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Receptors, Gastrointestinal Hormone
"Receptors, Gastrointestinal Hormone" is a descriptor in the National Library of Medicine's controlled vocabulary thesaurus, MeSH (Medical Subject Headings). Descriptors are arranged in a hierarchical structure, which enables searching at various levels of specificity.
expand / collapse MeSH information
Cell surface proteins that bind gastrointestinal hormones with high affinity and trigger intracellular changes influencing the behavior of cells. Most gastrointestinal hormones also act as neurotransmitters so these receptors are also present in the central and peripheral nervous systems.
expand / collapse publications
This graph shows the total number of publications written about "Receptors, Gastrointestinal Hormone" by people in UAMS Profiles by year, and whether "Receptors, Gastrointestinal Hormone" was a major or minor topic of these publications.
Bar chart showing 3 publications over 3 distinct years, with a maximum of 1 publications in 1990 and 1992 and 1993
To see the data from this visualization as text, click here.
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-5,791,589,263,662,840,000 | Unveiling the Facts about Aneurysms: Understanding a Silent Threat
Aneurysms are a potentially life-threatening medical condition that often goes undetected until a rupture occurs. This blog aims to shed light on this silent threat by presenting key facts about aneurysms, their causes, symptoms, and available treatment options. By increasing awareness, we can take proactive steps to mitigate the risks associated with this serious condition.
1. What is an Aneurysm?
An aneurysm is an abnormal bulge or weakening in the walls of a blood vessel, usually an artery. As the weakened area expands, it creates a balloon-like structure that can put pressure on surrounding tissues and organs.
2. Common Types and Locations
The most common types of aneurysms include abdominal aortic aneurysms (AAA), cerebral aneurysms, and thoracic aortic aneurysms. AAAs occur in the abdominal aorta, cerebral aneurysms in the brain’s blood vessels, and thoracic aortic aneurysms in the chest.
3. Silent and Potentially Fatal
Aneurysms are often asymptomatic, earning them the name “silent killer.” They can go undetected for years until a rupture occurs, which can lead to severe internal bleeding and even death. Early detection is crucial for effective treatment and prevention of rupture.
4. Risk Factors
Several factors increase the risk of developing an aneurysm, including age (over 60), family history, smoking, high blood pressure, atherosclerosis (hardening of the arteries), and certain genetic disorders such as Marfan syndrome and Ehlers-Danlos syndrome.
5. Signs and Symptoms
In most cases, aneurysms do not cause noticeable symptoms until they rupture. However, certain warning signs may include a pulsating sensation near the affected area, deep pain, dizziness, shortness of breath, and sudden, severe headache (in the case of a cerebral aneurysm).
6. Diagnosis and Screening
Imaging tests such as ultrasound, CT scan, MRI, and angiography are used to diagnose aneurysms and determine their size, location, and risk of rupture. Screening is recommended for individuals at higher risk, allowing for early detection and appropriate management.
7. Treatment Options
The treatment of an aneurysm depends on its size, location, and the patient’s overall health. Options may include monitoring through regular imaging, lifestyle modifications (e.g., blood pressure management), medication to control risk factors, or surgical interventions such as endovascular repair or open surgery.
8. Prevention and Lifestyle Changes
Although not all aneurysms can be prevented, certain lifestyle changes can help reduce the risk. These include quitting smoking, managing blood pressure, adopting a healthy diet low in saturated fats, engaging in regular exercise, and seeking prompt medical attention for any concerning symptoms.
Living with an aneurysm can be overwhelming for individuals and their loved ones. Support groups and online communities offer valuable resources, sharing experiences, and providing emotional support. Increasing awareness about aneurysms can save lives by promoting early detection and proactive management.
Understanding the facts about aneurysms is vital in recognizing this silent threat and taking necessary precautions. By being aware of the risk factors, symptoms, diagnosis methods, treatment options, and prevention strategies, we can work towards reducing the impact of aneurysms on individuals and society. Remember, knowledge is power, and early detection can be a lifesaver when it comes to aneurysms. Stay informed, take care of your health, and encourage others to do the same.
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Benefits of Interval Training
Scott Gray provides advice on the benefits of interval training.
Why should you switch from your traditional cardio workout to reap the benefits of interval training? Is it actually possible to get results without working hard for hours at a time?
Interval training is the ultimate cardiovascular workout. Just by practicing interval training once a week, you will be able to take advantage of a number of benefits, from more effective oxygen intake to a slower heart rate.
If your fitness goal is to lose fat fast, interval training is the only route to take. Interval training is more fun and more effective than your regular old cardio routine. Best of all, interval training makes it possible to get better results in less time, helping you reach your fitness and weight loss goals quickly.
Interval Training is similar to your everyday activities
One of the greatest benefits to interval training is the similarity to regular activities that the average person performs on a daily basis. Most people are not focusing on working at a moderate to high level of intensity for long periods of time through the day.
It is natural to take breaks and rest between activities, especially when such activities are so intense. Interval training is an excellent way to prepare your body for the sudden bursts of stress or activity that everyone experienced from time to time.
Interval Training improves oxygen utilization
The body's ability to make use of oxygen can be greatly improved through the practice of interval training. Oxidative capacity is how much oxygen muscles can use during aerobic exercise. If your muscles are not able to pull the oxygen from the blood stream, then it makes no difference if your lungs are working sufficiently.
The measure of oxidative capacity is known as VO2 max, which is the maximum amount of oxygen the muscles are able to take from the blood and use. Studies indicate that interval training significantly increases the ability to use oxygen by as much as 100%.
Interval Training saves time
You do not have to spend countless hours at the gym or running at high speeds for a couple of hours to take advantage of the benefits of interval training. With interval training, you can accomplish in just four minutes the same benefits as you would get from an hour-long run at 65% maximum capacity.
Martin Gibala is the chairperson for the Department of Kinesiology at McMaster University of Hamilton, Ontario, Canada where extensive research has been performed on short-burst, or interval training. Along with his colleagues, Martin Gibala published a study a few years ago that found that interval training for one and a half hours each week, including breaks for rest, produced the same results over a six week period as regular endurance training for close to five hours every week.
Interval Training improves the ability to burn fat
The muscle carbohydrate reserves, glycogen, is almost exhausted thorough interval training. It may seem a little backwards to think that improved fat burning is one of the many benefits of interval training because carbohydrates are used as the main source for fuel.
On the contrary, once the glycogen reserves have been exhausted replacement is necessary through the fuel source fat. Hours after you have completed your workout, you will continue to reap the benefits of interval training because your body will use up fat replacing the depleted glycogen.
Interval Training is an excellent way to train for any sport
The ideal way to train for any sport is with interval training. You can train for anything through the benefits of interval training, from a short sprint to a marathon.
Changing how much time you spend resting versus the time you spend working out at maximum capacity will effectively train the various energy systems necessary to dominate your favourite sport.
Interval Training increases human growth hormone production
With interval training, production of the human growth hormone, also known as somatotropin, is increased. Human growth hormone (HGH) is required to repair damage to tissues and build muscle.
Interval training has even been proven to increase the production of human growth hormone in older people. Proper HGH production aids in recovery following your workouts, ensuring you will be ready for your next session.
Interval Training improves heart efficiency
The amount of blood that is pumped throughout the body can be improved in two different ways. First of all, there is the amount of blood expelled by the heart. Secondly, heart rate, which is the rate that the heart pumps blood.
Research shows that fit individuals have a lower than average resting pulse. Interval training makes the heart stronger, making it possible for more blood to be expelled with each pump. This means that your heart will not have to pump as often, thus reducing your resting heart rate.
Interval Training reduces insulin dependency
Essentially, the body uses insulin to transport sugar to cells in the form of glucose to be used as energy. Exercise at a high level of intensity causes the body to produce lactate, which is a good thing.
Lactate is transported to cells much easier than glucose and it does not require any insulin to do so. Lactate is then converted into pyruvate, a major chemical that is used to produce energy quickly. The benefits of interval training positively affect the lives of both diabetics and non-diabetics alike.
Finally
Now that you have all of the information, it is easy to see that benefits of interval training are in great abundance. Interval training is not only a fun way to lose weight, but also a quick way. When you burn fat both during as well as after your workout, as with interval training, your workouts are more effective. A more effective workout will save you time, giving you the awesomely fit body you want in half the time. In addition, your overall fitness level will improve, your stress level will be reduced, your immune system will be stronger and you will be healthier than you ever thought was possible.
Page Reference
If you quote information from this page in your work then the reference for this page is:
• GRAY, S. (2011) Benefits of Interval Training [WWW] Available from: https://www.brianmac.co.uk/articles/article074.htm [Accessed
About the Author
Scott Gray is a fitness enthusiast and website publisher. He maintains a health and fitness tips website where you can find information about cardio for weight loss, exercise equipment and tips for getting and staying in shape.
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-5,410,876,015,996,991,000 | Will Your Milk Change If You're Exclusively Pumping? Science Explains
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Breastfeeding can be challenging and there are many reasons why you might not be able to breastfeed your baby. For some, that means choosing to exclusively pump. But how does that differ from exclusively breastfeeding? Experts say the benefits of breast milk include how it changes to fit your little one's needs, but will your milk change if you're exclusively pumping? Is it the biology of suckling that lets your body know what your baby needs, or is it possible to make flu-fighting milk with your pump?
Breast milk is a powerhouse food that is designed to feed your infant perfect nutrition to allow them to grow and develop into healthy children over time. However, it's not always the easiest or best route for you and your child. It's often fraught with emotional implications and physiological complexities that don't rear their head until after you've decided to breastfeed.
Many women are still dedicated to the process, though. I know I was, in spite of my son's horrible initial latch period where he just couldn't get the hang of it, even after many attempts and several meetings with the lactation consultant. I understand intimately why someone would want to go the way of exclusively pumping. But since breast milk is supposedly this malleable food that is reactive to the child, does the fact that the milk is expressed entirely away from the influence of your baby change the composition of the milk? Will your milk change if you're exclusively pumping?
There is little study on the differences in breast milk between breastfeeding and exclusively pumping, but that is changing. There is some research that could suggest that milk that is pumped is less adapted to baby's needs than milk that is expressed via pumping because the breast isn't exposed to the signal markers in the baby's saliva that trigger a bio-reactive shift in the composition in the milk via the mother's own receptors, according to Pediatric Clinics of North America.
Breast milk is also changeable during a period of hours when an infant is feeding from the breast. Research published in The Journal of Human Lactation posited that the protein density of the milk changes based on hunger triggers detected in irregular feeding patterns, seeking to attend to the baby's needs by providing more satiating food at subsequent feedings.
Breast milk changes again as the baby begins taking in solid food in addition to the breast milk. A study published in The American Journal of Clinical Nutrition found that the lipid content as well as sugars and proteins shifted once the children began receiving supplementary nutrition. The breast milk becomes quite dynamic — reacting to quality of diet and perceived needs based on the mechanisms of response in the mammary tissue. Does this still happen when a woman pumps exclusively, though?
I spoke with Lydia Absolam, a certified lactation consultant from the Detroit area. "Yes, it will likely not be as changeable as it would be if the baby was nursing directly from the breast," she tells Romper. "However, it is still a powerhouse of nutrition, and likely the easiest for baby to tolerate." She notes that it might change if the mother gets ill or if she has mastitis, but that it will be pretty steady, and still really wonderful.
However, we know that your body knows how long you were pregnant, and for how long you've been nursing because of the fatty content of the milk. The milk has more fats and proteins — pumped or expressed — in the case of preterm delivery, suggesting that while it might not have all of the shifts in enzymatic qualities of breast milk straight from breast to baby, it does shift in nutrient composition with time, according to a study in Early Human Development.
In the end, you have to do what works for you and your baby. Breast milk is amazing stuff, regardless of delivery. The way you feed your child is far less important than the fact that your child is fed.
Check out Romper's new video series, Romper's Doula Diaries:
Check out the entire Romper's Doula Diaries series and other videos on Facebook and the Bustle app across Apple TV, Roku, and Amazon Fire TV. | {
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-4,187,639,234,531,382,000 | REDMOND DENTAL GROUP
Frequently Asked Questions
Dental FAQs
What age should I first bring my child into the dentist?
As soon as you start to see teeth. Many of us remember being scared of the dentist as a child (or we know people who had a bad experience). It is important to us to create a fun and safe environment for children. To help accomplish this, we offer FREE HAPPY VISITS for young children. Meeting a child with the parents, picking out a toy or maybe making a balloon animal – these things go a long way toward building a rapport with a child, so they see us as friends and caregivers. This also gives us a chance to make sure the teeth are developing normally and answer any questions you may have about oral health and diet.
Do baby teeth need to be filled if they have cavities?
Maybe. If a baby tooth is loose or close to falling out, it often doesn’t make sense to put a filling in it. But, if a cavity is present in a tooth that we anticipate won’t be falling out for awhile, then it makes more sense to save the tooth with a filling. There are a few different reasons for this. First, baby teeth can develop an abscess which can cause a toothache, just like in adult teeth. Second, baby teeth act as space maintainers for adult teeth. So, if a baby tooth develops a toothache and has to be removed, the other teeth may shift slightly. This can create complications that may require braces (or more extensive braces) as the adult teeth try to grow into a space that may now be crowded by shifting teeth. Third, there have been studies that indicate that decay left in baby teeth will later spread to the adult teeth.
Why do I need an exam by the doctor if all I want is a cleaning?
This question comes up when a patient, new to our office, calls in to request just a cleaning. In Oregon, a dentist is required to evaluate a new patient before initiating treatment. Some individuals have health conditions that may require the attention of the doctor before a cleaning can be safely performed (they may require pretreatment antibiotics or a holiday from a blood thinner). Other individuals may have undiagnosed periodontal disease. This can lead to the loss of the bone and gums supporting the teeth. Areas with bone loss may require extra attention during the cleaning.
How often do I need a cleaning?
For most patients, a cleaning every 6 months will be sufficient to keep your teeth clean and healthy. This also gives your dentist the opportunity to evaluate your dental health and observe areas he may be keeping an eye on. Some patients who have issues with bone loss (periodontal disease) may require more frequent cleanings.
How does bleaching teeth work and is it safe?
Our patients are often concerned that their teeth are not as white as they would like. Bleaching under the supervision of a dentist is a safe way to improve on this. If the enamel (outer portion of the tooth) is stained, a good cleaning can leave the teeth looking whiter. In most cases the inner tooth (dentin) is dark in color and the more transparent enamel lets this show through. When we “bleach” the teeth, we use a carbamide peroxide to break up the stain particles within the dentin. Bleach trays are custom made for each individual to improve the whitening process and help minimize excess material on the gums.
What about laser bleaching?
There is some controversy about this in the dental community. The theory behind laser bleaching is that the heat from the “laser” light acts as a catalyst to speed up the bleaching process. While some studies seem to suggest that this ends up being a more efficient way to bleach the teeth, other studies have questioned any benefit as just being transient. Laser bleaching usually uses a very concentrated form of peroxide and many feel that the process dehydrates the tooth making it look whiter. The problem is, as the tooth rehydrates, there is a rebound to the darker color that then requires the use of home trays to continue the bleaching process.
I will admit that I receive a lot of questions about this from friends and acquaintances, outside of the dental office, who are interested in the latest techniques. And, in our office, we invest in proven technology for our patients. The problem is that most of the “dental gurus” that I respect in research and on the lecture circuits still are questioning laser bleaching effectiveness. If and when the process is perfected, we will feel comfortable offering it as a service to our patients.
You can read a little more about this on the following link. http://www.npr.org/templates/story/story.php?storyId=89514447
How about implants? Do you place them or do I have to go to an oral surgeon?
Yes, we place implants and restore them. One of our new patients was a real catalyst for this. She had been referred out of her previous office to have a painful tooth removed. She was going to have to wait quite awhile before she could have it removed. Quite by accident, she ended up at our office and we removed it that day. When it was time to replace the lost tooth we sent her for an implant consult with a specialist. It was too cost prohibitive and we were guilty of sending her somewhere else for treatment. An implant was the only treatment option to replace the tooth, so it became apparent that we had to offer this service in our practice to at least try to make the option more realistic for our patients.
We have been placing them ever since (and I am proud to say that patient has become a big advocate for our practice). Placing the implant also gives us more control over the result of the final restoration. A successful implant isn’t just one that integrates into the bone, the final tooth needs to be functional and look good. We can discuss and plan with you how best to restore the implant to replace missing teeth or stabilize a denture.
Redmond Dental Group
1765 SW Parkway Drive
Redmond, OR 97756
(541) 548-8175
info@redmonddentalgroup.com
HOURS
Monday through Friday
8:00am - 5:00pm
Redmond Dental Group
1765 SW Parkway Drive
Redmond, OR 97756
(541) 548-8175
Click Here to E-mail Us
HOURS
Monday through Friday
8:00am - 5:00pm | {
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-360,373,397,974,444,800 | WHY OUR GRANDPARENTS WERE HEALTHIER?
why our grandparents were healthier
Yes, you heard me right that why our grandparents were healthier, not only our grandparents lifted more weights than most of us do, but were physically more active, stronger, disease-free and healthier.
The human body is genetically designed to lift weights or heavy stuff. Understand that when I talk about weights or resistance, our muscles are blind. For the body, there is no difference between a 10kg sandbag, 10kg dumbbell, 10kg bucket of water, 10kg wooden log, or a bag of groceries weighing 10kg.
The muscles to grow and get stronger need stimulus. The heavier the stimulus, the more they will respond and adapt by getting stronger.
Our hunter-gatherer forefathers lifted heavy things throughout their lives, every day without a break. Be it lifting dead animals and carrying them for long distances, carry heavy stones or vessels of water, carry heavy logs of woods, etc. Our grandparents did not have any modern gyms back then, yet both our grandmoms and granddads lifted a lot of weight daily and did a lot of resistance training workouts.
why our grandparents were healthier
Wherein our grandfathers went to the local akharas to lift weights and do bodyweight workouts, our grandmoms did a similar form of workout in her daily chores. For e.g. grinding wheat in the heavy stone chakki, lifting heavy buckets of water and clothes and carrying it all the way to terrace to dry the clothes, carrying kilos of groceries for kilometers together, carrying water-filled vessels after pulling water from the well, and a lot more.
Our most grueling workouts may not be even close to the workout our ancestors used to do the entire day. Did our grandmothers got bulkier, or build muscles, or did our grandparents become a bodybuilder? No, they just got stronger. But that is why our grandparents were healthier than us.
A lot of people have a doubt that the exercises we do in the gym using machines, dumbbells and barbells, and other forms of resistance are not functional. Firstly, most people have no idea what the word functional means. Doing circus-type exercises in the gym using Bosu balls or Swiss balls is not functional. The simple definition of ‘functional’ would be an activity that helps you achieve your goal.
So if you underwent surgery of your knee, then a basic leg extension machine which helps you develop strength in your quads, and help you in rehab, is functional for you. Exercise like squats & deadlifts helps almost all the sportsmen develop basic strength which transfers directly to their sport, so these exercises are functional for them. A bench press would be functional for various sports like javelin, discus and shot put throwing events. For a mother who wants to lift her baby but is unable to do so due to back pain, any exercise which helps her regain her strength and get over the pain is functional for her.
You don’t want to come to the gym, and you think you don’t want to lift so-called unnatural weights? I’m fine with that. Just do one thing. Next time, when your mom has to get ration from the market which is 4-5kms away. Just carry the entire load in your hand, walking to your house. You will understand that this activity, multiplied by 10 is the amount of resistance your grandparents had on their body every day.
The problem is not that you can’t do it. The issue is that you won’t do it.
Most people are deficient in Vitamin D in the cities despite of ample sunlight. Why? Because they are not ready to expose themselves to the sun due to various stupid reasons. Do they want Vitamin D supplements? No. But they won’t go out in the sun either, so they have to take it, or they will suffer badly from various dangerous consequences like many people are.
You don’t want to study for your exams, you have to.
You don’t want to eat healthy and clean, you have to.
You don’t want to sleep and party all night. But you have to.
You don’t want to exercise. You simply, have to.
Given a choice, the majority of human beings won’t do anything. But, unfortunately for them, it’s not a choice, it’s a need.
Did our grandparents want to do that amount of physical activity? Nope, never, they wouldn’t have ever done it, just like you, if they have had the luxury of the lifestyle we live today. But in their times, they simply did not have the option. Basic living was tough, and they had to survive. Even if they didn’t like it, they simply had no option.
So, activities which they did unconsciously, we have to do the same movements consciously. The amount of resistance they overcame the entire day, we have to stimulate the same resistance in a place which is more focussed on such activities, i.e. your dear gym.
And remember, lifting puny pink dumbbells in the gym will never give you results. No one has ever got results from lifting them. Do you want to get stronger? Fitter? Lose more fat? Have an excellent body composition and physique to carry along? I hope you have got the answer that why our grandparents were healthier. So, start lifting some heavy stuff.
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4,649,287,120,142,716,000 | Neurological Gait Deviations
Original Editor - Stacy Schiurring based on the course by Damien Howell
Top Contributors - Stacy Schiurring, Jess Bell, Kim Jackson and Lucinda hampton
Introduction[edit | edit source]
Gait deviation is often synonymous with compensational movement.[1] The human body will find a way to make mobility happen, but this sometimes results in less than optimal movement patterns. It is the role of the rehabilitation professional to guide patients through a plan of care to improve and or correct movement dysfunction. The ultimate goal is to achieve an ideal movement for each unique individual.
There are often two schools of thought in physiotherapy: neurological and musculoskeletal clinical paradigms. A 2014 article[2] published in Manual Therapy looks at applying the concepts of neuroplasticity and motor learning to musculoskeletal physiotherapy practice. The authors found that integrating some of these concepts into traditional musculoskeletal physiotherapy treatments improved participants' outcomes with earlier and greater movement gains.[2]
"The authors compare and contrast neurological and musculoskeletal physiotherapy clinical paradigms in the context of the motor learning principles of experience-dependent plasticity: part and whole practice, repetition, task-specificity and feedback that induces an external focus of attention in the learner. It is proposed that increased collaboration between neurological and musculoskeletal physiotherapists and researchers will facilitate new discoveries on the neurophysiological mechanisms underpinning sensorimotor changes in patients with musculoskeletal dysfunction."[2]
The management of neurological gait deviations can differ from that of painful musculoskeletal syndromes in the following ways:[1]
1. Cognitive impairments can limit the use of explicit motor learning principles and require more implicit mechanisms of motor learning.
2. Organic degenerative processes that occur with some neurological diagnoses can limit the capacity to alter observed gait deviations.
3. Gait training for those with neurological gait deviations tends to focus on deviations in the swing phase and double support phase of gait. For musculoskeletal gait deviations, gait training tends to focus primarily on the stance phase of gait.
4. Gait deviations can be an early sign of some neurodegenerative diseases. The observed gait deviation may be the best available movement pattern for that individual to remain ambulatory and independent. For these patients, the rehabilitation professional needs to be more proactive in terms of potential side effects or unintended consequences when attempting to alter a gait deviation.
The management of neurological gait deviations are similar to that of painful musculoskeletal syndrome in the following ways:[1]
1. The motor learning mechanisms and considerations of good verbal cueing are applicable to both painful musculoskeletal syndromes and neurological gait deviations.
2. The motor learning principles of (1) external focus of attention, (2) using the patient's preferred sensory system preference, (3) using positive language, and (4) visual imagery are applicable to both painful musculoskeletal syndromes and neurological gait deviations.
3. The clinical reasoning process of symptom modification procedures and clinical reasoning of a working hypothesis is still applicable for gait deviations associated with both painful musculoskeletal syndromes and neurological gait deviations.
Neurological Gait Deviations[edit | edit source]
Pirker and Katzenschlager[3] provided a classification of 14 gait disorders associated with neurological conditions. This classification provides a broad description of different gait deviations. There is a need to provide more detail and sub-classification of deviations which occur during gait.[3]
[1][3]Please see the video in the Additional Resources section for demonstrations of many of these deviant gait patterns.
Gait Disorder Characteristics/description
Hemispastic gait Unilateral extension and circumduction
Paraspastic gait
• Bilateral extension and adduction
• "Stiff"
Ataxic gait
• Broad base
• Lack of coordination
Sensory ataxic gait
• Cautious
• Worsening without visual input
Freezing gait
• Blockage
• Stopping on turning and or stepping
Propulsive gait
Astasia gait Primary impairment of stance balance
Dystonic gait Abnormal posture of foot and or leg
Choreatic gait
• Irregular
• Dance-like
• Broad-based
Steppage gait Weakness of foot extensors
Waddling gait
• Broad-based
• Swaying
• Drop of swinging leg
Antalgic gait Shortened stance phase on the affected side
Vertiginous gait
• Insecure
• Tendency to fall to one side
Psychogenic gait
• Bizarre
• Rarely falls
The following is a list of common signs of neuromuscular conditions, which is based on the work of Scheets et al.[4] with additions from Dr Damien Howell.[1] A few of the more common neuromuscular conditions with potential clinical interventions will be outlined in more detail in the chart below.
1. Increased base of support (BOS)
2. Decreased BOS
3. Lateral shift of centre of mass (COM) toward stance limb
4. Knee hyper-extension stance
5. Sustained hip knee flexion stance
6. Vaulting
7. Toe walking
8. A limp: unequal step length, decreased time on uninvolved limb
9. Festination: decreased step length, increased cadence
10. Freezing difficulty initiating gait
11. Variable placement of foot
12. Pelvic elevation contralateral
13. Circumduction
14. Scissoring
15. Decreased hip knee swing phase
16. Foot drop
[1]
Gait deviation Examples of intervention with possible cue/prompt/feedback
Limp[5]
• “See that, don’t do that”
• Imagine / visualise walking with smooth rhythmic steps
• Take long even steps
• Spend less time on good leg
• Spend more time on the weak leg
• Step to the rhythm beat of the metronome
• Swing your arms
Slow gait velocity[5]
• Walk faster
• Step to the beat of the music at / or greater than 120 beats/minute
• Adjust treadmill speed
• Walk with a spring in your step, peer over the crowd
Knee hyperextension
• Visualise a scaffold around your knee
• Push off the floor, propel up and forward
• Therapist touches patient's calf muscle and cues "use this to control your knee"
• Orthotic trial: Supportive nonelastic[6] or elastic tape, Swedish knee cage
Sustained hip and knee flexion in stance
• Stay nice and tall
• Push foot into the ground
• Use a cane in the contralateral hand
Vaulting[7]
• Leave heel on the ground longer
• Imagine / visualise leaving an imprint of heel in wet sand
• Therapist touches thigh of swing leg and cues “relax the knee”
• Walk while keeping a book balanced on top of your head
• Gaitspot squeaker shoe adaptation (see handout in additional resources for details)
• Trial of a shoe lift with nonaffected limb
Toe walking
• Let the heel touch the ground
• Visualise leaving an imprint of your heel in wet sand
• Take long steps
• Walk/goose-step/march
• Backwards walking
• Gaitspot squeaker shoe adaptation
Freezing[8][9]
• Mental imagery: visualise coming to the threshold in a doorway and boldly stepping through into the room
• Self-talk, say out loud: “stop, stand tall, shake off, shift weight, step”
• Laser light pointer or line target
• Kinaesthetic specific self-prompting tricks
• Trial of assistive devices
Festination
• Mental imagery
• Laser light pointer or line target
• Metronome music
• Backwards walking
Circumduction[7]
• “See that don’t do that”
• Therapist touches the front of the patient's hip and cues "lift from your hip"
• Imagine / visualise walking in deep snow or shallow water
• Walk close to the wall, do not strike the wall, but do not lean away from it either
• Trial of a shoe lift for the nonaffected limb[7]
Foot drop
• Visualise a firm heel strike
• Trial of a temporary ankle foot orthosis (AFO) with nonelastic tape or an elastic therapy band. *** please see video below
• Shoe lift for the nonaffected leg
• Gaitspot squeaker shoe adaptation
Special Topic: Freezing of Gait (FOG)[edit | edit source]
FOG can be defined as a “brief, episodic absence, or marked reduction of forward progression of the feet despite the intention to walk”. FOG related features can include: (1) shuffling, (2) trembling, and (3) complete akinesia. These features are demonstrated during the brief episode of change in forward progression.[10]
Kondo et al.[10] described three phenotypes of FOG based on leg movements:[10]
1. FOG with very small shuffling steps and minimal forward movement (shuffling)
2. FOG with some leg trembling but no effective forward motion (trembling)
3. No observable forward motion of the legs (complete akinesia)
Clinical Pearls: Gait Analysis and the Power of Words[edit | edit source]
According to Dr. Damien Howell:
"Optimizing human movement requires clarity of description of movement. To know where you are going you must first know where you are.
To optimize human movement, analysis of human movement is required.
To identify optimal human movement clear qualitative and quantitative descriptions are needed.
When describing human movement confusion occurs when we fail to clearly identify a frame of reference and reference point.
A common description of a gait deviation is the individual is “hip hiking.” What is “hip hiking”? Is the thigh bone hiking? is the pelvic bone hiking? is the hiking during the stance phase or swing phase? We need a frame of reference and reference points.
