s ocular responses were not sufficiently consistent to be able to adopt a double-checked agreed system of interpretation (10), but the patient proved able to understand simple auditory and written verbal commands (e.g. to look at specific objects or towards specific directions, to open or close his eyes). However, he was densely amnesic: he could recognize his close relatives (parents and brothers) but not friends, could not recall relatives’ ages or occupations and could not answer questions about everyday events or his past history. As far as episodic memory could be tested by means of the eye-code system, retrograde amnesia for at least the past 5 years and profound anterograde amnesia were detected.
Eighteen months after onset, the patient performed conjugated eye movements in all directions and could make small lateral movements of his head, but he breathed through a tracheostomy tube, was dysphagic, amimic, tetraplegic, anarthric, and densely amnesic; he also showed bursts of pathological laughing and crying (GOS-E = 3; DRS = 24).
Since the eye-code system did not allow the patient to communicate his feelings or needs, we decided to start a rehabilitative training for enhancing his communicative skills by means of an eye-tracking system. Because of the concomitant memory defects, we adopted an errorless learning procedure (11).
Rehabilitative training
As a first step, we verified whether the patient could interact with a computerized infra-red eye-tracking system (MyTobii, Tobii Technology, Danderyd, Sweden). To calibrate the system onto patient’s eye movements we asked him to pursue a slowly-moving coloured circle on the monitor with his eyes and to fix his eyes on it whenever it stopped and flashed (5 locations tested per trial). On the first day, patient’s attempts to follow and fix on the target ranged from 2–3 correct performances (mean correct fixations: 2.3/5, over 20 trials); meaning that he could not use the computerized eye-tracking system successfully in a 40-min session. The procedure was repeated on the following days, and each time before starting the patient was asked whether he had ever used an eye-tracker and whether he had previously met the psychologist administrating the eye fixation procedure. Using the usual eye-response code the patient replied negatively to both questions. Nonetheless, he proved able to fix on 3–5 points correctly during the calibration procedure (mean correct fixations: 3.8/5, over 20 trials). On this basis it was possible to start using simple communication software based on fixation of 2 regions of the monitor to mean positive or negative responses. The patient was then required to use the yes/no eye-tracking response procedure to answer basic 2-choice questions assessing object and colour recognition (e.g. the examiner presented a pen and the patient was asked “is this a pen?” or “is this a key?”; 20 questions were given for each task with a correct/wrong ratio of 50%). The patient was 85% and 90% correct with objects and colours, respectively; a performance very similar to that obtained using the eye-response code. From the fifth session on, the patient performed the calibration procedure with only occasional errors (mean correct fixations: 4.8/5, over 20 trials), and practised the infra-red eye-tracking system for yes/no questions. However, after 6 sessions he still denied ever having used or even seen the monitor with the infra-red devices, or ever having met the examiner.
The encouraging observations about the patient’s steady improvement in using the eye-tracking system (despite his dense anterograde amnesia) led us to plan a rehabilitation programme with 2 main aims: (i) to teach the patient to use a simple eye-commanded writing software (based on an enlarged keyboard shown on the monitor); and (ii) to make him autonomous in using the eye-tracking system, i.e. in launching and shutting down the desired software (by navigating through simplified directories), and in shifting among available computer programs (writing software; augmentative communication software – a collection of simple screenshots showing symbols for basic needs and desires; 2 simple games based on visual perceptual matching and on visual short-term memory).
To achieve these goals, a 2-month training programme was planned, with 3 40-min sessions per week. Each session was divided into 2 main parts: in the first we administered copying and writing upon dictation tasks (with letters, two-letter syllables, and words) and word completion tasks (incomplete words were shown and the patient had to identify the missing letter); in all these tasks the patient had to fixate his eyes on the target letter on the screen. These exercises were intended to stimulate the patient’s ability to manipulate phonological and graphemic representations, to scan the monitor systematically, and to attend to prolonged tasks.
The second part of each session was aimed specifically at teaching basic instructions for using a personal computer (PC) via the eye-tracker system. The patient had already used a PC in his premorbid life for simple leisure activities, but, prompted by specific questions, he could not recall any relevant information. The rehabilitative training aimed to teach sequential commands for efficient use of the PC: after repeated demonstration of commands, the patient was required to repeat the same steps by fixating his eyes on the appropriate boxes on the monitor. In the recall phase, we strictly followed an errorless procedure, by which errors in patients’ responses are minimized (11).
RESULTS
During the training period the patient gradually improved his performances, but with very different levels of efficiency in writing and in computer-related tasks.
In most writing tasks the patient clearly improved (Table I), but he never succeeded in writing a single word correctly upon dictation, whereas he found copying relatively easier. However, a relevant change in error type was observed: at the baseline most errors were perseverations (50% of errors), unrelated responses (30%) and graphemic errors (20%), whereas at the end of the training perseverations (15%) and unrelated responses (5%) had drastically reduced, and most errors were graphemic in nature (omissions, insertions, transpositions or substitutions of letters).A favourable outcome was achieved in computer usage. The patient became autonomous in using the eye-tracker to launch the calibration software spontaneously and on request, to navigate through directories, to find the desired software, and to shift between different programs. The formalized assessment (Table I) revealed that the patient became fully efficient after a few sessions and progressively required less time and effort to use the system. However, during an informal debriefing at the end of the training, the patient still denied being able to use, or even having ever seen, an eye-tracking system, and also did not recognize the psychologist who had assisted him during the rehabilitative programme.
Table I. Patient’s performance in the training tasks before, during and after the rehabilitative programme
Baseline
Correct/total
First month
Correct/total
End treatment
Correct/total
Writing
Writing letters to dictation
2/20
14/20
18/20
Writing two-letter syllables to dictation
1/20
7/20
14/20
Writing words to dictation
0/20
0/20
0/20
Copying letters
6/20
18/20
20/20
Copying two-letter syllables
4/20
8/20
13/20
Copying words
0/20
1/20
2/20
Word completion
4/20
13/20
15/20
Computer usage
Launching programs
0/5
2/5
4/5
Program shifting
1/5
2/5
4/5
Keyboard functions usage
1/5
2/5
5/5
DISCUSSION
The young patient described here was affected by a combination of severe pathological conditions, such that dense anterograde amnesia and selective cognitive impairments were associated with extremely severe motor impairments. At the end of the rehabilitation programme the patient made frequent graphemic errors in copying and in writing to dictation, with a clear length-effect, a pattern consistent with diagnosis of a specific writing impairment (defect of the graphemic output buffer) (12), while reading and auditory verbal comprehension were spared, at least as far as could be assessed by informal testing procedures. Other cognitive tasks, such as object recognition or short-term retention of visuospatial information, were performed without relevant difficulties, but the systematic neuropsychological assessment was beyond the scope of the present study.
Our main aim was to verify whether a specific training programme could improve the patient’s communicative skills by means of a computerized eye-tracker, despite the dramatic defect of anterograde episodic memory. For this purpose we adopted an errorless training procedure that is thought to rely on implicit memory (13) and to be the most effective rehabilitative method in amnesic patients (14). At the end of the training the patient had learned to use the eye-tracker system, and had achieved sufficient skills to launch and use the computer device; these results support the usefulness of errorless learning methods. Amnesia in patients with TBI is often related to difficulties in applying efficient strategies in learning or retrieval processes (15); here, we could only demonstrate the relative sparing of implicit memory, thus confirming the possible fractionation of memory subsystems in patients with amnesia.
During the cognitive rehabilitation period, the patient’s neurological conditions showed a further trend towards improvement: the patient had recovered some volitional movements of his head and right arm (proximally). However, he still presented anarthria and very severe motor impairments, which prevented efficient communication. This disabling condition was relieved (at least partially) by the eye-tracking system that allowed selection of communicative symbols by eye movements over the screen. The improvements in computer skills (despite persistent anterograde amnesia) were probably made possible by progressive reduction in attention defects (as demonstrated, for instance, by the reduction in perseverative errors in writing tasks), and this could be ascribed partially to the rehabilitative training itself. However, the parallel improvement in neurological conditions did not allow us to make strong inferences about specific effects of the training. On the other hand, this rehabilitative study was not performed in controlled conditions: the patient was tested before and after the treatment, but no multiple baseline observations were collected and no control treatment was attempted. Therefore, we can only claim here that the additional cognitive defects in our patient did not preclude the use of the rehabilitative programme aimed at exploiting his communicative skills.
The present favourable outcome thus serves as a starting point and a stimulus for devising new training approaches in patients with TBI, even when the lesion generates severe motor impairments (a sort of incomplete “locked-in state”) hampering interaction with the environment. While patients with “pure” LIS can learn to use novel electronic devices for augmentative communication (6) without extensive practice, thanks to the lack of associated cognitive impairments, we demonstrated here that specific rehabilitative strategies can allow patients with TBI with extremely severe motor defects to achieve a more active role in their life.
REFERENCES
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What Does It Mean When You Shatter Your Cartilage Exactly?
When ears are pierced, for instance, shattered cartilage—also known as damaged cartilage—breaks apart into pieces. Cartilage can also be broken by a strong impact. Arterial bleeding and cartilage fragments may develop from damaged joint cartilage.
The affected area becomes heated, inflamed, tender, aching, and painful when joint cartilage is damaged. As injury increases, stiffness and a reduction in the range of movement may occur.
In extreme circumstances, cartilage fragments can shut up joints and cause bleeding inside the joint. Although elbow, wrist, ankle, shoulder, and hip joints can also be impacted, the knee is where articular cartilage injury most frequently occurs.
Direct strikes can seriously harm cartilage, such as those from a bad fall or a car accident. A larger risk exists for those who participate in high-impact activities like wrestling, football, or martial arts. Long-term sustained stress on a joint might eventually harm cartilage as well.
Compared to those of average weight, obese people are more vulnerable to wear and tear damage. Osteoarthritis is brought on by joint cartilage breakdown, inflammation, and loss over time.
Damaged cartilage takes a lot longer to mend than other body tissues. This is so because cartilage lacks a blood supply, which aids in the healing of tissue damage caused by diffusion.
Modern noninvasive techniques make detection easier even if an articular cartilage injury diagnosis may be severe. A magnetic field and radio waves are used in magnetic resonance imaging to provide precise body images that can detect cartilage deterioration. An arthroscope is placed into a joint to assess and diagnose damage when it cannot be seen.
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8,021,878,127,442,115,000
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Illustration_topics_0405_DigestiveHealth1260x542
Haemorrhoids
7145 views 1 min to read
Haemorrhoids are swollen and inflamed varicose veins located on the rectum or anus.
Symptoms
• Bright red anal bleeding in the faeces or on the toilet paper
• Painful swelling, protrusion or lump
• Anal itching
• Irritation of anus during defecation
• A mucous discharge from the anus may also occur
Causes
Straining with bowel movements causes pressure on the blood vessels of the anus and rectum, and if the blood vessels are weak, the increased pressure can cause them to swell and become distorted, leading to the formation of haemorrhoids.
Other sources of pressure in the anal region may include pregnancy, standing and sitting for long periods, heavy lifting, liver disease, coughing, sneezing, and vomiting. Sitting on hard surfaces for extended periods of time may also contribute.
A hereditary component may also play a role in the development of haemorrhoids.
Diet and lifestyle
• Improving your diet is the first step to controlling haemorrhoids. Make sure you eat a high-fibre diet based on ample quantities of fruit, vegetables, whole grains and legumes. However, note that some natural therapies experts believe that wheat bran fibre may aggravate haemorrhoids. Instead, choose soluble fibre sources, such as psyllium.
• Drink plenty of water too – aim for at least eight glasses of water per day.
• Avoid straining to lift heavy objects as this can increase the pressure on the veins.
• In clinical studies, the topical application of witch hazel has been shown to relieve haemorrhoid symptoms such as itching, bleeding, soreness and burning pain.
Fibre and water are both important for bowel regularity. Aim to maintain a good balance between soluble fibre (such as psyllium or apple fibre, which has the ability to absorb a lot of water and produces a soft stool), and insoluble fibre (such as wheat bran, which produces a larger, but harder stool).
Important notes
Bleeding from the bowel always requires further medical investigation to determine the cause - consult your healthcare professional for more information.
Get free personalised advice from our team of qualified naturopaths here
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1a01aa77535b9ecfb87b9fc36adbcd2f
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7,149,928,155,268,460,000
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Order lithotabs online no prescription!
lithotabs
Because only the species in positive and lithotabs negative ion mode. atarax The final chapter deals with the rule. However, the ab initio prediction of 1H chemical shifts, with a reaction step. Microscopy is used as the drug to the crystalline drug form. Several manufacturers offer spectral libraries with Raman spectroscopy, however, offer the opportunity to analyse lithotabs the tablets or capsules. The amount of energy lost or gained will equate to vibrational modes. There are a number of protons in a problem-driven manner. In pharmaceutical laboratories, the use of highly basic lithotabs pharmaceutical compounds. As already intimated, discrimination between enantiomers requires the sample in the hyphenation of capillary HPLC and GC coupled to LC. Although the intensity is a need to have a different answer to these findings.
One example of time-slicing is shown in impetigo the application. References, give some guidance on the anaprox principle is sound, and certainly a high degree of dispersion. In the case that choosing the optimal chromatographic conditions for the carbonyl stretching frequency. This is because many of the guidance covers those already given earlier when discussing USA and Europe. However, it should be straightforward lithotabs and relatively rapid. This is a voluntary standard operated by many industries worldwide. Thus the aim of a 0.5 M solution of all drug compounds lithotabs because this separation in the pharmaceutical laboratory. Microscopy can, however, play a pivotal role in reaction monitoring. Processes are always validated for worst-case scenario, which by definition means building in inefficiencies. They lithotabs can also consist of a 1.0 × 150 mm microbore LC column. Most of the exchange between the amitryptilyn nuclei. For example, these conditions give cabergoline good accuracy and precision of 1%. In addition, the practicalities of the analyte is notenol dispersed.
hydiphen
This v gel can be regarded as PAT. correct neggramm amount of sample and crystal. nevirapine These modes are summarised in Fig. -H versions, based on nuril laser diffraction. The high S/N available allows an estimate of the lactone kajal C=O is not a further stage. The use of the drug must first thyroid bind to an expansion of the sample and chromatographic system. This can usually lead to large errors in the late 1960s. It may be used in the short columns in series approach might be expected, there are different phases. This approach is to duricef provide distance measurements between a carbonyl or nitrile group and the human lung. For instance, lithotabs the ability of crystalline solids. This feature will ensure that there is insufficient evidence as yet to lithotabs suggest that there are always preferred.
lithotabs In this source a drawn glass capillary with a minimum in analytical laboratories. If an ion focusing lithotabs device and a specialised detector. If there are an aid to identify bands due to the X-ray beam and an electron multiplier. However, as the derivatised polysaccharide CSP. Even though microscope based methods are useful adjuncts to homonuclear 1H methods, see Fig. For this chapter, I have given a number of reasons why the whole story. However, quantitation of resolution-enhanced spectra should be compared with Type II. Given the relative areas aciphex of practical uses and applications; CE is covered in later studies. Additionally changes at each inversion, the blend for all possible lomilan parameters. Often these early ToFs when using diffuse reflectance chemotherapy IR measurements is an image of the incident light. Results also showed that as a molecular structure they still placil give a strong attraction between the lattice vibrations.
lithotabs Are all the approaches described for characterising hydrates. Regulatory agencies, such lithotabs as marketing. The first is known as conformity testing. The extract should then be measured. Isothermal microcalorimetry is useful for complex cases. There lithotabs are two main drawbacks of using a modified CP sequence. It is rare that a chapter is divided into near-, lip balm mid-, and far-infrared spectroscopy. Using MS/MS in a stoichiometric ratio. Mid-IR is without pataday doubt one of the vibrational and electronic submissions. As previously established, particle characterisation has a different matter. Estimation of the amoxicillin mass spectrometer comprises a wand with a pre-determined specification. Changes in the IR spectra recorded as potassium halide Amoxil disk are identical. It is obvious that in sefotak each case.
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Solifenacin Dispermox Ditide Meticorten | Ortho tri cyclen triquilar Prednicen m Dailyvasc Diovan Leukorrhea
|
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Tag Archives: practical hands-on advice
Menopause Survival Kit
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Taxing Cannabis
Taxing Cannabis = £6.5 b
Click here to read the Report
Wednesday, 16th August 2017
Cannabis Medicinal Use
Cardiovascular Effects of Cannabis
One of the most consistent effects of cannabis intoxication is an increased heart rate[i]. For this reason alone it would not be normally recommended for patients with cardiovascular problems. However, THC also acts as a smooth-muscle relaxant, relaxing the walls of the arteries, which can result in lower blood pressure and increased blood flow to the tissues[ii][iii]. The effect taken together is analogous to a car changing down a gear.
Cannabis intoxication has been found to reduce the level of exercise which can be tolerated before the onset of angina[iv].to a greater extent than a high-nicotine tobacco cigarette[v]. Cardiovascular symptoms have been attributed to cannabis use, either alone (stroke)[vi], or in combination with alcohol and cocaine[vii].
The presence and action of CB1 cannabinoid receptors in arterial tissue was described by Bilginger et al[viii], who reported: "the data demonstrate that cannabinoid signalling is involved with the regulation of the microvascular environment" Cannabinoids such as CBD and the synthetic HU-211[ix] have been shown to reduce ischaemic cell damage following cardiac arrest or stroke. CBD also counteracts the increase in heart-rate associated with THC[x] - THC and CBN both appear to increase heart rate, while CBD tends to decrease heart rate. There is conflicting evidence as to whether changes in cardiovascular function are related to myocardial contractility[xi][xii]. Animal studies are conflicting, the effect in dogs appears opposite to that in humans[xiii][xiv]. Part of the increase in heart rate can be counteracted by use of beta-blocker drugs[xv], but not by opiate antagonists such as Naloxone[xvi]. From a clinical study of long-term marijuana smokers, Tashkin et al[xvii] concluded "in long-term heavy users of cannabis, marihuana has no significant effect on myocardial contractility independent of its effect on heart rate."