A common description of a gait deviation is a “Trendelenburg sign.” This description confuses me. I am thinking is the patient is in an upside-down position that is used during a surgical procedure. Is there something wrong with superficial veins? Does he have a limp? Naming clinical tests and descriptions of movements after an individual is not helpful.
Describing gait deviation by pathology is not specific enough to direct treatment. Describing a person's gait as he/she is walking with a Parkinson's gait is very wide-ranging. Is there freezing; shuffling; festinating, all the above? The description of a “hemiplegic gait” is not very helpful. Whereas relative to vertical line there is a lateral shift of the sacrum (center of mass) towards the stance leg description of movement can provide direction for intervention.
Describing movement or motion requires using a frame of reference and a reference point. There are different frames of reference that are used to describe motion.
The Polar coordinate system is a 2-dimensional system in which each point on a plane is determined by a distance from a reference point and the angle of the reference point. It describes the movement, navigation, and travel. Interestingly indigenous people of Australia (Guugu Yimidhirr) use the polar coordinate system to describe human movement. They have no words for left and right. Instead, Guugu Yimidhirr speakers give all their descriptions and directions based on the fixed four cardinal points of the compass: north, south, east, and west. If I was providing Physical Therapy to a Guugu Yimidhirr I ask the individual to move your east arm/shoulder to the northeast instead of flexing your right arm/shoulder.
The allocentric frame of reference is describing motion with respect to other objects. For example, the person is moving relative towards or away from the window. The high jumper’s center of mass is passing under the bar and his pelvis passing over the bar.
An egocentric frame of reference motion is describing motion with respect to the individual's body axes of self, left-right, front-back, up-down.
There is consensus when describing human motion to use the coordinate system as a frame of reference. The cartesian coordinate system uses two perpendicular lines. We use it to specify a point in the 3-dimensional space.
Describing and analyzing human walking and running the coordinate system the frame of reference uses three perpendicular lines:
• Vertical line assumed to be a line of gravitational force - The body moves fore/aft or side to side relative to the vertical line.
• Horizontal line – The body moves up-down relative to the line of the horizon
• Line of progression – The body moves inward-outward relative to the line of progression.
Given these 3 lines of orientation then specific boney prominences are used as reference points to clearly describe human motion ... Given the frame of reference using vertical line, horizontal line, and line of progression and reference points of boney prominence the time/distance, the motion of joints, and/or body segments (kinematics) can be clearly described.
Using this process describing movement we can analyze motion or gait and make judgments whether the motion is normal, deviant, and optimal ... Avoiding the use of an individual’s name or the name of pathology to describe movement prevents confusion. Take time to describe movement relative to a frame of reference and reference points facilitating clarity. Using terminology that describes the frame of reference and reference points to describe motion will result in a movement system language, development of movement system diagnostic categories, and facilitating optimal movement."[11]
The above information was used with kind permission of Dr. Damien Howell PT. For more information, please explore Dr. Howell's professional blog.
Resources[edit | edit source]
Optional Additional Videos:
Please view this optional 15-minute video for demonstrations of deviant gait patterns.
[12]
Please view this short optional video for a demonstration of two methods to use an elastic therapy band for a soft trial for an AFO.
[13]
Optional Recommended Physiopedia Pages:
Clinical Resources:
Optional Recommended Reading:
References[edit | edit source]
1. 1.0 1.1 1.2 1.3 1.4 1.5 Howell, D. Gait Analysis. Neurologic Gait Deviations. Plus. 2022.
2. 2.0 2.1 2.2 Snodgrass SJ, Heneghan NR, Tsao H, Stanwell PT, Rivett DA, Van Vliet PM. Recognising neuroplasticity in musculoskeletal rehabilitation: a basis for greater collaboration between musculoskeletal and neurological physiotherapists. Manual therapy. 2014 Dec 1;19(6):614-7.
3. 3.0 3.1 3.2 Pirker W, Katzenschlager R. Gait disorders in adults and the elderly : A clinical guide. Wien Klin Wochenschr. 2017 Feb;129(3-4):81-95.
4. Scheets PL, Bloom NJ, MSOT P, Crowner B, MPPA P, McGee PN, PCS P, Norton BJ, FAPTA PP, Sahrmann SA, Stith JS. Movement System Diagnoses Neuromuscular Conditions.
5. 5.0 5.1 Chang MC, Lee BJ, Joo NY, Park D. The parameters of gait analysis related to ambulatory and balance functions in hemiplegic stroke patients: A gait analysis study. BMC neurology. 2021 Dec;21(1):1-8.
6. Wang RY, Lin CY, Chen JL, Lee CS, Chen YJ, Yang YR. Adjunct Non-Elastic Hip Taping Improves Gait Stability in Cane-Assisted Individuals with Chronic Stroke: A Randomized Controlled Trial. Journal of Clinical Medicine. 2022 Mar 11;11(6):1553.
7. 7.0 7.1 7.2 Fortes CE, Carmo AA, Rosa KY, Lara JP, Mendes FA. Immediate changes in post-stroke gait using a shoe lift on the nonaffected lower limb: A preliminary study. Physiotherapy Theory and Practice. 2022 Apr 3;38(4):528-33.
8. Nonnekes J, Růžička E, Nieuwboer A, Hallett M, Fasano A, Bloem BR. Compensation strategies for gait impairments in Parkinson disease: a review. JAMA neurology. 2019 Jun 1;76(6):718-25.
9. Tosserams A, Wit L, Sturkenboom IH, Nijkrake MJ, Bloem BR, Nonnekes J. Perception and use of compensation strategies for gait impairment by persons with Parkinson disease. Neurology. 2021 Oct 5;97(14):e1404-12.
10. 10.0 10.1 10.2 Kondo Y, Mizuno K, Bando K, Suzuki I, Nakamura T, Hashide S, Kadone H, Suzuki K. Measurement Accuracy of Freezing of Gait Scoring Based on Videos. Frontiers in Human Neuroscience. 2022;16.
11. Damien Howell Physical Therapy. Optimizing human movement requires clarity of description of movement. Available from: https://damienhowellpt.com/optimizing-human-movement-description-of-movement/ (accessed 8 November 2023).
12. Internal Medicine Made Easy. Abnormal Gait : Steppage, Trendelenburg, Hemiplegic, Diplegic, Antalgic, Ataxic, Parkinsonian. Available from: https://www.youtube.com/watch?v=Ndl8s-Td8mM [last accessed 6.10.2022]
13. YouTube. Foot Drop Treatment with Resistance Band - For Walking, Gait, and Function | Saebo. Available from: https://www.youtube.com/watch?v=iHBJ0f0C2uo [last accessed 03/08/2022] | {
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• Author: H. Erkan Kilinc x
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Gulcan Harput, H. Erkan Kilinc, Hamza Ozer, Gul Baltaci and Carl G. Mattacola
Context:
There is lack of information related to quadriceps and hamstring strength recovery during the early period of rehabilitation after anterior cruciate ligament reconstruction (ACLR) using hamstring-tendon graft (HTG).
Objective:
To investigate quadriceps and hamstring isometric strength at 4-, 8-, and 12-wk time points after ACLR and to document the strength changes of these muscles over time.
Design:
Longitudinal study.
Participants:
24 patients (age 28.1 ± 8.1 y) who underwent unilateral single-bundle anatomic ACLR with 4-strand semitendinosus and gracilis tendon graft.
Main Outcome Measures:
The isometric strength of quadriceps and hamstring muscles was measured on an isokinetic dynamometer at a 60° knee-flexion angle 4, 8, and 12 wk after surgery.
Results:
Quadriceps and hamstring strength significantly increased over time for both the involved limb (quadriceps F2,46 = 58.3, P < .001; hamstring F2,46 = 35.7, P < .001) and uninvolved limb (quadriceps F2,46 = 17.9, P < .001; hamstring F2,46 = 56.9, P = .001). Quadriceps and hamstring indexes significantly changed from 4 wk (QI 57.9, HI 54.4) to 8 wk (QI 78.8, HI 69.9) and from 8 wk to 12 wk (QI 82, HI 75.7) (P < .001); however, there was no difference between indexes at the 12-wk time point (P = .17).
Conclusions:
The results of this study serve as a reference for clinicians while directing a rehabilitation protocol for HTG ACLR patients to better appreciate expected strength changes of the muscles in the early phase of recovery. | {
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2,742,484,968,737,417,000 | What Is a Facial Faradic Treatment?
A faradic facial uses electrical pulses to contract muscles in the face producing an overall toned effect. The contractions increase blood circulation and build muscle. As the muscle builds underneath the skin, it produces the appearance of smoother skin on the surface as well as a fuller, firmer facial contour.
Treatment
Pads are placed on the face above the muscles targeted for stimulation. The pads transmit electrical pulses to the nerve endings, making the muscle contract. Frequency of the electric pulse is determined by the clinician and the recommended treatment plan. Sessions last about 15 minutes and are given at least twice a week to start. Maintenance treatments are required in order to maintain the appearance achieved.
Benefits
Increases skin-cell regeneration. Builds muscles, improving appearance of skin and contour of face. Stimulates the skin, improving its appearance. Muscle contraction causes increased blood and lymphatic flow, speeding up waste elimination.
Skin-Sensitivity Test
Before treatment, your clinician will perform a skin-sensitivity test. This will determine the sensitivity of your nerve endings and whether or not they will respond positively to the stimuli. It is a simple, quick and painless test.
During the test the clinician will lightly tap various areas on the client's face with a hard, pointed object (toothpick) and a soft object (cotton swab). Whether or not the client is able to tell the difference between the two determines the nerve sensitivity. If they are unable to discern the difference, the treatment will not be recommended. In order to prevent damage and pain it is very important for a client to be able to feel the stimulation and know whether or not the treatment is going as planned.
Other Wses
The treatment can be utilised on the arms, legs, hips and stomach to help tone muscles and reduce fat and cellulite. It is also widely used by doctors to help ease pain and accelerate, promote and stimulate growth, healing and restoration throughout the body.
Electrotherapy
The most common electrotherapy treatments offered by salons are: faradic, galvanic and laser.
A faradic current is an alternating current that affects the muscle only and causes no reaction in the skin. A galvanic current is a constant current that affects both the skin and muscle. Most often it is used for electrolysis and to firm skin, minimise pores and decrease redness due to acne. Lasers are used to firm and rejuvenate skin, smooth wrinkles and reduce the appearance of stretch marks.
There are many different treatments that are offered under each of these types of electrotherapy. It is important to thoroughly discuss each procedure and its benefits with the clinician in order to determine the most appropriate treatment plan.
Most recent
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3,749,450,141,070,382,600 | Why One Leg Is Stronger Than the Other and What to Do About It
Bulgarian split squats, single-leg deadlifts and reverse lunges can help strengthen our weaker leg.
Image Credit: PeopleImages/iStock/GettyImages
If you've ever been in the gym working on those buns of steel, more than likely you'll have noticed one leg seems stronger than the other. Spoiler: That's probably the case, says Chloe Costigan, DPT, co-owner of Mobility Doc.
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"We are not symmetrical beings in the first place," Costigan tells LIVESTRONG.com. "And we end up doing asymmetrical activities for a variety of reasons that create more strength or flexibility in one limb over the other."
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One example is writing — chances are, you grab a pen with your dominant hand every time, right?
But asymmetry isn't necessarily a bad thing, Costigan says. In fact, an asymmetrical body can be an efficient one. For example, if you're pushed, natural instinct will stabilize your dominant leg to hold you steady.
"Your body creates these patterns so it doesn't need to think about it," she says. "The problem is when dominance starts to really take over."
In those cases, your non-dominant side might become too weak, your dominant side too strong and inflexible. That could lead to pain or injury.
And we shouldn't necessarily equate dominance with strength. Your dominant hand, for example, is the one you're more likely going to use for everyday tasks, and while that can inherently lead to increased strength, that's not always the case, Costigan says.
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So, why is one leg stronger than the other? Two experts share a few likely answers, plus how to address this leg strength imbalance.
Why Your Dominant Leg Is Stronger
Which leg is usually stronger? The answer is usually your dominant leg, and there are a number of reasons for this.
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You Have One Dominant Hand
Often, hand dominance translates to leg dominance, Costigan says. If you're right-handed, for example, you'll usually defer to that hand for everyday tasks like holding a phone and picking up a bag. You might see that same pattern when you go to kick a ball or push something heavy — your right leg will move to the front for power.
And when you default to your dominant side for certain tasks over and over again, it's inevitable for that side to build strength.
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Your Activity Requires a Dominant Side
Certain activities will default to one side over another, which is often tied to hand dominance, but not always, Costigan says. When you do asymmetrical activities or have a history of doing them — you're a former soccer or hockey player, for example — you're more inclined to have more asymmetry and expose those dominance patterns, she says.
And while running is a symmetrical activity, where you run can affect strength, unequally. A road's camber — the angle the road is designed — can play a role in which leg might be more dominant or stronger. Running on a track can also do this, if you run in the same direction over and over again, Costigan explains.
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"If you're turning left [the traditional direction of track running] there is more weight on your left leg, and if your left leg is already dominant, that could cause additional stress," she says.
You Have a History of Injury
If you've had a severe injury in the past, say a torn left ACL 20 years ago, it likely still has some effect on you, Costigan says. Let's say you were right-side dominant and the knee injury forced you to rely even more on your right side — that can create an issue.
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How to Test Which Leg Is Stronger
Costigan shares a few ways you can determine which leg is stronger.
Test 1: Starting from a standing position, pretend to fall and note with which leg you catch yourself.
Test 2: Jump off of one leg and then the other to see how high you can jump. If you jump higher pushing off of your left, your left is likely to be stronger. Costigan says this test should be taken with a grain of salt if you're not used to jumping regularly.
Test 3: Balance on one leg and then the other. The side that provides balance is likely going to be stronger, and often the dominant side.
Why Your Non-Dominant Leg Is Stronger
Although it's not unheard of, it's less common for your non-dominant leg to be stronger. In that case it's likely because your dominant leg is overworked, Costigan says.
For example, if your right leg is dominant but your left leg is stronger it could be because your right hip has more tightness; that can inhibit increasing strength.
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When Asymmetry Becomes a Problem
As Costigan points out, it's natural to be somewhat asymmetrical. It only becomes a problem when there's pain or compensation that can affect things like gait.
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"Most people end up having an injury due to cumulative strain," she says. "Over time you might slowly move in the direction of injury."
Athletes who heavily favor one side are more likely to experience an injury, Costigan says.
"That asymmetry gets exposed in athletes," she says.
The best way to prevent asymmetry from becoming a problem is to take note of how you're moving, Costigan says.
"Being an observer of yourself is key to preventing injury or addressing an issue," she says. "I noticed I do this thing on my right side but not on my left."
Or are you more flexible on one side?
That doesn't mean you have to figure out why — that's what a physical therapist is for — but it makes you more aware of yourself.
"Loss of flexibility can be due to overuse on one side," she explains, noting that you'll want to focus on how you move, flexibility, and strength and stability. "When there's enough wrong with all three areas, you'll have pain."
How to Strengthen Your Weaker Leg and Restore (Some) Symmetry
Not only are we asymmetrical beings, but everyday living has us moving on one leg at a time — for example, shifting from one leg to another while walking or running — Abby Bales, PT, DPT, CSCS, owner of Reform PT, tells LIVESTRONG.com.
"We should practice doing that in our workouts," Bales says.
Other exercises, like Pilates and yoga use single-leg activities and opposite leg-to-arm movements. "That works into the transverse and rotational planes of motion we use on a daily basis," she says.
Bales shares three of her go-to moves to mimic some of the one-sided living we do, which can help strengthen the weaker side.
Tip
Bales demonstrates these moves using dumbbells, but you can use just your body weight to make the exercises easier. Alternatively, you can increase the amount of weight used to make the moves harder.
1. Bulgarian Split Squat
Region Lower Body
Goal Build Muscle and Improve Balance
1. Stand a few feet in front of a bench, box or chair, facing away from it and holding a dumbbell in each hand.
2. Reach your left foot back and place the top of your foot flat on the surface. To help with balance, widen your base of support by moving your left foot a few inches to the left.
3. Lean your torso forward slightly and bend your front knee to sink your hips toward the floor as low as you can comfortably go.
4. Your front-leg shin should be vertical or close to it, while your back knee should point down toward the floor. If either leg is out of place, move your front foot forward or backward until you’ve found the ideal positioning.
5. Push through the middle of your front foot to return to standing.
6. Repeat.
7. Complete all reps on one leg before switching to the other.
2. Single-Leg Deadlift
Region Lower Body
Goal Build Muscle and Improve Balance
1. Stand on your right leg while holding a dumbbell in each hand, palms facing forward.
2. Keeping the right knee slightly bent, perform the deadlift by bending at the hip, extending your free leg behind you for balance or resting the top of your foot on a bench. During this movement, make sure your hips remain square.
3. Continue lowering the dumbbell until your upper body is parallel to the ground.
4. Keeping your back flat, return to the upright position.
5. Repeat on the opposite side.
3. Reverse Lunge
Region Lower Body
Goal Build Muscle and Improve Balance
1. Stand with your feet about hip-width apart, arms at your sides, holding a dumbbell in each hand.
2. Step with your left leg 3 feet behind you and bend your knees until they form 90-degree angles. Your back knee should hover an inch above the ground and your front thigh should be parallel to the ground (or as close as possible).
3. At the same time, bring your left arm up to form a 90-degree angle.
4. Keep most of your weight in the front leg as you press into your left heel and straighten your left leg.
5. Bring the left leg and arm back to the starting position and stand up.
6. Repeat the motion with the opposite leg and opposite arm.
The Bottom Line
Having a dominant side is normal and asymmetry is normal. But when you cross the threshold of what your body can tolerate, it changes movement, affects performance and can cause pain, Costigan says.
You don't have to make your body symmetrical, but adding in exercises that shift from one side to another in your workouts can help keep things less imbalanced.
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-5,414,700,277,205,953,000 | All About Glaucoma
Image of a group of older people wearing glasses.
Glaucoma is a serious disorder that can damage the optic nerves of your eyes if left untreated. The optic nerve carries images from your eyes to your brain. If the nerve is damaged, full or partial vision loss can occur. In some cases, people develop glaucoma because the pressure in their eyes begins to increase while, in others, ocular (eye) pressure is not an issue.
Although the word "glaucoma" is used as a blanket term to describe this condition, there are actually several different forms of the disorder.
Primary Open Angle Glaucoma
This type of glaucoma occurs when you produce too much aqueous humor, the clear liquid that fills your eyeball, or when channels that drain the aqueous humor become blocked. In both cases, pressure in your eye begins to increase, which can lead to optic nerve damage. If you do not have a glaucoma test at your optometrist's office regularly, you probably will not know that you have primary open angle glaucoma until you begin to notice problems with your side, or peripheral, vision.
Acute Angle Closure Glaucoma
Acute angle closure glaucoma occurs due to a sudden blockage in the drainage channels in the eye. Eye pressure rises quickly, causing severe pain, redness, decreased vision and nausea. If you develop any of these symptoms, go to the emergency room immediately. If the problem is not corrected promptly, you may experience permanent vision loss.
Normal-Tension Glaucoma
In normal-tension glaucoma, optic nerve damage occurs even though the pressure in your eye remains at normal levels. The first sign that you have this form of glaucoma is often tunnel vision.
Less Common Forms of Glaucoma
Pigmentary glaucoma occurs when a tiny piece of pigment breaks loose from your iris and blocks the drainage channels in your eye while secondary glaucoma develops after an eye infection or injury. Some children are born with congenital glaucoma, an inherited form of the disorder.
Who Gets Glaucoma?
Although anyone can get glaucoma, some people have an increased risk of developing the disorder. Your chances of getting glaucoma may be higher if:
• You have structural abnormalities in your eyes.
• You are very nearsighted or have a family history of glaucoma.
• You are over 60, or are black, Hispanic or Asian.
• You recently had an eye infection or eye surgery.
• You have sickle cell anemia, diabetes, heart disease or high blood pressure.
• You take corticosteroids.
How Is Glaucoma Treated?
Optometrists prescribe a variety of eye drops that work by either decreasing fluid production or improving drainage. In some cases, oral medication also helps lower the pressure in your eye. Surgery can help improve drainage in your eye and is the recommended treatment if you suddenly develop acute angle closure glaucoma. Both traditional and laser surgery is used to treat the disorder.
How Can I Find Out If I Have Glaucoma?
Yearly eye checkups can help you avoid vision loss due to glaucoma. Since symptoms do not usually occur until there is already damage, frequent glaucoma tests are a must. Optometrists use several painless screening tests. Tonometry measures the pressure inside your eye while visual field testing tests your peripheral vision.
Special eye drops that dilate the pupils allow doctors to take a close look at your eyes and spot any signs that could indicate that you have glaucoma. Optic nerve imaging provides a picture of your nerve and is useful for spotting changes or damage.
Concerned that you are at risk for glaucoma? Call us today to schedule an exam and testing.
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-8,824,417,002,461,831,000 | Skip to the content
Cervical Screening
There are two sources of cervical screening information that we received at Karo:
• NSU (National Screening Unit) data which, since March 2016, we receive monthly, this data is sent to us towards the end of the month and should be up-to-date with almost all screening done in the previous month
• PMS data which is sent to us via the Clinical Event Export (either monthly or quarterly depending on your PHO).
We have a report which compares the results from the two data sources and you may find some differences between the two.
There are a few things you can check to ensure that the data from your PMS is accurate:
1. Check that your screening term outcomes are set up correctly - click here for the recommended screening codes and outcomes.
2. If there are women on our reports showing as overdue who are exempt from needing a cervical smear, to get them removed from our system, do a screening for them with the outcome of HYST or another outcome that maps back to 'X' in the screening template set-up. We will receive that information as part of the next export and will know they are exempt, and they will show up as exempt on future reports.
3. If a woman has been screened with you or elsewhere, make sure you complete a screening template (code CX) for her. Otherwise, we won't have a record of the screening being completed.
4. Please ensure that women who have not responded to recalls are not marked as exempt! To check if the Non-Responder category is set up properly, go to the screening set-up, select the cervical screening template and the 'add a code for Non-Responder' (if it doesn't already exist), and make sure the Outcome Ind is set to 'I'.
The screenshot below shows you how to add a new Non-Responder Outcome in MedTech: | {
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5,578,949,789,139,168,000 | Beauty
Related Condition Centers
What Can an Online Dermatologist Actually Do for You?
We asked the experts.
A woman looks at her phone to chat with an online dermatologist.
nattrass / Getty Images
Seeing a dermatologist can be a costly, time-consuming, and frustratingly drawn-out process. So it makes sense that a consultation with an online dermatologist would sound intriguing.
The idea is simple enough: You snap a couple of pics of your skin issue, answer a questionnaire, and receive a skin-clearing regimen in return. Whether that’s actually how the process plays out will depend on your skin type, specific concerns, and the service that you choose. As is so often the case, addressing a skin issue (online or IRL) is often trickier than it seems.
Here, we’ll answer some of the biggest questions you may have about the emerging (and pretty darn promising!) field of tele-dermatology.
How does an appointment with an online dermatologist actually work?
The exact consultation process will depend on the platform you choose. On one hand, there are such services as MDLive and DermatologistOnCall, which assign patients to on-call dermatologists who can address and diagnose a wide variety of skin conditions and concerns, from psoriasis to eczema to warts.
On the other hand, if you’re mainly concerned with acne or signs of aging, you might reach out to a platform like Curology, which focuses on providing customers with individual skin-care plans. Although Curology employs an array of board-certified dermatologists, physician assistants, and nurse practitioners, it doesn’t offer treatments for skin conditions other than acne and anti-aging.
Whichever service you decide best suits your needs, you’ll likely have to submit a photo or two of your skin and answer some questions about your skin health. For example, Curology asks patients about their skin concerns, skin type, and medical history through an online quiz, but other platforms may text, email, or notify their patients through a company app. You might even be asked to call your tele-derm or speak with them over a video call. Based on the info you provide, the platform will offer a diagnosis and recommend a treatment plan or regimen of topical products.
So who is actually looking at your skin to come up with your diagnosis and treatment plan? The truth is, it depends. Where some services work with board-certified dermatologists, others employ an array of medical professionals with varying levels of experience in dermatology, Adam Friedman, M.D., professor and interim chair of the department of dermatology at George Washington University, tells SELF. “Do your homework before jumping on board, because you have to pay for these [services],” he says. You can start by digging around on their website to see if they explain who exactly will be working on your case, or you might need to call the customer service line if it’s not clear.
Along those lines, it’s worth looking up your state’s regulations around telemedicine (some states only allow derms to practice telemedicine if they’re licensed in the state their patients are contacting them from, for example) and which programs your insurance will reimburse you for.
What can an online dermatologist do for you?
As you may have already guessed, there’s only so much information that a dermatologist can glean about you and your skin from looking at some photos and a questionnaire. To that end, tele-dermatology services will be most effective in prescribing common medications like oral antibiotics for acne or hydrocortisone (in states that allow e-prescriptions), and addressing more common or preexisting concerns like signs of aging, eczema, rosacea, or acne. Like, say, if you already know you have psoriasis, are experiencing a flare-up, and just need a prescription topical medication. Or if you have a mysterious itchy bug bite and aren’t sure whether you can just apply over-the-counter hydrocortisone or if you’ll need a prescription.
But in some cases, even these relatively straightforward conditions can be difficult to treat without an in-person consultation, Heather Holahan, M.D., assistant professor in the department of dermatology at the University of North Carolina, Chapel Hill, tells SELF.
For one thing, she points out that rashes may appear to be something non-urgent like eczema or psoriasis in a photograph but could actually indicate something as serious as T-cell lymphoma. “It can be very hard to see just a picture of a rash and say what [it] is,” Dr. Holahan says. “You don’t get to feel it. You don’t get to see [if] it’s scaly.”
And even acne can be difficult to diagnose and treat remotely, Dr. Holahan says. If you’d describe your acne as “mild,” you may benefit from a Curology-style regimen. But anything in the moderate-to-severe range may need more attention than an online service can provide—especially if you notice any scarring or cystic papules. “When people have scarring acne, that would require a visit in person, because there are more complex medications like [retinoids] that may be more appropriate,” she explains.
If you aren’t quite sure if your issue is run-of-the-mill or more urgent, there’s nothing wrong with reaching out to an online dermatologist for a consult—even if they end up referring you to someone in the flesh. “One of the greatest strengths of tele-derm is triaging between what really needs to be seen and what can probably be managed at home,” Dr. Friedman says.
When should you go straight to an IRL derm?
Although an online dermatologist can field some of your questions and concerns, there are certain red flags that will always warrant a face-to-face appointment: Fever, rashes in the mouth or on the genitals, dark bruises that don’t blanch when you press on them, weeping of the skin, and severe joint pain all number among serious causes for concern, both Dr. Friedman and Dr. Holahan explain. These can be signs of an underlying infection or virus that might need immediate medical attention.
Also, anything that could suggest the development of skin cancer, like a mole that’s changed in appearance, should be seen by a dermatologist in person. There are obvious limitations that come with only looking at photos, Dr. Holahan says, adding that the shape, texture, and feel of a growth can provide vital information as to whether it’s worrisome or not. “There are examples where just looking at an image you can say, ‘Nope, that’s definitely not skin cancer based on the morphology,’ but it’s going to be on a case-by-case basis,” Dr. Friedman says.
So if you’re worried that a mark or mole on your skin could be a sign of skin cancer, definitely seek out an IRL skin check. And, of course, and don’t forget to schedule an in-office visit for your regular skin check!
So who should you see the next time your skin is acting up?
If you’re in a particularly remote part of the country where specialized care is hard to come by, reaching out to someone online may be the easiest (or only) way to get seen—and that’s obviously better than doing nothing at all.
That said, tele-dermatology is most useful when you go into your consultation with some information already in your back pocket, Dr. Holahan says. So if you’ve already been diagnosed with something or you have a pretty good idea of the kind of treatment you’re interested in (whether that’s an acne medication or something for fine lines), then you’ll probably have more success with an online dermatology service than someone who isn’t really sure what their skin needs.
If it’s difficult for you to see a dermatologist in your area, you can also try chatting with your general-care doctor about simpler skin issues, like acne. “We’re not reinventing the wheel,” Dr. Holahan says. “There are topical medications that we all would [recommend], so your primary doctor can help with that.”
On the other hand, if you’re considering tele-dermatology just because it’s convenient, Dr. Holahan says you may want to reconsider. “It becomes dangerous when people have access to [in-person] dermatology and just want to send in a photo of their rash and get a quick answer [instead],” she says. In just the few seconds it takes to make that decision, “there can be a lot of dangerous assumptions and misdiagnoses.” And if you wind up with a misdiagnosis or an adverse reaction to a tele-dermatologist’s recommendation, it can be difficult to follow up with them, depending on the platform.
So if you’re dealing with ambiguous or severe symptoms—or a flat-out emergency—seek in-person care (even if it means having to travel) right away. But if you’re curious about treating your acne or if you need to refill your psoriasis medication, speaking with an online derm is absolutely an option. Just remember to do your research on the service that you’re using and know the limitations of what you can and can’t expect from an online dermatologist appointment.
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2,045,574,548,982,479,400 | Assessment of venous thromboembolism risk and prevention of deep vein thrombosis in childbirth
70
Assessment of venous thromboembolism risk and prevention of deep vein thrombosis in childbirth
Image described by caption and surrounding text.
All pregnant women have a risk of thrombosis from the first trimester until at least 6 weeks postpartum, the absolute risk being 1 : 1000 pregnancies.
The factors contributing to venous thromboembolism (VTE) include immobility, stasis of blood flow, alteration of the constituents of the blood (hypercoagulability) and abnormalities/damage to the vessel wall; all of these are affected by pregnancy. An increase in coagulation factors, with a decrease in natural inhibitors to anticoagulation, reduced venous tone and the pressure of the pregnant uterus all predispose to VTE. If left untreated, 25% of deep vein thrombosis (DVT) will be complicated by pulmonary embolism (PE), where a fragment of thrombus breaks away (Figure 70.1) and travels through the right side of the heart to lodge in the pulmonary circulation. The risk factors are listed in Table 70.1.
Antenatal assessment
NICE (2015), RCOG (2015) and SIGN (2010) recommend that all pregnant women should undergo a thrombotic risk assessment with numerical scoring at the first antenatal visit or prepregnancy wherever possible (Table 70.1). This assessment should consider personal and family history, the presence of any risk factors and any known thrombophilia, balancing with the risk of bleeding. If the woman’s circumstances change, such as excessive weight gain, immobility or vomiting with dehydration, or admittance to hospital, then assessment should be repeated. Once the baby is born, a further risk assessment should be undertaken. All details should be documented in her records.
Preventing VTE
If assessment identifies a risk of developing VTE or bleeding, the midwife should refer the woman to a specialist haematologist. Based on the numerical scoring from the thrombotic risk assessment, NICE recommend pharmacological VTE thromboprophylaxis with low molecular weight heparin (LMWH) or unfractionated heparin (UFH) for those with renal failure, as follows:
• From the first trimester if the total score ≥4
• From 28 weeks, if the total score is 3 antenatally
• For at least 10 days, if the total score is ≥2 postnatally.
• If admitted to hospital antenatally
• If prolonged admission ≥3 days or readmission to hospital within the puerperium.
Jun 19, 2019 | Posted by in MIDWIFERY | Comments Off on Assessment of venous thromboembolism risk and prevention of deep vein thrombosis in childbirth
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7,409,530,347,734,134,000 | Introduction
Posterior spinal fusion (PSF) is related to perioperative morbidity and mortality in the adult population [1, 2]. Risk factors, including advanced age, presence of comorbidity, and long segment fusion are associated with development of perioperative complications in PSF [3, 4]. Understanding of relevant risk factors is critical to minimize morbidity and mortality.
Abdominal complications such as iliac vein or artery laceration, ureter injury, splenic rupture, and incisional hernia have been reported to occur in conjunction with anterior spinal fusion [5]. Patients with history of abdominal or pelvic surgery are at a high risk of complications after anterior spine surgery [6]. However, few reports have described abdominal complications such as superior mesenteric artery syndrome [7, 8], acute pancreatitis [9], and abdominal compartment syndrome (ACS) [10,11,12,13] after the posterior approach. It has not been determined if abdominal surgical history increases abdominal complication risk after PSF. Recently, patients with ACS following PSF have been reported [12, 13]. ACS is one of the most unpredictable and fatal complications following PSF and is defined by elevated intra-abdominal pressure (IAP) > 20 mmHg with evidence of organ failure [14]. The authors present a patient with a history of abdominal surgery who experienced a left inguinal hernia after posterior lumbar fusion (PLF), showing features of ACS. The patient was informed that data concerning the case would be submitted for publication, and he provided consent.
Case presentation
History and presentation
A 73-year-old man with body mass index (BMI) of 23.02, medical history of hypertension, and surgical history of appendectomy 10 years prior presented with a 6-month history of low back, both buttocks, and leg pain, and he was experiencing progressive intermittent claudication. Preoperative X-ray (Fig. 1a) and magnetic resonance imaging (Fig. 1b, c) of the lumbar spine showed spondylolisthesis of L4 on L5 and spinal stenosis between L4 and L5. We performed L4–5 transforaminal lumbar interbody fusion with posterior screw fixation using the minimally invasive technique. Under general anesthesia, the patient was in the prone position with Jackson table. The operation time was 1.5 h, and there was no special event during operation. Anteroposterior and lateral lumbar spine X-ray imaging was performed on the first postoperative day showed acceptable positioning of the interbody cage and posterior instrumentation (Fig. 2a, b).
Fig. 1
figure 1
a Preoperative lumbar spine X-ray. b, c Lumbar spine T2-weighted MRI showing spondylolisthesis from L4 to L5. The views, include sagittal and axial at the L4 to L5 level
Fig. 2
figure 2
a, b Postoperative anteroposterior and lateral radiographs showing the fusion from L4 to L5
On the second postoperative day, the patient began to show nausea, vomiting, abdominal distention, and pain. He began to suffer from dyspnea and fever, by daybreak of postoperative day 4, then he was transferred from a private spine hospital to the advanced general institution’s emergency department for further evaluation.
Physical examination and investigations
On physical examination, he showed tenderness to palpation at the left upper quadrant, left lower quadrant, and right lower quadrant of the abdomen. There was no rebound tenderness or abdominal guarding. Laboratory studies revealed a white cell count of 13,310 per microliter (reference range: 4000–10,800), C-reactive protein (CRP) of 415.6 mg/L (reference range: 0.1–6.0), and procalcitonin of 5.66 ng/mL (reference range: 0.02–0.5). Arterial blood gas analysis revealed a pH of 7.395, pCO2 of 37.2 mmHg, and pO2 of 65.2 mmHg.
Abdominal and chest X-ray showed an enlarged abdomen with gas distention in the stomach (Fig. 3a) and pneumonia in both lungs (Fig. 3b). Abdominal computed tomography (CT) scan revealed left inguinal hernia of the small bowel with incarceration (Fig. 4a, b) and small pelvic ascites, but there was no sign of strangulation. Chest CT further showed multifocal peri-bronchial consolidation in both lungs with atelectasis in the right upper lung and both lower lungs (Fig. 4c).
Fig. 3
figure 3
a, b Plain radiographs performed on the fourth postoperative day showing gas-distended stomach with small bowel loops, and pneumonia in both lungs
Fig. 4
figure 4
a, b Abdominopelvic computed tomography showing left inguinal hernia of the mid small bowel with incarceration. The views, include anteroposterior and axial at the inguinal area. c Chest computed tomography showing pneumonia with atelectasis in the right upper lobe and bilateral lower lobes
Treatment
Because the patient presented with vomiting, fever, and dyspnea and there was evidence of pneumonia on chest X-ray, we assumed his diagnosis as aspiration pneumonia and treated him with antibiotics. We empirically started tazobactam, piperacillin, and ciprofloxacin, but his respiratory symptoms progressed to respiratory failure. He was admitted to the intensive care unit, intubated, and mechanically ventilated in conjunction with changed antibiotics (meropenem and levofloxacin). After about 2 weeks of mechanical ventilation, his symptoms and chest X-ray findings had improved. Finally, he was extubated and transferred to a nursing facility. CRP level was followed throughout his stay and revealed a prominent downward trend from 415.6 mg/L at presentation to 44.8 mg/L by 1-month postoperatively.
Although there was an incarcerated inguinal hernia of the small bowel with severe bowel distention suggesting IAH, there was no strangulation sign on CT finding. Nasogastric tube and rectal tube were inserted and maintained with negative pressure for 10 days. Three liters of greenish to dark brown color fluid drained through nasogastric tube for 2 days and decreased gradually afterwards. The inguinal hernia was manually reduced twice, and hernia truss was applied. Elective hernia surgery was scheduled later due to his general condition.
Discussion
Understanding complications and relevant risk factors after spinal fusion is important to minimize perioperative morbidity and mortality. It is well-known that pseudoarthrosis, wound infection, neural injury, dural tear, malpositioned screws, deep vein thrombosis, and arachnoiditis are complications of spinal fusion surgery [15, 16]. Czerwein et al. reported that abdominal complications such as vascular injury (iliac vein, artery, and inferior vena cava tear), visceral injury (ureteral injury, peritoneal tears, and bowel injury), and neural injury (injury to sympathetic chain, hypogastric plexus) can occur in conjunction with anterior lumbar fusion [5].
However, there is scant literature concerning abdominal complications after Posterior spinal fusion (PSF). We briefly summarize abdominal complications following anterior or Posterior lumbar fusion (PLF) (Table 1) [5,6,7, 9, 11]. Types of abdominal complications after PSF, include acute pancreatitis [9], superior mesenteric artery syndrome [7, 8], and Abdominal compartment syndrome (ACS) [10,11,12,13]. In this case, we report a patient who experienced inguinal hernia and developed significant abdominal pathology requiring intensive medical care following PLF. Recently, it was revealed that patients with a history of abdominal or pelvic surgery are at a higher risk of developing abdominal complications following anterior spinal fusion [6]. However, risk factors for developing ACS following PSF have not been determined.
Table 1 Abdominal complications following anterior or posterior spinal fusion
In this paper, we review reported ACS cases after PSF and propose probable risk factors for ACS development following posterior spinal surgery. ACS is defined as sustained Intraabdominal pressure (IAP) greater than 20 mmHg concurrent with evidence of organ dysfunction [14]. To determine IAP, different techniques such as transbladder, uterus, rectum, stomach methods could be utilized [17]. Because all air needs to be aspirated from stomach, measurement of IAP through nasogastric tube is inconvenient [17]. Measurement of bladder pressure is commonly used as a standard screening tool for ACS or Intraabdominal hypertension (IAH) [18]. Although the pathophysiology of ACS is not well established, it has been revealed that elevated IAP causes regional blood flow disturbances affecting the lung, kidney, and heart, resulting in IAH-induced organ dysfunction and development of ACS [19]. When patient is diagnosed with ACS or IAH, IAP should be measured first every 4–6 h with medical treatment to reduce IAP. Medical treatments are focused on symptomatic treatment including sedation, nasogastric/colonic decompression, use of promotility agents, diuretics, and fluid resuscitation [18]. If patient’s IAH/ACS is refractory to medical management, decompressive laparotomy must be strongly considered. Although there are no specific diagnostic methods and therapies, the prognosis of ACS is relatively better when diagnosed early [20].
Recently, Holodinsky et al. [21] reported 16 risk factors associated with ACS and 25 with IAH including obesity, age, and postlaparotomy status. It is also well-known that prone position contributes to IAP elevation [22,23,24,25], and obese patients have higher IAP compared to normal BMI patients [26, 27]. Thus, we suggest that patients who undergo PSF are more prone to suffer from ACS complications due to the position compared with anterior spinal fusion. Among the various prone position, Jackson table is the best method to decrease IAP [28]. We used Jackson table, so operation position is not related with ACS in this case. Previous abdominal surgical history and BMI could be risk factors for developing IAH or ACS after PSF. In this case, the patient who was finally diagnosed with acute respiratory distress syndrome had severe abdominal distention with left incarcerated inguinal hernia, small pelvic ascites, minimal pericardial effusion, and multifocal peribronchial consolidation. Although we did not measure intravesical pressure, we assume that the patient was experiencing IAH, because organ dysfunction exists at IAP levels between 12 and 20 mmHg—the range defined as IAH [29].
To our knowledge, eight cases have been reported for ACS or IAH after PSF [10,11,12,13] (Table 2). Almost all the studies clinically diagnosed patients with ACS or IAH without any measurement of bladder pressure. Most of patients presented with typical abdominal symptoms such as severe abdominal pain, nausea and vomiting in conjunction with CT findings, including peritonitis, ileus and inguinal hernia. Because our case experienced severe abdominal pain and vomiting with findings of inguinal hernia, peribronchial pneumonia and pelvic ascites in the setting of increased IAP, we also diagnosed our patient with IAH, which diagnostic process is consistent with previous reports. Thus, we infer that the diagnosis of ACS or IAH after PSF should be considered in the clinical experience. We found that most cases of spine surgery were long segment fusion, which require a long operation time in the prone position. Shih et al. [12] also reported four patients with high BMI and abdominal surgical history who developed ACS after PSF. We suggest that long segments fusion, abdominal surgical history and BMI could be the risk factor for development of ACS/IAH after PSF considering the number of previous cases. However, risk factors like obesity and long segments fusion, did not match in this case. To know the exact risk factors, we need further study including more cases.
Table 2 Reported cases of intra-abdominal hypertension or abdominal compartment syndrome after posterior spinal fusion
The risk factors of IAH is still unclear, but if there is any sign suggesting bowel obstruction such as increased nausea, vomiting, and worsening abdominal pain, high suspicion for IAH is required. Physical examination to assess distended abdomen, plain radiography, and CT scanning of the abdomen and pelvis should be performed quickly for early detection of ACS, which might require surgical decompression if refractory to medical management. Measurement of bladder pressure can be utilized to determine IAP. Furthermore, along with several suggested risk factors including abdominal surgical history, high BMI and long segments surgery, patients who undergo PSF should be carefully monitored for development of ACS or IAH in the intraoperative and postoperative periods.
Conclusion
Complications of spinal fusion contribute to perioperative morbidity and mortality. Therefore, it is essential to understand predisposing risk factors and minimize complications. Abdominal complications such as ACS rarely occur in conjunction with PSF but are associated with significant morbidity and mortality. If patients who have several suggested risk factors complain of severe nausea or vomiting after PSF, it is critical to suspect ACS or IAH as early detection and intervention are imperative. | {
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2,945,715,235,615,997,400 | #alcohol muscle twitching | steroids shop
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Muscle twitches after drinking alcohol - Expert answers on HealthTap
Medications to treat Muscle Twitching, the following list of medications are in some way related to, or used in the treatment of this condition. To put it simply, ice application
may exacerbate muscle twitching considerably. The twitching in arms may come and go but in some cases, it may continue for the entire day. Doctor insights on: Muscle Twitches After Drinking Alcohol. In most cases, muscle twitching in right arm or left arm is a minor issue and often goes unnoticed. Excessive caffine intake can cause muscle twitching. Muscle twitches can also occur in people affected with muscular dystrophy or spinal muscular atrophy. anon June 21, 2011 Very informative and helpful. Other causes are: occuring after muscular exertion, tension or anxiety and. There is a lack of accepted safety for use under medical supervision. Persons with benign fasciculation syndrome (BFS) may experience paraesthesia (especially numbness ) shortly after taking such medication; fasciculation episodes begin as the medication wears off. See also: Twitch (disambiguation) and, tremor, a fasciculation /fskjlen/, or muscle twitch, is a small, local, involuntary muscle contraction and relaxation which may be visible under the skin. A strenuous aerobic exercise is also most likely to trigger muscle twitching. Muscle twitching in arm is normally a result of following a rigorous exercise routine. Like even alittle now. When a nerve that ends in a muscle is compressed or damaged, it can also cause repetitive muscle movement in arm.
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Caffeine is present in coffee, tea and boldenone undecylenate and test 400 steroids injection cola. It's rather annoying but this article was helpful and will likely be clenbuterol dosage chart caused by my poor diet, lack of low testosterone levels vitamins, too much booze and not enough water. Prolonged exposure to anxious situations or an anxiety attack can contract the muscle for a considerable period of time. A gentle massage with your fingers causes muscles to relax and relieve twitching. Even if a drug such as caffeine causes fasciculations, that does not necessarily mean it is the only cause. So, one can apply heating pads or hot compresses to reduce spasmodic activity. Surface EMG is more sensitive than needle electromyography and clinical observation in the detection of fasciculation in people with amyotrophic lateral sclerosis. Also referred to as muscle fasciculations, it is often regarded as the body's response to fatigue. Considering steroids injection knee replacement surgery? Prescription or Over the Counter, pregnancy, a Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and where to buy winstrol steroids stanozolol dosage there is no evidence of risk in later trimesters).
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It is not intended to be a substitute for the advice of steroids a medical expert. 3, has a potential for abuse less than those in schedules 1 and. As 7080 of the adult population does not consume the recommended daily amount of magnesium, 4 inadequate intake may also be a common cause. An area of the muscle keeps on moving (jumping) up and down under the skin for some time (few seconds or minutes). Unsourced or poorly sourced material may be challenged and removed. It is getting worse but I'm afraid to go to the doctor because I feel like I would be wasting my time again. Soaking your arm in warm water for 15-20 minutes relaxes the muscles and may also provide immediate relief from twitches. Thus, the hyper excited nerves due to excess intake of caffeinated beverages can trigger rapid palpitations of muscles. "Long-term follow-up of 121 patients with benign fasciculations". Muscle fasciculations can also occur as a side effect of medicines like corticosteroids. Side Effects of Medications, drugs like diuretics are often used for the treatment of hypertension and congestive cardiac failure. A b Mateen FJ, Sorenson EJ, Daube JR (2008). Dehydration often causes disturbance in electrolyte balance, which eventually triggers muscle twitching.
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It injections has a currently accepted medical use in steroids treatment oxymetholone in the United States. Why Do Muscles Twitch, anxiety, anxiety is the leading cause for involuntary muscle side movement. Treatment edit This section needs more medical references for verification or relies effects too heavily on primary sources. N, fDA has not classified the drug. Alice September 5, 2010 I found side this info.
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Muscle twitches in MS patients may aggravate at achat night. A warm-up increases blood flow and make your muscles more receptive to exercise. D, there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies nandrolone in humans, but potential testosterone benefits may warrant use in pregnant women despite potential risks. Applying heat often works to soothe muscles and reduce twitching. Neurological Disorders, the dense network of nerves that run throughout the body relay signals from the brain to coordinate muscle movement. And steroids when you get home take a couple of aspirin and a couple of glasses cycle of water, even if you need to force the water down. | {
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Towards an optimized inhibition of liver stage development assay (ILSDA) for Plasmodium falciparum
Abstract
Background
Experimental vaccines targeting Plasmodium falciparum have had some success in recent years. These vaccines use attenuated parasites, recombinant sporozoite proteins, or DNA and virus combinations to induce cell-mediated immune responses and/or antibodies targeting sporozoite surface proteins. To capitalize on the success of these vaccines and understand the mechanisms by which these vaccines function, it is important to develop assays that measure correlates of protection in volunteers. The inhibition of liver stage development assay (ILSDA) tests antibodies for the ability to block sporozoite development in hepatocytes. As such the ILSDA is an excellent candidate assay to identify correlates of humoral protection, particularly against the liver stage of malaria infection. In addition, the ILSDA can be used as a tool to evaluate novel sporozoite antigens for future vaccine development. Historically the ILSDA has suffered from low sporozoite infection rates, absence of standardized reagents, and the subjectivity associated with the traditional primary outcome measures, which depend on microscopy of stained hepatocyte cultures. This study worked to significantly improve sporozoite infection rates in hepatocytes, modify key steps in the assay protocol to reduce experimental variability, and demonstrate the utility of the ILSDA in testing antibodies targeting the circumsporozoite protein.
Methods
Cryopreserved primary human hepatocytes, Plasmodium falciparum sporozoites, and circumsporozoite antibodies were used to optimize the ILSDA.
Results
Inoculation of cryopreserved primary human hepatocytes with Plasmodium falciparum sporozoites improved liver stage development in the ILSDA compared to HCO4 cells. In the ILSDA, circumsporozoite antibodies suppressed liver stage development in cryopreserved primary human hepatocytes in a concentration-dependent manner. Antibody-mediated suppression of parasite development in the ILSDA at a 96-hour endpoint was more robust than the 24-hour endpoint.
Conclusions
ILSDA performance is improved by the use of cryopreserved primary human hepatocytes, expediting interactions between sporozoites and hepatocytes, and extending the assay endpoint.
Background
Approximately half of the world’s population is at risk of contracting malaria and there were 660,000 deaths from malaria in 2010 [1]. Additionally, malaria parasites are becoming increasingly resistant to anti-malarial drugs [2], underscoring the need for a vaccine. Malaria infections start with a blood meal from a malaria-infected mosquito. The mosquito proboscis introduces sporozoites into the skin where the sporozoites then translocate to the bloodstream. From the bloodstream the sporozoites travel to the liver sinusoid, move through Kupffer cells, and eventually invade a hepatocyte to initiate schizogony. After 7–10 days, several thousand merozoites leave each infected hepatocyte to infect red blood cells (erythrocytes) and cause symptomatic malaria. Vaccine efforts have focused on targeting the asymptomatic sporozoite and liver (pre-erythrocytic) stages of the disease as a mechanism to prevent both symptoms and transmission [35].
The leading vaccine candidate, RTS,S, protects from malaria challenge by inducing antibodies targeting the major surface protein of the sporozoite (circumsporozoite protein, or CSP) [6]. CSP antibodies most likely function by blocking sporozoite entry and development in hepatocytes [7, 8]. Attenuated whole sporozoite vaccines also demonstrate efficacy by protecting volunteers in human challenge models and appear to induce protection through both cell-mediated and humoral immune responses [911]. Despite the fact that both of these experimental vaccine approaches induce antibodies binding to the parasite, there is no highly sensitive or specific humoral correlate of protection [11]. Both CSP ELISA and sporozoite IFA titers show significant correlations, but individuals with low titers following vaccination are sometimes protected, while individuals with high titers may remain susceptible.
Functional assays are considered a promising approach to developing stronger markers of protective immunity. These assays measure the ability of antibodies to interfere with normal function, such as inhibition of sporozoite motility, inhibition of sporozoite invasion (ISI), or inhibition of liver stage development (ILSDA). However, existing functional assays have been limited by lack of sensitivity, standardization, and reproducibility, by the non-specific inhibition exhibited by negative controls and by the subjectivity associated with relying on microscopy and histological stains to determine parasite viability [11]. This gap between promise and performance underscores the need for improved functional assays that quantitatively and reproducibly predict in vivo protection.
To strengthen existing functional assays, the Liver Stage Laboratory at the Naval Medical Research Center has established an in vitro Plasmodium falciparum liver stage culture system in cryopreserved primary human hepatocytes (CPHH) with real-time PCR-based measurement of parasite infection rates. In this study, infection and development rates in CPHH greatly exceed those observed in hepatocyte-derived cell lines such as HCO4 cells. The culture system allows performance of multiple liver stage experiments in the same host genetic background, improving experimental consistency. Here this culture system has been adapted for the ILSDA, yielding improved sensitivity and reliability relative to the classic ISI, which relies on immortalized hepatocyte lines as the host cell. As proof of principle, results in this study show that CSP monoclonal antibodies block liver stage development in a concentration-dependent manner.
This study describes the development of a new ILSDA and identifies requirements for the consistent measurement of antibody-mediated inhibition using CSP antibodies as a test reagent. The study highlights the ILSDA as a promising candidate to identify humoral correlates of protection from malaria vaccine trials.
Methods
Overview
The ILSDA is similar to the previously described ISI [12]. Both assays are designed to identify an activity in sera that blocks invasion into hepatocytes and subsequent development [13]. Hollingdale et al. practiced an ISI technique, whereby antibodies were introduced to hepatocyte cultures prior to inoculation of sporozoites [12]. In this study sporozoites were incubated with antibodies prior to inoculating the hepatocytes with the sporozoite-antibody mixture. In addition, the assay endpoint was delayed in this study to allow invaded sporozoites to develop and non-invaded sporozoites to senesce. Traditionally, the ISI read-out is performed a few hours to one day after sporozoite inoculation of hepatocytes. Although a shortened assay duration is convenient for increasing throughput, it can artificially augment the parasite load due to the presence of free sporozoite stages that have not yet washed out of the hepatocyte culture or senesced, resulting in a false signal. In the ILSDA described here, antibodies are incubated with sporozoites for 20 minutes at room temperature to allow an opportunity for test antibodies to bind to sporozoite proteins. The sporozoite-antibody mixture is then inoculated into a primary human hepatocyte culture. The culture is washed after three hours and again after 24 hours post-inoculation of sporozoites. The culture remains undisturbed for 72 hours after the second wash before harvesting cells, isolating the total RNA, and performing quantitative real-time PCR (qRT-PCR) for Pf 18S rRNA.
Antibodies
Navy falciparum sporozoite antibody 1 (NFS1) was developed in-house at the Naval Medical Research Center. Rabbit anti-Plasmodium falciparum polyclonal anti Heat Shock Protein 70 (HSP70) antibody was purchased from LifeSpan Biosciences, Inc (Seattle, WA).
Plating the hepatocytes
Cryopreserved primary human hepatocytes were purchased from Celsis IVT, Inc. (Baltimore, MD). The cell plating medium was prepared by adding Torpedo™ Antibiotic Mix containing pen/strep, gentamycin, amikacin, and fungizone to InVitroGRO™ CP Medium (Celsis IVT, Inc.). Vials of hepatocytes were thawed and added to the cell medium. Hepatocytes were counted and 140 k-200 k viable cells were added to each well in LabTek® chamber slides. After a three-hour incubation period, the medium was replaced with fresh media and incubated overnight.
The HC04 human liver cell line was obtained from Dr. Jetsumon Sattabongkot and maintained in culture at 37°C and 5% CO2 in DMEM/F12 medium supplemented with 10% FBS and 1% penicillin-streptomycin solution. HC04 (50 k/well) cells were seeded onto ECL Cell Attachment Matrix (Millipore, Billerica, MA) coated 48-well plates or LabTek® slides and incubated overnight. Twenty-four hours after seeding the cells the wells of the plates and slides were confluent with cells and contained approximately 140 k-200 k cells/well.
Plasmodium falciparum sporozoite preparation
Plasmodium falciparum (strain NF54)-infected Anopheles stephensi adult females were anesthetized by soaking with 70% ethanol followed by washing with DMEM medium containing anti-bacterial and anti-fungal antibiotics (BD Biosciences, 100 units/mL of penicillin, 100 units ug/mL of streptomycin, and 0.25 μg/mL of fungizone) and hepatocyte culture medium. Salivary gland dissection was performed by: 1 – Placing each mosquito on a glass slide; 2 – Using a dissecting microscope and two 27-gauge needles, separating the head from the thorax; 3 – Separating the two sets of salivary glands from the head and/or thorax and placing the salivary glands in hepatocyte culture medium in a microcentrifuge tube. The salivary glands were then disrupted by passing the medium through a 29.5-gauge needle and syringe. The sporozoites were subsequently counted using a haemocytometer and diluted in hepatocyte culture medium to a desired concentration.
Infection of hepatocytes
Sporozoites were introduced into the wells containing CPHH or HC04 cells and incubated at 37°C for 3 hours to allow sporozoites to infect hepatocytes. As a positive control for anti-CSP antibodies, sporozoites were incubated for 20 minutes with NFS1 at various concentrations at room temperature prior inoculation. After the sporozoite inoculation, the Lab-Tek slides were centrifuged at 110 × g for 1 minute at room temperature to expedite sporozoite-hepatocyte interactions. After the three-hour incubation period, CPHH or HC04 cells were washed with fresh hepatocyte culture medium to remove non-invaded sporozoites. For the one-day assay (24 hours), CPHH were incubated overnight until harvested. For the ILSDA (96 hours), CPHH or HC04 cells were harvested on Day 4.
Harvesting the hepatocytes
CPHH or HC04 cells were trypsinized, washed once at 835 × g in phosphate-buffered-saline for 5 minutes, and kept at -80°C until RNA extraction. To generate a standard curve for the qRT-PCR, sporozoites were serially diluted in hepatocyte culture medium, desired sporozoite numbers were added to hepatocyte mono-layers, and total host-cell/parasite material collected and stored at -80°C until RNA extraction.
RNA extraction
The cells were removed from -80°C storage and a Qiagen RNeasy Mini Kit protocol was followed to extract the RNA from the cells. The extracted RNA was analysed with a NanoDrop spectrophotometer (Thermo Fisher Scientific) and then stored at either 4°C (for short-term storage) or -20°C (for long-term storage).
Quantitative real-time PCR (qRT-PCR)
For each experiment RNA from each sample was diluted to the same concentration, added to PCR reaction plates, and converted to cDNA using the High Capacity cDNA Reverse Transcription Kit (Applied Biosystems, Foster City, CA). Reaction volumes of 20 μL were used in a Thermal Cycler (MJ Research Inc., Waltham, MA) set at the following amplification protocol: 25°C for 10 minutes; 37°C for 120 minutes; 85°C for 5 seconds; hold at 4°C. The resulting cDNA was used immediately or stored at -20°C.