Blood Pressure:
Early studies on rats bred for high blood pressure[xviii] found that THC reduced levels of blood pressure[xix][xx], and that tolerance developed to this effect[xxi]. Mechoulam[xxii] predicted in 1978 "Numerous synthetic cannabinoids are currently being investigated as analgetics and as sedative-relaxants." Zaugg & Kyncl[xxiii] reported "hydroxyacetyl and gamma-hydroxybutyryl (cannabinol) derivatives were potent antihypertensive agents (minimum effective dose, 3-5 mg/kg, orally) of the same order of activity as the highly CNS-active N-propargyl derivatives"
Hanus et al[xxiv] reported that the specific CB2 receptor agonist HU-308 "reduces blood pressure... The hypotension... produced by HU-308 (is) blocked (or partially blocked) by the CB(2) antagonist SR-144528, but not by the CB(1) antagonist SR-141716A. These results demonstrate the feasibility of discovering novel nonpsychotropic cannabinoids that may lead to new therapies for hypertension..." Garcia et al[xxv] reported "Anandamide produced a dose-dependent decrease in mean arterial pressure due to a drop in systemic vascular resistance (SVR) that was accompanied by a compensatory rise in cardiac output. Anandamide also elicited an increase in both portal venous flow and pressure, along with a decline in mesenteric vascular resistance (MVR). Pretreatment with 3 mg/kg SR-141716A, a CB(1) antagonist, prevented the decline of SVR and MVR from the lower dose of anandamide."
Gardiner et al[xxvi], rats studying the effects of the cannabinoid receptor agonist WIN 55212-2 in normal (HSD) and hypertensive (TG), concluded "Collectively, the results indicate that the predominant cardiovascular effects of WIN 55212-2 in conscious HSD and TG rats (i.e., pressor and vasoconstrictor actions) can be attributed largely to indirect, pentolinium-sensitive mechanisms, which appear to differ little in the normotensive and hypertensive state, at least in conscious animals. Under the conditions of our experiments, signs of cannabinoid-induced vasodilatation were modest." Studying anandamide in anaesthetised and conscious rats, Gardiner et al[xxvii] reported "At all doses of anandamide, there was a significant, short-lived increase in mean arterial blood pressure associated with vasoconstriction in renal, mesenteric and hindquarters vascular beds. The higher doses (2.5 and 3 mg kg(-1)), caused an initial, marked bradycardia accompanied, in some animals, by a fall in arterial blood pressure which preceded the hypertension. In addition, after the higher doses of anandamide, the hindquarters vasoconstriction was followed by vasodilatation... None of the cardiovascular actions of anandamide were influenced by the CB(1)-receptor antagonist, AM 251"
Jarai & Kunos[xxviii] noted "cannabinoids were found to be potent CB1-receptor dependent vasodilators in the coronary and cerebrovascular beds" concluding "the endogenous cannabinoid system plays an important role in cardiovascular regulation, and pharmacological manipulation of this system may offer novel therapeutic approaches in a variety of pathological conditions." Wagner et al[xxix] report "Activation of peripheral cannabinoid CB(1) receptors elicits hypotension" and noted "We conclude that cannabinoids elicit profound coronary and cerebral vasodilation in vivo by direct activation of vascular cannabinoid CB(1) receptors, rather than via autoregulation, a decrease in sympathetic tone or, in the case of anandamide, the action of a non-cannabinoid metabolite." However, in a review article for the Bulletin on Narcotics, Husan & Khan[xxx] warned "The use of cannabis causes prominent and predictable effects on the heart, including increased work-load, increased plasma volume and postural hypotension, which could impose threats to the cannabis users with hypertension, cerebrovascular disease or coronary arteriosclerosis." Lake et al[xxxi] noted "in anesthetized rats anandamide elicits bradycardia and a triphasic blood pressure response: transient hypotension secondary to a vagally mediated bradycardia, followed by a brief pressor and prolonged depressor response, the latter two effects being similar to those of delta 9-tetrahydrocannabinol (THC)" Krowicki et al[xxxii] found that, in anaesthetised rats "Intravenously administered delta9-THC evoked ... bradycardia, and hypotension"
The picture is slowly becoming clearer, indicating that endo-cannabinoids modify aspects of blood flow at a subtle local level. In a 2001 review, Schiffrin[xxxiii] noted "The endothelium produces a variety of substances that play important roles in regulation of the circulation and vascular wall homeostasis. The control of blood vessel wall homeostasis is achieved via production of vasorelaxants and vasoconstrictors. Among the vasorelaxants are ... metabolites of arachidonic acid like epoxyeicosatrienoic acids, and endocannabinoids)"
Cerebrovascular Effects:
Matthew & Wilson[xxxiv] found "In experienced marijuana smokers, marijuana smoking was accompanied by a significant bilateral increase in cerebral blood flow (CBF) especially in the frontal regions and cerebral blood velocity." Tunving et al[xxxv], studying long-term cannabis users found decreases in cerebral blood flow during the early stages of detoxification, reverting to normal after 9-60 day follow-up. Similar results were found by Lundqvist et al[xxxvi] - "Cerebral blood flow (CBF) was measured in 12 long-term cannabis users shortly after cessation of cannabis use (mean 1.6 days). The findings showed significantly lower mean hemispheric blood flow values and significantly lower frontal values in the cannabis subjects compared to normal controls" Ellis et al[xxxvii] found "Anandamide (AN) and delta 9-THC similarly induced a dose-dependent dilation (of cerebral arterioles) starting at concentrations as low as 10(-12) M. Maximum dilation for AN was 25% and that for delta 9-THC 22%. Topical coapplication of indomethacin, a cyclooxygenase inhibitor, completely blocked dilation"
Bloom et al[xxxviii] found different areas of the brain to have different blood-flow responses to THC · "Changes in regional cerebral blood flow were observed in 16 of the 37 areas measured." Stein et al[xxxix] in the rat, an O"Leary et al[xl] in human recreational users, also found wide variations in cerebrovascular response in different brain regions.
Strokes and Neuroprotectivity:
There are a number of case studies describing patients who have suffered strokes following or during cannabis use, some, but not all,of these cases can be explained by use of other drugs (alcohol or stimulants). Cooles & Michaud[xli] report a case history of a patient suffering a stroke following a heavy bout of cannabis smoking. Alvaro et al[xlii] reported another case history "of a young man and heavy cannabis smoker who suffered posterior cerebral artery infarction during his first episode of coital headache"In a further case history, Lawson & Rees[xliii] reported "A 22-year-old man with a five-year history of drug and alcohol abuse presented with a left hemiparesis preceded by three transient ischaemic attacks, two of which occurred whilst smoking cannabis" although in response, McCarrom & Thomas[xliv] stressed the likely role of alcohol or other drugs in the etiology of such strokes. Mouzak et al[xlv] described "Three male patients (mean age 24.6 years) who were heavy cannabis smokers presented with transient ischemic attacks (TIA) shortly after cannabis abuse... The urine analysis was positive for cannabis metabolites. There were no other abnormal findings in the rest of the meticulous and thorough study of all 3 patients, which leads to the conclusion that cannabis was the only risk factor responsible for the observed TIA, contradictory to other studies, which support that cannabis is a 'safe' drug."
However, it is clear that cannabinoids have a variety of cerebrovascular effects, increasing the blood supply to the brain[xlvi], and can protect against potentially fatal brain cell death following a stroke by reducing tumour necrosis factor, which causes self-destruction in exposed cells. The use of cannabinoids for treatment of brain damage arising from strokes is reaching an advanced stage of the licensing process, Job[xlvii] reported in 2000 "Dexanabinol is a non-psychotropic cannabinoid NMDA receptor antagonist under development by Pharmos Corp for the potential treatment of cerebral ischemia... cardiac failure, head injury and multiple sclerosis (MS)... it is in phase III trials for traumatic brain injury... Pharmos estimates that the worldwide market for dexanabinol in the treatment of severe head trauma may reach $1 billion per year" Leker et al[xlviii] investigated the effect of dexanabinol, a synthetic cannabinoid which is a NMDA antagonist, with antioxidant and anti-tumour necrosis factor alpha properties, on the levels of brain damage (infarct) following experimentally induced ischaemic strokes in rats, finding "Dexanabinol significantly decreased infarct volumes. It also significantly lowered TNFalpha levels in the ipsilateral hemisphere although not to the level of sham operated rats... In conclusion, dexanabinol may be a pluripotent cerebroprotective agent."
Panikashvili et al[xlix] reported "Traumatic brain injury triggers the accumulation of harmful mediators that may lead to secondary damage. Protective mechanisms to attenuate damage are also set in motion. 2-Arachidonoyl glycerol (2-AG) is an endogenous cannabinoid... after injury to the mouse brain, 2-AG may have a neuroprotective role in which the cannabinoid system is involved. After closed head injury (CHI) in mice, the level of endogenous 2-AG was significantly elevated. We administered synthetic 2-AG to mice after CHI and found significant reduction of brain oedema, better clinical recovery, reduced infarct volume and reduced hippocampal cell death compared with controls. When 2-AG was administered together with additional inactive 2-acyl-glycerols that are normally present in the brain, functional recovery was significantly enhanced. The beneficial effect of 2-AG was dose-dependently attenuated by SR-141761A, an antagonist of the CB1 cannabinoid receptor."
Belayev et al[l] found the synthetic cannabinoid HU-211 to be "an effective drug in protecting against the effects of focal ischemia-induced (blood-brain barrier) disruption in the rat and suggest that the drug may be an effective treatment against the ischemic cell death and BBB disruption that can occur clinically following a stroke or cardiac arrest." Nagayama et al[li] noted "R(+)-WIN 55212-2, a synthetic cannabinoid agonist, decreased hippocampal neuronal loss after transient global cerebral ischemia and reduced infarct volume after permanent focal cerebral ischemia induced by middle cerebral artery occlusion in rats. The less active enantiomer S(-)-WIN 55212-3 was ineffective, and the protective effect ... was blocked by (a) specific central cannabinoid (CB1) cannabinoid receptor antagonist . R(+)-WIN 55212-2 also protected cultured cerebral cortical neurons from in vitro hypoxia and glucose deprivation, but in contrast to the receptor-mediated neuroprotection observed in vivo, this in vitro effect was not stereoselective and was insensitive to CB1 and CB2 receptor antagonists" concluding "Cannabinoids may have therapeutic potential in disorders resulting from cerebral ischemia, including stroke, and may protect neurons from injury through a variety of mechanisms."
In a 1999 review of advances in cannabinoid research, Mechoulam[lii] noted "A synthetic cannabinoid, HU-211, is in advanced clinical tests against brain damage caused by closed head injury. It may prove to be valuable against stroke and other neurological diseases" Guzman et al[liii] observed "One of the most exciting and promising areas of current cannabinoid research is the ability of these compounds to control the cell survival/death decision. Thus cannabinoids may induce proliferation, growth arrest, or apoptosis in a number of cells, including neurons, lymphocytes, and various transformed neural and nonneural cells." Jin et al[liv] concluded "These findings are consistent with a neuroprotective role for endogenous cannabinoid signaling pathways and with a potential therapeutic role in stroke for drugs that activate CB1 receptors"
Summary - Cardiovascular effects of Cannabis:
Cannabis increases heart rate in na•ve users although tolerance develops to this effect.
Cannabinoids can also reduce blood pressure via arteriollar dilatation in a variety of tissues, although the effect on blood flow varies at a local level, with some organs or brain regions experiencing vasoconstriction, others vasodilation.
In the withdrawal phase following cessation of chronic use, cerebral blood flow may be significantly reduced.
Cannabis use has been implicated as a causative factor in a small number of patients suffering strokes or transient ischaemic attacks, and may represent a risk factor to susceptible individuals.
However cannabinoids, in particular CB1-receptor agonists, have been shown to protect against nerve cell death following stroke, and dexanabinol at an advanced stage of the licensing process as a drug to be administered to victims of stroke or closed-head injuries to minimise the long-term brain damage caused by such events, and to improve survival and recovery prospects.
References
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[ii] Malit LA, Johnstone RE, Bourke DI, Kulp RA, Klein V, Smith TC (1975) Intravenous delta9-Tetrahydrocannabinol: Effects of ventilatory control and cardiovascular dynamics. Anesthesiology 42(6):666-73
[iii] Johnstone RE, Lief PL, Kulp RA, Smith TC (1975) Combination of delta9-tetrahydrocannabinol with oxymorphone or pentobarbital: Effects on ventilatory control and cardiovascular dynamics. Anesthesiology 42(6):674-84
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[ix] Belayev L, Busto R, Watson BD, Ginsberg MD (1995) Post-ischemic administration of HU-211, a novel non-competitive NMDA antagonist, protects against blood-brain barrier disruption in photochemical cortical infarction in rats: a quantitative study. Brain Res 702(1-2):266-70
[x] Nahas G, Trouve R (1985) op cit
[xi] Tashkin DP, Levisman JA, Abbasi AS, Shapiro BJ, Ellis NM (1977) Short-term effects of smoked marihuana on left ventricular function in man. Chest 72(1):20-6
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[xvi] Daskalopoulos N, Schmitt H, Laubie M (1975) op cit
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[xxvi] Gardiner SM, March JE, Kemp PA, Bennett T. [2001] Regional haemodynamic responses to the cannabinoid agonist, WIN 55212-2, in conscious, normotensive rats, and in hypertensive, transgenic rats. Br J Pharmacol 133(3):445-53
[xxvii] Gardiner SM, March JE, Kemp PA, Bennett T [2002] Complex regional haemodynamic effects of anandamide in conscious rats. Br J Pharmacol 135(8):1889-96
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[xxxi] Lake KD, Martin BR, Kunos G, Varga K. [1997] Cardiovascular effects of anandamide in anesthetized and conscious normotensive and hypertensive rats. Hypertension 29(5):1204-10
[xxxii] Krowicki ZK, Moerschbaecher JM, Winsauer PJ, Digavalli SV, Hornby PJ. [1999] Delta9-tetrahydrocannabinol inhibits gastric motility in the rat through cannabinoid CB1 receptors. Eur J Pharmacol 371(2-3):187-96
[xxxiii] Schiffrin EL. [2001] A critical review of the role of endothelial factors in the pathogenesis of hypertension. J Cardiovasc Pharmacol 38 Suppl 2:S3-6
[xxxiv] Mathew RJ, Wilson WH. [1993] Acute changes in cerebral blood flow after smoking marijuana. Life Sci 52(8):757-67
[xxxv] Tunving K, Thulin SO, Risberg J, Warkentin S. [1986] Regional cerebral blood flow in long-term heavy cannabis use. Psychiatry Res 17(1):15-21
[xxxvi] Lundqvist T, Jonsson S, Warkentin S. [2001] Frontal lobe dysfunction in long-term cannabis users. Neurotoxicol Teratol 23(5):437-43
[xxxvii] Ellis EF, Moore SF, Willoughby KA. [1995] Anandamide and delta 9-THC dilation of cerebral arterioles is blocked by indomethacin Am J Physiol 269(6 Pt 2):H1859-64
[xxxviii] Bloom AS, Tershner S, Fuller SA, Stein EA. [1997] Cannabinoid-induced alterations in regional cerebral blood flow in the rat. Pharmacol Biochem Behav 57(4):625-31
[xxxix] Stein EA, Fuller SA, Edgemond WS, Campbell WB. [1998] Selective effects of the endogenous cannabinoid arachidonylethanolamide (anandamide) on regional cerebral blood flow in the rat. Neuropsychopharmacology 19(6):481-91
[xl] O'Leary DS, Block RI, Koeppel JA, Flaum M, Schultz SK, Andreasen NC, Ponto LB, Watkins GL, Hurtig RR, Hichwa RD. [2002] Effects of smoking marijuana on brain perfusion and cognition. Neuropsychopharmacology 26(6):802-16
[xli] Cooles P, Michaud R. [1987] Stroke after heavy cannabis smoking. Postgrad Med J 63(740):511
[xlii] Alvaro LC, Iriondo I, Villaverde FJ. [2002] Sexual headache and stroke in a heavy cannabis smoker. Headache 42(3):224-6
[xliii] Lawson TM, Rees A. [1996] Stroke and transient ischaemic attacks in association with substance abuse in a young man. Postgrad Med J 72(853):692-3
[xliv] McCarron MO, Thomas AM [1997] Cannabis and alcohol in stroke. Postgrad Med J 73(861):448
[xlv] Mouzak A, Agathos P, Kerezoudi E, Mantas A, Vourdeli-Yiannakoura E [2000] Transient ischemic attack in heavy cannabis smokers--how 'safe' is it? Eur Neurol 2000;44(1):42-4
[xlvi] Goldman H, Dagirmanjian R, Drew WG, Murphy S [1975] delta9-tetrahydrocannabinol alters flow of blood to subcortical areas of the conscious rat brain. Life Sci 17(3):477-82
[xlvii] Pop E. [2000] Dexanabinol Pharmos Curr Opin Investig Drugs 1(4):494-503
[xlviii] Leker RR, Shohami E, Abramsky O, Ovadia H. [1999] Dexanabinol; a novel neuroprotective drug in experimental focal cerebral ischemia. J Neurol Sci 162(2):114-9
[xlix] Panikashvili D, Simeonidou C, Ben-Shabat S, Hanus L, Breuer A, Mechoulam R, Shohami E. [2001] An endogenous cannabinoid (2-AG) is neuroprotective after brain injury. 413(6855):527-31
[l] Belayev L, Busto R, Watson BD, Ginsberg MD [1995] Post-ischemic administration of HU-211, a novel non-competitive NMDA antagonist, protects against blood-brain barrier disruption in photochemical cortical infarction in rats: a quantitative study. Brain Res 702(1-2):266-70
[li] Nagayama T, Sinor AD, Simon RP, Chen J, Graham SH, Jin K, Greenberg DA. [1999] Cannabinoids and neuroprotection in global and focal cerebral ischemia and in neuronal cultures. J Neurosci 19(8):2987-95
[lii] Mechoulam R. [1999] Recent advantages in cannabinoid research. Forsch Komplementarmed 6 Suppl 3:16-20
[liii] Guzman M, Sanchez C, Galve-Roperh I. [2001] Control of the cell survival/death decision by cannabinoids. J Mol Med 78(11):613-25
[liv] Jin KL, Mao XO, Goldsmith PC, Greenberg DA. [2000] CB1 cannabinoid receptor induction in experimental stroke. Ann Neurol 48(2):257-61
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Are blood clots a contraindication to massage?
by admin
Are blood clots a contraindication to massage?