The following probe and primers were used to detect parasite 18S ribosomal RNA (rRNA): Taqman® MGB Probe (Applied Biosystems, Sequence: 5′ – 6FAM - CAG GTC TGT GAT GTC C - MGBNFQ - 3′); Sequence Detection Primer 1 (Applied Biosystems, Sequence: 5′ - TAA CAC AAG GAA GTT TAA GGC AAC A - 3′); Sequence Detection Primer 2 (Applied Biosystems, Sequence: 5′ - CGC GTG CAG CCT AGT TTA TCT - 3′). A plate document on the 7500 Fast System was set up according to experimental design prior to each run. To prepare the qRT-PCR reaction plate, cDNA (diluted to 15–20 ng/mL), probe (250 nM) and primers (600 nM) were mixed with TaqMan® Fast Universal PCR Master Mix (Applied Biosystems) to a total volume of 20 μL per reaction in a MicroAmp Fast Optical 96-Well Reaction Plate (Applied Biosystems) covered with MicroAmp Optical Adhesive Film. The reaction plate was then placed in a 7,500 Fast Real-Time PCR System (Applied Biosystems) to quantify parasite 18S rRNA using the default thermal cycling conditions: Stage 1 – enzyme activation: 95°C for 20 seconds; Stage 2 (repeated 40 times) – melting at 95°C for 3 seconds, annealing and polymerization at 60°C for 30 seconds. Results were analysed using the Applied Biosystems standard PCR calculation system once each run was completed. Experimental samples were compared to the standard curve generated from host cell and sporozoite mixtures containing known numbers of sporozoites.
Results
Cryopreserved human hepatocytes support Plasmodium falciparum liver stage development
Studying the liver stage of P. falciparum malaria requires a robust and reliable system of in vitro parasite cultivation. Recent efforts to cultivate P. falciparum liver stage sporozoites have focused on the hepatocyte-derived cell line HC04 [14]. However, HC04 cells suffer from a low P. falciparum sporozoite infection rate [14]. After testing multiple different cell sources, we found that cryopreserved primary human hepatocytes (CPHH) are ideal for supporting liver stage development, consistent with earlier reports using fresh primary human hepatocytes (FHH) [15]. Unlike FHH, CPHH can be obtained in large quantities, allowing for a substantial number of repeat experiments while holding host cell genotype constant. We inoculated CPHH purchased from commercial vendors with dissected P. falciparum sporozoites and found that CPHH with greater than 80% viability supported robust liver stage parasite development of HSP70-staining P. falciparum schizonts (Figure 1A and B).
Figure 1
figure 1
Development of P. falciparum in CPHH. A: Representative view of one 40X field typically contains several P. falciparum (Pf) liver schizonts. B: Pf liver stage schizont developing within a CPHH in vitro. Schizonts were stained with mAb anti HSP70 (purchased from LifeSpan Biosciences, Inc.) followed by fluorescein-tagged secondary antibodies (green). Nuclei were stained with DAPI (blue). Scale bar = 20 μm. C: Correlation between qRT-PCR Pf 18s rRNA copy number and counting of HSP70-positive liver stage schizonts was determined by plotting a scatter chart and linear regression (R2) Fifteen data points from 6 separate experiments using sporozoites alone and two data points from two separate experiments using sporozoites mixed with NFS-1 are shown. In all of the samples shown on the graph hepatocytes were analysed 96 hours after sporozoite inoculation. D: Comparison of sporozoite development at 96 hours after 25 k sporozoites inoculated in CPHH and HC04. Error bars represent the standard deviation of the mean.
18S rRNA qRT-PCR provides an objective, quantitative outcome measure for liver stage burden
Liver stage schizonts are often detected using immunofluorescence analysis of fixed cells (Figure 1A and B). However, these manual counting processes are subject to operator error and potential bias. To develop a more quantitative assessment of liver stage parasite biomass we measured 18S rRNAs from P. falciparum using qRT-PCR. Two distinct 18S rRNA genes are expressed during the P. falciparum lifecycle. It was shown that one 18S rRNA gene was expressed during asexual, or blood-stage malaria, while the other 18S rRNA gene was expressed during sexual, or mosquito-stage malaria. During liver stage parasite development, expression switches from the sexual to the asexual copy [16]. For the studies described here a set of primers designed to amplify both the sexual and asexual 18S rRNA was used.
To assess the extent of correlation between 18S rRNA copy number and liver stage schizonts we infected 200 K CPHH with 25 K sporozoites in six separate experiments with duplicate samples in each experiment. Plasmodium falciparum 18S rRNA qRT-PCR and HSP70 schizont staining were performed at 96 hours and compared in parallel, but in different samples, to avoid degradation of parasite RNA during fixation. For one of the experiments described here exceptionally high schizont yields of 300–375 HSP70-staining parasites per well were observed with 14,000-20,000 P. falciparum 18S rRNA copies per sample. Typically, between 10 and 70 HSP70-stained schizonts were observed per sample corresponding to 1,000-11,000 P. falciparum 18S rRNA copies. To suppress parasite development we treated sporozoites with 5 μg/mL of NFS1 antibodies targeting CSP prior to hepatocyte inoculation. The NFS1-treated sporozoites produced no detectable HSP70 stained schizonts and essentially no P. falciparum 18S rRNA signal. All of our samples were plotted with P. falciparum 18S rRNA levels on the Y-axis against HSP70 stained schizonts on the X-axis. A line of best fit was applied to the samples assuming a linear relationship between P. falciparum 18S rRNA and HSP70 stained schizonts. The coefficient of correlation between 18S copy number and HSP70 stained schizont numbers was between an R2 of 0.8362 and 0.95, indicating a strong correlation between ribosomal RNA levels and stained schizonts (Figure 1C). Removing the samples that had exceptionally high parasite yields (300–375 parasites per well) provided an R2 of 0.764. Because 18S rRNA qRT-PCR is quantitative, highly specific, and less susceptible to background effects, 18S rRNA levels using qRT-PCR were used for the remainder of the study.
Cryopreserved primary human hepatocytes provide a significantly higher infection load compared to HC04 cells
Liver stage infection loads of 200 K CPHH or 200 K HC04 cells inoculated with 25 K dissected P. falciparum sporozoites were analysed by 18S rRNA qRT-PCR after 96 hours of development in vitro in 20 replicate experiments. CPHH show a 21-fold increase in parasite 18S rRNA levels compared to HC04 cells infected with the same number of sporozoites over the same incubation period (p = 3 × 10-14) (Figure 1D). This result suggests that CPHH display a marked improvement in parasite development compared to HC04 cells. Results presented here and those of Mazier et al. suggest that primary hepatocytes, but not hepatocyte-derived cell lines support robust parasite development [15].
Liver stage parasite burden approaches saturation after sporozoite dose escalation
It is reasonable to speculate that incubating CPHH with an increasing load of sporozoites might result in a concomitant elevation in developed liver stage schizonts. To test this hypothesis 200 k CPHH were incubated with 25 k, 50 k, 75 k, 100 k, or 140 k P. falciparum sporozoites for 24 (1D) or 96 hours (4D) with media changes. From these samples parasite burden was assessed by P. falciparum 18S rRNA qRT-PCR. Plasmodium falciparum 18S rRNA levels from these samples showed a sporozoite-dependent increase in liver-stage parasite infection load (Figure 2A). These results suggest that increasing the number of sporozoites that are co-cultured with CPHH generally results in an increase in liver stage parasites. However, the liver stage parasite load appeared to reach a plateau in samples that were inoculated with 100 K-140 K sporozoites, suggesting that a saturation point was reached for liver stage development in samples that were inoculated with >100 K sporozoites. Performing a student t-test (equal variance 2-tails) between the samples analysed after 1 day of sporozoite inoculation of hepatocytes yielded a p = 0.0001 for 25 K sporozoites compared to 50 K sporozoites, p = 0.18 for 50 K sporozoites compared to 70 K sporozoites, p = 3.54 × 10-6 for 50 K sporozoites compared to 100 K sporozoites, p = 0.002 for 70 K sporozoites compared to 100 K sporozoites, and p = 0.48 for 100 K sporozoites compared to 140 K sporozoites. Performing a student t-test (equal variance 2-tails) between the samples analysed after 4 days of sporozoite inoculation of hepatocytes yielded a p = 0.002 for 25 K sporozoites compared to 50 K sporozoites, p = 0.09 for 50 K sporozoites compared to 70 K sporozoites, p = 0.009 for 50 K sporozoites compared to 100 K sporozoites, p = 0.13 for 70 K sporozoites compared to 100 K sporozoites, and p = 0.32 for 100 K sporozoites compared to 140 K sporozoites.
Figure 2
figure 2
Factors influencing P. falciparum liver stage development in CPHH. A: Effect of various sporozoite numbers on infection rate of CPHH. CPHH were inoculated with 25 k, 50 k, 75 k, 100 k and 140 k P. falciparum (Pf) sporozoites. The liver stage parasite burden was measured by Pf 18s rRNA qRT-PCR on day 1 (D1) and day 4 (D4). Error bars represent the standard deviation of the mean. B: Effect of centrifugation on invasion rate of CPHH. CPHH were inoculated with 25 k Pf sporozoites and harvested after 96 hours. Pf 18s rRNA copy numbers of centrifuged samples were compared to samples without centrifugation. Error bars represent the standard deviation of the mean.
Centrifugation enhances sporozoite invasion and liver stage development
CPHH display a complete adherence to collagen-coated slides. As a result the hepatocyte media surface is approximately 2 millimeters from the surface of the cells. Sporozoites inoculated into the hepatocyte media are buoyant and might float in the media for an extended time period before interacting with the hepatocyte target, possibly losing infectivity during the process. Previous results indicate that a brief centrifugation of the sporozoite-inoculated hepatocytes can expedite interactions between the parasite surface proteins and the hepatocytes [17]. In three replicate experiments it was observed that centrifugation after inoculation of 200 K hepatocytes with 25 K sporozoites increased liver stage parasite load by ~5.3 fold (p = 3 × 10-4) compared to an inoculum that was not subjected to centrifugation (Figure 2B). These results suggest that forcing sporozoite-hepatocyte interactions by centrifugation significantly elevates the liver stage parasite infection load in vitro.
CSP antibodies suppress liver stage development in a concentration-dependent manner
Although several studies have shown that anti-CSP or anti-sporozoite antibodies suppress liver stage development in the ISI assay, few studies have demonstrated a concentration-dependent inhibition of sporozoite invasion or development [12]. To test the potential for linearity in the ILSDA, a range of CSP antibody concentrations (n = 2 at each antibody concentration) was tested. Using the anti-CSP antibody NFS1 targeting the NANP-repeat sequences of CSP, we observed a clear concentration-dependent inhibition of parasite 18S levels in the ILSDA (Figure 3A). Plasmodium falciparum 18S rRNA levels were not detectable when sporozoites were incubated with NFS1 antibodies at a concentration range of 0.04-1 μg/mL, suggesting that these antibodies have potent anti-sporozoite activity. Diluting the NFS1 antibody beyond a concentration of 0.04 μg/mL de-repressed liver stage development resulting in elevated P. falciparum 18S rRNA levels. Each five-fold dilution of NFS1 antibody resulted in an approximate 2-fold elevation in P. falciparum 18S rRNA levels, suggesting that the inhibitory activity of NFS1 antibodies was concentration dependent.
Figure 3
figure 3
Activity of CSP antibodies in the ILSDA. A: CSP antibodies demonstrate concentration-dependent inhibition of liver stage development in CPHH. 25 k P. falciparum (Pf) sporozoites were mixed with NFS-1 at six different concentrations (0.0003, 0.0016, 0.008, 0.04, 0.2, or 1.0 μg/mL) and inoculated into CPHH. Hepatocytes were analysed after 96 hours of sporozoite inoculation. Pf 18s rRNA copy numbers were measured by qRT-PCR. Each data point shows the mean of a duplicate sample. B: Effects of NFS-1 (10 μg/mL) on the sporozoites ability to invade (1D = 1 day) and develop (4D = 4 days) in CPHH. Error bars represent the standard deviation of the mean.
Assay endpoint is critical during analysis of liver stage burden
CSP antibodies are used as positive controls in the ISI assay and ILSDA. In the ISI, investigators incubate sporozoites or hepatocytes with antibodies, inoculate the sporozoite-antibody mixture into a hepatocyte culture, and then assay for invaded sporozoites by immunostaining or qRT-PCR after 1–24 hours. The ILSDA is essentially identical to the ISI except the assay endpoint is extended from 24 to 96 hours to allow for parasite development. This study tested NFS-1 anti-CSP antibodies for liver stage growth inhibition in both the ISI (24 hour endpoint) and the ILSDA (96 hour endpoint) (Figure 3B). Using 1 μg/mL of NFS1 in the ILSDA (96-hour endpoint) resulted in a 151-fold reduction of P. falciparum 18S rRNA levels compared to untreated sporozoite samples (p = 5.95 × 10-15). In contrast, NFS1 antibodies showed only a minor reduction (<1.5-fold) in P. falciparum 18S rRNA levels compared to untreated control cultures in the ISI (24-hour endpoint) (p = 0.014). Collectively, these results suggest that allowing liver stage parasites to mature (96 hours) can reveal the inhibitory activity of anti-sporozoite sera. Conversely short-term incubation of sporozoites with hepatocytes in the presence of CSP antibodies (≤ 24 hours) has only a minor effect on liver stage parasite burden.
Discussion
Establishing a liver stage infection model in cryopreserved human primary hepatocytes
Understanding the basic science of the P. falciparum liver stage has been an area of research interest for decades but has been limited by a lack of a productive and robust culture system. Here a method for cultivating the P. falciparum liver stage using cryopreserved human hepatocytes was characterized. This system provides a higher infection rate than hepatocyte-derived cell lines. Additionally, the use of CPHH has a distinct advantage over FHH in that FHH cells represent a finite and variable resource. Because each human liver has approximately 1 × 1011 hepatocytes [18, 19], a single CPHH donor can provide a series of repeatable experiments studying the same host/hepatocyte-parasite interaction. Collectively our results show that CPHH allow experimental repeatability with higher P. falciparum infection rates compared to immortalized hepatocyte cell lines.
The gold standard for detection of the P. falciparum liver stage involves immunostaining for exoerythrocytic forms with antibodies specific for parasite proteins. Immunostaining suffers from the subjective interpretation of what is and is not a liver stage parasite. Additionally, immunostaining liver stage parasites is less amenable to automation, which reduces the throughput of the assay. In this study we performed a correlation analysis of immunostained P. falciparum parasites and 18S rRNA levels. There was a strong correlation between the number of immunostained, mature liver stage schizonts and 18S rRNA levels in this study. Importantly, these results are consistent with those observed by previous studies [20, 21]. Collectively, these results suggest that quantifying P. falciparum 18S rRNA levels can function as a substitute for counting individual liver stage parasites. Additionally, assaying parasite development by 18S rRNA qRT-PCR has the potential advantage of increased throughput and quantitation over immunostaining techniques. Finally, amplification of P. falciparum 18S rRNA is unambiguous which facilitates throughput and simplifies our experimental readout.
Ways to increase productive infections in CPHH
It is natural to assume that increasing sporozoite numbers would influence the number of infected hepatocytes in vitro. Increasing the number of sporozoites that were incubated with hepatocytes resulted in an elevation in P. falciparum 18S rRNA levels. However, P. falciparum 18S rRNA levels began to saturate between 100-140 K sporozoites in wells seeded with 200 k CPHH. Importantly, this result suggests that increasing the sporozoite load will not necessarily result in a concomitant increase in the number of developing liver stage schizonts in CPHH. We hypothesize that this can be explained by several possible factors. First, it is reasonable to speculate that not all P. falciparum sporozoites dissected from the salivary gland have the potential to bind, invade, and develop in hepatocytes. In this scenario only sporozoites that had achieved a particular developmental profile would have the potential to establish a productive infection in a hepatocyte. Second, it is possible that the cell surface architecture of most CPHH cells is not ideal for sporozoite binding and invasion. For example, during the processing of donor liver tissue, hepatocyte surface proteins might be lost or depleted resulting in a reduction of host cell binding receptors for sporozoites. Despite the fact that we do not observe a 1:1 infection ratio of sporozoites to CPHH, this culture system appears superior to immortalized cell lines derived from hepatocytes for cultivating the liver stage of P. falciparum.
Consistent with previous observations, expediting the interaction between sporozoites and hepatocytes by centrifugation enhanced parasite development [17]. This result suggests that hepatocyte entry and/or subsequent development might be dependent on the proximity of the sporozoite. In this model sporozoites might benefit from an initial “dive” into the first hepatocyte until finding a final hepatocyte to initiate development. Sporozoites inoculated into culture might float for hours before precipitating to the tissue culture well bottom to interact with a hepatocyte. During this time the sporozoites could lose invasion and/or developmental potential.
ILSDA as a quantitative assay for antibody suppression of parasite development
The ISI has been used to demonstrate strong anti-sporozoite activity in sera from RAS-protected volunteers, sera from malaria endemic areas, and monoclonal antibodies targeting CSP. These past experiments have focused on characterizing antibodies that show an exceptional inhibition of sporozoite invasion compared to non-protected or pre-immune samples [11, 12, 22, 23]. NFS-1 antibodies targeting the CSP NANP repeat sequence suppressed P. falciparum development in the ILSDA in a concentration-dependent manner. Using the ISI, Hollingdale et al. used CSP monoclonal antibodies to inhibit sporozoite invasion at concentrations as low as 2.5 μg/mL [12]. Using similar CSP-targeting antibodies in the ILSDA a complete inhibition of liver stage development at concentrations as low as 0.04 μg/mL was observed. These results suggest that the ILSDA has the potential to identify the anti-sporozoite activities of non-CSP antibodies that exhibit lower activity (compared to CSP antibodies) in functional assays.
ILSDA versus ISI and the importance of assay endpoint
Experiments employing the ISI and ILSDA have yielded conflicting results [11]. In this study the ILSDA detected strong anti-sporozoite activity from CSP antibodies (>1000-fold inhibition) compared to control antibodies. The anti-sporozoite activity of CSP antibodies in the ILSDA and the ISI were compared in parallel. While the experimental conditions of the ILSDA suggested a >1000-fold inhibition in parasite development, the ISI showed less than a 1.5-fold reduction in parasite 18S rRNA levels between samples treated with CSP antibodies compared to controls. The ILSDA and the ISI are essentially the same experiment; in both cases sporozoites are incubated with antibodies for 20 minutes at room temperature and introduced to hepatocytes, but are incubated for different periods, either 24 hours (ISI) or 96 hours (ILSDA). Therefore, the primary difference between the two assays is the co-incubation time of antibody-bound-sporozoites and hepatocytes. The difference in observed activity between the ISI and ILSDA suggests that: 1. Non-invaded sporozoites provide a background signal during amplification of the P. falciparum 18S rRNA, or 2. Antibodies bound to sporozoites suppress parasite development after hepatocyte invasion. Taken together, our results suggest that the ILSDA has the capacity to distinguish hepatocyte-invaded and developing parasites from non-invaded sporozoites. Because the ILSDA is more sensitive than the ISI, it should be considered a more conclusive determination of humoral anti-parasite activity.
Conclusions
This work describes an improved method of cultivating P. falciparum liver stage parasites, identifies ways to enhance hepatocyte infection, and used this novel culture system to assess functional antibody responses to parasites using the ILSDA. Future work will assess the ILSDA for sensitivity and specificity in predicting protection against controlled human malaria infection in humans immunized with candidate malaria vaccines inducing protective humoral immunity.
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Acknowledgements
The authors would like to extend their thanks to Christin McDonough for assistance with preparing high quality images and to Stephen Lizewski and Eileen Villasante for helpful reviews of the manuscript.
This work was funded by the Military Infectious Disease Research Program (MIDRP) “Follow on Optimization of the in vitro P. falciparum Liver Stage Infection Model using Cryopreserved Human Primary Hepatocytes”, work unit #0602787A.870.F.A1214. VG, MZ, BH and TLR were active duty military personnel at the time they contributed to this work. The work of these individuals was prepared as part of official government duties. Title 17 U.S.C. §105 provides that 'Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person’s official duties. The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Department of the Navy, the Department of Defense, or the U.S. Government.
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RVG, CZ and TLR wrote the paper. RVG, MZ, and BH served as Principal Investigator. RVG, BH, CZ, and MZ designed experiments. CZ performed experiments. CZ, RVG, MZ, and BH analysed data. All authors read and approved the final manuscript.
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Zou, X., House, B.L., Zyzak, M.D. et al. Towards an optimized inhibition of liver stage development assay (ILSDA) for Plasmodium falciparum. Malar J 12, 394 (2013). https://doi.org/10.1186/1475-2875-12-394
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Keywords
• ILSDA
• Sporozoite
• Functional assay
• Antibody
• Liver stage
• Hepatocyte
• CSP | {
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739,777,788,983,019,100 | @article {Ponte:2007:0963-6897:595, title = "Toward Maximizing the Success Rates of Human Islet Isolation: Influence of Donor and Isolation Factors", journal = "Cell Transplantation", parent_itemid = "infobike://cog/ct", publishercode ="cog", year = "2007", volume = "16", number = "6", publication date ="2007-06-01T00:00:00", pages = "595-607", itemtype = "ARTICLE", issn = "0963-6897", eissn = "1555-3892", url = "http://www.ingentaconnect.com/content/cog/ct/2007/00000016/00000006/art00004", doi = "doi:10.3727/000000007783465082", keyword = "Islet purification, Islet transplantation, Pancreatic islets, Pancreas recovery, Pancreas preservation, Islet isolation, Donor management, Organ selection", author = "Ponte, Gaston M. and Pileggi, Antonello and Messinger, Shari and Alejandro, Angel and Ichii, Hirohito and Baidal, David A. and Khan, Aisha and Ricordi, Camillo and Goss, John A. and Alejandro, Rodolfo", abstract = "In order to make islet transplantation a therapeutic option for patients with diabetes there is an urgent need for more efficient islet cell processing to maximize islet recovery. Improved donor management, organ recovery techniques, implementation of more stringent donor criteria, and improved islet cell processing techniques may contribute to enhance organ utilization for transplantation. We have analyzed the effects of donor and islet processing factors on the success rate of human islet cell processing for transplantation performed at a single islet cell processing center. Islet isolation outcomes improved when vasopressors, and in particular pitressin, and steroids were used for the management of multiorgan donors. Higher islet yields were obtained from adult male donors, BMI >25 kg/m2, adequate glycemic control during hospital stay, and when the pancreas was retrieved by a local surgical team. Successful isolations were obtained in 58% of the cases when 4 donor criteria were met, and even higher success rates (69%) were observed when considering 5 criteria. Our data suggest that a sequential, integrated approach is highly desirable to improve the success rate of islet cell processing.", } | {
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6,243,176,466,982,631,000 | Supplementary Materialsba025684-suppl1. a humanized defucosylated built antibody directed against BAFF-R, antagonized BAFF-mediated apoptosis protection and signaling at the population and single-cell levels in CLL cells. Furthermore, VAY-736 showed superior antibody-dependent cellular cytotoxicity compared with CD20- and CD52-directed antibodies used in CLL. VAY-736 exhibited in vivo activity as a monotherapy and, when combined with ibrutinib, produced prolonged survival compared with either…
Supplementary Materialsijms-19-03432-s001. of NSCs. that is one of the Umbelliferae family members, using column chromatography and slim level chromatography (TLC) (Supplementary Body S1A,B). To check whether Trend displays the cytotoxicity on glioblastoma Pifithrin-alpha cells, we treated U373 glioblastoma cells with two different doses (10 M or 40 M) of Trend. The cytotoxic results were dependant on the phosphorylation of H2AX…
Supplementary MaterialsFigure S1: Low GP expressers and Mock-transfected cells are stained similarly for cell-surface human leukocyte antigen class-1 (HLA-I) molecules and NCR ligands. fixed the cells to ensure intracellular staining (B,D). (E) HEK293T cells were co-transfected with MICA-green fluorescent protein and GP-YFP and analyzed without further staining or permeabilization in the flow cytometer. (FCI) H5-transfected HEK293T cells were harvested and…
Supplementary MaterialsSupplementary Information 41467_2018_5854_MOESM1_ESM. seems to be involved in the dysfunction in knockout (KO; transgenic) naive CD4 T cells more rapidly senesced after receiving TCR stimulation than did the wild-type (WT) control cells10. Similar to KO naive CD4 T cells, the growing rate of KO naive CD8 T cells was reduced after day 7, even in PF-4136309 cost the presence…
nonnative ligands for development factor receptors with distinctive chemical properties and various natural activities have the to become healing applications. activation of the molecules. Within a 3-D lifestyle of bile duct cancers cells in collagen gel, HGF induced solid activation of MET, ERK, and AKT, that was associated with improved appearance of genes involved with bile duct advancement and following…
Supplementary MaterialsSupp Fig S1-S3. for these microRNAs. To verify and lengthen these observations, PBMC were transfected with either mimics or antagomirs of miR181 and 221and protein levels of the transcription factors and growth factors were decided. Transfection of microRNA mimics led to a ARN-509 pontent inhibitor reduction in both STAT-3/ARNT as well as VEGF/HGF/G-CSF levels. The opposite end result was…
The estrogen receptor (ER) can be an important regulator of growth and differentiation of breast epithelium. all situations have elevated degrees of cyclin D1 (Schuuring et al. 1992a,b; Buckley et al. 1993; truck Diest et al. 1997). The relevance of cyclin D1 overexpression is certainly underscored with the discovering that tissue-specific transgenic appearance of cyclin D1 in mice leads to…
People of the same age may not age at the same rate. aswell as age-related illnesses, such as for example cardiovascular illnesses 6, 7, tumor 8, and neurological disorders 9. The hyperlink between DNA harm and repair continues AMD3100 pontent inhibitor to be implicated in maturing by the deposition of senescent cells 10 or genomic rearrangements 11. Recently, this link…
Supplementary MaterialsSupplementary Material emboj2011202s1. sufficient to support NLC in SynPres (data not proven). Finally, oxalate (10 mM) put into the cytoplasm didn’t cause NLC in the transport-incompetent rPres both in the lack and in the current presence of high concentrations of Cl? in the extracellular alternative (Amount 7C, right -panel). Many observations indicate which the noticed potentiation of NLC by…
The standard procedure for the osteogenic differentiation of multipotent stem cells is treatment of a confluent monolayer using a cocktail of dexamethasone (Dex), ascorbic acid (Asc) and -glycerophosphate (-Gly). provide special focus on the differences between bone-specific and dystrophic mineralization. Launch Osteogenic differentiation protocols using dexamethasone (Dex), ascorbic acidity (Asc) and -glycerophosphate (-Gly) are generally used GSK2126458 small molecule kinase… | {
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4,874,060,311,584,393,000 | Are Your Vigorous Workouts Stalling Your Progress?
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Published: April 26, 2016
Fitness
HIIT and vigorous workout regimes like it have been all the rage lately and for good reason. They are an amazing way to get a fantastic workout in a short amount of time. Also, when these types of workouts are done right, they can challenge your body in ways that you didn’t think possible while leveling up your workout prowess and your results. But as with everything it is possible to have too much of a good thing.
HIIT workouts, when programmed correctly, will get you results. But the same HIIT workouts that you’ve come to love and depend on for the results you’re working so hard to get can keep you from reaping the benefits of your hard work.
The Impact
HIIT’s Impact on Your Cells
Fat loss is a lot about what’s going on in your body on a cellular level. When you’re eating too much food, you’re giving your cells more energy than they need to keep your organs and organ systems going. And the excess energy gets stored as fat. But for your cells to take up the energy that they need, they need to be in prime working condition. This means you’re not just beating yourself up at the gym, but you’re eating the highest quality nutrition that you have access to and can afford. It also means that your cells are no-more damaged than usual.
Consistent HIIT without a break can sabotage your results at this cellular level because excessive intense workouts without the needed rest can lead to cellular oxidative stress. Oxidative stress is defined as the total toll that free radicals that are released in the course of your daily life can take on your body. Your body has it’s own mechanism from preventing this from being an issue long-term, but your HIIT habit might short circuit these mechanisms if you’re not eating a healthy diet and are not resting sufficiently.
HIIT’s Impact on Your Hunger Levels
Fat loss is also about shifting your energy balance to where you’re eating a healthy diet that gives your body the high quality nutrition it needs in a lower calorie package. And exercise is one way to shift this energy balance without cutting your calories too much. But the relationship between exercise and weight loss is about so much more than burning calories. Have you noticed that you might get hungrier on the days you do intense workouts? Well this nuanced relationship is at play here.
The physical demand that intense workouts can put on your body after a workout goes beyond the initial calorie burn. If you’re working out intensely, you’re burning calories during and after your workout. This is what is called EPOC (Excess Post-Exercise Oxygen Consumption). And it is normally a great thing, but only if you fuel for it. Fueling for the calorie burn during exercise and EPOC requires that you’re eating the right nutrients i.e. whole foods that give your body the nutrients and energy and not just lower calorie foods.
So if you’re just focused on cutting calories and are not considering the quality of the calories that you are eating, you will feel hungrier because your body needs more energy.
The Fix
Recover Appropriately
One fix to managing the effect of exercise induced oxidative stress would be to give your body enough rest and recovery time. If you’re nervous about cutting out workout sessions, just change up what you’re doing. This might mean taking one or two days a week from your current HIIT sessions and using them for recovery workouts like walking or hatha yoga.
Eat to Fuel Your Intense Workouts
Exercise burns calories yes, but the way your body works will require that you add back those calories somehow. To do this, it’s best to fuel with high quality calories, and I’m not referring to the price here but the content. Quality calories include foods like non-starchy vegetables, animal or plant protein, healthy fats, starchy vegetables and whole grains. If your eating pattern consists of mostly these foods in quantities that don’t leave you feeling overfed, you will be eating a naturally lower calorie diet that supports intense activity and weight loss.
I want you to look at your workout schedule, is it packed with high intensity workouts and vigorous activities from calendar wall to calendar wall? Or do you make time for the leisure activities that will help minimize the impact of exercise stress on your body? Making the time for recovery, even active recovery, can help you make sure that your hard work pays off.
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About Ejiro Ogenyi
EJ (Ejiroghene) is a Lifestyle Coach and owner of the Team by EJ Ogenyi LLC. She helps busy women lose weight without taking their eyes off their other priorities - their families, their careers, their wallets, and their lives. She is a Certified Personal Trainer and Nutrition Coach and she enjoys bringing her skills and her experience losing weight herself to the awesome task of helping her clients create healthy lives and bodies that they absolutely love. She is also a wife and mama to a beautiful little boy.
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-8,715,964,584,470,851,000 | Difference between revisions of "Phage therapy"
4,036 bytes added , 21:11, 26 March 2013
Line 28: Line 28:
== Bacteriophages ==
== Bacteriophages ==
:
:
Bacteriophage (phage) is a virus that infects bacteria host cells. Viruses are
acellular microbes that are obligate intracellular pathogens; requiring living cell
hosts to carry out metabolic and reproductive needs. Bacteriophages carry with
them a protein coat called a capsid that surrounds a small amount of DNA genetic
material. The size of the DNA can vary from 5 genes to over 100 genes(1). The
majority of the genes on phage DNA code for capsid proteins, proteins to protect
viral DNA from degradation, and proteins used in the release from the host cell(1,
2). Because phage cannot reproduce or undergo metabolism on their own, they
must infect living bacteria cells in order to reproduce. As part of their reproductive
cycle, phages kill the bacteria cell they are infecting. There are two main types of
reproductive cycles that a phage can use: the lytic cycle and the lysogenic cycle.
A typical phage lytic cycle consists of five main steps. The first step is
attachment. The attachment occurs between the phage and a receptor or structure
on the surface of the bacterial cell. Attachment is very specific for the
bacteriophage, with each phage being able to only infect one species of bacteria.
After attachment is entry and this is where the phage DNA enters into the cytoplasm
of the bacteria cell. Once inside the bacteria cell, the phage takes over the metabolic
machinery of the cell, degrades the bacteria DNA, and changes the cell into a phage
producing factory. The viral DNA is translated and viral proteins are made in the
synthesis part of the viral cycle. In addition to translation, viral DNA is also being
replicated to produce more viral DNA. Once enough viral capsid proteins and viral
DNA are synthesized, the assembly part of the cycle occurs. During assembly, the
viral capsid proteins surround the viral DNA to build more bacteriophage. When
enough bacteriophage particles have been assembled, the release phase occurs.
During the release phase, the host cell lysis open, releasing numerous bacteriophage
into the environment. The bacteriophage can then go and attach to another bacteria
host cell to repeat the lytic cycle over and over again until no bacteria are available
for attachment.
Although the lytic cycle can occur with all bacteriophage, some phage can
enter a dormant cycle called the lysogenic cycle. In the lysogenic cycle, attachment
and entry still occur but the host cell DNA is not degraded upon entrance. Instead,
the phage DNA incorporates into the host cell DNA to form a prophage. A prophage
implies that a bacteriophage has infected the host cell and is in a dormant cycle. The
length of this dormant cycle depends on a number of parameters such as, the
specific bacteriophage, the host cell, and the stress of the environment. Most
bacteria that enter this dormant stage never re-enter the lytic cycle. Each time the
bacterial cell divides and replicates its DNA, the prophage DNA is also being
replicated. Eventually induction occurs which is when the prophage excises out of
the host DNA and re-enters the lytic cycle at the synthesis stage. During the
synthesis phase, the host cell DNA is degraded and viral proteins are translated.
The assembly and release phases will follow. Many things can trigger induction
such as nutrient depletion, UV damage to host cell, or any change in environment
temperature or pH(3).
Bacteriophages provide a selective method for targeting and destroying
specific bacteria. In addition, because bacteriophage cannot replicate without the
presence of their host bacteria, once the bacteria have been eliminated, the viral
particles will soon degrade and also be eliminated. For each bacteria that exists,
there is at least one bacteriophage specifically able to attach and infect it. This
makes bacteriophage the most abundant entity on earth an estimated 10^31 present
on Earth(1). With such an abundance, this makes bacteriophage an excellent
candidate for eliminating bacterial infections.
== Questions and Specific Aims ==
== Questions and Specific Aims ==
:
:
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4,595,144,491,991,269,400 | Close
Reconstruction of Transmission Pairs for novel Coronavirus Disease 2019 (COVID-19) in mainland China: Estimation of Super-spreading Events, Serial Interval, and Hazard of Infection.
Abstract
Non-negligible frequency of super-spreading events, short serial intervals, and a higher risk of being infected outside of households for male people of working age indicate a significant barrier to the identification and management of COVID-19 cases, which requires enhanced non-pharmaceutical interventions to mitigate this pandemic.
Knowledge on the epidemiological features and transmission patterns of COVID-19 is accumulating. Detailed line-list data with household settings can advance the understanding of COVID-19 transmission dynamics.
A unique database with detailed demographic characteristics, travel history, social relationships, and epidemiological timelines for 1,407 transmission pairs that formed 643 transmission clusters in mainland China was reconstructed from 9,120 COVID-19 confirmed cases reported during January 15 - February 29, 2020. Statistical model fittings were used to identify the super-spreaders and estimate serial interval distributions. Age and gender-stratified hazard of infection were estimated for household versus non-household transmissions.
There were 34 primary cases identified as super-spreaders, with 5 super-spreading events occurred within households. Mean and standard deviation of serial intervals were estimated as 5.0 (95% CrI: 4.4, 5.5) and 5.2 (95% CrI: 4.9, 5.7) days for household transmissions and 5.2 (95% CrI: 4.6, 5.8) and 5.3 (95% CrI: 4.9, 5.7) days for non-household transmissions, respectively. Hazard of being infected outside of households is higher for age between 18 and 64 years, whereas hazard of being infected within households is higher for young and old people.
MIDAS Network Members
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-6,571,033,632,024,442,000 | Do Inversion Tables Work for Lower Back Pain?
Do Inversion Tables Work for lower back pain? Yes, Inversion table works for lower back pain. Every day we use the back extensively. You may not realize just how much your back makes everything you do work, but it certainly does. With this in mind, you cannot deny your back relief when it begins to have pain.
Lower back pain is the most common of back pains and is often caused by strenuous labor, or accidents while exercising. In this content, I share you do inversion table work for back pain?
People have been using a large variety of methods to treat lower back pain since the beginning of time. Everything from seeing a chiropractor to using heated pads can help relieve lower back pain.
However, there is one method that many people find themselves unsure about the benefits of inversion tables.
While the method has become increasingly popular over the years, it is still unclear to some people whether the inversion tables can relieve lower back pain effectively. Thankfully, we are here to solve the mystery.
Statistics often help support the case for inversion tables. In fact, a recent study done by The Energy Center reported that a full 75% of lower back pain sufferers felt relief after using inversion tables.
This allowed them to bypass riskier routes, such as invasive surgery that would alter muscles in the lower back.
What is Inversion Tables Exactly?
When using inversion tables for back therapy, you lie on the table and hang either partially or 100% upside down. This practice helps to promote increased traction on the spine.
The procedure began as far back as Hippocrates, the father of modern medicine. He used inversion table-like treatments, as he would hang patients upside down from objects like ladders.
We have made inversion tables much more comfortable and safe since that period. However, and now they are used by both physical therapists and chiropractors all around the world. You can even get an inversion table for your own home if you so choose.
Why am I Experiencing Lower Back Pain in the First Place?
The human spine is made of many separate bones, known as vertebrae. If you look between each of the separate vertebrae, each disc is filled to the brim with nerves and fluids.
These discs pad the area between each vertebra so that they do not rub together as you move around. However, as you age, gravity and other external factors such as exercise and strain begin to wear out the discs that prevent this rubbing from happening.A
Additionally, poor posture can weaken the strength of your vertebrae’s discs. Thankfully, inversion tables can be used to being stretching your spine back in the opposite direction, allowing more space to be regained between each vertebra. This goes a long way toward helping to relieve the lower back pain you are experiencing.
What is the Accordion Effect?
Beyond the situations described above, spinal fluid can build up in your discs, causing lower back pain and other serious issues.
By using an inversion table, you can slowly begin rocking after starting in a horizontal position, allowing you to effectively teeter-totter back and forth. This rocking motion is known as having an “Accordion Effect” on the spine.
When applying the effect, you allow milking, which helps get rid of some of the extra built-up fluid that has congregated in your spinal discs. In effect, a lot of tension will be taken off of your spinal cord, and your lower back pain will begin to feel relieved.
How Can I Reverse My Spinal Issues?
By using inversion tables to perform traction therapy, you can begin reversing some of the damage your spine has sustained. This action will help to reverse the negative affects gravity and years of poor posture and poorly thought exercise routines have done to your spinal cord.
You also will be decreasing the effects of or decreasing the chances that you gain, other serious spinal defects that go beyond simple lower back pain. Ailments such as scoliosis and sciatica can be relieved or prevented with this method.
Sciatica, in particular, is important to avoid, as it is a pain that happens in the hip and legs due to pinched nerves in your lower pain. This will cause a ton of lower back pain if it occurs, but it can also be treated by using inversion tables properly.
Are there any Dangers Associated with Inversion Table Use?
Yes, there are a few potential issues with using inversion tables, despite their overall advantage of relieving lower back pain.
For example, simply hanging upside down for long periods of time, can cause unsafe increased blood flow to your head and eyes. For this reason, you should always use inversion tables safely, and with the careful guidance and/or supervision of a trained medical professional.
Additionally, if you have glaucoma or have suffered retinal detachment in the past, you should never use an inversion table under any circumstance. It is also recommended that you should avoid using inversion tables if you suffer from circulatory or blood pressure issues.
How Do Inversion Tables work for Lower Back Pain?
Many studies have concluded that for non-specific acute lower back pain, you should remain as inactive as possible.
However, for both sub-acute and chronic lower back pain, there exists a ton of evidence that supports the benefits of inversion tables. Gravity simply will help relieve the strain you’ve been experiencing in your lower back.
What are Some Other Benefits of Inversion Therapy?
Beyond simply stretching the muscles out, inversion tables have many other useful benefits. In addition to stretching, you are likely to stretch ligaments, reduce muscle spasms, and improve your overall circulation.
One of the main benefits of inversion therapy, however, is that it increases the flow of your lymphatic fluids. These fluids are a primary part of your body’s waste disposal system.
For good blood circulation, you need to keep these chemicals steady in your body. As an added bonus, it will help with your lower back pain.
Talking to Your Doctor about Inversion Therapy
Just as you should with any other medical condition, you should always talk to your doctor before starting to use inversion tables to treat lower back pain.
Not only can they determine whether or not the practice will be safe for you, but they can give you further information about benefits, ways to approach the therapy, and much more.
Additionally, they can give you great advice about where to get the best deal for an inversion table, and which brands inversion tables will best suit your needs.
In most cases, you should be dealing with a physical therapist or chiropractor when seeking advice about inversion therapy.
Being approved for inversion therapy by your doctor is the most important reason to consult them. Certain medical conditions and medications can make using inversion therapy completely unsafe.
Due to this, a doctor may tell you to avoid the practice altogether. Obese patients, in particular, can cause further ligament and spinal issues by using inversion tables.
Additionally, some conditions will cause you to need to take a break from using the practice until they have healed up.
These conditions include hernias, eye and ear infections, pregnancy, and a few more. Consult your doctor in this area for a full list.
How Do I Start Using Inversion Therapy?
So, now you are likely wondering: how do I start using inversion therapy effectively? To put it simply, you should be doing it at a slow pace. You need to slowly adjust your body to hanging upside down.
Start out with a slight angle, maybe even only 15-degrees. Even this small amount of difference in your angle will begin to stretch your muscles.
Eventually, you will get to a stronger degree. In fact, most people never need to exceed 60-degrees to get access to the many benefits of inversion therapy.
Just listen to your body when increasing your angles, and if you begin to feel sore, especially in your lower back, stop using your inversion table immediately.
Conclusion:
There are a number of inversion tables in the market but this particular Alpine table is more comfortable and works for lower back pain.
So if you are looking for an inversion table that can meet up your expectation and save your pocket, this one is undoubtedly the best option for you. | {
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-1,607,551,564,024,303,000 | Fasting Intestine Folds
Overview. Together the duodenum, jejunum, ileum, and ileocecal valve make up what is commonly referred to as the small intestine. Food from the stomach is let into.
they were located near his small intestine. Doctors at JJ advised the police to ask Rotimi to eat something so that the digestive process would help eject the capsules. But Rotimi changed the script: he said he was going on a fast. ANC.
By the time Wandera was one-and -a -half years old, his stomach was swelling so fast that his parents took him to a herbalists who prescribed some concoctions. He took the herbal medicine for a period of six months, and the.
If you are popping up common over-the-counter drugs daily to treat acid reflux and stomach ulcers. The longer PPIs were used, the greater was the risk of developing stomach cancer, rising to 5-fold after more than a year, to more than.
A vitamin B12 deficiency is a serious disorder and indications of a deficiency of vitamin B12, when they do reach a stage where they have shown up, can be quite severe.
Case Details. A 40 -year-old man presents with chest pain that radiates to his left jaw and shoulder. He is diagnosed with a myocardial infarct (heart attack) and is.
Definition Colonoscopy is an endoscopic medical procedure that uses a long, flexible, lighted tubular instrument called a colonoscope to view the rectum and the.
GASTROSCOPY Definition. An upper endoscopy is a procedure used to visually examine your upper digestive system with a tiny camera on the end of a long, flexible tube.
chapter i—number 24,601 becomes number 9,430 chapter ii—in which the reader will peruse two verses, which are of the devil’s composition, possibly
By the time Wandera was one-and -a -half years old, his stomach was swelling so fast that his parents took him to a herbalists who prescribed some concoctions. He took the herbal medicine for a period of six months, and the.
Dumbell Press Standards How do you challenge your core while working your triceps? Try a Stability Ball Dumbbell Tricep French Press! This exercise is performed in a bridge position off the stability ball. The ball creates an unstable base for your head and back. Wright put two silver 15-pound dumbbells in my hands and showed me how to
10 Association of Avian Veterinarians cecal material supports the rabbit’s high nutrient requirement per unit of body weight and improves feed utilization
Start studying MLT Missed Question Review. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
UTMCK Small Intestine Anatomy 270 to 290 cm – Duodenum 20 cm – Jejunum 100 to 110 cm – Ileum 150 to 160 cm Mucosa has transverse folds (plicae
MELAKA: Cyber crimes in the country particularly the ‘Love Scam’ saw losses increasing almost four-fold, from RM52.3 million last year. especially in “love scams” where we have to act fast to stop outflow of money,” he said.
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There’s a little…C-shaped curve like that, and then it comes back up, tucks up underneath the stomach and then we start getting all the folds and folds of the small intestines. My guts are a bit different. So, it’s all the same until we get to the.
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SMALL INTESTINE Multiple Choice Questions and Answers pdf free download objective type interview questions for Viva MBBS students very important questions
There’s a little…C-shaped curve like that, and then it comes back up, tucks up underneath the stomach and then we start getting all the folds and folds of the small intestines. My guts are a bit different. So, it’s all the same until we get to the.
C-reactive protein (CRP) a protein that is produced in the liver in response to inflammation. CRP is a biomarker of inflammation that is strongly associated with the.
MELAKA: Cyber crimes in the country particularly the ‘Love Scam’ saw losses increasing almost four-fold, from RM52.3 million last year. especially in “love scams” where we have to act fast to stop outflow of money,” he said.
Your stomach bacteria may be behind your lean figure! A gut bacteria responsible for most stomach ulcers may also help prevent obesity, a new study claims. The germ Helicobacter pylori is the cause of most stomach ulcers, but new.
they were located near his small intestine. Doctors at JJ advised the police to ask Rotimi to eat something so that the digestive process would help eject the capsules. But Rotimi changed the script: he said he was going on a fast. ANC.
Your stomach bacteria may be behind your lean figure! A gut bacteria responsible for most stomach ulcers may also help prevent obesity, a new study claims. The germ Helicobacter pylori is the cause of most stomach ulcers, but new.
If you are popping up common over-the-counter drugs daily to treat acid reflux and stomach ulcers. The longer PPIs were used, the greater was the risk of developing stomach cancer, rising to 5-fold after more than a year, to more than.
Case details. A fifty-one year old woman presented to her internist with complaints of swelling In the front of her neck. Upon history and physical examination, her.
Both a barium swallow and a barium meal test involve a series of X-rays being taken of your upper digestive tract.
I Weigh 220 Pounds And Want To Lose Weight David Cowan lost nearly 220 pounds thanks to good ole diet and exercise. Along the way, he got his brother Andre involved, who is now at least 120 pounds slimmer. The two want to give you tips on how to lose weight, stay. On January 15th, I weighed 344.2 pounds. As of July 8th, I | {
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-4,749,611,832,254,949,000 | AU - Larijani, Bagher AU - Goodarzi, Parisa AU - Payab, Moloud AU - Alavi-Moghadam, Sepideh AU - Rahim, Fakher AU - Bana, Nikoo AU - Abedi, Mina AU - Arabi, Maryam AU - Adibi, Hossein AU - Gilany, Kambiz AU - Arjmand, Babak TI - Metabolomics and Cell Therapy in Diabetes Mellitus PT - JOURNAL ARTICLE TA - ijmcmed JN - ijmcmed VO - 8 VI - 2 IP - 2 4099 - http://ijmcmed.org/article-1-1040-en.html 4100 - http://ijmcmed.org/article-1-1040-en.pdf SO - ijmcmed 2 AB - Diabetes with a broad spectrum of complications has become a global epidemic metabolic disorder. Till now, several pharmaceutical and non-pharmaceutical therapeutic approaches were applied for its treatment. Cell-based therapies have become promising methods for diabetes treatment. Better understanding of diabetes pathogenesis and identification of its specific biomarkers along with evaluation of different treatments efficacy, can be possible by clarification of specific metabolic modifications during the diabetes progression. Subsequently, metabolomics technology can support this goal as an effective tool. The present review tried to show how metabolomics quantifications can be useful for diabetic monitoring before and after cell therapy. Cell therapy is an alternative approach to achieve diabetes treatments goals including insulin resistance amelioration, insulin independence reparation, and control of glycemia. OMICs approaches provide a comprehensive insight into the molecular mechanisms of cells features and functional mechanism of their genomics, transcriptomics, proteomics, and metabolomics profile which can be useful for their therapeutic application. As a modern technology for the detection and analysis of metabolites in biological samples, metabolomica can identify many of the metabolic and molecular pathways associated with diabetes and its following complications. CP - IRAN IN - LG - eng PB - ijmcmed PG - 41 PT - Mini-review YR - 2019 | {
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See detailBenefits of napping and an extended duration of recovery sleep on alertness and immune cells after acute sleep restriction.
Faraut, Brice; Boudjeltia, Karim Zouaoui; Dyzma, Michal et al
in Brain, Behavior & Immunity (2011), 25(1), 16-24
Understanding the interactions between sleep and the immune system may offer insight into why short sleep duration has been linked to negative health outcomes. We, therefore, investigated the effects of ... [more ▼]
Understanding the interactions between sleep and the immune system may offer insight into why short sleep duration has been linked to negative health outcomes. We, therefore, investigated the effects of napping and extended recovery sleep after sleep restriction on the immune and inflammatory systems and sleepiness. After a baseline night, healthy young men slept for a 2-h night followed by either a standard 8-h recovery night (n=12), a 30-min nap (at 1 p.m.) in addition to an 8-h recovery night (n=10), or a 10-h extended recovery night (n=9). A control group slept 3 consecutive 8-h nights (n=9). Subjects underwent continuous electroencephalogram polysomnography and blood was sampled every day at 7 a.m. Leukocytes, inflammatory and atherogenesis biomarkers (high-sensitivity C-reactive protein, interleukin-8, myeloperoxidase, fibrinogen and apolipoproteins ApoB/ApoA), sleep patterns and sleepiness were investigated. All parameters remained unchanged in the control group. After sleep restriction, leukocyte and - among leukocyte subsets - neutrophil counts were increased, an effect that persisted after the 8-h recovery sleep, but, in subjects who had a nap or a 10-h recovery sleep, these values returned nearly to baseline. Inflammatory and atherogenesis biomarkers were unchanged except for higher myeloperoxidase levels after sleep restriction. The increased sleepiness after sleep restriction was reversed better in the nap and extended sleep recovery conditions. Saliva cortisol decreased immediately after the nap. Our results indicate that additional recovery sleep after sleep restriction provided by a midday nap prior to recovery sleep or a sleep extended night can improve alertness and return leukocyte counts to baseline values. [less ▲]
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See detailMicroarray analyses of the effects of NF-kappaB or PI3K pathway inhibitors on the LPS-induced gene expression profile in RAW264.7 cells: synergistic effects of rapamycin on LPS-induced MMP9-overexpression.
Mendes, Sofia Dos Santos; Candi, Aurelie; Vansteenbrugge, Martine et al
in Cellular Signalling (2009), 21(7), 1109-22
Lipopolysaccharide (LPS) activates a broad range of signalling pathways including mainly NF-kappaB and the MAPK cascade, but recent evidence suggests that LPS stimulation also activates the PI3K pathway ... [more ▼]
Lipopolysaccharide (LPS) activates a broad range of signalling pathways including mainly NF-kappaB and the MAPK cascade, but recent evidence suggests that LPS stimulation also activates the PI3K pathway. To unravel the specific roles of both pathways in LPS signalling and gene expression profiling, we investigated the effects of different inhibitors of NF-kappaB (BAY 11-7082), PI3K (wortmannin and LY294002) but also of mTOR (rapamycin), a kinase acting downstream of PI3K/Akt, in LPS-stimulated RAW264.7 macrophages, analyzing their effects on the LPS-induced gene expression profile using a low density DNA microarray designed to monitor the expression of pro-inflammatory genes. After statistical and hierarchical cluster analyses, we determined five clusters of genes differentially affected by the four inhibitors used. In the fifth cluster corresponding to genes upregulated by LPS and mainly affected by BAY 11-7082, the gene encoding MMP9 displayed a particular expression profile, since rapamycin drastically enhanced the LPS-induced upregulation at both the mRNA and protein levels. Rapamycin also enhanced the LPS-induced NF-kappaB transactivation as determined by a reporter assay, phosphorylation of the p38 and Erk1/2 MAPKs, and counteracted PPAR activity. These results suggest that mTOR could negatively regulate the effects of LPS on the NF-kappaB and MAPK pathways. We also performed real-time RT-PCR assays on mmp9 expression using rosiglitazone (agonist of PPARgamma), PD98059 (inhibitor of Erk 1/2) and SB203580 (inhibitor of p38(MAPK)), that were able to counteract the rapamycin mediated overexpression of mmp9 in response to LPS. Our results suggest a new pathway involving mTOR for regulating specifically mmp9 in LPS-stimulated RAW264.7 cells. [less ▲]
Detailed reference viewed: 583 (0 ULiège)
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See detailResveratrol inhibits the activity of equine neutrophil Myeloperoxidase by a direct interaction with the enzyme
Kohnen, Stephan ULiege; Franck, Thierry ULiege; Van Antwerpen, Pierre et al
in Journal of Agricultural and Food Chemistry (2007), 55(20), 8080-8087
Resveratrol is a polyphenolic antioxidant present in beverage and food known for its multiple protective effects. We report the inhibitory effects of resveratrol on equine myeloperoxidase (MPO), a hemic ... [more ▼]
Resveratrol is a polyphenolic antioxidant present in beverage and food known for its multiple protective effects. We report the inhibitory effects of resveratrol on equine myeloperoxidase (MPO), a hemic peroxidase present in the granules of the neutrophils involved in the inflammatory response. Resveratrol inhibited the production of reactive oxygen species (ROS) by stimulated equine neutrophils by acting as a direct scavenger of the ROS released by the cells but did not modify the degranulation of the stimulated neutrophils as the amounts of released MPO were unchanged. Resveratrol strongly inhibited the chlorination, oxidation, and nitration activities of MPO in a dose-dependent manner. By an original technique of specific immunological extraction followed by enzymatic detection (SIEFED), we demonstrated that resveratrol inhibited the peroxidasic activity of the MPO measured by a direct interaction such as the fixation of resveratrol on the enzyme. The observation of a decrease of the accumulation of compound II suggested that resveratrol acts as an electron donor for MPO reduction. [less ▲]
Detailed reference viewed: 128 (8 ULiège)
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8,075,775,169,992,969,000 | Meet Your Coding Needs With the Right EHR
by Patricia S. Wilson, RT (R), CPC, PMP
An integral part of the coding process is to verify that documentation supports procedures and services performed. Although documentation of medical services and procedures seems a logical part of medical practice, it sometimes is a secondary function of medical care. The concept of medical documentation as a secondary function in medical care is not a new concern, as Florence Nightingale referred to it in 1863:
“In attempting to arrive at the truth, I have applied everywhere for information, but in scarcely an instance have I been able to obtain hospital records fit for any purposes of comparison. If they could be obtained … they would show subscribers how their money was being spent, what amount of good was really being done with it, or whether the money was not doing mischief rather than good…”
Service documentation is sometimes considered by clinicians as an onerous obligation of their profession. They rarely see the immediate benefit of clearly and completely dictating or writing down what they did. Many see it as a means to keep the HIM, coding, and compliance departments out of their hair.
As Florence Nightingale indicated, it is the lack of precise, clear, and complete medical documentation that often causes mischief—not only for the provider, but for the patient, too.
In 1999, the Institute of Medicine (IOM) published a study indicating 98,000 patients die every year primarily due to inadequate medical record charting and reporting. The use of an electronic health record (EHR) was sited as being a key mechanism to support quality and efficiency in patient care. The health care industry took this information to heart. Over the following years, a variety of EHRs came on the market to solve the problem of incomplete, low quality medical documentation. The federal and state payers are changing the reimbursement paradigm from frequency based to quality based.
There are as many different types of computerized or electronic health record types as there are acronyms used to describe them. The health care industry has struggled to define what is necessary to make health care information consistently of good quality and used by the provider. Less than 10 percent of small physician practices use a form of an EHR and with large practices about 30 percent use one. The adoption of EHRs by hospitals across the country is somewhere in the range of 16 percent to 56 percent. The reason for the huge variance in hospital EHR adoption statistics is due to the variable definition of an EHR.
The professional coder can lend a voice in the area of EHR definition and adoption. There is a significant shift in health care reimbursement with the desire to provide high-quality health care. The EHR is the silver bullet to assure good documentation and provide quality health care. However, the silver bullet may shoot right through the coding process and—more importantly—compliance if the coder and compliance officer are not included in the process up front.
The medical coder and compliance officer are sometimes overlooked as important stakeholders when a medical practice or hospital is purchasing an EHR. Instead of waiting for an invitation to the decision making process, the coder and compliance officer, in most cases, need to outline their points of concern. Here are some ‘gotcha’ points for the coder to consider when purchasing or implementing an EHR.
The overarching question to ask is how will the EHR operate with the existing billing system? The answer to this single question determines additional questions asked and to what extent the EHR could change your current coding practices.
Here are secondary questions to ask that determine how the EHR will impact coding:
Is it a stand-alone EHR? This means that it does not interface with any other electronic medical system, especially the billing system. A stand-alone system requires double entry of outside information into the EHR. It is highly unlikely that even a solo medical practice would never refer a patient to a hospital, imaging center, laboratory, nursing home or other medical service. Double entry data leaves room for human error and inconsistencies, takes extra time and effort, and is a red flag for a compliance officer.
To what extent does the EHR “auto-code?” EHRs have a mechanism for suggesting both diagnostic and procedural coding based on the clinician’s data input. The system could be a template-based format that prompts the clinician to fill in information they may otherwise have missed. Other systems use natural language processing to parse out certain words and phrases to determine the diagnosis and procedure. The issue with EHRs that auto-code is the extent to which they can adhere to specific coding rules established by local and even federal insurance carriers. Even the best auto-coding system requires some measure of review and a method to override the suggested codes. This leads us to the next question to ask:
If the EHR does auto-coding and is able to interface with data flowing into your existing billing system, can data flow back out of your billing system and into the EHR?
This is an essential component for auditing and compliance. If a suggested EHR diagnosis or procedure code should be over-ridden for claim submission, the change should be input into the EHR for the purpose of audit tracking. Many EHR systems are recognizing this need and upgrading their systems to provide a complete coding audit trail.
There are several other questions to consider depending on your practice. The most important is how flexible is the candidate system at implementing coding and billing changes required by the industry. Medical practices rely on coders and compliance officers to provide accurate, complete, and consistent coding for their financial benefit. It is up to you to take an active role in staying abreast of how an EHR will impact your workflow and the bottom line.