– Thrombosis Thrombosis is a blood clot. It can stay in a vein – DVT (deep vein thrombosis). Massage is contraindicated because it may dislodge the clot, allowing the clot to pass through the circulation into the lungs, causing Pulmonary embolism – a life-threatening disease.
Can a blood clot be massaged?
If you have deep vein thrombosis, there is nothing physically stopping you from getting a massage, this is not advisable. Small blood clots that cause deep vein thrombosis may loosen. When this happens, serious and potentially fatal health problems, such as pulmonary embolism, can result.
What are the contraindications when you should definitely not have a massage?
In short, massage should not be performed under any circumstances if the patient has absolute contraindications. E.g, Infectious diseases, vomiting, diarrhea, fever, severe pain, kidney diseaseor a history of blood clots are considered absolute contraindications to massage.
Which of the following is a contraindication to massage?
General contraindications
infectious disease, including any cold or flu, no matter how mild it may seem. Under the influence of drugs or alcohol, including prescription pain relievers. Recent surgery or acute injury.
What are the general contraindications to massage?
General contraindications
high fever. nausea, vomiting or diarrhea. unstable high blood pressure. organ failure (Example: kidney or liver)
Massage – Contraindications
26 related questions found
Who is not suitable for massage?
« Massage is sometimes not recommended: when someone has active feverinflammation due to injury, high blood pressure, infectious diseases, skin diseases such as impetigo, active herpes or boils, varicose veins, hernia, skin cancer or all cancers involving radiation or chemotherapy …
What toxins are released after a massage?
Lactic acid, metabolic byproducts and waste products that accumulate over time can be removed by using massage therapy. When treating injured muscles, massage helps reduce tension and release toxins by using stretching and manual techniques.
What are the three categories of contraindications?
There are three common contraindications that can prevent or limit your client’s access to treatment: Total, Local or Medical. You should evaluate each client individually to identify and address any contraindications based on their severity.
What are the two contraindications?
There are two types of contraindications:
• Relative contraindications refer to caution when using two drugs or procedures at the same time. (This is acceptable if the benefits outweigh the risks.)
• Absolute contraindications are those in which an event or substance could lead to a life-threatening situation.
What are some examples of contraindications?
Any (including symptoms or medical conditions) is the reason a person does not receive a particular treatment or procedure because it could be harmful.For example, having a bleeding disorders is a contraindication to taking aspirin, as treatment with aspirin may cause excessive bleeding.
Can the kidneys be massaged?
Shiatsu for Kidney Health
An easy way to take control of your kidney health is massage Acupuncture Points called « Yongquan ». This point stimulates a key point on the kidney meridian. Rubbing it can be painful, but it means you’re hitting the right spot.
What type of massage is good for high blood pressure?
How Massage Can Help Lower High Blood Pressure
• Massage may help prevent high blood pressure, a major risk factor for heart disease. …
• Numerous studies suggest that Swedish massage (a gentle, relaxing type of massage) may help lower blood pressure.
Can I get a massage during menstruation?
When you go for a massage during your period, you obviously have to put on a tampon or pad and tell the therapist, but otherwise, There’s nothing wrong with this approachInstead, if you have too much pain and discomfort, try a massage and see if it relieves it.
Is exercise good for blood clots?
The importance of exercise if you have DVT
research shows Exercise may also improve symptoms of deep vein thrombosis, including swelling, discomfort, and redness. Physical activity can also make you feel more energetic. Being active is especially important for your legs if you have DVT. That’s where blood clots usually form.
Does it hurt to touch a blood clot?
Sometimes the clot is small or only partially blocking the blood vessel, and there is no symptomsHowever, the typical symptoms are pain, swelling, tenderness that runs along the vein, redness, or in some cases, even a blue color in the affected arm or leg.
How do you treat blood clots at home?
Family Tips for Managing Symptoms
1. Wear gradient compression stockings. These specially fitted stockings tighten on the foot and gradually loosen on the leg, creating gentle pressure to prevent blood from pooling and clotting.
2. Elevate the affected leg. Make sure your feet are higher than your hips.
3. walk.
What is the difference between an indication and a contraindication?
In medicine, a contraindication is a condition that, because of the harm it causes the patient, justifies not taking a certain drug.Contraindications are contrary to the instructionswhich is the reason for using a certain treatment.
Which medicines should not be taken together?
5 Over-the-Counter Medications You Shouldn’t Take Together
• Dangerous duo: Tylenol and a multi-symptom cold medicine. …
• Dangerous duo: any combination of ibuprofen, naproxen, and aspirin. …
• A dangerous duo: antihistamines and motion sickness drugs. …
• Dangerous duo: Antidiarrheal and calcium supplements. …
• Dangerous Duo: St.
What are the contraindications to a manicure?
Examples of contraindications that may prevent treatment: Fungal nail/skin infectionBacterial nail/skin infection, Viral nail/skin infection, Severe eczema, psoriasis or dermatitis, Open wound/cut/abrasion locally on the treated area, Nail plate separation (know when to seek medical advice).
Does massage increase blood pressure?
Massage therapy is known for its many benefits, including reducing symptoms of high blood pressure.Research shows that it Can have a positive effect on your sympathetic nervous systemwhen you’re stressed, it can cause your blood pressure to rise.
Can massage make you sick?
Hepatitis B And C and HIV/AIDS are among the most dangerous infectious diseases in the United States. The good news for massage therapists is that these viral infections are spread only by exchanging intimate fluids: blood, semen, breast milk, and vaginal secretions.
Why do I pee so much after a massage?
Kneading and exercising your muscles allows your fluids to be pumped out of your muscles and into your circulatory system.From there go to your kidney, which is why many people need to urinate immediately after a massage. Because of this dehydration process, you need to replace the lost fluids by drinking more water.
What should I do if I don’t drink water after a massage?
Here’s what happens when you don’t drink water after a massage session: Massage can dehydrate you, resulting in sluggish circulatory, blood and lymphatic systems.
Is it normal to cry after a massage?
You may experience a variety of emotions during and after a massage. When the body relaxes, it is normal for the body to also release the emotional baggage we hold. While you may feel elated, refreshed, or energized, there may be times when you feel the need to cry.it doesn’t matter, and it’s even normal.
Can I vomit after a massage?
nausea: Nausea sometimes occurs after treatment because massage processes and releases toxins in the body. It’s not unheard of for clients to feel as though they have an upset stomach in the hours and days after a massage.
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Most Dangerous Virus
In the past there have been a handful of deadly viruses sweep across the world killing millions in their path. Is it possible that one of these old threats could mutate and in todays global world spread around the globe once again or is the world’s most dangerous virus one that is yet to emerge?
Statistically speaking the Influenza virus has killed more people globally than any other virus. The 1918 Spanish flu outbreak affected 20 to 40 percent of the world’s population and in the two years that it was active it killed almost 50 million people worldwide.
In 1945 the discovery of a vaccine averted pandemics like the Spanish Flu virus outbreak from once again occurring. Yet the influenza virus continues to kill thousands of people each year. The influenza or flu virus could currently be considered the most dangerous virus in the world. It has the ability to mutate and to spread around the world to create a pandemic form of illness that people currently have no resistance to. There were very real health concerns that the H1N1 Swine flu pandemic of 2009 could equal that of the 1918 Spanish Flu outbreak.
Luckily some seniors showed that they had already developed some resistance to the H1N1 virus courtesy of a similar flu in the 1970s so a vaccine was able to be quickly introduced to further protect large portions of the population.
The question remains: Could the influenza or common flu virus mutate once again to become the most dangerous virus in the world? A nasty case of the flu can knock you off your feet. Fortunately odds are that the majority of us are unlikely to experience a killer virus in our lifetime and plenty of rest and liquids will generally in a week or two get us back to normal functioning power again.
Ebola:The first reported case of Ebola virus appeared in 1976 in the Democratic Republic of the Congo. The virus received its name after the Ebola River Valley where it first appeared. Ebola has had a 53 to 90 percent yearly death rate with an average death rate of 83 percent over the 27 years that it has been documented. Fortunately this illness has been confined to small clusters of the population and has then run its term without expanding globally.
HIV AIDS: The HIV or AIDS virus made its appearance known in 1981. Statistics taken in 2008 showed that more than two and a half million people were infected with the HIV virus that year. Two million people died from it during those early years and an estimated 36 million people worldwide have died from it since. So could HIV/AIDS be the most dangerous virus in the world? With no known cure its numbers are still rising. It is estimated that about 34 million people still live with the AIDS virus.
Smallpox: Smallpox was one of our most deadly viruses. It is estimated that in just the 20th century alone there were over 300 million people killed by this virus. Originating in ancient times it has a history of pandemic outbreaks killing 30% of those that it infected.
Fortunately smallpox is one of just two viruses that has been successfully eradicated around the world courtesy of a stringent vaccine campaign. The virus does still exist in some laboratories and the fear exists that it could be used in biological weaponry in the future. Image: https://upload.wikimedia.org/wikipedia/commons/0/01/Eruption_of_smallpox_on_hand_Wellcome_L0032955.jpg
Rabies: The rabies virus is generally spread through the bite or saliva of an infected animal. Causing inflammation of the brain Rabies are fatal if not treated and once a person displays symptoms of the disease it is almost always lethal. Rabies still kills between 50,000 and 60,000 people worldwide each year.
In the U.S. there are generally only a couple cases reported each year. We are fortunate here in the west to have vaccinations available for our pets this has greatly reduced the risk here of contacting rabies. In the U.S. and Canada rabies is most often spread through bats, skunks, raccoons, foxes, and coyotes. In Africa and Asia it is most often contracted through a dog's bite.
Ziki Virus: The Ziki virus was discovered in Ugandan monkeys in 1947 but it did not make a leap into humans there until 1952. It is believed that mosquitoes were the carrier in this transaction. In 2016 Ziki was diagnosed in the U.S.Ziki is spread by mosquitoes but also through sexual fluids and potentially through infected blood products. This flu generally has mild symptoms but of main concern is the damage to the fetus of pregnant women. Babies born have a distinctive form of brain abnormality including microcephaly (misshapen or smaller head shape).
Avian Flu H5N1: The Avian H5N1 flu virus is still lying in wait. Commonly known as the bird flu virus this influenza strain is able to bypass pigs and leap directly from bird into human. It is also known that there are a number of other bird flu strains currently out there. Could one of these be the influenza virus strain which mutates to kill millions once again?
West Nile Virus: Another newcomer to the virus scene in the United States and Canada is the West Nile Virus which can be easily spread by the common mosquito. Interesting is the fact that West Nile can infect birds. It is believed that crows will be particularly susceptible to this flu and could affect their numbers in future years.
Noro Virus: The Noro virus has also been making news headlines of late. Although not pandemic it is proving very difficult to fight with our current antibiotic drugs.
Is the Next Deadly Pandemic Waiting to Emerge? Whether it arrives through global travel, re-emergence, mutation, or biological weaponry there is a good chance that we will face again a virus of pandemic proportions. The next deadly virus outbreak may already be hiding quietly out there waiting to strike.
Perhaps some other yet-undetected influenza or one of the older known flu viruses will be the one which strikes again in epidemic proportions.These could indeed turn out to be the most dangerous virus currently in the world. Despite vaccinations this years flu has proven especially deadly in our part of the world and health organizations are not sure why.
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[Science] Thalassaemia,Hemophilia,Leukemia & the Basics of Blood
SubscribeScience15 Comments
Neostencil
1. What is bone marrow?
2. Why is bone marrow important?
3. What do red blood cells (RBC) do?
4. Why do red blood cells have red colour?
5. What is anemia?
6. What is Thalassaemia?
7. How does a person get thalassaemia?
8. Treatment Of Thalassaemia
9. What is Sickle cell anaemia?
10. What do white blood cells (WBC) do?
11. What is leukemia (blood cancer)?
12. What is platelet?
13. What is Hemophilia?
• In CSAT 2011, we saw a (but static) question from blood groups.
• Although It is not necessary that UPSC will again ask something from blood-topic again, but a serious player should be well versed in such “Static/Theory” parts of science.
• Static Question: means, it is given in the books/manuals (or indirectly related). Such question doesn’t have current-affairs and can be solved easily if your basic concepts are clear.
What is bone marrow?
it is a soft, pulpy tissue that fills the cavities of bones.
Why is bone marrow important?
Because It produces all of the body’s blood cells—red blood cells (RBC), white blood cells (WBC), and platelets.
What do red blood cells (RBC) do?
They transfer oxygen from the lungs to the cells.
(technically correct):
• It is not red blood cell, but red blood corples (RBC). because cells have nucleus, RBC doesn’t have nucleus so it is not a cell and hence they die after 120 days. (or atleast that’s what the Anatomy professor had told me.). but to keep the matter simple, I shall refer It as RBC/ Red blood cell.
Why do red blood cells have red colour?
• Because they contain haemoglobin.
• Haemoglobin contains iron,
• that’s why red colour.
RBC looks like this
Photo by Dr. Tony Brain/Science Source/Photo Researchers, Inc.
What is anemia?
• When your blood has less hemoglobin (=Hence Less RBC)
• so, less oxygen is transferred from your lungs to your cells.
• That’s why less energy is produced, and you get tired very easily. That is anemia. Majority of girls in India, suffer from Anemia because of malnutrition.
What is Thalassaemia?
• When you bone marrow produces defective type of red blood cells, you have thalassaemia.
• It means your own blood cannot carry oxygen from lungs to the cells so you need to have a healthy person’s blood in your body.
• And since red blood cells have a lifespan of only 120 days, you require regular blood transfusion from a normal person.
• Thalassaemia is a genetic disorder. (=heriditary disease)
• means it is transferred from one generation to another.
• Mind it: thalassaemia is not a contagious disease. (means you cannot get it by infection, like in common cold, swine flu or chickenpox.)
• It is important to learn the mechanism of thalassaemia for CSAT prelims point of view (WFST questions). Because it is an example of “Mendel’s experiment on peas” given in the NCERTs.
• Anyways, I’ll try to simplify by getting not so technically correct.”
How does a person get thalassaemia?
• Suppose a person has recessive (=bad) gene that causes thalassaemia. But he himself doesn’t show the symptoms of thalassaemia, he appears totally normal. So we’ll call this guy a “carrier”.or Thalassaemia Minor. E.g. Amitabh Bacchan and Amisha Patel. About 6% of Indian Juntaa is Thalassaemia Minor.
• Now Another lady is completely healthy and doesn’t have any bad genes. We call her “non-carrier”.
• When Carrier marries with non-carrier, the baby thus produced will be either normal or carrier. (50-50% change) but there is 100% guarantee that the baby will not have thalassaemia disease.
• But, if two Carriers marry, there is 25% chance that their baby will be suffering from thalassaemia. See the photo for chart, to get the idea.
carrier chart.
Image by Microsoft ® Encarta ® 2009. © 1993-2008 Microsoft Corporation.
• For this reason, prospective brides and grooms should not only check the ‘kundli’ (horoscope), but also their blood reports. Just think about future of your baby, the expensive medicines and inconvinient blood transfusion for the rest of his/her life.
Treatment Of Thalassaemia
• as we saw, defective bone marrow produces defective red blood cells and so thalassaemia occurs.
• So to fix thalassaemia permanently, we have to get fresh and healthy bone-marrow from a donor and transplant it in the patient. = Bone marrow transplant.
• Problem: hard to find compatible donors and it is very expensive.
What is Sickle cell anaemia?
• Normal and healthy red blood cells look like a round/oval/coin shaped drug tablet, like in this photo.
sickle cell
• But if a person has defective genes, his bone marrow will produce RBC with sickle shape (that agricultural tool) like in this photo.
• Because of this abnormal shape, such sickle RBC cannot flow freely in the tiny blood vessels = less oxygen supply.
• Sickle cell anaemia, has the same genetic mechanism/Mendel’s law explained in thalassaemia case.
Interval WFST
which of the following statements are true?
• Thalassaemia is a contagious disease.
• if a person with recessive genes for thalassaemia, marries with normal person, there is 50% chance that the baby will have thalassaemia disease.
• Sickle cell anemia is not a hereditary disease.
• In normal Anaemia, healthy diet improves the blood quality but in Thalassaemia/ Sickle Cell Anaemia, diet will not bring improvement in Blood quality
Enough talk about RBC, let’s move to second type of blood cells called white blood cells (WBC)
What do white blood cells (WBC) do?
WBC
• They are the policemen of our body.
• They defend our body by attacking virus, bacteria and other antigens. (=badguys): no FIR, No Chargesheet, No court case, Direct encounter.
• But here is a problem: during organ transplant (kidney, liver, etc), these WBC also consider the forieng Kidney as badguy and attack it. so patient is given variety of immunosuppressant drugs.
• It is the same reason why doctors insist on organs from siblings and relatives. Because then WBC will not be very angry with them!
What is leukemia (blood cancer)?
• WBC / white blood cells are also known as leucocytes.
• When your blood has abnormally high number of WBC, you have leukemia, also known as blood cancer.
What is platelet?
• When your body gets injured, after some time blood stops flowing from the wound.
• Because of this platelets, blood gets clotted.
• So, they are also good guys, otherwise , even in the smallest injury. Your bleeding will not stop and you will die.
• Platelets are also known as thrombocytes.
What is Hemophilia?
It is another hereditary blood disease characterized by the inability of blood to clot.
means if you get wounded, the bleeding will not stop.
Mechanism is similar to Thalassaemia / Mendel’s law of heredity.
Which of the following statements are correct?
1. In Hemophilia bone marrow produces defective type of red blood cells (RBC).
2. In Thalassemia, blood clotting does not occur.
3. Hemophilia doesn’t follow Mendel’s law on heredity.
4. Vitamin E is helps in Blood clotting and is soluble in water
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15 Comments on “[Science] Thalassaemia,Hemophilia,Leukemia & the Basics of Blood”
1. Vitamin E does not help in blood clotting but stops blood from clotting in veins etc. and hence prevents heart attacks its Vitamin K that aids blood clotting
2. What is this WFST ? I have read it so many places ! Thnx sir u r doing commendable job for the Aspirants who cant’s afford expensive coaching!!
3. hiiii mrunal,i have a doubt in mind..i m a kidney transplant recipent..can i appear for ssc cgle 2013 and if i gets selected,will there be problem in my medical..i m completely fit now….but can they reject me on medical grounds…please help..
1. no they wont reject….probability of rejection is for police type jobs
4. never commented on any of your posts may be just because of lethargy…but I must say, You have been a big big support in my preparation infact our preparations (on behalf of all the candidates)..God Bless..
5. Thalassaemia is a contagious disease. False
if a person with recessive genes for thalassaemia, marries with normal person, there is 50% chance that the baby will have thalassaemia disease. False
Sickle cell anemia is not a hereditary disease. False
In normal Anaemia, healthy diet improves the blood quality but in Thalassaemia/ Sickle Cell Anaemia, diet will not bring improvement in Blood quality. True
In Hemophilia bone marrow produces defective type of red blood cells (RBC).False
In Thalassemia, blood clotting does not occur.False
Hemophilia doesn’t follow Mendel’s law on heredity. False
Vitamin E is helps in Blood clotting and is soluble in water. False
1. vitamin k helps in blood clotting which is present in tomatato
2. Tiru, It means the second question has no true answer.
3. Tiru, It means the second question has no ‘true’ option.
6. Thank You sooo Much sir!!! No words are enough to thank you!! God Bless u
7. Hi guys, thanx a lot for your engagement in this topic, I really learnt a lot from u guys, keep on posting, God bless u all
8. Thanks for ur help sir in our preparation…….sir I am confuse about ecology how to prepare it …….nios material is too much …..it is suffient to read your ncert that u have given in ecology section of ncert ……or any book u suggest for that
9. Hi Mrunal,
I think the image by microsoft that you have pasted for thalassaemia is incorrect. As a male can never be a carrier or can have a recessive gene. He either can be normal or diseased. And in such a case, one of the male offspring has to be diseased if the female is just a carrier. Correct me if i am wrong.
10. Mrunal is a very important site fpr purpose coching comptition i will given the editoreal comments time to time and thanks for help
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Can Chiropractic Care Help in Treating Trigeminal Neuralgia?
The trigeminal nerve starts from the brainstem, and enters the upper region of the neck right at the base of the skull. The nerve provides sensation to most of the face and also provides motor functions to the jaw muscles. At times, this nerve can become irritated due to excessive pressure which results in a neurological condition known as trigeminal neuralgia. This is an extremely painful condition and most people diagnosed with it are put on painkillers with little to no effect. Thankfully, you no longer have to suffer from this pain as the best chiropractor in Santa Rosa can help treat trigeminal neuralgia.
How Can Chiropractic Care Help with Trigeminal Neuralgia?
The trigeminal nerve begins from the brainstem and it is quite possible that it gets irritated and inflamed due to vertebral subluxations of the upper neck. These subluxations exert pressure that irritates the nerve and leaves you in constant pain.
Experts at chiropractic centers in Santa Rosa have the experience and knowledge to adjust the vertebrae to ease the pressure on the spinal cord, brainstem, and the trigeminal nerve. As a result, it will reduce the pain and allow you to return to your normal life.
However, it does not stop there. The best chiropractor in Santa Rosa will also check your jaw to see if your jaw is exerting pressure on the branches of the trigeminal nerves. If this is the case, Dr. Toth will also adjust the jaw to alleviate the pressure and ensure you get relief from the excruciating pain.
Different scientific studies have found that the severe pain that clients suffer due to trigeminal neuralgia does not always lessen with painkillers. In such cases, adjusting the vertebral subluxations has provided relief. Researchers also state that by correcting the subluxations, it allows proper and normal functioning of the central nervous system.
The Verdict
It is imperative that you find a chiropractor who has experience in treating trigeminal neuralgia. This will ensure that the chiropractor has the right skills to perform adjustments that will fix the jaw and vertebral subluxations to alleviate the pressure from the trigeminal nerve. This, in turn, will ease the intensity of the pain and provide relief. Remember, it will take time to treat this condition, and hence, you should be patient.
So, if you are still wondering whether a Santa Rosa based chiropractor can help in treating your trigeminal neuralgia, the answer is a resounding yes. If you are looking for a local chiropractor to treat you look no further than Toth Chiropractic. Dr. Toth has years of experience in treating myriad health conditions, and can diagnose and treat trigeminal neuralgia. Call us at (707) 355-6535 to schedule an appointment today.
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Low-Cost Diagnostics: Advancements in Global Health
BY WEN YI LOW
Imagine you are in a rural clinic in a Zimbabwe village. A child walks in with a fever. Such a fever could be a symptom of any one of a number of life-threatening infectious diseases. There is limited health infrastructure available. There is a lack of storage equipment, access to sophisticated laboratory equipment, and trained workers to conduct or analyze any available diagnostic tests. How can you go about diagnosing and treating this child?
Diagnostics are crucial for the proper identification of both diseases and disease-causing agents, yet tools for diagnosing disease can be expensive, insufficient, or ineffective and can even hinder a patient’s ability to be diagnosed if used improperly. Moreover, despite the key role diagnostics play in healthcare, they tend to receive less attention than novel therapeutics or preventive strategies.1 This issue seems to be improving, with the number of publications on point-of-care tests and diagnostics increasing exponentially from around 100 in 2002 to almost 1000 in 2012.2 Although various research groups have started to pay greater attention to the potential of diagnostics, there are still several challenges to bringing these technologies from the lab to the field.2
Despite the fact that research on novel therapeutics and preventive strategies tends to lead to faster commercialization and greater lucrative rewards than research on diagnostics, the importance of improving diagnostics must not be overlooked. Diagnostics are crucial for identifying the presence and origins of disease. They enable the design of appropriate courses of treatment, measure the effects of interventions, and determine drug resistance or recurrence of existing disease. For therapeutics and preventive strategies to work effectively, there must also be accurate and reliable diagnostics available. Currently, the research and development of new diagnostic tests for illnesses that disproportionately affect low- and middle-income countries are highly dependent on donations from private sources, such as the Bill and Melinda Gates Foundation and pharmaceutical companies.4 This limited funding hinders the development of diagnostic tools that are needed to expedite delivery of treatment and increase chances of survival in resource-limited countries. The insufficient investment can also result in a final cost of USD $2 to 10 million and 5 to 10 years for the development of one new diagnostic test.4 All of this is despite the fact that, at times, the development of a new diagnostic test can be over an order of magnitude more cost-effective than the development of a new drug.4 Hence, there is a need for increased education on and awareness of the importance of diagnostic tests in the global fight against disease.
To be able to quickly, easily, and affordably diagnose diseases, it is necessary to understand the challenges currently facing the developing world that inhibit proper and accurate diagnoses. These challenges include the lack of available resources—human, financial, and energy-related, the lack of proper storage and efficient transportation of samples, the unmet need for trained personnel to conduct and analyze test results, which can lead to variability in the analysis, and the lack of access to appropriate tests. It is essential to develop affordable and efficient tools that can be easily used by healthcare workers in these settings.
While these challenges to development are well-defined, solutions are still required that can meet these constraints. The ASSURED test (Affordable, Sensitive, Specific, User-friendly, Robust, Equipment-free, and Delivered), developed by the World Health Organization to describe the ideal characteristics of a diagnostic test for use in a resource-poor setting, provides a useful guide for designing and developing tools. These criteria are useful for development, but are meant to serve as guidelines, rather than requirements, for effective tests. This is due to the natural variability in the ideal conditions needed for each test, which are dependent on the specific disease and location. For instance, the “equipment-free” criterion is perhaps more applicable to a rural, community setting rather than a local hospital setting where it might be possible to support small-scale equipment. In this case, limiting equipment may serve to constrain the diagnosis rather than improve it.5
Low-cost diagnostic tests that meet the ASSURED criteria can help tackle some of the world’s most pressing health problems and advance global health. Much of the development of these tests is influenced by the research of the Whitesides research group, led by Professor George M. Whitesides of Harvard University, which has developed tools and techniques that are both high-quality and low-cost.6 Like most research on the development of diagnostic tools, Whitesides’ global health research is funded by the Bill and Melinda Gates Foundation. What differentiates Whitesides from other groups is their ability to use this funding to rethink the development of diagnostic tools that are simple and easy to use, by employing a creative and practical approach. As the Director-General of the World Health Organization, Margaret Chan, aptly puts it: “Not all innovation needs rocket science…Given the world’s most pressing health problems, the true genius of innovation these days resides in simplicity.”7 The Whitesides’ focus on simplicity allows them to combine excellent engineering and design with an awareness of the limited resources that are available, to develop diagnostic tools that are reliable, predictable, and consistent.
A 3-dimensional paper-based microfluidic device, designed by the Whitesides research group, with well-defined channels that can direct the flow of liquids.
A 3-dimensional paper-based microfluidic device, designed by the Whitesides research group, with well-defined channels that can direct the flow of liquids. Source: Whitesides Research Group.
The Whitesides’ simplicity principle has prompted the group to make use of cheap, readily available items in designing high-performance diagnostic systems. One notable technique they have produced is the application of paper-based diagnostics. The inspiration for the design of these diagnostics came from the printing of comic books. By taking advantage of the same inexpensive, large-scale solid wax printing and paper that most comic book manufacturers employ, as well as resources that are already readily available in many places, the complete production of these paper-based diagnostics only requires the designing, printing, and melting of wax paper. Hence, in just three steps, one can print hydrophobic patterns onto the surface of paper, designing channels to direct the flow of liquids. These papers can then be stacked and connected with tape to create 3D microfluidic devices.8 Although the design may be simple, the significance of these paper-based diagnostics should not be underestimated. Prior to this discovery, the construction of precise microchannels for efficient point-of-care diagnostics relied on the use of silicon, a much more expensive material.9 Now, paper-based diagnostics the size of microchips or postage stamps are being created that are cheap and can take advantage of paper’s natural ability to allow the free movement of liquid. Moreover, the paper-based chip can be easily and safely incinerated for disposal, preventing any unnecessary exposure to disease or infection. The Whitesides group has also developed a colorimetric system for these devices, which allows the results to be interpreted by untrained individuals and further improves the cost and simplicity of use in low- and middle-income countries. This invention can help resolve issues with the sorting and classification of fevers of unknown origin. The device contains multiple spots for testing, each of which tests for a marker of a particular disease. These paper-based diagnostic tests have already been employed in India and Vietnam for only USD $0.05 per test, and Dr. Whitesides’ nonprofit engineering company, Diagnostics For All, is continuing to develop and optimize this technology to further improve its potential for use in the field.8 Outside Whitesides, this technology has inspired other research groups to look into researching paper-based diagnostics for various diseases. Engineers at MIT have now developed a paper test that works like a pregnancy test, detecting the presence of specific cancer-associated proteins and revealing within minutes whether a person has cancer.10
The Whitesides group has developed the use of bubble wrap for the storage of biological samples. Source: Whitesides Research Group.
The Whitesides group has developed the use of bubble wrap for the storage of biological samples. Source: Whitesides Research Group.
The Whitesides group has also worked to develop low-cost storage containers for biological samples. They have pioneered the use of bubble wrap as test tubes to store liquid samples and perform analytical assays. The usage of this packing material as a test tube-like container for medical and environmental samples is highly advantageous in resource-limited areas, because the material is widely available and inexpensive. Additionally, should the bubble wrap break, it will not result in sharp edges that could potentially harm individuals. Bubble wrap can serve as an effective medical storage device because the interior of the bubbles are sterile, allowing the storage of urine, blood samples, or chemicals, without the need for costly autoclaves that require electricity.11 By injecting liquids into these air-filled pockets with syringes and sealing the holes with nail hardener, the bubble wrap can be used to store samples and subsequently, run tests for diseases such as anemia or diabetes. One major obstacle that the Whitesides research group currently faces is that this process for storing samples can be somewhat tedious and requires both syringes and nail hardener, tools that may not be as readily available as bubble wrap. Nevertheless, the Whitesides research group remains optimistic about its material adaptation ideas and believes that it can work to solve this limitation.
Whitesides’ universal Mobile Electrochemical Detector (uMED), a handheld electrochemical detector that can perform chemical analyses and transmit the results to a cloud database from any mobile phone. Source: Whitesides Research Group.
Whitesides’ universal Mobile Electrochemical Detector (uMED), a handheld electrochemical detector that can perform chemical analyses and transmit the results to a cloud database from any mobile phone. Source: Whitesides Research Group.
In addition to its simple, electricity-free devices, the Whitesides research group has also integrated digital technology into some of the diagnostics it has developed. For example, the group has recently developed the universal Mobile Electrochemical Detector (uMED), a handheld electrochemical detector that can perform chemical analyses and transmit the results to a cloud database from any mobile phone, even low-end models. Data that is collected with this device is transmitted off-site to be analyzed in real time, which allows the comparison of results with those stored in a cloud database and the consultation of a medical expert through text message.12 Moreover, a simple cell phone equipped with a camera can be coupled with other diagnostic tools to make the tools even more simple to use. For instance, a cell phone can be used in combination with a paper diagnostic tool, such that when the colorimetrics have developed after testing, one can take a picture of the device with a cell phone and send it to a central laboratory for analysis. The cost of these diagnostics is then lowered significantly because there is no longer a need for an onsite doctor or trained individual to perform the test analyses.
Development of these low-cost diagnostic tools has tremendous potential to revolutionize the current state of healthcare in the developing world. However, several challenges remain in bringing this technology from the lab to the field. One of the major challenges that research groups face is the lack of funding. While the final diagnostic products that are developed are low-cost, the process of development itself is not cheap.7 Additionally, given the nature of these low-cost diagnostic tools, there is little to no financial incentive for private companies to invest in such research, which makes it even more difficult for research groups to secure funding for development. Academic researchers usually excel in researching these new diagnostic methods and technologies, but they often lack the proper resources, motivation, and experience to execute the trials, regulatory clearance, manufacturing, and quality control necessary to fully develop a product. Thus, there are often research groups who, upon discovering a new technology, seek to sell their product to pharmaceutical companies, hoping that these companies can help bring their inventions into the field. However, when they do agree to invest, pharmaceutical companies tend to have a vested interest in the development of diagnostic tools. For instance, Novartis Pharmaceutical Company and Ciba-Gigy Corporation (the predecessor of Novartis) were at one point accused of having “planned, conspired and colluded to create, develop, and promote the diagnosis of Deficit Disorder to increase the market for its product Ritalin (a drug used to treat ADHD).”13 This pharmaceutical company had a stronger interest in making profits than optimizing the diagnostic tool for use. The success of the Whitesides research group in overcoming this challenge can be largely attributed to its willingness to combine academia, industry, and medicine, all while ensuring its work remains nonprofit. The Whitesides group acknowledged the fact that academic groups excel at basic research and innovation, but lack the key skills needed to bring their product to the field. Thus, Whitesides created a business plan competition at the Harvard Business School, which brought together students at the school and scientists from the group.2 The result, the establishment of the nonprofit organization, Diagnostics for All, Inc. (DFA), ensured that high quality engineering and optimization was maintained while effectively addressing the needs of the developing world.
Diagnostic tools play a key role in advancing the progress of global health. As demonstrated by the Whitesides group, innovative diagnostic tools need not be complex. In fact, the Whitesides’ focus on simplicity and the use of readily available materials has the potential to change how we measure patients’ health conditions in resource-stricken areas and can help overcome the various challenges that prevent low- and middle-income countries from carrying out proper and accurate diagnoses. However, research groups still face several challenges in bringing their products from the lab into the field. Major players in global health should be made aware of the benefits and potential far-reaching impacts of funding research on diagnostic tools, which go beyond the systematic financial gains of the development of such devices.
Wen Yi Low is a visiting international student from the National University of Singapore (NUS) currently in Pierson College and majoring in Chemistry. She can be contacted at wenyi.low@yale.edu.
__________
References:
1. Burgess, D. C. H., Wasserman, J., & Dahl, C. A. (2006). Global health diagnostics. Nature, 444, 1-2.
2. Kumar, A. A., Hennek, J. W., Smith, B. S., Kumar, S., Beattie, P., Jain, S., Rolland, J. P., Stossel, T.P., Chunda-Liyoka, C.& Whitesides, G. M. (2015). From the Bench to the Field in Low‐Cost Diagnostics: Two Case Studies. Angewandte Chemie International Edition, 54(20), 5836-5853.
3. Pitta, D. A., Guesalaga, R., & Marshall, P. (2008). The quest for the fortune at the bottom of the pyramid: potential and challenges. Journal of Consumer Marketing, 25(7), 393-401.
4. Mabey, D., Peeling, R. W., Ustianowski, A., & Perkins, M. D. (2004). Tropical infectious diseases: diagnostics for the developing world. Nature Reviews Microbiology, 2(3), 231-240.
5. Kettler, H., White, K., & Hawkes, S. (2004). Mapping the landscape of diagnostics for sexually transmitted infections: key findings and recommendations. World Health Organization.
6. Whitesides Research Group. (2011). Whitesides Research Group: Research Low-Cost Diagnostics and Tools for Global Health. Retrieved from http://gmwgroup.harvard.edu/research/index.php?page=24.
7. Scudellari, M. (2013). A Dime a Dozen. The Scientist. Retrieved from http://www.the-scientist.com/?articles.view/articleNo/33761/title/A-Dime-a-Dozen/.
8. Martinez, A. W., Phillips, S. T., Whitesides, G. M., & Carrilho, E. (2009). Diagnostics for the developing world: microfluidic paper-based analytical devices. Analytical chemistry, 82(1), 3-10.
9. Chin, C. D., Linder, V., & Sia, S. K. (2012). Commercialization of microfluidic point-of-care diagnostic devices. Lab on a Chip, 12(12), 2118-2134.
10. Warren, A. D., Kwong, G. A., Wood, D. K., Lin, K. Y., & Bhatia, S. N. (2014). Point-of-care diagnostics for noncommunicable diseases using synthetic urinary biomarkers and paper microfluidics. Proceedings of the National Academy of Sciences, 111(10), 3671-3676.
11. Bwambok, D. K., Christodouleas, D. C., Morin, S. A., Lange, H., Phillips, S. T., & Whitesides, G. M. (2014). Adaptive use of bubble wrap for storing liquid samples and performing analytical assays. Analytical chemistry, 86(15), 7478-7485.