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286,760,782,071,342,270 | Vitamins to boost immune system
How To Super-Charge Your Immune System. I also love recipes such as my Immune Boosting Chicken. lemons and limes are an excellent source of vitamin C which.
Vitamin D Council | Vitamin D and influenza
Although many dietitians recommend getting vitamins from the diet, taking vitamin supplements can be a helpful and easy way to absorb the vitamin into the body if particular foods are not available.Over 90% of the documented adverse reactions to foods are not true allergies, occur on a delayed basis (up to 4 days after exposure), and will avoid detection by conventional skin scratch tests.
boost immunity - Oregon State University
The Immune System. 2 nd ed. New. Vitamin effects on the immune system: vitamins A and D take centre stage.The 4 Best Immune System Vitamins By content. 0. Diet Pills and.For most of these individuals, supplementing pancreatin (pancreatic enzymes) should help resolve the absorption issue.Scientists have found that vitamin D is crucial to activating our immune. the killer cells of the immune system.There are many other immunity boosting supplements I could have discussed.Vitamins are essential constituents of our diet that have long been known to influence the immune system.This occurred prior to the introduction of sulfa drugs and penicillin.Below is a short list of other supplements readily available from most health food stores and some pharmacies which have a substantial amount of evidence that supports their use.
Protect Your Health with Immune-Boosting Nutrition
Numerous studies attest to the fact that it is well worth supplementing.Proper diet, proper sleep- wake cycles, healthy environment, proper exercise are the foundation of good health and good immune health.In the 1950s, prior to the wide scale use of corticosteroids as anti-inflammatory agents, colostrum was used for the treatment of rheumatoid arthritis.
8 Foods That Boost Your Immune System - Dr. Group's
The 4 Best Immune System Vitamins - 3FatChicks on a Diet!
Boost Kids Immune System With Vitamins Most adults understand how stressors can compromise the immune system, but few think in terms of how stress, improper diet.This false advice on limiting the length of time that one should be using Echinacea originates from a German study that actually said the opposite.Albert Sabin, discovered that colostrum contained antibodies against polio and recommended it for children susceptible to catching the disease.The Best Immune System Vitamins for Men. Immune system vitamins are vitamin supplements that give your immune system a boost and help protect you against illness.For information on these tests, contact Gamma Dynacare at 905-790-3000 or ask your family doctor.Seasonal Defense: Boosting Your Immune System. Is there a simple way to boost your immune system so you will. to get enough vitamin E to boost your immune system.
Immune system vitamins - Health Forever
Lots of products promise to boost your immune system, but Consumer Reports explains the best ways to prevent disease and heal faster.A healthy immune system is the best defense we have against microbes, bacteria, and viruses that would otherwise invade the body and destroy our health.Can you prevent more serious illnesses such as cancer and autoimmune disorders using a natural supplement regime.No doubt you have heard of the benefits of taking cod liver oil during the winter months.
Boosting the immune system – sorting science from myth
Here are some of the best dog supplements to boost immune system in dogs.One of the most ridiculous pseudoscientific claims from the junk medicine crowd is that some magical substance is critical to boosting the immune system.
What vitamins to take to boost immune system - PocketCapsule
As a woman, your body is constantly subjected to a variety of different.Select immune system vitamin supplements on sale at i-Supplements.com.This means the immune system needs a healthy dose of vitamins.Vitamin C is one of the biggest immune system boosters of all.
If you want to learn how to boost your immune system, look to these 10 antimicrobial, immune-boosting and antiviral supplements and essential oils.A safer and more accurate alternative to the elimination diet is the IgG (subclass 4) RAST blood test.My Top 10 Immune Boosting Supplements GOOD. the major active ingredients of cod liver oil that work their magic on the immune system are vitamin D and.Boost your immune system with Vitamin C, B Complex, Zinc, Specialty Formulas and more.Often, if clients clean up their diets, they stop getting sick as well.There are now over 4,000 clinical studies from around the world detailing research that has been done using colostrum in the treatment of dozens of different diseases.He or she is then advised to abstain from these foods for a period of months or years.
boost immune system vitamins | eBay
Enhancement of immunity in the elderly by dietary supplementation with the probiotic Bifidobacterium lactis HN019.
High dose zinc combined with vitamin C can offset excessive lead levels in the body.A healthy and robust immune system is vital for good health and fitness.For the best source of information and documentation of all the benefits, visit.These bacteria modulate the immune system by increasing the numbers of certain while blood cells (T lymphocytes).Supplements may be necessary to get enough vitamin E to boost your immune system.Most people immediately turn to Vitamin C for a quick boost,.Recently published studies conclude that eliminating the foods detected by this test are at least 80% effective in reversing or reducing the symptoms of dozens of chronic illnesses associated with impaired immunity.Vitamin A is a common component of many multivitamin supplements but some people just do not absorb enough of it from their diet because of unsuspected food allergies and insufficient secretion of pancreatic digestive enzymes.
A few days later, Piers developed a cough and hoarseness that could only be attributed to the shot he had recently received.
Boost Immune System Vitamin | Arnold Supplements
So the next time your little one is feeling ill, try these natural immune boosters for kids. vitamins and minerals help the immune system perform at its best.This same dose of vitamin C was found to boost immune cell functions in women who were an average of 72 years old. 28.
Once again, to be healthier with autoimmune disease, take echinacea in large doses. (Caveat: If you have a ragweed allergy you might react adversely to Echinacea because it belongs to the same plant family.).When vitamins are injected directly into your body, they go.Firstly is this a genuine question or just some trolling just to ignite an argument.When people consider using natural remedies to boost their immune system,.
Top 3 Supplements to Boost Your Immune System
The researchers concluded that vitamin D supplements might be.Taking plenty of vacations in warm climates helps and so does laughter. | {
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4,987,223,539,430,923,000 | HAL CCSD Chronic exposure to hexachlorobenzene results in down-regulation of connexin43 in the breast. Delisle, Ariane Ferraris, Emanuelle Plante, Isabelle Institut Armand Frappier (INRS-IAF) ; Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP) International audience ISSN: 0013-9351 EISSN: 1096-0953 Environmental Research Elsevier pasteur-01351082 https://riip.hal.science/pasteur-01351082 https://riip.hal.science/pasteur-01351082 Environmental Research, 2015, 143 (Pt A), pp.229-40. ⟨10.1016/j.envres.2015.10.020⟩ DOI: 10.1016/j.envres.2015.10.020 info:eu-repo/semantics/altIdentifier/doi/10.1016/j.envres.2015.10.020 PUBMED: 26519829 info:eu-repo/semantics/altIdentifier/pmid/26519829 en Akt Breast Connexin43 Gap junction Hexachlorobenzene ILK [SDV]Life Sciences [q-bio] info:eu-repo/semantics/article Journal articles Decreased expression of connexins has been associated with cancer, but the underlying mechanisms are poorly understood. We have previously shown that a 5 day exposure to hexachlorobenzene (HCB) resulted in decreased connexins expression in hepatocytes 45 days later, and that this down-regulation was linked to activation of Akt through the ILK pathway. Because HCB promotes cancer in both the liver and breast, the present study aimed to determine if the mechanisms are similar in both tissues. MCF-12A breast cells were thus transfected with vectors coding for either Akt or a constitutively active form of Akt. In those cells, activation of Akt was correlated with decreased Cx43 levels. Female rats were then exposed to HCB by gavage either following the same protocol used previously for the liver or through a chronic exposure. While no changes were observed after the 5 days exposure protocol, chronic exposure to HCB resulted in increased Akt levels and decreased Cx43 levels in breast cells. In vitro, Akt was activated in MCF-12A cells exposed to HCB either for 7 days or chronically, but no changes were observed in junctional proteins. Together, these results suggested that, while activation of Akt can decrease Cx43 expression in breast cells in vitro, other mechanisms are involved during HCB exposure, leading to a decrease in Cx43 levels in a model- and duration-dependent manner. Finally, we showed that HCB effects are tissue specific, as we did not observe the same results in breast and liver tissues. 2015-11 | {
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3,860,902,115,245,039,600 | Keep Allergies At Bay With Curcumin
The changing weather comes with lots of bad winds at this time of the year, curcumin is a compound that can be effective to treat allergies
Allergy
An allergy is the overreaction of the body's immune system to allergens such as pollens, foods, some pets, and house dust mites. Pixabay
The changing weather comes with lots of bad winds at this time of the year. Along with that comes allergy, a major contributor to skin problems stemming from the overreaction of the body’s immune system, such as food, dust and more. Curcumin is a compound that can be effective to treat allergies. These health tips can go a long way when combating allergies.
Found in abundance in spices like turmeric and in traditional South Asian dishes, curcumin has been considered as a gold standard of health foods. Dr. Saurabh Arora, Inventor of SNEC30, Arbro Pharmaceuticals shares with IANSlife some common types of allergies and how curcumin can effectively treat them.
An allergy is the overreaction of the body’s immune system to allergens such as pollens, foods, some pets, and house dust mites. Though for most people, these substances referred to as allergens pose no problem but in allergic individuals, their immune system treats them as a threat and thus produces an inappropriate response. Curcumin, the main component of turmeric, has proven to be effective in preventing the onset of allergic reactions.
Signs And Symptoms Of Allergy
The allergic reactions can be manifested by:
Runny and itchy nose
Sneezing associated with itchy red eyes.
Redness of skin and rashes
Excessive cough, wheezing, and shortage of breath.
Nausea, vomiting, abdominal discomfort and diarrhea.
Curcumin
Curcumin is a compound that can be effective to treat allergies. Pixabay
There are certain risk factors related to allergies are as following:
Age: Younger children are more prone to suffer from allergies than adults; though a lot of times children outgrow allergies as they grow older.
Family History of Asthma or allergies: Individuals with a family history of asthma or allergies are at higher risk of developing allergies themselves.
Personal History of Asthma or allergies: Having a history of asthma or allergic reaction to one thing can actually indicate an increased risk of other allergies as well.
Effects Of Curcumin on Allergies
Curcumin helps to modulate immunity: Curcumin has known immune system modulation properties. It can alter the immune response so as to avoid hypersensitivity reactions. Allergies actually result from the hypersensitive reaction of the immune system and curcumin helps balance these reactions.
It reduces Histamine release and acts as a decongestant: Curcumin contains a highly potent form of Curcumin that acts as a decongestant and anti-histamine working on reducing mast cell degranulation which results in the release of histamine. Thus it can treat chronic as well as acute allergies effectively.
Inflammatory mediator inhibitor: Curcumin acts as a natural Leukotriene, an inflammatory mediator inhibitor for allergic reactions and thus helps in respiratory allergic conditions such as bronchial asthma and other lung problems.
Allergies
Changing weather comes with lots of bad winds that can cause allergies. Pixabay
Brings down inflammation: Curcumin present acts on reducing inflammation in asthma by inhibiting the activity of the Notch-GATA signaling pathway while it suppresses the activity of nuclear factor-kappa B- which is the master protein that regulates inflammation. Also, it alleviates airway inflammation by creating a balance of immune cells called T helper cells. These actions prevent hypersensitivity reactions. It also controls other biochemical agents so as to control the inflammation and also prevents the narrowing of the airways. Thus, reducing bronchial inflammation related to asthma.
Anti-oxidant effect: Allergies trigger an inflammatory response in the body. Curcumin helps in scavenging free radicals that attribute to inflammation and thus help relieve allergies.
Anti-allergen: Since Curcumin prevents the accumulation of inflammatory cells while preventing constriction of airways. Also, it helps with a decrease in mucus production and its anti-allergic properties help reduce the incidences of allergy-induced asthma.
Also Read: Fitbit to Introduce Low-Cost, Easy-to-use Emergency Ventilator
Anti-microbial agent: Curcumin is known to have an antimicrobial and antiseptic effect. It has a natural ability to fight against bacterial and viral infections. It is as effective as antibiotics and helps eradicate respiratory infections which can trigger asthma attacks. (IANS)
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1,807,365,961,013,164,500 | RISK ASSESSMENT
Risk assessment is a qualitative and quantitative evaluation based on the health history and clinical assessment to identify any risks to general and oral health. The data provide the clinician with the information to develop and design strategies for preventing or limiting disease and promoting health.
Examples of factors that should be evaluated to determine the level of risk (high, moderate, low) include but are not limited to:
A. Fluoride exposure
B. Tobacco exposure including smoking, smokeless/spit tobacco and second-hand smoke
C. Nutrition history and dietary practices including consumption of sugar-sweetened beverages
D. Systemic diseases/conditions (e.g., diabetes, cardiovascular disease, autoimmune, etc.)
E. Prescriptions and over-the-counter medications, and complementary therapies and practices (e.g., fluoride, herbal, vitamin and other supplements, daily aspirin, probiotics)
F. Salivary function and xerostomia
G. Age and gender
H. Genetics and family history
I. Habit and lifestyle behaviors
1. Cultural issues
2. Substance abuse (recreational drugs, prescription medication, alcohol)
3. Eating disorders/weight loss surgery
4. Piercing and body modification
5. Oral habits
6. Sports and recreation (swimming, extreme sports [marathon, triathlon], energy drinks/ gels
J. Physical disability (morbid obesity, vision and/ or hearing loss, osteoarthritis, joint replacement)
K. Psychological, cognitive, and social considerations
1. Domestic violence
2. Physical, emotional, or sexual abuse
3. Behavioral
4. Psychiatric
5. Special needs
6. Literacy
7. Economic
8. Stress
9. Neglect
Georgia Dental Hygienists’ Association
A Constituent of the American Dental Hygienists' Association Representing Dental Hygienists throughout the State of Georgia.
The Georgia Dental Hygienists' Association does not endorse any business or its product(s). See disclaimer
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2,761,943,804,850,442,000 | What happens if you eat Mistletoe?
What happens if you eat Mistletoe?
Mistletoe may be the perfect excuse for getting up close and personal with the object of your affections, but the plant itself should stay firmly suspended a foot above your head.What happens if you eat mistletoe? Is it safe? Will it kill you? What about if your dog snaffles a few berries off the floor?
Does Mistletoe’s loving peck, actually deliver the ‘kiss of death’?
What is Mistletoe?
Mistletoe is an evergreen plant with white berries that parasitically grows in the branches of certain trees. It is traditionally used in festive decorations and according to Nordic mythology and Medieval beliefs, it is a symbol of peace, love and friendship.
Is Mistletoe Poisonous?
Mistletoe IS poisonous, although it is doubtful as to whether it will actually cause death. All parts of the plant are toxic (that’s berries, stem and leaves). The Mistletoe plant contains Phoratoxin and Viscotoxin, which are both poisonous proteins when ingested. With over 1500 varieties of Mistletoe in the world, some are more toxic than others.
What Happens if you Eat Mistletoe?
There is likely to be a more severe reaction to eating the white berries rather than the drinking a tea made with the leaves, but symptoms will range from mild to severe. The list of possible symptoms include:
• Blurred vision
• Fever
• Hallucinations
• Diarrhea
• Nausea
• Stomach pain
• Vomiting
• Drowsiness
• Slowing of the heat rate
• Heart problems
• Mistletoe has been known to cause miscarriage in pregnant women
If a child has ingested any part of a Mistletoe plant, the reaction is likely to be more severe than if an adult has eaten an equivalent amount. As soon as you become aware of Mistletoe ingestion, it is advisable to seek medical advice as quickly as possible.
IS THIS THE SAME FOR ANIMALS?
If your cat or dog has gobbled a couple of berries that have fallen from the festive wreath, what will happen? Pretty much the same as if eaten by a human. The reaction may be more severe, so it is important that you seek medical advice from your vet straight away, as more berries may have been eaten than you might be aware of.
ADVICE FOR AVOIDING ACCIDENTAL MISTLETOE POISONING
General advice on avoiding the risk of Mistletoe Poisoning would be to keep the plant away from children and animals. Remove all berries from your festive decorations and place them at a height, which they cannot easily be reached. | {
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-7,365,982,231,004,707,000 | Plantation, Florida Dental Implant Specialist Dr. Mauricio Hervas
Cracked Teeth
All About Cracked Teeth
Did you know that the human jaw can close with a force up to 270 lbs?
You could either be a patient of 15 or 72 years of age, and present to a dental office for a comprehensive exam with a chief complaint that the tooth on the upper right side had had a root canal done twice, and you are still in pain.
Teeth are protected by a hard outer layer called enamel. Enamel is a high mineralized substance in the human body. It is the part that covers each single tooth in our mouth. In some patients the color of it could be a little more white than others, depends on how well you treat them, you clean them and also it all depends on your food habits. The enamel of our teeth will protect them from decay. It is mandatory to avoid them from eroding. It will also protect your teeth from sensitivity due to cold or hot drinks or food.
In case the enamel on your teeth is destroyed there is nothing you or your dentist can do. It is not replaceable. It has no living cells that make it impossible to regenerate on its own. Filling will be the only alternative.
It is also important to mention to avoid very hard foods, like candy or ice cubes. It not only can crack or chip your teeth, it also can destroy the enamel on your teeth. Environmental factors and diet can weaken the enamel and make the tooth prone to decay, cavities and eventually cracking.
Also, over time teeth with larger fillings in them can develop cracks. As cracks progress deeper into the tooth they become more difficult to restore (from restorable to extractions).
What can you do to prevent cracked teeth?
Having a good and constant oral health care will definitively help. Brushing twice a day prevent cavities that weaken enamel and make teeth prone to cracks. Fluoride can also help restore tooth enamel that is weakened by acidic foods and bacteria.
Regular dental visits to your dentist to check up will help to identify problems early so they can be treated.
What are the symptoms of a cracked tooth?
Small cracks may have no symptoms. As the crack progresses you may become sensitive to hot or cold. Or you may feel pain from time to time when biting down on the tooth.
What can you do if you think you have a cracked tooth?
Visit your dentist they will examine the tooth and take an x-ray to confirm the severity of the crack.
What can you do to fix a cracked tooth?
A small crack in a tooth is like a chip in a windshield. The longer you leave it there the greater the risk that it will get worse. If caught early a crown can replace the entire top of the tooth to protect it like a helmet. If the crack is deep you may need more extensive work to reinforce the inside of the tooth.
What if the crack is too deep to fix?
This tooth will need to be removed in order to prevent infection and other complications. Modern implant technology allows the tooth to be replaced in a way that mimics natural teeth.
For more information please contact Dr. Mauricio Hervas to 954.476.0770 and visit our website www.implantationdentalcenter.com
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5,880,532,171,353,982,000 | Articles
December 1, 2019
IBS and Anxiety - The Gut-Brain Connection, Symptoms, Treatments
Irritable bowel syndrome (IBS) is a gastrointestinal tract condition that causes problems in the digestive system. IBS affects 1 in 7 people globally, and common symptoms include bloating, pain and constipation though vary between patients. Although IBS is not life-threatening, it is often a chronic condition.(1)
Anxiety is a mental disorder of persistent fear and worrying, and anxiety disorders affect 20% of the population.(2) According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), anxiety disorders may be classed as panic disorder, obsessive-compulsive disorder, and generalised anxiety disorder. Common symptoms of anxiety disorders include nausea, restlessness and shortness of breath.(3)
Comparison of Symptoms
IBS
• Bloating and gas
• Abdominal pain
• Constipation/diarrhoea
• Changes in stools
Anxiety Disorders
• Panic, fear and unease
• Shortness of breath
• Restlessness
• Nausea
IBS and Anxiety
IBS and psychiatric disorders such as anxiety and depression commonly occur together. Up to 40% of IBS patients also suffer from an anxiety disorder. Anxiety is common in patients with IBS, and gastro-intestinal specific anxiety describes thoughts and emotions related to the digestive system. These feelings arise out of fear of sensations in the GI tract, and that events may trigger a flare-up of symptoms.(4)
Higher levels of anxiety are associated with worsening IBS symptoms. In one study, people with higher levels of anxiety reported higher symptom severity for pain, cramping and bloating and lower quality of life. However, anxiety does not cause IBS or vice-versa, the disorders only exacerbate each other.
IBS and Mental Disorders
Anxiety disorder is one of several mental disorders linked to IBS. These include:
• Depression
• Post-traumatic stress disorder (PTSD)
• Panic disorder(5
What causes IBS?
To understand the link between anxiety disorder and IBS, it is important to understand the cause of IBS. Several theories have been put forward to explain the origin of IBS. Traumatic life events, periods of stress and food allergies and illnesses have been suggested to play a role in the development of IBS. Scientific theories suggest several additional factors may lead to IBS developing and persisting:
• Altered pain perception
• Increased gut sensitivity
• Stress: acute or chronic
• Problems of the immune system(6)
IBS worsens anxiety
The method of action for IBS worsening anxiety disorder is straightforward. Symptoms of IBS such as cramping, bloating and abdominal pain are unpleasant and contribute to mental distress. These feelings of worry or concern over of IBS symptoms and unexpected flare-ups worsen the anxiety disorder. The financial and social stresses of IBS may also contribute to the development and persistence of anxiety disorders.
IBS has been shown clinically to have a devastating toll on one’s psychological state. One study showed 38% of IBS patients had attended multiple specialist appointments for a third or fourth opinion had experienced suicidal thoughts. This finding explains how anxiety is worsened by IBS.(7)
Anxiety worsens IBS
How anxiety may cause or worsen IBS is less clear. It is thought that anxiety disorder and IBS are linked together by abnormal initiation of the ‘fight or flight’ response. In this view, people with anxiety disorder and IBS overreact to perceived sources of danger. These individuals may interpret both environmental cues and sensations in the gut as harmful, causing both anxiety and IBS.
Biologically, the division of the nervous system that links to the gut to the brain (‘gut-brain axis’) is likely to be involved in this process. A model taken from psychiatry known as the biopsychosocial model may also help explain the connection between anxiety and IBS.
The Gut-brain axis
The gut-brain axis is a two-way communication channel between the GI tract and the brain. It helps to explain how anxiety disorder may trigger IBS and vice-versa.
The gut and brain may influence each other in several ways. Microbes in the colon have been shown to affect mental health, and may even cause psychological illnesses such as anxiety disorder and depression. This occurs as a direct impact of the microbes themselves or their impact on permeability and inflammation in the GI tract. The impact of these microbes also implies that diet can have a direct effect on mental health.(8)
The brain also influences the gut, as the GI tract contains over 500 million neurons that connect to the brain via the nervous system. The stomach and intestines are lined with millions of nerve cells, which pass messages from the gut to the brain and vice versa. These signals are transmitted via the vagus nerve. The combination of these two pathways explains how anxiety may influence IBS may influence one another.(9)
Biopsychosocialmodel
In addition to the gut-brain axis, the biopsychosocial model helps to explain the link between anxiety and IBS. This model, conceived in 1977, refers to the connection between human biological, psychology, and social interaction. It explains how social experiences such as trauma may lead to psychological and in turn, biological effects in individuals. It also helps to explain how biological processes in IBS such as distension of the bowel may influence psychological distress and anxiety.(10)
Treatment for IBS and Anxiety
Both anxiety disorder and IBS are treatable conditions despite there being no cure. IBS has been effectively treated with several therapies including hypnotherapy, CBT, mindfulness-based treatment, anti-depressants and elimination diets such as low FODMAP.
Anxiety disorder is most often treated using psychological therapies such as CBT and coping strategies, or anti-depressant medication. Therapies targeting the nervous system, such as hypnotherapy, CBT and anti-depressants may treat symptoms of both IBS and anxiety.
Below is a list of treatments that may be beneficial in both IBS and anxiety disorder.
1. Anti-depressants
Antidepressants are not only prescribed for psychiatric conditions such as anxiety and depression; they are also useful in treating IBS. Two classes of antidepressants commonly prescribed are:
• Tricyclic antidepressants: Tricyclic antidepressants are well-supported for IBS. A 2015 study assessing several clinical trials found Tricyclic antidepressants improved overall symptoms of IBS more than comparable antidepressants. Tricyclics in particular may be used to treat abdominal pain in IBS and work best for diarrhea-predominant IBS.(11)
• Selective serotonin reuptake inhibitors (SSRIs): These antidepressants are less strongly supported treatment for IBS but have been used successfully in some patients. SSRIs are commonly prescribed for anxiety disorders and are effective in constipation-predominant IBS.(12)
2. Hypnotherapy
Hypnotherapy involves progressive relaxation and hypnotic suggestion. This form of therapy has been adapted to treat functional gastrointestinal disorders and been shown effective for IBS in several studies. In one study, six weeks of hypnotherapy lessened IBS symptoms in 70% of patients, an effect equal in effect to that of the low FODMAP diet. Hypnotherapy also benefited patients in this study by reducing psychological scores for anxiety.(14)
Hypnosis is not generally considered a treatment for anxiety by itself, but an aid to psychotherapy. The hypnotic process involves relaxation and allows people to probe more deeply into painful thoughts that may be hidden from the conscious mind and teach coping skills through experiential learning. Hence, anxious thought patterns can be more easily accessed and treated by techniques such as CBT.
3. Cognitive-Behavioural Therapy
Cognitive-behavioral therapy (CBT) is a type of talk therapy that treats both anxiety disorders and IBS. CBT involves relaxation techniques, cognitive restructuring, exposure techniques, stress management, and teaching patients to challenge negative thoughts.
Cognitive restructuring is a CBT technique that allows patients to avoid obsessive thought patterns relating to IBS, to reduce symptoms. Patients are encouraged to build an awareness of the connection between distorted thinking patterns and digestive symptoms.(13)
Relaxation strategies such as diaphragmatic breathing activate the parasympathetic nervous system and promote normal digestion. This may help to lessen gastrointestinal symptoms.(13)
Exposure techniques involve the patient overcoming fearful situations by confronting them. In IBS, these fears may be tension or other sensations in the gut or eating feared foods.(13)
4. Diets for IBS
Diets that eliminate foods known to trigger symptoms are commonly prescribed treatment for IBS. Monash University has developed a diet, low FODMAP diet, which has been shown in numerous studies to reduce IBS symptoms in 70% of patients. The low FODMAP diet eliminates common molecular triggers of IBS (fermentable oligosaccharides,disaccharides, monosaccharides, and polyols).(15)
Following an elimination diet to relieve IBS symptoms may benefit anxiety disorder by reducing anxious and obsessive thoughts relating to the GI tract.
A Word from Mindset Health
The connection between anxiety and IBS is complex. Both conditions are unpleasant and may interfere with daily activities. What remains clear is the importance of treating the two conditions together, rather than individually, and the value of adding psychological treatments to standard medical care. This will lead to the best health outcomes in patients.
Outdated views of IBS as a purely or purely psychological condition are being updated by research into the gut-brain connection. Future research may provide doctors more tools to identify and treat complex disorders that involve both the GI tract and nervous system.
Article Sources >
Mindset Health only uses high-quality sources, including peer-reviewed research, to support our articles. We work with experts to ensure our content is helpful, accurate and trustworthy.