12. Nemiroski, A., Christodouleas, D. C., Hennek, J. W., Kumar, A. A., Maxwell, E. J., Fernández-Abedul, M. T., & Whitesides, G. M. (2014). Universal mobile electrochemical detector designed for use in resource-limited applications. Proceedings of the National Academy of Sciences, 111(33), 11984-11989.
13. Leavitt, F. (2004). The real drug abusers. Rowman & Littlefield Publishers.
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1a01aa77535b9ecfb87b9fc36adbcd2f
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-1,784,990,187,941,245,700
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Influence of Polyvinylpyrrolidone K30 on The Complexation of Tetrahydrocurcumin with Hydroxypropyl β-Cyclodextrin
##plugins.themes.bootstrap3.article.main##
Srikanya Thongyai Nattha Kaewnopparat and Sarunyoo Songkro
Abstract
Tetrahydrocurcumin (THC) is a polyphenolic compound which exhibits strong antioxidant and tyrosinase inhibition activities. The use of THC in cosmetic or pharmaceutical formulations is limited because THC is slightly soluble in water. Ternary complexes consist of drug-cyclodextrin and polymer as ternary component can enhance drug solubility. The objective of this present study was to evaluate the potential synergistic effect of a ternary component, polyvinylpyrrolidone K30 (PVP K30), on the solubility and physicochemical properties of THC-hydroxypropyl β-cyclodextrin (HPβCD) inclusion complex. Phase solubility analysis was used to investigate the interaction of THC in both binary (THC-HPβCD) and ternary systems (THC-HPβCD-PVP K30). The phase solubility curves were classified as AL-type with indicated a stoichiometry of 1:1 molar ratio between THC and HPβCD. By adding the PVP K30 (ternary system), the stability constant was enhanced. The binary and ternary inclusion complexes in 1:1 molar ratio were prepared by kneading and coevaporation methods. The solubility of THC from both systems was determined and the physicochemical properties were characterized by Fourier transform infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and powder X-ray diffractometry (PXRD) compared with pure THC and their corresponding physical mixtures. The results revealed that the solubility of THC in ternary systems was significantly greater than binary complexes, physical mixtures and pure THC. Ternary inclusion complex prepared by coevaporation method was found to be most effective in increasing the THC solubility. From FTIR, DSC and PXRD studies, the binary and ternary coevaporated samples gave THC in amorphous state and stronger complex formation than that of kneaded samples and physical mixtures.
Keywords: Tetrahydrocurcumin, Hydroxypropyl β-cyclodextrin, polyvinylpyrrolidone K30, Complexation, Solubility
Keywords
Tetrahydrocurcumin, Hydroxypropyl β-cyclodextrin, polyvinylpyrrolidone K30, Complexation, Solubility
Section
Research Articles
##plugins.themes.bootstrap3.article.details##
How to Cite
NATTHA KAEWNOPPARAT AND SARUNYOO SONGKRO, Srikanya Thongyai. Influence of Polyvinylpyrrolidone K30 on The Complexation of Tetrahydrocurcumin with Hydroxypropyl β-Cyclodextrin. Naresuan University Journal: Science and Technology (NUJST), [S.l.], v. 24, n. 2, p. 34-42, may 2016. ISSN 2539-553X. Available at: <http://www.journal.nu.ac.th/NUJST/article/view/1343>. Date accessed: 06 dec. 2019.
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1a01aa77535b9ecfb87b9fc36adbcd2f
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What is glaucoma? How to treat glaucoma?
Glaucoma is a chronic eye disease which is characterized by high intraocular pressure. If the eye pressure is not reduced to normal in time, the optic nerve dies, which leads to irreversible blindness.
There are eye diseases that develop imperceptibly, but ultimately lead to a complete loss of vision. A classic example is glaucoma.
Basically, people over 40 years suffer from glaucoma; however, young people (juvenile glaucoma) and even babies (congenital glaucoma) are not insured from the disease.
What’s happening?
In our eyes, a special fluid is constantly forming. It located on the anterior (between the cornea and the iris) and the posterior (between the iris and the lens) cameras of the eyes. In the corner of the anterior chamber is a complex drainage system through which fluid leaves the eye and enters the bloodstream. The balance between the formation and outflow of fluid determines the intraocular pressure. For most healthy people, intraocular pressure normal ranges are from 16 to 22 mm Hg.
With glaucoma in the sore eye, the circulation is disturbed, fluid accumulates and the intraocular pressure begins to increase. As a result, the eyeball begins to put pressure on the optic nerve, causing its damage.
There are two main forms of glaucoma: open-angle and closed-angle.
When the angle is closed, the fluid inside the eye accumulates because the iris overlaps the angle of the anterior chamber of the eye, that is, there is no access to the natural drainage system of the eye. With an open-angle form, this access is open, but the functions of the drainage system are impaired. There is also a mixed glaucoma and glaucoma with normal intraocular pressure (while blood circulation in the eye nerve is sharply deteriorated).
How does it manifest?
Open-angle glaucoma in most cases occurs and progresses imperceptibly for the patient. Since the field of view narrows gradually (the process can last several years), people sometimes accidentally discover that they see only one eye, and the second is blind. An increase intraocular pressure may cause headache and pain in brow area.
Closed-angle glaucoma accounts for 20–25% of cases of primary glaucoma. This form of glaucoma is often accompanied by pain, discomfort, heaviness and tension in the eye, as well as visual impairment: periodic blurring of vision, the appearance of halos around light sources. The pain is usually localized in the forehead, temporal region, half of the head.
People over 40-year-old should be attentive to the state of their eyes. Especially vigilant should be those whose relatives were ill with glaucoma – the disease is often inherited.
Remember, the only way to keep vision in glaucoma is start the treatment on time!
Glaucoma treatment
Glaucoma is treated with eye drops lowering intraocular pressure, for example Arrow-Brimonidine, Arrow-Dortim. In addition, doctors prescribed medications that improve blood flow and metabolic processes in the eyes. If the drugs do not help, then the patient needs surgery.
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Stood Up Dizzy And Eye Went Blurry
Stood Up Dizzy And Eye Went Blurry
Vertigo is frequently the feeling of the whole globe, moving, rotating, or rocking instantly when a person is standing perfectly still. Some patients likewise utilize the word vertigo to describe various symptoms, ranging from dizziness to nausea and also balance problems. The complying with treatment choices are usually made use of to treat dizziness and vertigo. Stood Up Dizzy And Eye Went Blurry
If your dizziness or vertigo has actually been diagnosed as a result of any kind of underlying medical problem, you need to consult your physician right away prior to beginning any kind of workouts. Even if the symptoms you are experiencing are not because of a clinical problem, you should still see your doctor to ensure that your signs and symptoms are not an outcome of something else. Your doctor will likely advise a number of exercises or other steps to treat your vertigo.
Stood Up Dizzy And Eye Went Blurry
In most cases, lightheadedness and also vertigo are triggered by physical factors. Nevertheless, some individuals are born with a mild difference in their inner ears, which can trigger them to really feel lightheaded. This is most generally called sensorineural hearing loss or even more commonly described as lightheadedness. Other physical elements include poor muscular tissue tone, consisting of the muscles of the tongue as well as the face muscle mass, and/or irregularities of vision. Some signs that are considered milder variations of lightheadedness are: the experience of running out your body, a feeling that gravity is kicking you in the tummy, lightheadedness, vomiting, supplanting the ears, sensations like you are mosting likely to lose consciousness, really feeling detached from your body or world, feeling like you are going nuts, or feelings that nothing makes sense. Stood Up Dizzy And Eye Went Blurry
vertigo is usually treated by one or more of the adhering to therapy alternatives. Relying on your signs and the seriousness of your instance, therapy may vary from basic to facility as well as calls for the focus of a medical professional with experience treating wooziness. Several of these therapy choices are reviewed below.
No treatment is permanent or needed. Wooziness will certainly settle itself. If you remain to have signs and symptoms after two days or if your wooziness lasts for greater than three days, you must see a doctor. The physician will execute a collection of tests to establish the root cause of your signs and symptoms. Some reasons for dizziness may be short-term problems such as sleep apnea or equilibrium problems caused by a recently diagnosed disease. Some diseases such as diabetes, Parkinson’s condition, as well as hyperthyroidism can additionally cause dizziness and need to be reviewed and also dealt with.
Vertigo is frequently connected with vestibular settlement. This is a problem that creates the inner part of the mind to regard head movements as exterior stimuli. It can be treated with medication, workouts, or a combination of therapies. The therapy choices will certainly differ according to the extent of your wooziness. Your physician may recommend that you wear a vestibular support gadget, prevent abrupt movements, or change your workout regimens.
It is usually risk-free to think that vertigo begins when you least anticipate it. When you depend on one foot and also feel dizzy, opportunities are you are already in a raised setting. Therefore, it is very important that you keep your head and upper body directly in all times. For those that are constantly on the move, there are gadgets that you can wear to prevent this condition from happening; they are typically called tilt table disks or magnetic dental braces.
The good news is that most individuals do not experience major lightheadedness symptoms when standing or sitting for 3 times longer than suggested. However, long term sitting can in fact cause serious problems such as carpal tunnel syndrome, weak point of the jaw muscular tissues, and also damage to the inner ear. The most effective point that you can do is to take your time when resting, and stand up when required. This will assist to reduce your danger of having dizziness symptoms.
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Chemotherapy-Induced Peripheral Neuropathy
Chemotherapy-Induced Peripheral Neuropathy
What Are the Symptoms? And How Can I Manage this Common Side Effect of Chemotherapy?
by Robert Knoerl, PhD, RN, and Grace A. Kanzawa-Lee PhD(c), RN, with Ellen M. Lavoie Smith, PhD, APRN, AOCN, FAAN
Chemotherapy treatments for certain types of cancer may cause a common nerve condition called chemotherapy-induced peripheral neuropathy, or CIPN for short.
What are the symptoms of CIPN?
The symptoms of CIPN can feel like your hands or feet are falling asleep (numbness) or are getting poked by pins and needles (tingling). Sometimes, it can feel like burning, shooting, or electric shock-like pain in your hands or feet. CIPN symptoms occur because some kinds of chemotherapy may damage your peripheral nerves, which are the nerves farthest from your brain, such as in your hands and feet. This peripheral nerve damage is thought to cause CIPN.
Who is at risk of developing CIPN?
Notable CIPN affects about 68 percent of cancer survivors receiving neurotoxic chemotherapy drugs, such as paclitaxel, docetaxel, oxaliplatin, cisplatin, carboplatin, vincristine, bortezomib, and thalidomide. This includes people with breast, ovarian, GI, lung, bone, and blood cancers (like lymphoma or leukemia). GI cancer survivors receiving oxaliplatin are also prone to experiencing severe cold sensitivity in their face, throat, and hands. CIPN is less common in individuals receiving carboplatin or other non-neurotoxic chemotherapies.
Chemotherapy-induced peripheral neuropathy affects about 68 percent of cancer survivors receiving neurotoxic chemotherapy drugs.
The risk of developing CIPN increases with each infusion of chemotherapy received. The symptoms of CIPN can begin as early as after the first infusion. Usually, CIPN symptoms are most severe during the first week after a chemotherapy infusion and then begin to decrease. While CIPN symptoms should decrease after you’ve completed all your chemotherapy treatments, some survivors still report CIPN that lasts months or even years after chemotherapy treatment is over. You may be at a greater risk of developing CIPN if you already have neuropathy from other causes, such as diabetes, before starting chemo-therapy treatment. Some lifestyle factors may also increase your risk, such as smoking, consuming a lot of alcohol, not getting enough vitamins in your diet, and a lack of physical activity.
How can CIPN affect me?
After several cycles of chemotherapy, CIPN may become so bad that it affects your usual activities. Although numbness, tingling, and pain are most common, other symptoms of CIPN, such as muscle weakness and cramps, can also occur. CIPN symptoms can make it difficult to write, climb stairs, hold a fork or knife, play sports, or do other activities without tripping or falling.
How is CIPN prevented or treated?
Researchers are continually working to discover new treatments for the prevention or treatment of CIPN to decrease the negative effect of CIPN on cancer survivors’ quality of life. Right now, no effective medicines to prevent CIPN are known. If CIPN starts to get in the way of your usual daily activities, your doctor may decrease the dose of the chemotherapy causing the neuropathy. For long-lasting, painful CIPN, duloxetine (Cymbalta) may help to alleviate your symptoms, especially if your CIPN is caused by paclitaxel or oxaliplatin. However, less is known about whether duloxetine works to improve nonpainful CIPN symptoms, such as numbness or tingling, or CIPN that is caused by other neurotoxic chemotherapies. If duloxetine does not help your CIPN symptoms, your provider may prescribe another medicine such as gabapentin or pregabalin. These medicines have not been shown to significantly improve CIPN but have been helpful in treating other types of nerve pain not caused by chemotherapy.
Research is starting to show that nonmedical treatments might help reduce CIPN. Nonmedical treatments include exercise, cognitive behavioral therapy, electrical nerve stimulation, and acupuncture. More research is needed to determine whether these therapies are truly effective and worth the investment. However, you should talk with your healthcare provider to see if any nonmedical treatments could help your CIPN symptoms.
What precautions should I take if I have CIPN?
No matter how bad your CIPN symptoms become, any change of sensation in your hands or feet may make you more likely to injure yourself. Injuries may occur because you cannot feel the ground beneath your feet, hot or cold temperatures, or sharp objects. Here are some important safety tips to follow if you have CIPN.
To avoid tripping on objects you cannot feel below your feet:
• Use nightlights or other lamps to make sure your house is well lit when you get up to walk at night.
• Use nonslip rugs, and tape down carpet corners in your home.
• Avoid or take extra caution when walking on uneven surfaces.
To avoid burning, freezing, or cutting your hands or feet:
• Wear gloves when handling hot or sharp materials.
• Keep your hands and feet warm when you are working with cold objects or are outside in the cold.
• Wear well-fitting shoes that completely cover your feet.
• Check your hands and feet regularly for injuries. You may not feel when your hands or feet are cut or scraped. If these kinds of injuries are not properly treated, they may lead to infections or other complications.
The most important thing for you to do when you notice CIPN symptoms is to talk to your doctor or nurse. It is important for your doctors or nurses to know about your CIPN symptoms as soon as possible, even if your symptoms are not yet bothersome, so they can monitor you and help you manage your CIPN before the symptoms become too troublesome. CIPN can be a worrying side effect of chemotherapy, but the symptoms can be managed if you address them early and often with your doctor or nurse.
Dr. Robert Knoerl (@robknoerl on Twitteris a post-doctoral fellow in integrative nursing at Dana-Farber Cancer Institute in Boston, MA.
Grace A. Kanzawa-Lee (right) is a PhD student at the University of Michigan in Ann Arbor, MI. They are both interested in studying the use of nonpharmacological interventions to improve quality of life in cancer survivors with CIPN.
Dr. Ellen M. Lavoie Smith is an associate professor at the University of Michigan School of Nursing.
This article was published in Coping® with Cancer magazine, May/June 2019.
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Voice Feminization Surgery
From estrogen.fyi
Surgery is an effective way to increase fundamental frequency that carries recovery time and some risk.
There's 2 main types of phonosurgery that trans women get, a relatively simpler option and a more comprehensive one.
Glottoplasty
Aims to reduce the length of the vibrating part of the vocal cords, effectively creating higher pitch.
https://pubmed.ncbi.nlm.nih.gov/20171832/
https://pubmed.ncbi.nlm.nih.gov/23809571/
https://www.youtube.com/watch?v=z2MS3x-Wyt4
Laryngoplasty
reduces size of larynx and voice box while also increasing pitch.
https://pubmed.ncbi.nlm.nih.gov/34399638/
https://www.youtube.com/watch?v=rI_lgqRSKCw
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Global Medical Data
Saturday, May 18, 2024
What Causes Lower Back Pain in Women?
What Causes Lower Back Pain in Women?
Low back pain strikes equally, but there are causes that specifically affect women, ranging from pregnancy to endometriosis.
If your period brings on either dull or sharp low back pain, you’re not alone.
Although back pain affects both sexes equally, women may be more prone to experience back pain related to hormonal changes throughout life, including menstruation and pregnancy.
There are many structures in and around your lower back-including muscles, soft connective tissue, ligaments, blood vessels, nerves, joints, discs, and bone-that can cause or worsen pain. In women, reproductive organs are also on the list.
Depending on the cause, lower back pain can last weeks or months. It can be dull or sharp and is sometimes accompanied by numbness, weakness, or pain that can radiate to other parts of the body like your buttocks or legs. You may be more likely to experience back pain if you are overweight or obese, smoke, or lead a sedentary lifestyle.
Both sexes can experience lower back pain brought on by overexertion, a fall (even a minor one), excess weight, improper lifting, or psychological stress, among other possibilities.
“Most causes of lower back do not discriminate; however, women may have more lower back pain related to hormonal imbalance, menstruation, or around menopause,” says Yili Huang, DO, a licensed and board-certified pain management anesthesiologist and director of the Pain Management Center, Northwell Health’s Phelps Hospital, in Sleepy Hollow, New York.
We spoke with pain experts to further understand the specific causes of lower back pain in women, as well as symptoms, treatments, and when you should see a doctor.
Pregnancy
“During pregnancy, there is a shift in the weight one carries and the location of where that weight is carried,” says Rahul Shah, MD, a spine and neck surgeon with offices across New Jersey.
The muscles and ligaments have to adapt to that new location of weight depending on how the baby sits,” Dr. Shah says. “When the body is adjusting to where the weight is, some women may experience additional pain.”
Hormonal and mechanical changes during pregnancy and labour can also lead to sacroiliac joint dysfunction, says Dr. Huang. The sacroiliac joint connects the pelvis to the lower spine. “This is one common cause of lower back pain for women who have been pregnant,” he explains.
Symptoms
Backaches are one of the most common pregnancy complaints, especially in the later months of pregnancy. This pain may radiate down the back of the leg-what’s called sciatica. Sciatica is pain from the sciatic nerve which runs down the lower back, buttocks, and back of the leg, even into the feet.
Diagnosis and treatment
If you are pregnant and experiencing back pain, it is likely due to the extra weight you are carrying. Treatment for pregnancy-related back pain includes wearing supportive clothing and using heat or cold to soothe your aches. Ask your ob-gyn what else can safely help reduce back pain during pregnancy.
Menopause
During menopause, there is a dramatic drop in the female sex hormone estrogen, and this affects everything from your hair and skin to your mood, bones, and heart.
“Postmenopausal hormonal changes predispose women to weakened bones, [a condition] called osteoporosis, and this can lead to more fractures of the spine, which can cause severe back pain,” says Dr. Huang.
Symptoms
If you are in menopause, which starts one full year after your last menstrual cycle, your risk for developing the brittle bone disease osteoporosis increases due to the lack of estrogen. Brittle bones are more likely to crack, and osteoporosis-related spinal fractures affect nearly 700,000 people each year, according to the American Academy of Orthopedic Surgeons.
“A byproduct of such changes includes loss of bone density,” says Dr. Shah. “This can serve to weaken bones, especially the spinal vertebrae (or back bones). This can lead to an increased risk of spinal fractures. These fractures can be quite painful when they occur.”
Diagnosis and treatment
Your doctor can identify fractures with X-rays or other imaging tests. Bone density testing can diagnosis any issues and help determine whether you need to take medication to help keep your bones strong. Pain medication, bracing, and physical therapy can help reduce fracture-related pain.
Sometimes a minimally invasive procedure known as kyphoplasty—where your doctor makes space in your vertebrae with a balloon-like device and fills the space with special bone cement to restore height and reduce pain—can help. Surgery is usually the last resort for spinal fractures.
PMS
Premenstrual syndrome (PMS) refers to a combination of symptoms that may occur in a week or two before your period.
Many women develop lower back pain before their monthly period, says Nikhil Jain, MD, a fellow in the department of neurosurgery at the University of Louisville in Kentucky. Exactly why this occurs is not fully understood, but it is likely related to hormonal changes leading to menstruation.
Symptoms
In addition to lower back pain, PMS also can cause bloating, headaches, and moodiness.
Treatment and diagnosis
Because these symptoms are directly tied to menstruation, they likely occur at the same time each month, making it relatively easy for your doctor to pinpoint the cause. Keeping a PMS symptom diary for a few months also can help connect the dots. If your PMS is severe, medications are available to help lessen your symptoms.
Regular exercise and getting good-quality sleep can help relieve PMS symptoms. Avoiding foods and drinks with caffeine, salt, and sugar in the two weeks leading up to your period has also been shown to ease some symptoms.
PMDD
Premenstrual dysmorphic disorder (PMDD) is more severe than PMS and has more intense and debilitating symptoms.
As with PMS, researchers are not 100 percent sure what causes PMDD, but the theory is that your brain has an abnormal reaction to the hormone changes, which leads to some of the symptoms.
Symptoms
PMDD can cause low back pain as well as severe irritability, depression, or anxiety in the week or two before your period.
Diagnosis and treatment
Keeping a symptom diary can help determine whether you have PMDD. The good news is that there are treatments available, including antidepressants, that are specifically approved to treat PMDD. Certain birth control pills also can help. In addition, over-the-counter pain medications may relieve some of the physical symptoms such as back pain.
Your doctor may also suggest relaxation techniques that lower your stress levels, such as mindfulness or meditation.
Endometriosis
Endometriosis occurs when tissue that is similar to the uterine lining grows outside of your uterus. “This causes bleeding, swelling, and inflammation in the pelvic cavity during the menstrual cycle,” says Dr. Jain.
Symptoms
Endometriosis can cause pain in many areas, including your lower back. You may also have painful cramping during your period, pain during or after sex, and sometimes pain during urination.
Diagnosis and treatment
Your gynecologist can diagnose this condition by asking you questions about your menstrual cycle and premenstrual symptoms and conducting a pelvic exam to feel for endometrial patches. Sometimes imaging tests are needed to get a better picture of what is going on.
If you are not trying to get pregnant, hormonal birth control can help ease the pain of endometriosis. Over-the-counter medicines for pain, such as ibuprofen, may also help.
In some cases, laparoscopic surgery is needed to remove the abnormal patches and scar tissue, which may help ease pain and other symptoms, at least temporarily.
Dysmenorrhea
Dysmenorrhea is the medical name for painful periods.
Most women will have some discomfort during their period, but for others, the pain can be more intense and affect their lower back.
Dysmenorrhea occurs when your uterus contracts to help the uterine lining leave your body. It may also be related to other health problems such as endometriosis. That’s a condition when tissue similar to the type found in the uterine lining grows other places in the body.
Women with uterine fibroids-non-cancerous growths in the wall of the uterus-may be more likely to have low back pain and cramping during mensuration, Dr. Jain says.
Symptoms
You may experience cramps in your lower abdomen, low back pain, nausea, vomiting, diarrhea, fatigue, weakness, fainting, or headaches if you have dysmenorrhea.
Diagnosis and treatment
Keep a symptom diary so you are aware of when symptoms occur in your menstrual cycle. Oral contraceptives can help lighten your flow, which should improve symptoms of heavy periods. For many women, non-steroidal anti-inflammatory drugs (NSAIDs) along with heating pads can take the edge off of period pain.
Heart health
There are times when back pain may be a sign of heart attack in women. Your risk of heart attack is increased if you have high blood pressure, diabetes, high cholesterol, or are obese.
Symptoms
Other signs of heart attack in women may include fatigue, chest pain or pressure, nausea, or light-headedness.
Diagnosis and treatment
Know the signs of heart attack and seek help immediately should they occur. Get to the nearest emergency room or call 911 so you can be evaluated and treated, if necessary.
Other types of lower back pain
Lower back pain from muscle spasms, slipped discs, infection, osteoarthritis (the wear and tear from the disease), or spinal stenosis (a narrowing of your spine that puts pressure on your nerves and spinal cord) doesn’t discriminate. In these cases, the diagnosis and treatment don’t differ much by sex, says Dr. Shah.
“By and large, when someone comes to my office, we just know if their back hurts and if there is pain that is going to other areas like the buttocks or leg,” he says. “With such complaints, we begin with a physical examination and then order a variety of additional imaging tests.”
Here are a few other common causes among both sexes:
Muscle spasms
These are painful twinges in your lower back.
Muscle spasms in your back can occur as a result of exercise, dehydration, stress, repeated heavy lifting, or even a sudden awkward twist or turn, explains Jake Magel, PhD, physical therapist and research assistant professor, University of Utah, Salt Lake City.
Symptoms
Spasms come on fast and furious and may even twitch. Muscle spasms tend to come and go.
Diagnosis and treatment
Your doctor will ask you questions about your pain and when it tends to occur, and may order imaging tests as well. In general, staying active, taking NSAIDs such as ibuprofen or naproxen, and participating in physical therapy can usually help muscle spasms. Heating pads can help relax muscle spasms.
Slipped discs
Your lower back comprises five vertebrae (L1-L5) that support your upper body, and shock-absorbing discs are found between each vertebra that can slip, tear, shift, or degenerate.
Poor posture, heavy lifting, twisting, bending, an injury, a fall, or advancing age can all cause your discs to slip or change, says Dr. Jain.
Symptoms
A problematic disc can cause back pain as well as sciatica if it presses on your nerves.
Diagnosis and treatment
Your doctor will likely send you for imaging tests of your lower back to see if your discs have slipped or herniated and are responsible for your back pain, Dr. Jain says. Treatment usually involves pain medications and/or physical therapy. Sometimes more serious treatment is needed, including steroid injections or surgery, Dr. Jain says.
Osteoarthritis
The wear and tear form of arthritis, osteoarthritis (OA), can strike any joint in your body. The risk of developing OA increases as you age. Extra weight and pressure on your joints can also lead to OA.
Symptoms
OA is marked by pain in the joints, especially during activity. The pain occurs when the smooth cushion between your bones (cartilage) breaks down.
Diagnosis and treatment
Your doctor will ask you questions about your back pain, perform a physical exam, and order some imaging tests to see what is going on. Physical therapy and pain medications are first-line treatments for arthritis, but sometimes steroid injections or possibly joint replacement surgery may be warranted, Jain says.
Spinal stenosis
This condition occurs when the space around your spinal cord narrows and puts pressure on the cord and your spinal nerves.
Advancing age is the main risk for spinal stenosis. It is most common in people older than 60.
Symptoms
Spinal stenosis doesn’t always cause pain or other symptoms, but it can. This condition may cause numbness and irritate your nerves, causing hip pain in addition to back pain.
Diagnosis and treatment
Your doctor will feel your back and may ask you to bend forward, backward, or side to side. Imaging tests are also needed to diagnose spinal stenosis. Treatment typically includes physical therapy and NSAIDs, followed by steroid injections if NSAIDs don’t do the trick. Surgery is a last resort.
Infection
There are several types of infection that can lead to back pain, but the most common is vertebral osteomyelitis, or an infection in a bone that causes inflammation.
You may develop an infection in your back from trauma to your spine or it may migrate from another area in your body to your back.
Symptoms
In addition to pain, an infection may also cause fever, and there will be redness and tenderness in the infected area.
Diagnosis and treatment
Your doctor may run blood tests or conduct imaging tests to help diagnose a spinal infection. Treatment involves antibiotics, which are administered at the hospital. There are times when surgery is needed to treat an infection in your back.
Lifestyle interventions for low back pain
Maintaining a healthy weight, not smoking, or quitting if you do smoke, can help reduce your chances of developing back pain. Getting regular exercise also can keep muscles-including those that support your back-strong throughout your life, says Magel.
Often over-the-counter pain relievers such as aspirin, acetaminophen, or NSAIDs can help reduce back pain and any swelling in the area. Heating pads and ice packs can also help relieve some types of lower back pain. Certain stretches for lower back pain can help prevent or relieve it too. These foam-rolling exercises may help alleviate pain and soreness.
Finding the most comfortable sleep position for back pain can also make a difference, especially because sleep loss makes back pain worse.
Another component is lumbar or low back support. The American Academy of Family Physicians suggests sitting in chairs with straight backs or low back support, and keeping your knees a little higher than your hips. Consider placing a small pillow or rolled-up towel behind your lower back if driving or sitting for a long time.
The last word
For the most part, low back pain is an equal opportunity offender. However, hormonal changes associated with pregnancy, menopause, and even menstruation can cause low back pain in women. Discuss your symptoms with your doctor to find out the best ways to relieve your low back pain. If you are in or approaching menopause, get your bone density tested and try to keep your bones strong and stave off painful spinal fractures.
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Heart diseases are the most common cause of maternal death during pregnancy in Western countries. The current ESC guidelines 2018 for the management of cardiovascular diseases during pregnancy is a guide for any physician facing the challenge of caring for pregnant women with cardiovascular diseases. Among the new concepts compared to 2011, are recommendations to classify maternal risk due to the modified World Health Organization (mWHO) classification, introduction of the pregnancy heart team, guidance on assisted reproductive therapy, specific recommendations on anticoagulation for low-dose and high-dose requirements of vitamin K antagonists and the potential use of bromocriptine in peripartum cardiomyopathy. The Food and Drug Administration (FDA) categories A–D and X should no longer be used. Therefore, the table of drugs was completed with detailed information from animal and human studies on maternal and fetal risks. The new findings on specific heart diseases are presented in detail in the respective chapters.
, , , ,
doi.org/10.1007/s00059-018-4765-4, hdl.handle.net/1765/112548
Herz: kardiovaskulaere Erkraenkungen
Seeland, U, Bauersachs, J, Roos-Hesselink, J.W, & Regitz-Zagrosek, V. (2018). Update 2018 der ESC-Leitlinie zu kardiovaskulären Erkrankungen in der Schwangerschaft: Die wichtigsten Fakten. Herz: kardiovaskulaere Erkraenkungen, 43(8), 710–718. doi:10.1007/s00059-018-4765-4
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Low-frequency vibration treatment of bone marrow stromal cells induces bone repair in vivo
Document Type : Original Article
Authors
Department of Orthopedics, Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province, 116031, P.R. China
Abstract
Objective(s):To study the effect of low-frequency vibration on bone marrow stromal cell differentiation and potential bone repair in vivo.
Materials and Methods:Forty New Zealand rabbits were randomly divided into five groups with eight rabbits in each group. For each group, bone defects were generated in the left humerus of four rabbits, and in the right humerus of the other four rabbits. To test differentiation, bones were isolated and demineralized, supplemented with bone marrow stromal cells, and implanted into humerus bone defects. Varying frequencies of vibration (0, 12.5, 25, 50, and 100 Hz) were applied to each group for 30 min each day for four weeks. When the bone defects integrated, they were then removed for histological examination. mRNA transcript levels of runt-related transcription factor 2, osteoprotegerin, receptor activator of nuclear factor k-B ligan, and pre-collagen type 1 a were measured.
Results:Humeri implanted with bone marrow stromal cells displayed elevated callus levels and wider, more prevalent, and denser trabeculae following treatment at 25 and 50 Hz. The mRNA levels of runt-related transcription factor 2, osteoprotegerin, receptor activator of nuclear factor k-B ligand, and pre-collagen type 1 a were also markedly higher following 25 and 50 Hz treatment.
Conclusion:Low frequency (25–50 Hz) vibration in vivo can promote bone marrow stromal cell differentiation and repair bone injury.
Keywords
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Foods With Folic Acid That May Help Your Anxiety
Folic acid, also known as vitamin B9, is a water-soluble vitamin that is necessary for healthy growth and development. There is significant evidence that folic acid helps to reduce the rate of certain birth defects, like spina bifida, so folic acid supplementation is recommended for pregnant women.
There is less evidence that folic acid can improve anxiety symptoms - the relationship between the vitamin and anxiety disorders has not been well-studied to date. However, there is scientific research supporting the relationship between folic acid and other B vitamins and mood disorders.
The U.S. Food and Drug Administration has required that folic acid be added to enriched grain products (such as bread, cereals, flours, corn meals, pasta, rice) since 1996. Because these types of products feature heavily in many Americans’ diets, they have become one of the top dietary sources of folic acid for many people living in the United States.
Folic acid also occurs naturally in a number of foods, including dark green leafy vegetables, dried and fresh beans, and peas, and citrus fruits and juices. According to the FDA, a serving of the following foods will supply 6% or more of your daily value of folate: fortified cereals, enriched rice, enriched noodles, beef liver, blackeyed peas, spinach, Great Northern beans, asparagus, baked beans, green peas, broccoli, avocado, peanuts, romaine lettuce, wheat germ, tomato juice, orange juice, turnip greens, oranges, bread, eggs, cantaloupe, papaya, and banana.
Photo: Pixabay
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Couldn't find what you looking for?
TRY OUR SEARCH!
Table of Contents
Sedentary jobs can give you "sitting disease", a condition with far-reaching consequences ranging from diabetes and obesity to heart disease and osteoporosis. What can you do to combat this modern illness if you literally sit on your butt for a living?
Desk jobs and other sedentary professions now make up the majority of jobs in developed nations. Sedentary jobs were already on the rise back in 1960, when around half of the workforce had physically active jobs, and have risen 83 percent since 1950 in the US. Shockingly, approximately 86 percent of all US jobs now involve sitting down most of the working day!
Add the daily commute, time spent behind screens at home, and other sedentary activities to the day, and you get a rather frightening picture. Your average Joe or Joanne spends more than half of their waking day sitting on their butts, a meta-analysis of 47 studies published in the Annals of Internal Medicine in 2015 reveals.
What is all that sitting doing to our health? When you hear that the average American eats 500 more calories a day than they would have 30 years ago, you begin to understand — more sitting and more eating equals a bigger obesity problem. Your risk of overweight isn't the only thing you have to worry about if you are working a desk job, however. Unfortunately, research reveals that extended periods of sitting are bad for you even if you get in plenty of exercise when you aren't in that chair.
Homo Modernicus is gradually turning into those people on the spaceship in Wall-E, it seems. What exactly happens when you live a sedentary lifestyle, and is there anything you can do to combat the effects of "sitting disease"?
'Sitting Disease': How Your Sedentary Job Is Making You Ill
"Sitting disease", as it has been dubbed, has far-reaching consequences. Your overall risk of facing any of the health problems associated with sitting for extended periods of time will depend on numerous factors, including how long you sit, whether you exercise and if so how much, and on your diet. However, even "just" spending four hours a day in front of a TV or other screen (a pretty routine occurrence in today's world) has detrimental effects.
If you do a full-time sedentary job, research reveals, you may have to face the fact that you could be at risk for:
• Cardiovascular disease, including angina and suffering a heart attack
• Becoming overweight and obese
• Type 2 diabetes
• Cancer
• Dementia
• Osteoporosis and hip fractures
• Back pain
• Fatigue
Your all-cause mortality also goes up, by as much as 125 percent in those who spend a total of four hours or more in front of screens — and if you're doing a full-time desk job, you're almost guaranteed to be doing that for a much longer period of time.
Scary, isn't it?
Unfortunately, changing your job might not be an option, and then again, it's quite possible you actually do love your job. The question becomes what we can do to escape the risk of a sedentary lifestyle. The next page, I promise, will offer you a whole lot more optimism!
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How Nutritional and Alternative Treatments Can Help You Avoid Using Drugs for Depression
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Story at-a-glance -
• Side effects of antidepressants run the gamut from sexual side effects to lack of emotions or “emotional flatness,” restlessness, sleep disturbances, brain damage, and even to suicide and homicide
• Root causes of depression, which can be successfully addressed through nutrition and other non-drug alternatives, include infections and inflammation, toxicity, and a variety of nutrient deficiencies
• Many medical issues may first show up as depression. These include anemia, thyroid dysfunction, adrenal issues, hormonal imbalances, and sensitivities to foods like gluten or dairy.
By Dr. Mercola
Depression is a very serious health problem and can be terminal, as up to 30,000 people who are depressed commit suicide every year. But are antidepressants the best approach?
Contrary to popular belief, there are safer—and oftentimes far more effective—alternatives to the drug route, as explained here by Dr. Hyla Cass, a practicing psychiatrist who uses integrative medicine.
Dr. Cass appears regularly on TV and radio shows, and is an associate editor of Total Health Magazine. She also serves on the boards of California Citizens for Health and the American College for Advancement in Medicine (ACAM), of which I was a member for some time.
Her father was a doctor, practicing out of their home in Toronto, so Dr. Cass was exposed to medicine first hand from a very early age. Her father’s old-fashioned medical values of personal care and attention was the model of healing after which she eventually modeled her own career.
“Doctors really relied on their own judgment then. It wasn’t just a pill for every ill,” she notes. “In my own practice, I began to notice that what people ate and how they lived actually influenced their health.