1. Bommelaer G, Poynard T, Le Pen C, Gaudin AF, Maurel F,Priol G, Amouretti M, Frexinos J, Ruszniewski P, El Hasnaoui A. Prevalence of irritable bowel syndrome (IBS) and variability of diagnostic criteria. Gastroenterologie clinique et biologique. 2004 Jun 1;28(6-7):554-61. https://www.ncbi.nlm.nih.gov/pubmed/15243388
2. Kroenke K, Spitzer RL, Williams JB, Monahan PO, LöweB. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Annals of internal medicine. 2007 Mar 6;146(5):317-25. https://www.ncbi.nlm.nih.gov/pubmed/17339617
3. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American PsychiatricPub; 2013 May 22. https://www.psychiatry.org/psychiatrists/practice/dsm
4. Fond G, Loundou A, Hamdani N, Boukouaci W, Dargel A,Oliveira J, Roger M, Tamouza R, Leboyer M, Boyer L. Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. European archives of psychiatry and clinical neuroscience. 2014Dec 1;264(8):651-60. https://www.ncbi.nlm.nih.gov/pubmed/24705634
5. Mykletun A, Jacka F, Williams L, Pasco J, Henry M,Nicholson GC, Kotowicz MA, Berk M. Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC gastroenterology. 2010 Dec;10(1):88. https://www.ncbi.nlm.nih.gov/pubmed/20687933
6. Foxx-Orenstein A. IBS–review and what's new. Medscape General Medicine. 2006;8(3):20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1781307/
7. Miller V, Hopkins L, Whorwell PJ. Suicidal ideation inpatients with irritable bowel syndrome. Clinical Gastroenterology and Hepatology. 2004 Dec 1;2(12):1064-8. https://www.ncbi.nlm.nih.gov/pubmed/15625650
8. Saulnier DM, Riehle K, Mistretta TA, Diaz MA, MandalD, Raza S, Weidler EM, Qin X, Coarfa C, Milosavljevic A, Petrosino JF.Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome. Gastroenterology. 2011 Nov 1;141(5):1782-91. https://www.ncbi.nlm.nih.gov/pubmed/21741921
9. Gershon MD. Nerves, reflexes, and the enteric nervous system: pathogenesis of the irritable bowel syndrome. Journal of clinical gastroenterology. 2005 May 1;39(5):S184-93. https://www.ncbi.nlm.nih.gov/pubmed/15798484
10. George E, Engel L. The clinical application of the biopsychosocial model. American journal of Psychiatry. 1980 May5;137(5):535-44. https://www.ncbi.nlm.nih.gov/pubmed/7369396
11. Rahimi R, Nikfar S, Rezaie A, Abdollahi M. Efficacy of tricyclic antidepressants in irritable bowel syndrome:a meta-analysis. World journal of gastroenterology: WJG. 2009 Apr7;15(13):1548. https://www.ncbi.nlm.nih.gov/pubmed/19340896
12. Friedrich M, Grady SE, Wall GC. Effects of antidepressants in patients with irritable bowel syndrome and comorbid depression. Clinical therapeutics. 2010 Jul 1;32(7):1221-33. https://www.ncbi.nlm.nih.gov/pubmed/20678672
13. Kinsinger SW. Cognitive-behavioral therapy for patients with irritable bowel syndrome: current insights.Psychology research and behavior management. 2017;10:231. https://www.ncbi.nlm.nih.gov/pubmed/28790872
14. Peters SL, Yao CK, Philpott H, Yell and GW, Muir JG,Gibson PR. Randomised clinical trial: the efficacy of gut‐directed hypnotherapy is similar to that of the low FODMAP diet for the treatment of irritable bowel syndrome. Alimentary pharmacology & therapeutics. 2016 Sep;44(5):447-59. https://www.ncbi.nlm.nih.gov/pubmed/27397586
15. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG.A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014 Jan 1;146(1):67-75. https://www.ncbi.nlm.nih.gov/pubmed/24076059
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2,683,496,041,570,921,000 | Discover Ayurveda
Ayurveda meaning 'science of life,' is a traditional branch of medicine belonging to India. The ayurvedic therapies are so effective that it has become popular all over the world as alternative medicine. According to Ayurveda, the five great elements or “Panchatatva”- earth, water, fire, air and space- compose the Universe, not forgetting the human body. It says that human body is made of three main constituents- Dosha Dhatu Mala. Doshas- “vata” or wind/spirit/air; “pitta” or bile; and “kapha” or phlegm- are principles that control all physical activities. Dhatus are main physical constituents that maintains physical condition of human body. Mala, the waste products, are to be excreted out of the body.
Ayurveda advocates a balance among the three “doshas” of the body. When any of the three- Vata, Pitta or Kapha- become accumulated in the body, it leads to diseases. Ayurveda treats such diseases through recommendation of specific lifestyle, nutritional guidelines, and Ayurvedic medicines made of Indian herbs. If toxins in the body cannot be controlled by them, then Ayurveda conducts a cleansing process called “Pancha Karma” to eliminate all the undesirable toxins. It believes that a healthy metabolic system, good digestion, and proper excretion are key to a good health and fulfilling life. It gives great importance to exercise, yoga, meditation, and massage.
The alternative therapy of Ayurved gives significance to maintaining ones daily life and habits in a proper way and avoid the onset of diseases at the first place. However, Ayurveda & Diseases can't be separated in any way because there remain many factors that are not in human control and will cause some or the other disease. Ayurveda gives equal importance to ailments & remedies. It does not give treatments on just the basis of symptoms. It has extensive ways to diagnose the diseases. In fact, Maharishi Ayurveda (ayurveda preached by great saints) has specified five tools to identify diseases which are jointly called 'Nidan Panchak'. Ayurveda herbal remedy as well as ayurvedic home remedies are prescribed only after taking into consideration the five clues for diagnosing the disease. Discover Ayurveda and its unique ways to define, classify, diagnose and treat various diseases in the following sections.
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2,871,796,064,478,044,000 | Skip to main content
Frequently Asked Questions (FAQs)
Answers to the most frequently asked questions about Clinical Trials.
A clinical trial is a research study that is done to find out if people’s health can be improved using a medical treatment. A medical treatment can be a drug, medical device, medical procedure, or a change in a person’s behavior such as diet or exercise. People who take part in clinical trials are volunteers. They are also called “participants.”
Clinical trials are the fastest and safest way to find treatments that help improve people’s health. When people participate in clinical trials they help contribute to medical research that finds new or better treatments for people with illnesses and diseases. The results of every clinical trial is important because it gives researchers more information about the risks and benefits of the treatments in the trial.
All clinical trials have rules about who can and cannot participate. These rules are called “eligibility criteria.” The criteria are based on factors such as age, gender, the type and stage of a disease, previous treatment history, and other medical conditions. Eligibility criteria is not used to reject people personally. Instead, the eligibility criteria helps to make sure that the participants in the trial are safe and that the trial gets the most accurate information about the treatments being researched.
Some clinical trials seek participants with certain illnesses or conditions, while others need healthy participants.
Clinical trials are run and funded by sponsors. Sponsors can be organizations or individuals such as pharmaceutical companies, medical institutions, foundations, voluntary groups, and individual physicians. Clinical trials are usually led by a medical doctor who is called the “principal investigator.” And there is usually a team of people, called the “research team” who work on each trial. Clinical trials can take place in a variety of locations, such as hospitals, universities, doctors' offices, or community clinics.
The costs for the treatments and tests in the trial are usually covered by the research sponsor. This can include the treatment being studied and other treatments, such as blood tests, physical examinations, and imaging scans like X-rays.
However, there can costs that are not covered by the sponsor. These may include time away from work, travel to and from the research site, child care coverage during study appointments, etc. In some cases, the research sponsors will provide trial participants with compensation to help pay for these costs. People who are considering participating in a trial can ask the research staff about any costs before agreeing to participate in a trial.
Potential benefits of participation may include:
• Playing an active role in one’s own health care
• Gaining access to new research treatments before they are widely available
• Receiving medical services such as physical exams, blood tests, or imaging scans
• Helping others by contributing to medical research
Potential risks of participation may include:
• The possibility of unpleasant, serious, or even life-threatening side effects
• The treatment may not be effective
• The trial may require a great deal of time and effort, including trips to the study site, hospital stays, or complex dosage requirements
People who are considering taking part in a trial can discuss the benefits and risks of the trial with the research team.
A protocol is the plan that the clinical trial must follow. The protocol is carefully designed to protect the health of the participants and answer specific research questions.
A protocol describes:
• the length of the study
• the rules about who may or may not participate in the trial
• the schedule of tests, procedures, medications, and dosages
• the information the researchers want to collect about the treatment
Informed consent is the process of learning about a clinical trial before deciding whether or not to participate. To help someone decide whether or not to participate, the doctors and nurses involved in the trial are required to explain the details of the study. They also provide a written document that includes details about the study including the purpose, risks and potential benefits, duration, required procedures, and important contact information. This document is called the “informed consent form”.
People who are considering participating are allowed to take a reasonable amount of time to review the informed consent form. They can also ask the doctors and nurses any questions they have about the trial before deciding to participate. They can also talk with family, friends, or their personal doctor before they choose to participate.
Each person decides whether or not to sign the form to participate in the trial and no one should pressure or influence their decision in any way. If the participant is a child, then the parent or guardian will determine whether or not to sign the form and enroll the child in the trial. Informed consent is not a contract and the participant may leave the trial at any time for any reason.
Clinical trials follow the same the laws and ethical standards that all doctors, nurses, and other medical professionals follow. The government also oversees most clinical research and has requirements in place to protect the participants. All trials must follow a detailed study plan, or protocol, that tells the researchers what to do in the study.
The government has also established guidelines and regulations that require every clinical trial to be reviewed and approved by an independent committee to make sure that the trial follows the law and ethical standards.
Clinical trials are generally designed to protect participants’ privacy and confidentiality. This means participants names and other identifying information about illnesses and behaviors are only known by a few people at the study site. The study sponsor and other researchers will not know this information and the published results of the trial will not include this information.
Yes. A participant can leave a clinical trial at any time and for any reason. Although it is not required, the participant should let the research team know if they are leaving the trial and the reasons for leaving. This helps make sure the trial results are accurate.
Yes. Most clinical trials provide treatments related to a specific illness or disease for a short amount of time. But trials do not provide complete primary health care. When the primary health care provider works with the research team, the participant can make sure that their other medications or treatments will not conflict with the study plan. Participants can talk to their research team about how their clinical trial data will be shared with their health care provider.
A placebo looks like a treatment but does not have any medicine in it. Researchers use a placebo to help make sure any the effects they see in the participants who take the real treatments are actually caused by the treatments. Not all trials use a placebo and the study plan and informed consent form must state if a placebo will be used in a trial.
Usually, researchers use a computer program to randomly choose the treatment each participant received. This helps make sure the groups are chosen fairly. Researchers do this so that comparing the results of each treatment is as accurate as possible. But in some trials, the doctors will choose the treatment a participant receives if that is what is best for their health.
Some clinical trial are “blinded”. This can mean that none of the participants know what treatment they are receiving. In some blinded trials, even the doctors or other study staff do not know what treatment each participant is receiving. Trials are done this way because knowing what treatment the participants are getting can affect the accuracy of the results.
Clinical trials are conducted in steps that are called “phases”. There are four phases of trials. Each phase has a different purpose and helps researchers answer different questions:
• In Phase I trials, researchers test a new drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
• In Phase II trials, the study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.
• In Phase III trials, the study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
• In Phase IV trials, post marketing studies delineate additional information including the drug's risks, benefits, and optimal use. | {
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6,923,941,142,127,627,000 | What If You Swallowed the Most Venomous Spider
What If You Swallowed the Most Venomous Spider
It’s been said that a person swallows about
eight spiders in their sleep every year. This person should be located and stopped
right now! While that story may or may not be true, it’s
enough to make me want to swear off sleeping for the rest of my life. Or wear a space helmet to bed. But, it makes a kind of sense. Spiders like warm dark places and the inside
of your mouth sure fits that description. Gross as it sounds, if the story’s true,
it seems to be mostly harmless. But what if it wasn’t? What if you swallowed a spider that wasn’t
just venomous, but the most toxic spider in the world? Oh, and please, please, don’t try this at
home. Or at work, or the skating rink, or the mall
or anywhere else for that matter. Do not eat live venomous spiders! Was I clear enough? Okay. This hairy little monster is known as the
Sydney funnel-web spider, or “Atrax robustus” if you want to show off. It, like way, way, way too many of planet
Earth’s other most dangerous wildlife, hales from the continent of Australia. G’day mate! Incidentally, when exactly did we decide to
make Australia a tourist destination? Even their cutest animal, the Koala, can have
an aggressive side. And kangaroos? Those overgrown rodents may look graceful
and majestic, but their legs aren’t just for hopping. It wouldn’t be a vacation for the faint
of heart, to say the least. At least with kangaroos, you have to drive
deep into the outback and go out of your way to make them angry. The Atrax, meanwhile, is more than willing
to do house calls. Their natural habitat may be the underside
of rocks and fallen trees, but the Sydney funnel-web is just as at home in yours! Assuming your home is within a hundred miles
of Sydney, Australia. If not, I have some great news! If so, well, I guess you could always move. The good news is that at up to two inches
in length and notoriously skittish, you’re unlikely to swallow one of these by accident. I also have a hard time believing someone
would eat one voluntarily. So, what would happen if you chowed down on
the most dangerous spider in the world? Well, that’s going to depend if it’s still
up and about when it goes down your gullet. The Sydney funnel-web can hold its breath
for over a day, in some cases surviving underwater for up to thirty hours. With that in mind, I wouldn’t place any bets
on it running out of air on the way down. In this case, your biggest concern would be
the possibility for the spider to bite you on the way down. Atrax really don’t like to be handled, and
their fangs are large and powerful enough to punch a hole in your fingernail. Making matters worse, (like they could be
worse) the Atrax isn’t a bite and run kind of spider. It will dig in its’s fangs and hold on for
the ride. The Atrax’s venom is a special kind of nasty,
attacking its prey’s nervous system. Symptoms will begin within minutes as the
neurotoxin starts shorting out your nerves. After being bitten, your heart will start
beating rapidly as your blood pressure spikes through the roof. This is followed by breathing trouble, muscle
spasms, and numbness around the mouth. Finally, the venom begins to attack the brain,
causing disorientation and eventually loss of consciousness. In as little as fifteen minutes after the
initial bite… Well, you know. If you were looking to kick a bucket , now’s
the time. Now, if the bite is on your foot or hand,
you can buy yourself a bit of time by tying a tourniquet around the injured limb. Once that’s done, you must seek medical help
immediately. You’re in for anywhere from two to twelve
injections depending on the severity of your symptoms. The good news is that it’ll probably feel
like being poked with a wet noodle compared to the bite itself. Wait, is that good news? Eh, moving on. Unfortunately, a tourniquet isn’t going to
do you any favors if the bite is inside your throat. I suppose it isn’t that strange to want to
risk it all on dangerous foods. After all, people will fly across the ocean
and spend thousands of dollars for a single bite of Fugu fish, the meal so hazardous that
the Emperor of Japan is banned from eating it. What about you, viewers? Care to ride the fugu tsunami? They say it’s carefully regulated, but I’m
not sure I want to take that chance. Why don’t you tell me in the comments whether
I need to grow a backbone or if this whole thing seems a little fishy to you. Anyway, let’s say you managed to wrangle
a Sydney funnel-web into your mouth without getting bitten. What happens then? Surprisingly, not as much as you might think. A spider is just a tiny cow with twice the
legs and way too many eyes. And fangs, I guess. And a segmented thorax and abdomen. Okay, they’re not very much like a cow,
but you can milk them! My point is that meat is meat as far as your
stomach is concerned, and spiders can be digested just as easily as anything else. But what about the poison? It’s still in your body, isn’t it? Well, first off, there’s a difference between
poison and venom. The average person may use the terms interchangeably,
but that’s the kind of mislabeling that will make a biologist pull their hair out. You should try saying it in front of one. It’s very funny. For the record, something is poisonous if
you get sick from eating it, and venomous if you get sick from being bitten. There may be a lot of venomous spiders, but
no one’s ever found one that’s poisonous. Venom is dangerous if it gets in your blood,
but harmless if swallowed; although I have no idea why or how anyone would end up doing
so. Maybe they found an unlabeled bottle in a
lab somewhere? Then again, they don’t usually let small
children into labs, and I can’t think of anyone else who’d willingly ingest a vial
of mysterious science juice. Even if our hypothetical spider muncher happens
to have a stomach ulcer, they’re probably in the clear. Your stomach is basically just a big bag full
of hydrochloric acid and the mucus that keeps it from digesting itself. The former will quickly dissolve all the proteins
in the spider’s venom, rendering it inert upon contact. Hooray! That means any “epic dare” videos I really
hope we didn’t just inspire, have a chance of going smoothly. Again, please don’t do this at home. Or anywhere else. Although, there are a few members of your
household that could get away with this kind of reckless behavior. I’m talking about your dog, the animal voted
most likely to eat things that aren’t food. As it turns out, most mammals are entirely
immune to the Atrax’s venom. Only invertebrates and primates are vulnerable,
anything else gets off with the equivalent of a bee sting. Cats, dogs, and frogs? No problem. You, me, and a monkey named Pete? A trip to the hospital or worse. Funnily enough, if a beetle gets bitten, it
has the opposite effect. Instead of having muscle spasms, insects and
arachnids will be completely paralyzed. Some might take this to mean the spiders don’t
want to hurt humans. But I can’t help but feel like all the creepy
crawlies of Australia want humans off its shores yesterday, and are bending over backward
to make that happen. Does that make me paranoid? Yes. Yes it does. But that’s a whole different video. Hey, if you learned something new today, please
don’t go out and try it, instead give the video a like and share it with a friend! And here are some other cool videos I think
you’ll enjoy. Just click to the left or right, and stay
on the Bright Side of life!
Randy Schultz
Related Posts
51 thoughts on “What If You Swallowed the Most Venomous Spider
1. BRIGHT SIDE says:
Which creature do you fear the most? 😖
2. Craziest_Chris says:
I had fugu… It's pretty good
3. Awesomestarwi Gaming says:
If u search kangaroos 🦘 fighting ooohh it will be bad
4. Gacug Gamer says:
does this man not realize that the most toxic spider is the BRAZILIAN WANDERING SPIDER?
5. KYLER BRO10 says:
Real Title: What if you swallowed a daddy long leg?
6. Diamond and Starlight says:
Me: Sees the title
Also Me: who in the right mind-
7. AV1711 says:
I did it
8. Jigz Villanueva says:
TARANTULA AY FIAR
9. Ary anna says:
Omg I if I swallow it I die
10. Yasmo Power says:
I can’t sleep now😣😖😭😰 that made me scared but I live in the Isle of Man luckily it’s most peaceful ever and there are only normal harmless spiders 🕷🕸 I’ll sleep soon hopefully😅
11. Little Drake says:
How
12. Sarah Lizy says:
Which one Brightside, The infographics show, be amazed
13. SubZeros Hyper says:
I saw smn do a experiment would a spider go in your mouth and it actually wont it would just go over your mouth and then probably walk away
14. Thee Bazzza says:
Jokes on you, Australia isn’t real.
15. xingxing123425 :P says:
I’m never going to Australia now
16. shadow master says:
Stop being a wimp and eat the freaking spider
17. shadow master says:
Who knows you might turn into spider Man
18. Kalisto PLAY'S says:
Team tree donate to the website so we can grow 20 million trees
19. Ruby Lombax says:
I’m literally going to Sydney in just over a month so this has made me a little paranoid tbh
20. WWE says:
make a vid of what if a bug went right up your nose
21. Tay meh Boi says:
I want some mysterious science juice
22. Doggie says:
My mom hates it when I ask what if questions. Bright side is okay sometimes.
23. Fernando Le says:
I'm eating, thanks for ruining my meal
24. kaleen Sibley says:
as far as I know that it not real as far as I know
25. Dima GameZZZ says:
“Bright side”
Since when?
26. Liam Gordon says:
Spiders dont go in your mouth they find it as a threat and wont jump in. Hope I relieved your anxiety Have a good night
27. Luke Peters says:
Shows most dangerous creatures bright side show kangaroo.
28. DrearMeteor 8535 says:
"People swallow about 8 spiders a year"
Me: So that explains what my teacher said about Ketchup-
29. Declan Rafferty says:
I live in Australia NSW Sydney.
30. Korie Connor says:
Your lying about Australia
31. y/n lifeu says:
Me: *reads the title
Also me: Why would you😂
32. ᖇᗩIᑎEᗪ KIᔕᔕ says:
I think we all know not even to touch spiders.
33. Corban Lacy says:
Where me Aussies at?
34. Sweet Delinquent says:
1:17 not meaning to sound rude but come on! Really? It’s a beautiful country with beautiful beaches and locations, Not to mention the cultural events because it’s a multicultural place, It’s warm, Really warm but still amazing. Like you said it has really dangerous animals but maybe if idiots didn’t walk up to some of them it wouldn’t be dangerous. Of course some animals/insects will bite without being provoked but Australia is an amazing place for vacation!
35. richan and drew says:
Mean you are fragment
36. kel c says:
Bright side,you need to grow a backbone and STOP DOIND PUNS!!😡
37. Raven ! says:
Knock knock
Whos there joe
Joe who
JOE MAMA!
38. Ingrida Aukštuolienė says:
My cat eats spiders XDD
39. Nixiienixroy says:
Im a aussie its really nice its only summer snakes come
40. Roblox tawan Kunlacha says:
This now So CRAZY
41. IS7AHAN says:
Jokes on you I don't live in Australia
42. gracey cords says:
Good thing i dont open my mouth while sleeping
43. Krisha Arya says:
I will not die when I swallowed this spider but I would definitely die due to heart attack in thought of that I have swallowed SPIDER.😨😩😵😶😶
44. Ken Lajara says:
I was expecting the spider to be digested by hydrohloric acid from the stomach
45. Estnoob Nintendo says:
Lol
46. potato and cookie girl UwU says:
I live in Australia, i have never come acros one of these spiders. No one in my family have come across one of these spiders. We have a family farm and my dad works in gardens and stuff. So its ither my family is extremely lucky or theres not comen comen but they are definitely around. Fun fact, if you come to australia we have some spiders that can bite through very thick matiroals if there not mettle or something. I think if i was visiting from anouther country i would try learn a bit about the area. In fact i would do that for anywhere. Better safe than sorry! 😊
47. Toni Rosander says:
I AM NOT SLEEPING
48. Jovy Jean Gumabon says:
Nothing
49. Toni Rosander says:
Love the middle
50. Surya Suraj says:
Where is Arnold
51. EvieCookiies says:
I mean..
Who would eat the most toxic spider?
Leave a Reply
Your email address will not be published. Required fields are marked * | {
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412,418,217,497,959,100 | Health / Expert Advice
Here’s What Actually Happens to Your Body When You Drink Too Much
With the holidays coming up, figure out how much is too much.
The holidays are right around the corner, which means ‘tis the season for turkey, mashed potatoes, gingerbread, candy canes, and—for many people—lots and lots of cocktails. With all the boozy brunches, office parties, and get-togethers with family and friends, the holiday season offers a seemingly endless array of opportunities for indulging in alcohol. Plus, chances are, if you’re drinking over the holidays there may be an occasion or two when you overindulge and drink too much.
Alcohol in moderation can be part of a healthy lifestyle. We’re certainly not going to tell you to skip the cocktails. But it’s important to know how too much alcohol impacts both your brain and body. Here we break down the exact physical and mental side effects of one (or a few) too many drinks. So, you can drink responsibly this season and always.
This is your brain on booze.
“Alcohol can affect your brain in several ways,” says Michael Jay Nusbaum, MD, FACS, FASMBS, chief of Bariatric Surgery at Morristown Medical Center. “[Alcohol] affects the frontal lobes of your brain..where personality and higher cognitive functions occur.” Your frontal lobe is the part of the brain that is responsible for reasoning and decision-making. And, when you have too much to drink, your brain’s ability to reason and make decisions is compromised. This is why people have a tendency to make terrible decisions (“I’m fine to drive!”) after indulging in too many cocktails.
Having too much to drink can also mess with your mood—and exacerbate any underlying mental health issues. “Although alcohol can have a temporary relaxing or uplifting effect on mood, alcohol is a depressant,” says Adam Perlman, MD, MPH, FACP, and integrative health and wellbeing expert at Duke University. “It affects our brains and the chemicals in our brains…in ways that make it more difficult for us to manage stress and lead to increased risk for depression, anxiety, and even suicide.”
Alcohol also negatively impacts the hippocampus, which is the area of the brain responsible for forming new memories. This is why you might have a hard time recalling certain details of a night out drinking, or, in extreme cases, experience a full-on blackout. Boozing it up can also impact the cerebellum, which regulates stability balance. It is the culprit behind the clumsy way people walk (or, more realistically, stagger) when they’ve had too much to drink.
If you only have too much alcohol on rare occasions, your brain will bounce back pretty quickly. But if you’re overindulging on the regular, you could experience long-term cognitive impairments and damage to the brain.
This is your body on booze.
Drinking too much can also do some serious damage to your body—starting with dehydration. “Alcohol causes you to urinate too much—and, in doing so, you become dehydrated,” says Nusbaum. “[Alcohol also] causes your blood vessels to expand, which [can] exacerbate the dehydration, drop your blood pressure, and [can] lead to headaches and passing out.”
Alcohol also can create an inflammatory response in the body. One study found that CRP, an inflammatory marker, proportionately increased with alcohol consumption. In other words, the more you drink, the more inflammation you’ll experience. And, that inflammatory response could be even worse if you’re on certain medications. “Even relatively small amounts of alcohol can cause issues, such as inflammation of the stomach, particularly if combined with medications such as anti-inflammatories,” says Perlman.
Another way that too much booze messes with your body? It can cause your blood sugar to spike and crash. The post-crash side effects aren’t going to leave you feeling too hot. “Alcohol can cause your blood sugar to fall,” says Nusbaum. “A reduced blood sugar can cause fatigue, weakness, shakiness, mood disturbances—even seizures.”
Drinking too much alcohol (and drinking too much, too often) messes with your liver, your pancreas, and your heart. It can even lead to certain cancers. “Alcohol intake can damage your liver and interfere with the detoxification of other harmful substances and drugs,” says Nusbaum. “Alcohol intake can [also] lead to cancers such as throat, mouth, esophageal, stomach and even breast cancer,” he adds.
And, if that’s not enough for you, drinking too much can lead to unwanted weight gain. “Weight gain is very common with alcohol use,” says Nusbaum. “Alcohol contains hundreds, if not thousands, of empty calories…some mixed drinks can contain an entire day’s worth of calories.”
How to Know When You’ve Had Too Much
So, clearly, drinking too much isn’t good for your brain, your body, or your health in general. But, how do you know when you (or someone you’re with) has crossed the line from having fun with a few cocktails to not having any fun because of too many cocktails?
“Early signs that someone may have drunk too much include loss of coordination, flushed face, and slurred speech,” says Perlman. “This can progress to more concerning signs like confusion, vomiting, loss of consciousness, irregular breathing, decreased body temperature, and seizure.”
If you start to experience some of these more serious symptoms, you might be dealing with alcohol poisoning—and you need to get help immediately. “With continued drinking, being ‘tipsy’ or drunk can progress to alcohol poisoning. [This] can be a life-threatening condition, and, if suspected, needs emergency treatment,” says Perlman.
If you wake up the morning after a night of heavy drinking feeling like absolute hell, consider the hangover that you have as your brain and body’s way of telling you that however much you drank the night before was too much.
“Hangovers are likely caused by multiple factors, including dehydration, toxic byproducts of the metabolism of alcohol—as well as other inflammatory chemicals—additives to the alcohol (found in higher amounts of dark liquors, which may be why they are more likely to cause a hangover), low blood sugar, and disrupted sleep,” says Perlman.
Don’t let drinking too much become a habit.
If you overindulged at your company’s holiday party or had one-too-many eggnogs at your Aunt’s potluck, don’t sweat it. The key is to not let it become a habit. Next time you’re out drinking, stick to the Center for Disease Control and Prevention’s moderate drinking guidelines. That is, one drink a day for women, two drinks a day for men.
And, in the meantime, maybe Google some hangover cures, drink a glass of water, and get back into bed.
(If you’re worried about your alcohol use, help is available. The National Institute on Alcohol Abuse and Alcoholism has resources and information to help you determine if your drinking is a problem—and where to find help if you need it.)
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-5,806,824,921,853,603,000 | Proceedings of The Physiological Society
Europhysiology 2018 (London, UK) (2018) Proc Physiol Soc 41, PCB335
Poster Communications
Human myometrial artery function is critically affected by maternal BMI
C. Prendergast1, S. Wray1
1. Cellular & Molecular Physiology, University of Liverpool, Liverpool, United Kingdom.
The incidence of obesity in the pregnant population is growing and is a well-recognised risk factor for adverse pregnancy outcome. We have studied human myometrial artery function in order to better understand the (patho)physiology of myometrial vessels and how obesity might affect this. We have therefore examined whether maternal BMI affects the ability of the human myometrial arteries to contract and relax in vitro. Human myometrial biopsies were collected during elective c-section from women with uncomplicated singleton term pregnancies, after informed consent, at Liverpool Women's Hospital. Small arteries were dissected (2mm sections), mounted in a wire myograph containing oxygenated physiological salt solution at 34°C and set to their normalized diameter (0.9 x IC100). Vessels were separated into 2 groups: BMI<25 (normal weight) and BMI≥25 (overweight/obese). There was no significant difference in vessel size between groups. Vessel function was assessed using contractile (AVP, U-46619) and relaxatory (bradykinin (BK), CCh, SNAP) agonists. In addition, vessels (BMI≥30) were treated with 2% methyl cyclodextrin (MCD), to sequester cell membrane cholesterol, for 20min prior to assessing function. Data are expressed as mean±sem, where n=vessels, N=biopsies. Contractile responses were altered in the BMI≥25 group. U-46619 was significantly less potent (pEC50=6.83±0.13, n=21/N=11 v 7.14±0.15, n=22/N=11, t-test p=0.018) compared to BMI<25. AVP showed a similar trend (pEC50=8.94±0.09, n=17/N=9 v 9.20±0.09, n=21/N=13, p=0.054). When pre-contracted with AVP, all vessels relaxed equally well to BK (BMI<25: pEC50=7.71±0.14, n=12/N=9 v BMI≥25: pEC50=7.80±0.06, n=20/N=12). In contrast, only a subset of vessels relaxed when challenged with CCh (14 out of 44). The BMI of women whose vessels responded to CCh (23.64±0.72, N=14) was significantly lower than those not responding (29.22±1.11, N=30). Overall, 15% of BMI≥25 vessels (4/27) and 59% of BMI<25 vessels (10/17) responded to CCh. In fact, no vessels from obese women (BMI >30) responded to CCh, although they all relaxed to BK. The CCh pEC50 in responding vessels was 7.41±0.25 (n=9/N=6). No significant difference in response to SNAP was observed. Exposure to MCD failed to restore a response to CCh in vessels from obese women. Vasoconstriction and vasodilation are impaired in myometrial arteries from overweight/obese women, although responses are agonist-specific: the CCh response is ablated and U-46619 is less potent. Full relaxation was observed with SNAP, suggesting no deficit in arterial smooth muscle responses with increased BMI. If hyperlipidemia caused the loss of the CCh response, then treatment with MCD could potentially restore sensitivity to CCh, however this was not the case. Impaired vessel function may contribute to the significant adverse pregnancy outcomes experienced by overweight/obese women.