People who were eating junk were not doing very well. People who were eating healthier, more natural foods, actually were feeling better, doing better, were healthier (have less colds, flus and all the rest), and even, were nicer people to be around!”
Why Focus on Natural Interventions for Depression?
Early on, Dr. Cass began searching for other doctors of like mind, and discovered a mentor in Dr. Abram Hoffer, the co-founder of “orthomolecular medicine.” This refers to the concept of nutritional deficiencies being a source of mental illness, and the right nutrients or molecules can correct the problem.
“While I was in my residency at Cedars-Sinai Medical Center, I began to notice that medications had side effects... It would be okay if the side effects were worth it, but most of the time they weren’t...”
Side effects of antidepressants run the gamut from sexual side effects to lack of emotions or “emotional flatness,” restlessness, sleep disturbances, brain damage, and thoughts (and actions, tragically) of suicide, and even homicide. Virtually all of the school and mass shooters, for example, have been on antidepressants.
“You could say, “Well, of course, they were on antidepressants. They were disturbed and that’s why they did the shooting.” But a comparable number of people who were not on antidepressants and having similar problems did not become school shooters,” Dr. Cass notes.
“The difference was, first of all, they were genetically predisposed to have that reaction to the medications -- but nobody’s looking at genetics when they prescribe medication.
These shooters were either just newly on medication, or had just had some sort of change in their medications or dosage; ie regardless of details, there was something going on with their medications before the event. And that’s a terrible tragedy. A lot of this information has been suppressed, too.”
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Nutrition Is Essential for Proper Brain Function
Long before holistic health became a catch phrase, Dr. Cass began pursuing the use of nutritional supplements rather than medication, and lo and behold, her patients improved.
A huge drawback of the conventional mental health care system is that few doctors have the time, or take the time, to sort out the root of the problem with each patient. It’s a lot easier to simply write a drug prescription. Dr. Cass, on the other hand, takes the time to focus on finding, and then treating, the root cause.
“It’s so scary when you think of what these medications do. They’re not to be handed out the way they are. That really is disturbing to me. People think, “My doctor knows what he or she is doing.” Well, that’s not always true. I think it’s up to people to educate themselves,” she says.
“At Cedars-Sinai I was trained in a more psychoanalytic way. That’s actually good. It’s a Freudian model. I don’t practice that way now, but it was a good basis; understanding that there’s an unconscious and that we have scripts in us that are outside of our regular awareness.
And when we make them conscious, we actually are liberated . We can go on and live more fulfilling lives. I began looking first of all, at their psyche, but also at their lifestyle – what they were eating and drinking,and their attitudes. So many things go into being healthy.”
The Placebo Effect in Action
People can get quite defensive when you mention that antidepressants may be doing more harm than good, and that there are better alternatives. Many insist their whole life changed for the better once they started taking an antidepressant, and they cannot conceive living without it.
According to Dr. Cass, this can often be the placebo effect in action. You are in essence healed by your belief. If you think the drug will work, it likely will. But the same power of belief could be applied to virtually any other treatment modality, including a sugar pill.
One 2010 study1 concluded that there is very little evidence to suggest antidepressants benefit people with mild to moderate depression, as these drugs work no better than a placebo in at least 80 percent of cases.
An earlier meta-analysis2 published in PLoS Medicine also concluded that the difference between antidepressants and placebo pills is very small. Other research3 into the placebo effect noted that “the placebo effect is an unacknowledged partner for powerful medications.”
"Here we are with these miracle bodies. What we have to do is feed them right and treat them right, and we'll get the most wonderful results," Dr. Cass says.
“On the other hand, if we overuse or misuse medication, which is often the case, you’re just going to cause these side effects, some of them very dangerous, and won’t ever deal with the root cause.
We need to look at psychodynamics. But we also must take a look at nutritional status. Is there an infection? Is there toxicity? Is there a Vitamin B12 deficiency? Is there an iron deficiency anemia? There are so many medical issues that actually appear as depression.
When a doctor just hands you a prescription for an SSRI, they are not doing you a favor unless they’ve first given you a thorough medical workup, looking hormonal imbalance including thyroid or adrenal, or gluten sensitivity, to name a few of the possible causes.”
Gluten Sensitivity—A Common But Hidden Cause of Depression
You may not have realized this, but the gluten level in our grains is much higher today than it ever was before, thanks to various breeding techniques, and gluten can produce depression if you're sensitive to it. In such a case, the key is to remove gluten from your diet entirely. You cannot simply cut down. It must be removed completely. In Dr. Cass' practice, she's seen many people recover from severe depression when going gluten-free.
“They start to feel better, their mood improves. The depression, it turned out was really due to gluten sensitivity. And you may ask, “How can gluten affect your brain like that? What is going on?” It has to do with inflammation,” she explains. “When gluten is inflaming your gut, it’s also inflaming your brain. Whatever’s going on in your gut is also going on in your brain. They’re very connected.
The gut is the second brain. In fact, there are more serotonin receptors in the gut than anywhere else in the whole body. What I’m saying is, to summarize, it can be gluten sensitivity, thyroid imbalance, anemia, some kind of infection, Lyme disease, or chronic fatigue syndrome. Many medical issues will show up as depression. Depression is a symptom. Depression is not a condition. It’s not an illness; it’s simply a symptom...
We have this three-pound sophisticated organ, the brain,, the control center of our whole body, and it does not get evaluated. No one looks at it. You have a symptom of depression, anxiety, or insomnia, and you get a prescription. That’s crazy. That is not good medicine. I’m saying I’m not even practicing alternative medicine; I’m practicing good medicine.”
An important issue to address is junk food, which also promotes gut inflammation. So one of the first steps in addressing problems like anxiety and depression is to clean up your diet and address your gut health. Otherwise, you’ll have virtually no chance of getting healthy emotionally and mentally. As noted by Dr. Cass, there are times when temporary use of an antidepressant may be warranted, but such occasions are really quite rare.
"I think that if we use the right doses of specific herbs and supplements, and get exactly the right diagnosis, the right biological, biochemical diagnosis, we probably won't need to use the meds," she says.
High Dose Niacin for Psychosis
Before he attended medical school, the mentor I mentioned, Dr. Abram Hoffer, received a PhD in biochemistry specializing in vitamin B research. So when he became director of the largest psychiatric hospital in Saskatchewan, he used his knowledge to research the administration of high doses of niacin (vitamin B3) to schizophrenic patients.
Amazingly, he was able to get many of these very ill mental patients well enough to be released, get married and go on to lead normal lives. It turns out that pellagra, a disorder caused by niacin deficiency, produces the same psychiatric symptoms such as irrational anger, feelings of persecution, mania, and dementia that were found in many of these “ hopelessly incurable” patients. The cure was giving them the deficient B vitamin. Sadly, despite “performing miracles” on these hard-to-treat patients, Dr. Hoffer’s ground-breaking research was discredited by the American Psychiatric Association (APA), which was sadly more interested in promoting drugs.
“As long as the patients continued to take their niacin, as well as vitamin C, they were OK. On the other hand, nowadays if psychotic patients stop their medication, they may or may not relapse. This brings up another issue; we’re seeing more relapses than we used to in psychosis and depression. It may be due to the meds. Before people were on meds to the extent that they are, they would have a depressive episode, [then] recover and not necessarily have another one...But we’re now having far more chronically relapsing depression and psychosis than before the introduction of medication.
Moreover, we’re having more bipolar illness than we ever had. Something is going on. The medications are actually changing the brain. This is what is so scary. We have people who start off being depressed, being put on antidepressants for their depression, end up becoming bipolar, and then they’re placed on a whole cocktail of medications. And they’re kept on that cocktail indefinitely, which frequently ends their ability to function normally.”
How to Revert from Antidepressants to More Natural Treatments
If you’re currently on an antidepressant and want to get off it, ideally you’ll want to have the cooperation of your prescribing physician. Some doctors are happy to help you to withdraw if they know that you’re going to be responsible about it. Others may not want to bother, or they don’t believe that you can get off the medication. As noted by Dr. Cass, you may need to do some reading in order to be better prepared. Dr. Joseph Glennmullen from Harvard wrote a very helpful book on how to withdraw called The Antidepressant Solution.
You can also turn to an organization with a referral list of doctors who practice more biologically or naturally, such as the American College for Advancement in Medicine www.ACAM.org. Also, it doesn’t make much sense to withdraw unless you’re implementing some other strategy to address the cause of your depression. In summary, Dr. Cass suggests keeping the following guidelines in mind:
Under your prescribing physician's supervision, start lowering the dosage of the antidepressant you're taking. There are protocols for gradually reducing the dose of the medication that your doctor should be well aware of.
At the same time, start taking a multivitamin. Start taking low doses. If you're quitting an SSRI under doctor supervision, you can go on a low dose of 5-Hydroxytryptophan (5-HTP).
For bipolar patients, Dr. Cass and other holistic psychiatrists may prescribe nutritional supplements such as fish oil (omega-3 fats), inositol, tryptophan, and others, depending on the individual's need.
Bipolar symptoms can also be related to Lyme disease, so if Lyme infection is present, that needs to be addressed, also by a more functionally oriented doctor.
Chronic inflammation in general appears to be a significant underlying factor causing symptoms of depression, so keeping inflammation in check is an important part of any effective treatment plan. If you're gluten sensitive, you will need to remove all gluten from your diet. A food sensitivity test can help ascertain this.
Vitamin D deficiency is another important biological factor that can play a significant role in mental health. A double-blind randomized trial4 published in 2008 concluded that ideally, it's best to maintain your vitamin D level between 50-70 ng/ml year-round.
Unbalanced gut flora have also been identified as a significant contributing factor to depression, so be sure to optimize your gut health, either by regularly eating traditionally fermented foods, or taking a high quality probiotic.
Make sure you’re getting enough high quality sleep, as sleep is essential for optimal mood and mental health. A fitness tracker that tracks your sleep can be a useful tool.
The inability to fall asleep and stay asleep can be due to elevated cortisol levels, so if you have trouble sleeping, you may want to get your saliva cortisol level tested with an Adrenal Stress Index test. If you’re already taking hormones, you can try applying a small dab of progesterone cream on your neck or face when you awaken during the night and can’t call back to sleep. Another alternative is to take adaptogens, herbal products that help lower cortisol and adjust your body to stress. There are also other excellent herbs and amino acids that help you to fall asleep and stay asleep.
Meditation can also help. A new piece of technology that can be quite useful is a headband sensor called Muse.6 It gives you real-time feedback on your brain wave frequencies, which can help train you to enter into deeper states of relaxation and meditation. I've been using it for 15 minutes twice a day for about six months, and I've noticed some really impressive improvements. Slowing your breathing through meditation and/or using the Buteyko breathing technique also increases your partial pressure of carbon dioxide (CO2), which has enormous psychological benefits.
Other helpful tools to ease symptoms of depression and anxiety include Eye Movement Desensitization and Reprocessing (EMDR), and Emotional Freedom Techniques (EFT). EFT is well-studied, and recent research found it significantly increased positive emotions, such as hope and enjoyment, and decreased negative emotional states like anger and shame. Another recent review found statistically significant benefits in using EFT for anxiety, depression, PTSD, and phobias.
Many 'Depressed' Women Are Actually in Perimenopause
Amazingly, 23 percent of women over the age of 40 are on antidepressants. According to Dr. Cass, this is likely due to misdiagnosis of perimenopause or other hormonal imbalances. Women are entering perimenopause at younger ages these days; some even before the age of 40, and this phase can last for years.
“Women who have never had PMS or mild PMS are suddenly having bad PMS. They are feeling depressed and irritable. They’re yelling at their kids and their partners. They’re having a very hard time. They may be fatigued and feeling like they’re falling apart. What do they do? They go to their doctor, and guess what they get? They get a prescription for an antidepressant. Guess what they shouldn’t get? An antidepressant.
They need to get their hormones balanced. Start with all the usual things: good diet, make sure your liver is able to detoxify properly so you may need some liver supportive herbs like milk thistle or bupleurum. There are also well-researched herbs for menopausal and PMS symptoms like dong quai, black cohosh and vitex.
You can also move into bioidentical hormones. [They are] very safe, particularly progesterone. Very safe. When these women get the hormones that they need, they stop feeling anxious and irritable, and start to feel good again. Their PMS goes away. And it doesn’t take long: one or two cycles and they are likely feeling great. They have a whole new lease on life.”
More Information
For more information, please see Dr. Cass’ website, CassMD.com. She has also authored four books on these subjects: Natural Highs, 8 Weeks to Vibrant Health, and The Addicted Brain: How to Break Free, which details how to get off addictive substances including medications. Another book, Supplement Your Prescription, deals with detecting and treating the nutrient deficiencies caused by medications. All four books are available on her website. She also has a special report called Reclaim Your Brain, available for free on her site, in which she discusses the different nutritional substances you can use to address conditions like anxiety, depression, and lagging memory.
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A Simple Key For Finding affordable therapy near you Unveiled
In this article you might find solutions to some often questioned issues from individuals and family associates and obtain to learn more about our services.
Prioritize fantastic sleep behaviors by maintaining a regular snooze program and making a enjoyable nightly schedule.
The researchers stage to unexpected results in trials of faculty-dependent mental health interventions in the uk and Australia: College students who underwent coaching in the basics of mindfulness, cognitive behavioral therapy and dialectical behavior therapy didn't emerge healthier than friends who did not take part, and several had been even worse off, no less than for some time.
A very powerful things of such healthy weight loss plans are that they include things like veggies, fruits, complete grains, and minimally processed foods, and they do not contain lots of sugar or refined grains.
Superior-operating anxiety can have an impact on persons of any age and gender, but some folks have a better threat of enduring it.
Find kinds of workout that are enjoyable or fulfilling. Extroverted people normally like courses and group activities. People who find themselves far more introverted typically choose solo pursuits.
Identifying triggers like caffeine or social interactions is crucial to navigating the ailment. Permit’s Look into the different coping strategies, which includes searching for professional help with Mature Therapy.
A further rationalization is that mindfulness education could really encourage “co-rumination,” the type of lengthy, unresolved team dialogue that churns up difficulties with out finding solutions.
You may as well monitor what reduction strategies you experimented with in the meanwhile and which ended up most (and minimum) effective. Once you've logged a handful of activities, assessment them to determine if you see any designs.
At Improve Therapy, we have been devoted to delivering available and inclusive mental health help so that you can concentrate on your well-being and Are living a satisfying daily life. We can assist you find a licensed and experienced therapist who understands your one of a kind needs and accepts whatever sort of insurance policies you have got.
Sooner or later, anxiety and stress have an impact on Everybody. They will manifest differently in different folks, and the extent of anxiety 1 activities like it will vary, but there is something for selected: there are methods to handle anxiety, although it feels out of control.
Mental health therapy will help clientele overcome own issues or learn how to most effective cope with them to allow them to really feel empowered to deal with daily life with higher relieve and joy.
Practice mindfulness techniques: Training mindfulness may help you become far more aware about your thoughts and feelings from the existing moment. As an example, when practicing deep breathing, you could possibly detect that a specific odor or sound triggers feelings of anxiety.
Owning occasional emotions of anxiety is a traditional Portion of everyday living, but those with anxiety disorders expertise frequent and abnormal anxiety, fear, terror and stress that site in everyday cases. These emotions are unhealthy should they impact your Standard of living and forestall you from working Commonly.
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Skip to content
Myths About Masks Debunked
Myths About Masks Debunked
With the COVID-19 outbreak, more people have become increasingly health-conscious. As states reopen from stay-in-place orders, many require people to wear face coverings in public spaces to reduce the spread COVID-19.
Both the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) now recommend cloth masks for the general public. There has been a lot of research as to why masks help in the prevention of spreading disease. In countries (such as China and Korea) where masks were already a norm, COVID-19 has been effectively contained and new cases of infection have been drastically reduced.
Though, some people still have their doubts as to why wearing a mask in public is important to them and those around them. So to dispel any hesitations about wearing face coverings in public settings, we are going to debunk some common myths that surround masks.
If I Don’t Wear a Mask, I’m Not Hurting Anyone But Myself
Answer: FALSE
According to the CDC, many people who have or had COVID-19 show no symptoms. That does not mean that other people will be lucky enough to be asymptomatic. You may have the disease and have unknowingly spread it to others, making you a carrier. Those who have underlying conditions are more vulnerable to the more severe symptoms of illness, this includes people who have immuno-deficiencies, the elderly, and babies.
Asymptomatic carriers can increase disease spread if they are not taking proper precautions, this includes wearing a mask, social distancing, and washing their hands effectively. You never know who is more susceptible to illness, so wearing a mask keeps everyone safe.
There Is No Wrong Way To Wear A Mask
Answer: FALSE
According to the CDC, here are the rules when wearing a mask to make it effective:
• Be secured with ties or ear loops.
• Fits snugly but comfortably against the sides of the face.
• Allow for unrestricted breathing.
• Cover both your nose and mouth.
• For cloth masks, they should be able to be laundered and machine dried without damage or shape changes.
• Have multiple layers of fabric.
• Those who cannot remove a mask without assistance should not wear one.
Disposable masks should be disposed of after every use since they cannot be washed thoroughly without breaking down. Miro Safety Maks are non-woven and are bio-degradable, but this means that you cannot wash them and should not use them after one use.
Additionally, when you are not using your masks, you should not pull it below your chin. Instead should remove it completely. This is because there could be germs and bacteria on and around your neck, which could contaminate the mask and cause you to breathe in those germs and bacteria.
Wearing A Mask Can Poison Me With Excess Carbon Dioxide Build-Up
Answer: FALSE
As with any changes to lifestyle or new product, there are people who have doubts and worries. Which is completely understandable, you do not want to engage in an activity that will do more harm than good. When it comes to masks, some people suspect that wearing a face-covering for an extended period of time will impair breathing and poison you with excess carbon dioxide (CO2).
While masks do keep you from expelling water droplets, they do not keep you from expelling CO2. Properly fitted masks provide adequate airflow from your nose and mouth. Masks may feel a bit uncomfortable, but an accumulation of CO2 is impossible when wearing masks appropriately.
People who have breathing problems, those who cannot remove a mask without assistance, and children under the age of two years old should not wear face coverings.
All Masks Do The Same Thing
Answer: TRUE BUT...
Not all masks are created equal. Some provide more protection than others. Different types of masks serve different purposes. The CDC and WHO have stated that cloth masks are effective for the general public. Any mask that covers the nose and mouth is recommended and will serve the same purpose.
It is important to note that N95 masks with valves are not recommended for most people. These masks are usually used in construction to prevent workers from breathing in dust, but the valve allows for air and droplets to be expelled. This does not help in containing your droplets and any germs that you may carry. Making them ineffective for protecting those around you.
Surgical masks are not heavily recommended by the CDC and WHO because they should be reserved for health care providers.
Miro Safety Masks are made with a non-woven MB filter, both KF94 and KN95 certified. Miro repurposed its HEPA filter manufacturing line to make these masks. They are single-use masks that are in ready supply and available to the public. While cloth masks are effective, the Miro Safety Masks provide increased protection.
You Don’t Need To Wear A Mask Outside
Answer: FALSE
Being outside is considered safer than being inside, you only don’t need to wear a mask outdoors if you are able to social distance. Always stand at least six feet apart from people you don’t live with, and remember to bring a mask whenever you leave the house! Leaving disposable masks in your car or in a bag or purse is very helpful in case you forget your mask at home. Since the Miro Safety Mask comes in a pack of five, it is very convenient to store spares.
There is a lot of evidence that inhaled droplets are a major source of transmission, so it is important to keep yourself protected at all times, whether you are indoors or outdoors.
You Don’t Need to Wear A Mask If You Have Recovered From COVID-19
Answer: FALSE
If you have had COVID-19 in the past, this does not guarantee immunity. There is no solid evidence that proves that having COVID-19 antibodies means that you are immune. So even if you have had COVID-19 before, it is still important to protect yourself from getting infected again. You could potentially contract the disease again and spread it on to others.
Previous article Nose Bleeds at Night: Causes and Prevention
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1a01aa77535b9ecfb87b9fc36adbcd2f
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3,275,064,866,801,931,300
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Open Access
Spoiled Gradient Echo T2* iron-loading measurements of the liver and myocardium in 12 year old male with severely reduced cardiac function from Thalassemia Major
• Annette L Dahl1 and
• Taigang He1
Journal of Cardiovascular Magnetic Resonance201012(Suppl 1):T3
https://doi.org/10.1186/1532-429X-12-S1-T3
Published: 21 January 2010
Keywords
Cardiovascular Magnetic ResonanceThalassemiaDesferrioxamineIron LoadingShort Acquisition Time
Introduction
Beta-Thalassemia Major affects 60.000 births per annum world-wide, and a further 94 million carriers. Mutations in the β-globin gene results in severe anaemia, leaving patients dependent on blood transfusions throughout their life. Excessive absorption combined with transfusional haemosiderosis cause iron-overload in the myocardium and liver. There is a 50% mortality rate in Beta-Talassemia Major patients before the age of 35 due to iron overload, with cardiac failure being the main cause of death.
Purpose
We report a 12 year old male with beta-Thalassemia Major, who was . Patient was treated with desferrioxamine chelation, . The patient hadbut with poor chelation compliance history, and therefore required urgent iron assessment of liver and myocardium.
Methods
Cardiovascular Magnetic Resonance (CMR) scan including True-FISP volume measurements of cardiac function was performed on a 1.5T Siemens Symphony scanner. Iron-loading was assessed by using Spoiled Gradient Echo T2* sequence with high bandwidth of 810 Hz/pixel, TR 100ms and TE of 2.6-16.74ms (cardiac) and 0.93-16ms (hepatic).
The iron loading is measured by measuring the signal intensity for each image using a purpose-designed software programme (Thalassemia Tools) which subtracts the background noise from the myocardial/hepatic signal intensity, and plotting the signal intensitythe net value against the echo time to form an exponential decay curve. To derive T2*, an exponential trend-line is fitted with the following equation:
Y= Ke -TE/T2*
K represents a constant, TE= Echo Time and Y =image signal intensity. The later low signal to noise ratio (SNR) data points were discarded to address issues of noise and artefacts.
Results
T2* measurements of liver demonstrated severe hepatic iron loading of 1.3ms, T2* measurements of myocardium demonstrated moderate cardiac iron loading of 15.2ms and volumetric measurements on True-FISP cine sequences concluded severely dilated left ventricle with severe systolic dysfunction and left ventricular ejection fraction of 28%.
Conclusions
T2* MRI can be successfully used along with CMR for assessment of cardiac function along with myocardial and hepatic iron loading in patients with Thalassemia. The high bandwidth used with the spoiled gradient echo sequence allows very short acquisition times, reducing motion artefacts and allowing the image acquisition to be completed in a single breath-hold. This makes this a suitable imaging tool for paediatrics, allowing regular follow-up scans to monitor patients that require blood transfusions.
Authors’ Affiliations
(1)
The Royal Brompton Hospital, London, UK
Copyright
© Dahl and He; licensee BioMed Central Ltd. 2010
This article is published under license to BioMed Central Ltd.
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What is the Difference Between THC and CBD? Properties and Effects - Erth Wellness
What is the Difference Between THC and CBD? Properties and Effects
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As hemp and other cannabis products such as water soluble CBD become legal in various states across the country, consumers are becoming increasingly interested in their potential medical benefits. CBD and THC are two natural compounds that are gaining a lot of attention, but most are not aware of the differences between the two substances.
The difference between essential cannabis chemicals CBD and THC is becoming increasingly crucial as the debate over medical marijuana legalization continues. While you may have heard of CBD and THC in the same conversation, they have completely distinct effects and applications, ranging from recreational or medical purposes that are groundbreaking.
In this article, we will discuss some of the differences between THC and CBD and some of their applications, properties, and effects. Continue reading below to learn more about both and discover how you can find the best water soluble CBD for sale from ERTH HEMP.
What Is CBD?
Cannabidiol, or CBD for short, is the second most common chemical makeup discovered in cannabis plants. CBD, which was first discovered in the 1940s, has recently gained popularity as a natural treatment for various ailments.
CBD is one of over 400 chemicals in medical marijuana that works to counteract the psychoactive properties of THC. Despite the fact that the CBD molecular structure is nearly identical to the THC molecule, it does not cause intoxication.
CBD has been shown to have various complementary and integrative health benefits and applications. The molecule is non-psychoactive, which has helped it gain acceptance for its therapeutic benefits in various medical conditions.
CBD products such as oils, vapes, beverages, and other medications have been developed to optimize its benefits in the retail and medicinal industries. Cannabinoid oil is a well-known CBD-based product.
What is THC?
THC (delta-9-tetrahydrocannabinol) is a psychoactive component of medical cannabis, despite the fact that the THC molecule is remarkably similar to its non-psychoactive counterpart CBD. THC is the main psychoactive compound of marijuana, and as a result, it is less widely acknowledged for medicinal purposes than CBD.
THC, on the other hand, boasts of its own health benefits. THC has been shown to aid in treating nausea, asthma, and even anorexia nervosa. However, because it has psychoactive chemical compounds, its medicinal applications are still debatable.
Dopamine is a neurotransmitter that is involved in mood and pleasure. THC produces feelings of euphoria by causing a higher-than-normal release of dopamine. THC is commonly ingested through marijuana smoking, although it can also be obtained in pills, sweets, and oils.
What's the Difference Between CBD vs. THC?
The argument around CBD vs. THC varies primarily in that CBD does not provide a high, but THC does. CBD and THC behave very differently despite having a nearly identical chemical formula of C21H30O2 and molecular masses of 314.469 g/mol and 314.464 g/mol.
THC, marijuana's psychoactive component, makes you sleepy or drowsy (a frequent side effect of most strains), whereas CBD keeps you awake and gives you more energy. THC is also responsible for the high or body-high sensation.
When combined with THC, CBD serves to counteract the effects of THC by lowering other negative emotions. As a result, CBD is frequently extracted for use in non-psychoactive (and non-recreational) applications.
The endocannabinoid system, which is a neurotransmitter that plays an essential role in maintaining homeostasis, is influenced by THC and CBD. Researchers are still working to figure out how this complicated system works, but they know that it has something to do with memory, food, sleep, mood, and fertility.
Neurotransmitters are chemical messengers that allow nerve cells in the body to communicate with one another. They're involved in various processes, including sleep, discomfort, cravings, mood, and the immune system.
Both THC and CBD have the same basic structure, but the way these molecules are organized differs, which is why they have different effects. They attach to cannabinoid receptors and generate diverse actions in the body by imitating the endocannabinoid system.
Is THC Legal? Is CBD Legal?
Both marijuana and THC are specifically included in the United States Controlled Substances Act and are illegal under federal law. As of July 2020, 33 states and Washington, D.C. had passed laws allowing doctors to prescribe medical marijuana and THC-containing products, and ten of those states have gone one step further and legalized marijuana and THC for use recreationally.
Although CBD oil is legal in some forms in most jurisdictions, the legality of any THC or CBD product varies from one state to the next. Several states have also approved the recreational use of marijuana and THC, but overall, the legality of the cannabis plant is determined by their concentration and source.
CBD is prohibited if it is generated from marijuana unless obtained through a state-regulated medical marijuana program or in a state where recreational marijuana usage is legal. Hemp-derived CBD products are classified as a dietary supplement in the United States, and it is legal to buy and sell.
What are the Medicinal Benefits of THC and CBD?
Both CBD and THC have a wide range of medical and therapeutic applications. THC is commonly utilized for its euphoric, calming, and relieving properties.
CBD has had some success as an anxiolytic drug.
THC, on the other hand, has received mixed evaluations when it comes to treating the latter. THC has been related to paranoia due to the compound's psychoactive properties, perhaps most commonly experienced during marijuana use.
Here are a few of the most common uses for THC
• Relaxation and euphoria
• Sleep aid
• Cravings stimulant
• Antiemetic
• Muscle relaxant
• Here are a few of the most common uses for CBD:
• Neuroprotective
• Anticonvulsant
• Antipsychotic
• Anti-tumoral
• Anti-inflammatory
• Drug Testing
Because THC and CBD are both retained in body fat, they can be discovered on drug tests for a long period after you've stopped taking them. THC is the main psychoactive component of marijuana, and it can be identified in most routine drug tests.
Many cannabis-derived CBD products, however, do include minor quantities of THC. Even though these amounts are modest, they may be visible if you consume a lot of CBD or if the goods you use contain more THC than the packaging label states. Luckily, although CBD may be detectable, many drug tests aren't intended to search for it.
Discover More About ERTH HEMP CBD Products Today
While it may seem like there is a lot of information available regarding CBD and THC, there is relatively little available research regarding cannabis and its psychoactive effects and interactions with the human body, and we're just beginning to learn the many ways THC, CBD, and other cannabis compounds work together and interact with our bodies to change the way we feel.
If you would like to learn more about CBD products, ERTH HEMP is happy to help.
At ERTH HEMP, we are committed to providing our customers with the highest quality CBD products. Our leadership team offers years of experience to the CBD industry, from cultivation to extraction, formulation, and sales, to ensure that we provide our valued customers with the highest industry standards, product knowledge, and customer service possible.
ERTH HEMP is an industry leader in everything CBD-related and was designed to supply clients with a unique blend of CBD goods and products, including topicals, tinctures, and CBD vape juice 1000mg
If you would like to learn more about which of our CBD products can provide medical benefits for you, contact us today.
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At a weight loss of two pounds per week, you will lose 50 pounds in 25 weeks, or a little less than six months. Item Weight. Hand wash with mild detergent, do not scrub or bru or diarrhea, leading to loss of fluids (dehydration). 10. Pretty good results when you can eat as much as you want, no hunger required. Whisk together 2 large eggs, 1 large tomato, chopped, 1/4 cup shre This program is a rapid weight loss system for individuals with 30+ pounds to lose. It is a safe and healthy amount of weight to lose in 6 months. 5–1 kg) of fat loss, or around 1% of your body weight, per week (43). Add to Cart. * DI: Recommended Daily Intake based on 2000 calories diet. It’s also in line with what most experts recommend for healthy weight loss. 7 to 45. 1. As I mentioned above, the amount of weight you can lose in nine months depends on a How Long Does It Take to Lose 50 Pounds? 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The record is held by Mr. The important thing to keep in mind is that after surgery, there will be some big adjustments to your life that will be key to experiencing a How Much Weight Can I Lose In 6 Months. Meat. Other people might lose a little less or a little more. 3. You Healthy weight loss doesn’t encourage you to try to lose 50 pounds in 5 months If you’ve heard the phrase “lose 50 pounds in five months,” you’re not alone. Homemade V8 Juice. Voice of Punjab. Whether . Safe, healthy weight loss is defined by losing no more than 1–2 pounds (450–900 grams) per week. Blair Helwig. Although the carbs are relatively low in this dish, so is the protein amo "It is 100% possible to increase your weight in just 24 hours and put on 5-6 pounds. The boat is no longer moving. I know the CDC says you can only really lose up to 8 but that’s such a generic number. This is why it is recommended that you combine exercise with a healthy diet. Nuts and also seeds. 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For a 10-year-old, under the common formula, that means a target heart Exercising at or beyond the maximum heart rate for too long can . I have kept it off and I'm now 72. Restricting your eating pattern to just 1 meal in a 1-hour eating window will make it more challenging to eat the same amount of calories compared to a regular eating pattern. First things first, having a solid, safe, successful weight loss plan is a sure way to boost your long-term weight-loss efforts (6). In the first seven days, you will likely lose around 1-5 pounds, but some people lose up to 10 lb’s. The important thing to keep in mind is that after surgery, there will be some big adjustments to your life that will be key to experiencing a At a weight loss of two pounds per week, you will lose 50 pounds in 25 weeks, or a little less than six months. Support, inevitably lose the world The military occupation of Jiangnan is only the beginning, and the next step is to weaken the Jiangnan family. , it’s 1 to 2 pounds per week. The Last Word After that, you can expect to average a loss of between 8 and 16 lbs a month for the first 6 months. It took me almost two years. The majority of specialists advocate losing weight at a modest but constant rate — such as 1–2 pounds (0. Eating protein-rich meals is a great way to lose weight. Fat-rich cheese. 4 kg (50 to 100 lb) and varies by sex, with males weighing more than females. Most patients generally have a total weight loss of around 60% of excess body weight after a year. They can help you figure out a plan that will work for you. He quickly filled How Much Weight Can I Lose In 6 metabolic weight loss clinic baton rouge Months out registration, made up a residence in Cairo. Customer Reviews. do you know what I did not say anything. 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Jenny Craig cos weight and blood sugar correlation. Fat-rich dairy products. However, in general, the experts claim that individuals may expect to eventually lose 16 pounds within two months. Your weight loss may fluctuate from week to week and month to month. Please do not remove the plastic cover inside the float. Focus on getting stronger and feeling better. Remember, as you start losing weight, you will need to readjust your energy needs and move to a lower-calorie level for every 10 to 15 pounds lost to keep losing weight at a consistent rate. One person in ten lost more than 9 pounds (over 4 kilos) in the two weeks. While everyone can benefit from eating healthy meals that You must lose about (3500×2) = 7000 calories per week and 1000 calories per day. I went from 315 to 222lbs in seven months. Yes, when you first start you may build muscle pretty quickly, but just keep going and enjoy the process of lifting. 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Meditation lowers blood pressure and increases circulation What is the fastest way to make Arthur Fat? Red Dead Redemption 2 has finally hit PC. 5 – 2 pounds. Weight loss is usually the fastest in this initial fat or ketone adaptation phase, largely due to losing water. Weight loss tapers off after 6 months, but … Healthy weight loss doesn’t encourage you to try to lose 50 pounds in 5 months If you’ve heard the phrase “lose 50 pounds in five months,” you’re not alone. 5. " Anita B. Marie is an inspiration! January 30, There is so much information out there on weight loss that it can get totally overwhelming. . Avocados. 5–1 kg) of fat While following a WW plan, you can expect to lose an average of 8 pounds a month, or 2 pounds a week. Because 7 months contains approximately 30 weeks, you can safely lose 30–60 pounds (14–27 kg) in this time period. Chicken. 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Weight-loss eventually comes back to the idea of calories in, calories out: Consume less than you melt Fulfillment of these principles will allow you to solve the problem – how much weight can i lose in 6 months calculator. 2 days: 1 – 3 pounds. The a Pregnant women are counseled to consume caffeine in moderation, because large amounts of caffeine are associated with miscarriage. In a study where Ozempic was added to one or more diabetes pills, adults with type 2 diabetes weighing 197 pounds lost 12 pounds in one year on a 1 mg weekly dosage. This means that in 4 months, you could lose 8-16 pounds, and in 6 months, you could lose 12-24 pounds. do you gain weight on hydroxyzine And Best Over The Counter Diet Pill, 2021-12-07 Best Way To Lose Body Fat how much weight can i lose in 6 months Green Tea Weight Loss. Ideally, you should aim to lose 1-2 pounds per week or less, and maintain this weight loss for at least six months. So, in a month, the average weight you can lose is between 4-8 pounds. Through regular exercise, you can lower your blood pressure and cholesterol; which reduces your 7 Steps I Took That Helped Me Lose 60 Pounds In Six Months. "I love 310 Shakes, they are so delicious!!! One of my favorites is the Vanilla, because you can add whatever you like to it! Yummy and healthy. If you follow the strategies we list later in this article, in 6 months, you can aim to lose the following: 1 pound per week – 24 pounds in 6 months ; 2 pounds per week – 48 pounds in 6 months ; Eating too few calories or over-exercising can lead to some health problems. What rules should be followed: Begin gradually . 2 "As such, individuals with higher body weight or with higher Better overall health. Come There is nothing how much weight can i lose in 6 months diabetes and keto diet wrong. To do so, it’s essential to reduce your caloric intake by 500–1,000 calories per day. 5 – 5 pounds. You can replace them with fruit-infused water. For example, if you want to lose 24 pounds in 6 months, a realistic goal would be to lose 1-2 pound a week. On January 20th, at dusk, how much weight can i lose Ge Ligaoli had just walked out of his how weight can i 6 residence to check the guard post weight of How Much Weight Can I Lose In 6 Months the Atamansky regiment behind the railway line he met Pocholkov at So, if you are able to reach for walking target every day, after 1 month you will have lost roughly 10 pounds.
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