Where applicable, experiments conform with Society ethical requirements | {
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This Positive Thought Pattern Can Help Combat Stress & Inflammation
William Cole, IFMCP, DNM, D.C.
Functional Medicine Practitioner
By William Cole, IFMCP, DNM, D.C.
Functional Medicine Practitioner
Will Cole, IFMCP, DNM, D.C., is a leading functional medicine practitioner with a certification in natural medicine and a doctor of chiropractic degree.
Young woman sitting on a bed with her eyes closed meditating
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For most of human history, our stress came from threats like being chased by predators and hunting for food to survive. Of course, even in our modern, relatively comfortable society, we can often use a little more of the grit of our ancestors, despite the fact that in most cases, our stressors these days are tamer and rarely relate to our immediate survival.
But one layer of our modern problems is unquestionably worse today. Over the long term, our chronic stressors are turning out to be the demise of our health. The rat race of today, with its deadlines, time stressors, 24-hour news cycle, perpetual hyper-connection through social media, and poor sleep is severely damaging our well-being.
Over time, humans have adapted a physiological pattern called the conserved transcriptional response to adversity (CTRA). This is a type of gene expression that's associated with increased inflammation1. So if you were being chased by a predator, CTRA allowed for some helpful short-term benefits, such as increased healing, physical recovery, and the increased likelihood of your survival. But in ancient times, humans weren't constantly being chased by large predators or human enemies. The stressful times would eventually calm down and allow the body to recuperate.
Now, with our modern mental and emotional stressors rarely turned off, our body constantly thinks it's being chased by predators. As a result, long-term activation of our brain's CTRA is contributing2 to chronic inflammation and increasing the risk of health problems.
Because of CTRA and other stressors, our emotional stress is a chase that never ends, and it's wearing on our brains and bodies.
How self-compassion can reduce stress and inflammation.
A study published in the journal Clinical Psychological Science3 found that self-compassion had a very real impact on our health. People in the study who were asked to focus on their bodily sensations, as well as those told to think kind thoughts toward others and themselves, had lower heart rates and a lower sweat response at the end of the experiment.
Unsurprisingly, the participants who were encouraged to think critically about themselves had a faster heart rate and greater sweat response. The findings suggest that being kind to oneself switches off the threat response and puts the body in a state of safety and relaxation important for regeneration and healing.
Instead of complaining either in your head or out loud, try speaking love into your life. About 37 trillion cells are intently listening to how you speak to them. Speak kindly. Words and thoughts are powerful modulators of your biochemistry.
Acceptance and self-compassion can fight chronic inflammation from stress and in turn, help decrease the risk of health problems. This is the immense power that your thoughts and emotions have over your health. I see so many people who eat perfectly but remain unwell in part due to the unhealthy emotional pain and stress they are holding on to. Forgive yourself and forgive others.
The highest, most noble battle you will ever wage is the war between what you feel and what you know deeply, beneath the feelings. The more you like yourself, the less you need others to like you. Learning to love yourself is a journey, but it's a beautiful one, with ups and downs alike. One of the side effects of our new breed of chronic stress is the mental and emotional alienation from our true selves and others. We get lost in our own minds, consumed with a constant stream of obsessive and repetitive thoughts, and fail to develop habits—such as mindfulness meditation and yoga or taking breaks from social media—that bring peace and calm into our lives.
Sometimes the best form of healing is acknowledging the role you play in your own suffering
Sometimes the best form of healing is acknowledging the role you play in your own suffering and showing yourself grace and compassion to evolve from that awareness. In short, you are not your negative thoughts and emotions. Take them captive and observe them for the transient things they are. Build a healthy relationship with yourself. True sustainable wellness flows from realizing your intrinsic worth.
And finally, when you cultivate more compassion for yourself, you can show compassion to others more abundantly. It's easy to reflexively judge something or someone we don't understand, especially when we are exponentially harder on ourselves. True compassion says, "I don't understand this or it's not for me, but I see the humanity in this person and show kindness anyway." Otherwise, we become what we hate in others: judgmental, hateful, shaming, small-minded, and militant. Kindness, compassion, and empathy are nothing more than empty words and vapid virtue signaling until you can show them to people you disagree with or don't understand.
Excerpt courtesy of Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel. Copyright © 2023 by Will Cole. Published by goop Press, an imprint of Penguin Random House.
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Effects of different brainwave frequencies
From scientific findings, it has been established that there are five waves within the brain with each having a unique frequency that affects activities of the brain and each of these frequencies has its own specific function that can never be undermined. Here are the effects of each wave;
• Delta waves (1–4 Hz)
Delta wave has the lowest frequency of all waves of the brain and it has been indicated as being dominant during deep sleep state. It is very useful in meditation as it involves rest and sleeps which are some of the best means of rejuvenating the mind, spirit and body.
• Theta waves (4–7Hz)
Simply associated with light sleep state, dream and hypnosis, theta waves are very important for meditation as the person is not fully awake but rather in a state of reduced consciousness.
• Alpha Waves (7-13Hz)
Alpha waves are mostly present in a relaxed state of mind when the mind wanders away from the present travails and troubles. The tranquilizing effect of this state is very useful during meditation.
• Beta Waves (13-30Hz)
Basically, beta waves are dominant during alertness and wakefulness and they are often highly dominant during concentration and ecstasy.
• Gamma waves (30-70Hz)
Alongside other waves, gamma waves indicate a state of wakefulness and they are also dominantly present during processes of touch, auditory and visual stimuli.
Using brain wave audio technology can enhance the performance of the body, mind and spirit; therefore, buy a brain wave audio device and optimize the performance of your brain
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Radiotherapy is the treatment with high-energy rays to destroy cancer cells. Like surgery, radiation therapy is a local treatment. How to prepare your child for radiation therapy.
Before starting treatment, a specialist radiotherapy doctor will talk to you and your child about treatment.
The doctor will also mark the exact area where the radiation will be done, as the treatment is always given in the same place.
These marks must remain in place throughout the treatment. The skin may be sensitive during radiation, so it is important to avoid using soaps or lotions near the marks or part of the body that receives the radiation without the approval of the radiation team. Lotions must be removed before treatment.
Because of radiation exposure, you will not be allowed to stay in the room with your child during treatment. Your child will not be radioactive during or after radiation therapy, so no one needs to be afraid of being around him.
What will happen during radiation therapy?
Radiotherapy does not cause pain. It is very similar to a regular X-ray, except that your child needs to stay longer at the radiotherapy site and for this reason the doctor may give you a medication to help you relax or to put you to sleep. Parts of your child's body that are not being treated will be covered by special shields made of lead to protect body parts from radiation.
Decrease your child's fears
Some children may find the radiotherapy machines frightening. Your child and you will visit the area before the first treatment, so you both can see the machines and see how they work. Younger children may be afraid to be alone in the room and you can tell your child that you will be outside, waiting for him.
Side effects of radiotherapy:
High doses of radiation are intended to kill cancer cells, but they can also harm normal cells. Side effects depend on the treatment dose and the body part to be treated.
The most common effects are:
Redness on the skin: leave the skin uncovered, clean as indicated, use the ointments indicated by the doctor, keep your child out of the sun and use SPF 30 sunscreen.
Hair loss occurs in the irradiated area and should regrow within a few weeks to 3 months after the end of treatment, but some areas that received higher doses may not grow back. To preserve hair, use a mild shampoo, cut and avoid dryers, protect your scalp from the cold and the sun, use a wide-toothed comb.
Side effects according to the location of radiotherapy:
Head and neck:
Mouth sores: use mouthwashes without alcohol to wash your child's mouth. Give your child a soft toothbrush. Avoid hot, spicy or acidic foods. Prefer to serve soft foods. Contact your doctor if your child has mouth sores, painful areas or red or white spots on the mouth.
Dry mouth: drink plenty of water, rinse your mouth with a mouthwash recommended by the doctor or dentist.
Offer foods with sauces to make them moist and easy to swallow.
Stomach and abdomen:
Nausea and vomiting: ask your child's doctor about medications to control nausea and vomiting. Offer light foods 3-4 hours before treatment. Encourage your child to eat small amounts of food, often slowly. Avoid serving sweet, fatty, spicy foods and foods with strong odors.
Serve cold meals for the child, such as sandwiches instead of hot foods.
Encourage your child to rest after meals.
If your child is vomiting, do not give anything to eat or drink until it is under control. Once the vomiting is controlled, give small amounts of clear liquids (for example, water, broth, ice cream without milk and gelatin desserts).
When your child is accepting clear liquids well, try thicker liquids (for example, pudding, yogurt, milkshakes, soups). Gradually offer food up to the solids.
Diarrhea:
Contact your doctor if the diarrhea is liquid and more than three stools a day.
Avoid giving your child fatty foods.
Try foods high in protein and calories but low in fiber, such as yogurt, rice with broth or pasta.
Serve potassium-rich foods that do not cause diarrhea, such as bananas, peaches and apricot juice, and boiled potatoes or mashed potatoes.
Make sure your child drinks plenty of fluids.
Long-term side effects of radiation therapy
Radiation therapy can also affect your child in the future.
For example, radiation to the brain can cause learning and coordination problems, especially in very young children.
Radiation therapy can also affect your child's growth or can cause a second cancer. Thus, the doctor may delay radiation therapy, or, if possible, choose another treatment, such as chemotherapy.
Your child's care team has no way of knowing exactly what long-term effects your child may have, but they can help you know what are the possible effects and ways of diagnosis and prevention.
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-532,080,733,322,939,800 | Home » Blog » Low Blood Sugar
Low Blood Sugar
• by
Low-Bloods
Hypoglycemia, also known as low blood sugar, is a drop in blood sugar to a level below normal. Glucose is the “sugar” that is low in this case, and when it drops below 70 milligrams per decilitre of blood, a person is concerned with hypoglycemic. People may use the term blood sugar very rarely casually to express hunger, or feelings of fainting or burning when skipping a meal. Some people will feel a little nauseous if they don’t eat regularly and may attribute this to “low blood sugar.” But sometimes people who don’t have diabetes can also get low blood glucose. There are two kinds of non diabetic hypoglycemia
Types of hypoglycemia
• Reactive hypoglycemia, This occurs a few hours after eating a meal.
• Fasting hypoglycemia, This could have something to do with medicine or a sickness
Low Blood Symptoms:
If you have diabetes or some other health condition it can cause low blood sugar. Symptoms of low blood sugar are sweating, blurred vision, and confusion. It is possible that you may not always have the same symptoms.
• 1. Such as Sweating
• 2. Nervousness, shakiness, and weakness.
• 3. Extreme hunger and slight nausea.
• 4. Dizziness and headache.
• 5. Blurred vision.
• 6. A fast heartbeat and feeling anxious.
Symptoms of moderate low blood sugar
1. Inability to concentrate.
2. Confusion and irritability.
3. Slurred speech
4. Unsteadiness when standing or walking.
5. Muscle twitching.
6. Personality changes, such as anger or crying.
Symptoms of severe low blood sugar:
1. Seizure
2. Loss of consciousness
3. Stroke
4. Death
High blood pressure and low blood sugar symptoms
Normal blood pressure is between 90/60 and 140/90. If your reading is 140/90 or higher, you have high blood pressure (hypertension), which puts you at a higher risk of developing serious health conditions, such as heart attack or stroke. Individuals with a blood pressure reading of about 90/60 or less are generally considered to have low blood pressure.
Symptoms of high blood pressure
Most diabetics with high blood pressure have no symptoms.
However, very high blood pressure or rapidly rising blood pressure can cause:
• Headaches
• Vision problems
• Nose bleeds
• Trouble breathing
• Fits
• Black-outs
Symptoms of low blood pressure
Similar to high blood pressure, the symptoms of low pressure may not always be apparent. If you do get symptoms, they may be identified as any of the following:
• Feeling dizzy, light headed or fainting
• Blurred vision
• A rapid or irregular heartbeat
• Feeling nauseous
• Confusion
Causes of low sugar level
When your blood sugar (glucose) level drops too low, hypoglycemia ensues. This can happen for a variety of causes, the most prevalent of which is a side effect of diabetes medications.
Blood sugar regulation
When you ingest carbohydrates from foods like bread, rice, pasta, vegetables, also fruit, and milk products, your body breaks them down into numerous sugar molecules, including glucose.
Insulin, a hormone generated by your pancreas, helps glucose, your body’s major energy source, enter the cells of most of your Issues. Insulin allows glucose to enter cells and give the energy that your cells require. Glycogen is a type of glucose that is stored in your liver and muscles.
If you haven’t eaten in several hours and your blood sugar lowers, your pancreas sends a signal to your liver, telling it to break down stored glycogen and release glucose into your bloodstream. Until you eat again, this keeps your blood sugar in a reasonable range.
Possible causes, of diabetes
If you have diabetes, you may not produce enough insulin (type 1 diabetes) or be less receptive to it (type 2 diabetes) (type 2 diabetes). As a result, glucose in the bloodstream tends to build up and can reach dangerously high levels. To address this issue, you may need to use insulin or other medications to lower your blood sugar levels.
However, too much insulin or other diabetic drugs can induce hypoglycemia, which is when your blood sugar level drops too low. Hypoglycemia might also happen if you eat less than usual after taking diabetes medication or exercise more than usual.
Without diabetes, possible causes
Hypoglycemia is substantially less common in those who do not have diabetes. The following are examples of possible causes:
Medications-Taking someone else’s oral diabetes medication accidentally is a possible cause of hypoglycemia. Other medications can cause hypoglycemia, also especially in children or in people with kidney failure.
Excessive alcohol consumption. Hypoglycemia is caused by excessive drinking without eating, also which prevents your liver from releasing stored glucose into your bloodstream.
Some critical illnesses-Hypoglycemia can be caused by serious liver diseases such as cirrhosis or severe hepatitis. Kidney issues, which prevent your body from effectively excreting drugs, might cause a buildup of such medications, which can alter your glucose levels.
Long-term starvation, such as that seen in the eating disorder anorexia nervosa, might cause your body to produce too few of the components it needs to make glucose.
Insulin production is excessive-Insulinoma, a rare pancreatic tumor that can cause you to produce too much insulin, leading to hypoglycemia. Other tumors can cause an excess of insulin-like molecules to be produced. Excessive insulin release can be caused by the enlargement of insulin-producing cells in the pancreas, resulting in hypoglycemia.
Hormone deficiencies-A shortage of essential hormones that regulate glucose synthesis can be caused by certain adrenal gland and pituitary tumor illnesses. If a child’s growth hormone levels are low, hypoglycemia might develop.
Hypoglycemia after meals
Hypoglycemia is most common when you haven’t eaten, although it can happen at any time. It’s symptoms might arise after eating high-sugar foods because your body creates more insulin than you require.
Reactive hypoglycemia, also known as postprandial hypoglycemia, is a kind of hypoglycemia that can occur in persons who have had gastric bypass surgery. It can also happen to persons who have never undergone this procedure.
Complications
Untreated hypoglycemia can lead to:
• Seizure
• Loss of consciousness
• Death
Hypoglycemia can also contribute to the following:
• Such as Dizziness and weakness
• Falls
• Injuries
• Motor vehicle accidents
• Greater risk of dementia in older adults
Unawareness of hypoglycemia
Hypoglycemia unawareness can develop over time as a result of recurrent episodes of hypoglycemia. Shakiness or irregular heartbeats are no longer produced by the body or brain as warning indications of low blood sugar. The danger of severe, life-threatening hypoglycemia rises when this happens.
If you have diabetes and experience recurrent episodes of hypoglycemia or hypoglycemia unawareness, your doctor may adjust your therapy, increase your blood sugar level objectives, and suggest blood glucose awareness training.
Undertreated diabetes
Low blood sugar episodes can be uncomfortable and worrisome if you have diabetes. Fear of hypoglycemia may induce you to take less insulin to avoid a dangerously low blood sugar level. This can lead to diabetes that is out of control. Discuss your fears with your doctor, and don’t adjust your diabetic medication dose without his or her permission.
How Insulin Treatment Helps Your Blood Sugar
Insulin aids in the transport of glucose from the bloodstream to the cells. Some of the sugar is used by your cells for energy, and the rest is stored in your fat, muscles, and liver for later use. Your blood glucose level should return to normal once the sugar has moved into your cells.
A sudden drop in blood sugar
When your blood sugar (glucose) level drops too low, hypoglycemia ensues. This can happen for a variety of causes, the most prevalent of which is a side effect of diabetes medications.
Persistent hypoglycemia
Newborn with Persistent Hypoglycemia. Definition: Inability to consistently maintain. pre-prandial glucose concentration: > 50 mg/dL up to 48 hrs of life OR. > 60 mg/dL after 48 hrs of life.
Drugs used to manage diabetes are the most common cause of hypoglycemia. Other medicines, acute sickness or organ failure, a reaction to carbohydrates (in susceptible persons), an insulin-producing tumor in the pancreas, and various types of bariatric (weight loss) surgery are all less common causes of hypoglycemia.
low blood sugar attack
If you use diabetes drugs that raise insulin levels in your body, you may experience low blood sugar. Hypoglycemia can cause a variety of dangerous symptoms if not treated promptly. This can involve mental confusion, seizures, brain injury, coma, and, in extreme situations, death.
Treatment:
1. if you think your sugar level may be low Check your blood sugar, such as below 70 mg/dL.
2. From a quick-sugar source, eat about 15 grams of carbohydrate. If you are at home, you will probably already have something close at hand that contains sugar, such as fruit juice or table sugar. Carry some glucose tablets or hard candy with you when you are away from home. Then solid foods, Liquids will raise your blood sugar faster.
3. Check your sugar level again about 15 minutes after eating the 15 grams of carbohydrate. Eat another 15 grams of carbohydrate from quick-sugar food, If your sugar is still below 70 mg/dL, Repeat 15 grams of fast-acting carbohydrate every 15 minutes until your sugar is in a safe target range, such as higher or 70 mg/dL. Eat a small snack when your sugar returns to your target range if your next planned meal or snack is more than a few hours away
If you do not have diabetes
You should see a doctor if you experience symptoms of hyperglycemia because you may have undiagnosed diabetes. Your doctor will test your blood glucose level and discuss the results with you. If you have diabetes, you will be given advice on how to manage this condition.
• Eat small meals and snacks every few hours.
• Include a broad variety of foods, including protein, fatty, and high-fiber foods
• Don’t eat a lot of high-sugar foods.
Work with your doctor to figure out anything else that may be causing your symptoms
Prevention
• If you have diabetes, planning your medication and eating regularly can help prevent hypoglycemia. Monitoring your blood sugar levels is also important. Monitoring your blood glucose levels regularly can help keep your blood glucose normal and stable, and prevent you from developing hypoglycemia. It Will help to cure the signs and symptoms quickly.
• Your blood glucose level can vary throughout the day, so you may need to check it several times a day, depending on the treatment you’re taking. You can use a blood glucose meter, a small device Monitor your blood glucose level by using a device that measures the concentration of glucose in your blood.
• Food and Alcohol If you have diabetes, excessive physical activity can lead to hypoglycemia. Eating foods containing extra carbohydrates before and during exercise can help reduce the chance of this happening. If you are taking insulin, your doctor may recommend that you lower your dose before doing vigorous physical activity. Alcohol can also affect your body’s ability to release glucose.
• Do not drink too much alcohol and have a snack after drinking alcohol. Recognizing the symptoms Hypoglycemia can develop suddenly,
• It is important to be aware of the symptoms of hypoglycemia so that you can treat it quickly.
When should you seek medical help?
You should seek medical attention immediately if you start experiencing any of these symptoms-
• Nausea or vomiting (feeling sick or being sick)
• stomach ache
• Your breath has a fruity odor, which may resemble pear droppings or smell like nail varnish.
• drowsiness or confusion
• hyperventilation
• Dehydration (when your body’s normal water content is reduced, which can cause headaches, dry skin, and a weak, rapid heartbeat)
• fainting
• If you have these symptoms, you may have diabetic ketoacidosis, and you will need hospital treatment.
If you’re on a meal plan or on insulin-increasing drugs to manage low blood sugar, it’s critical to keep to the plan your doctor suggested to avoid blood sugar decreases.
Blood sugar levels can decline if you don’t eat the proper foods or take the right medications at the right times. Check-in with your doctor on a regular basis so that they can make any required adjustments to your treatment plan.
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-8,131,830,244,109,206,000 | A QUICK LOOK AT DRY EYE
How your tears work
Every time you blink, a thin layer of tears is spread across the cornea. This thin layer of moisture, known as the tear film, forms a protective coat that lubricates your eyes and washes away any debris that might harm or obscure your vision1.
Why dry
eye occurs
Dry eye happens when the tear glands stop making enough tears, produce poor-quality tears, or the tears evaporate too quickly, causing your eyes to feel dry and irritated.2,3
Why dry eye occurs
Dry eye happens when the tear glands stop making enough tears, produce poor-quality tears, or the tears evaporate too quickly, causing your eyes to feel dry and irritated.2,3
What Treatments Exist
Although there's no cure for dry eye, there are a variety of SYSTANE® products available to temporarily relieve its symptoms. Plus, try these tips and tricks.4 learn more
SYSTANE<sup>®</sup> is the #1 Doctor Recommended Brand for Dry Eye Symptom Relief
References:
1. 1. 2007 Report of the International Dry Eye Workshop (DEWS).
http://www.tearfilm.org/dewsreport/pdfs/TOS-0502-DEWS-noAds.pdf Page 75,87.
2. Holly F. Lemp MA. Formation and rupture of the tear film. Exp Eye Res 1973; 15: 515-25
3. TFOS International Dry Eye Workshop (DEWS II). Ocular Surf. 2017 Jul; 15 (6): 269-650.
4. National Eye Institute. http://www.nei.nih.gov/health/dryeye/factsaboutdryeye.pdf Pages 1,2. Accessed March 12, 2013. | {
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2,384,599,312,832,987,000 | Am I a Solid Candidate for One or More Dental Implants?
Dental implants are a high-tech and innovative solution to bridges and dentures, offering a permanent fixture to your smile that cannot accidentally come out or become loose. As these fixtures become more and more popular in replacing one, multiple, or all of a person’s teeth, the procedure has been dominating dental blogs and websites.
While people of all ages and lifestyles can pursue dental implants as an alternative to bridges and dentures, not everybody is a solid candidate for them. If you are considering getting one or more missing teeth replaced by a permanent implant, consider the following factors to determine if you are eligible.
Who is a Good Candidate for Dental Implants?
Adults with fully-formed jaws and healthy gums are ideal candidates for receiving dental implants. This, quite fortunately, means that most adults can safely receive one or more implant to replace missing teeth. Because the implants will need to fuse to the bone, it is also important that you have enough healthy bone in your jaws to secure the implants. To ensure this, you will receive X-rays and perhaps a CT scan to determine your eligibility.
Who Isn’t a Good Candidate for Dental Implants?
Receiving dental implants requires your body to undergo some serious healing, so not everybody is a strong candidate for these fixtures. People with certain medical conditions like uncontrolled diabetes, uncontrolled gum disease and alcoholism are especially likely to have poor outcomes.
But this does not mean that you will never be a candidate for dental implants. Confer with your dentist to make a plan of action that will increase your eligibility so that you can get the smile you’ve always dreamed of – and deserved. Oftentimes, it only takes a few small lifestyle changes to make this happen. | {
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561,648,079,168,325,250 | Aged transgenic mice with increased glucocorticoid sensitivity in pancreatic beta-cells develop diabetes.
Abstract
Glucocorticoids are diabetogenic hormones because they decrease glucose uptake, increase hepatic glucose production, and inhibit insulin release. To study the long-term effects of increased glucocorticoid sensitivity in beta-cells, we studied transgenic mice overexpressing the rat glucocorticoid receptor targeted to the beta-cells using the rat insulin I… (More)
Topics
9 Figures and Tables | {
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-2,287,646,118,128,059,000 | Instagramm Facebook
Home | Blog
Egg Donor Qualifications and Requirements – Become an Egg Donor
calendar April 17, 2019 user eye 602
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egg donor qualifications main image
The basic egg donor qualifications are the following:
• Egg donor age limit: 19-31 years old;
• Absence of hormonal disorders;
• Regular menstrual cycle;
• Lack of bad habits, such as smoking, alcohol, drugs;
• Willing to help other families conceive a child;
• Good physical and emotional health;
• Without hereditary diseases;
• Willing to provide complete personal information about the occupation, marital status, children, etc.;
• Ready to undergo a medical examination and take the necessary medications.
Now it’s high time to give a more detailed overview of the process and explain which egg donor qualifications and requirements are critical and why they are important for the IVF program.
Who Can Become an Egg Donor?
Probably you saw the announcements like `looking for an egg donor,` `looking for an oocytes donor,` or ‘need a surrogate mother,` etc. They are connected by the same purpose – to find a perfect person. And you can become the one, thereby supporting a childless couple to achieve their dream.
How to do that? Well, there are specific egg donor qualifications you should have to apply for one of those programs.
Egg Donor Age Limit: 19-31
egg donor age limits
Egg donor age limit varies between 19 and 31. We accept egg donors in our pool starting from 19 years. The main reason is that during this time women are at the peak of fertility. Moreover, they already have enough responsibility to take the process seriously.
At the same time, after 30 women fertility decreases. That’s why we usually accept new donors who are not older than 30 considering. One more reason is that it will take up to one year to match with intended parents.
Hormonal Health and Regular Menstrual Cycle
It is highly essential for an egg donor to have perfect hormonal health. The first reason is to secure the donor`s health and avoid possible complications during hormonal treatment and egg retrieval.
Secondly, during the hormonal treatment, the doctors have to synchronize the donor`s and recipient`s cycles. In the case of hormonal deviations or non-regular periods, it can be quite complicating.
Good BMI – Eat Well, Do Sports
healthy diet for healthy sperm
Good Body Mass Index (BMI) is also an essential qualification for egg donors. One of the main reasons is that being overweight or underweight can cause hormonal shifts. Besides, potential parents are struggling to find a donor with a healthy weight to make sure their child will inherit it.
If you want to estimate your BMI and check if it fits the norm, you can use an online calculator.
Say NO to Smoking, Alcohol, and Drugs
egg donor bad habits and smoking
According to multiple international pieces of research, smoking decreases your fertility by 10-40%. There are also theories proving that it can be the primary cause of each 10th infertility case. That`s why, we only accept donors without bad habits such as smoking, alcohol and drug addictions, etc.
Having Your Biological Children as a Requirement
biological child
We gladly accept egg donors who have their own biological children. Some intended parents mention this as one of prerequisite egg donor qualifications. Thus, they try to make sure that the IVF process will have higher success chances.
Such a requirement is not mandatory for an application process, though. We accept egg donors with and without biological kids.
Genetic History and Hereditary Diseases
egg donor qualification - genetics and family history
One of the first appointments you get during your application is with a geneticist. You will have to provide your family history to make sure that you don`t have any inherited diseases that can be transmitted to the future baby.
The same relates to the medical conditions and other disqualifiers like HIV, Hepatitis, physical and mental disorders.
Dedication and Discipline
egg donor requirement - discipline
If you decide to become an egg donor, you should be disciplined. Never miss appointments, medical examinations and take the prescribed medications. The success of the retrieval and the overall IVF process depends on you. Moreover, understanding the good you bring to the family helps to release the related discomfort of the procedures.
As an egg donor, you should always remember, that egg donation is not a job. It usually works better when a donor truly wants to help other families conceive and give birth to their dream baby.
I Have all Necessary Egg Donor Qualifications, What Should I Do?
single parent surrogacy frequently asked questions
Questionnaire
The process starts with filling out the questionnaire. It is created in order t help the intended parents find the best match in our database. Moreover, it highlights additional egg donor qualifications and featured the couples are willing to know.
1. Metric data;
2. Personal data such as family and marital status, as well as biological children;
3. A detailed description of your appearance and phenotypic signs: height, weight, eyes color and shape, nose shape, overall physique;
4. Genetic diseases and bad habits, if you have any.
5. Biological children, if you have them.
After completing the application, the questionnaire our fertility expert checks it. Based on the responses, the expert decides whether or not the potential egg donor meets the necessary requirements.
Personal Meeting
The next step is a personal meeting. If this stage is successfully overcome, the next step will be the mandatory examination of the candidate, which includes:
• medical examination and consultancy with a geneticist;
• appointment with a psychiatrist;
• medical examination with a physician;
• pelvic organs and mammary gland ultrasound;
• blood tests;
• determining antibodies to the human immunodeficiency virus, as well as hepatitis B and C ;
• examination and conclusion of the gynecologist.
After the results of all the studies are ready, the reproduction physician decides whether a particular woman can be an egg donor or not.
It is essential to understand that a specialist evaluates all possible risks to the health of a woman to eliminate any potential complications. If the doctor has doubts egg donor qualifications and health of the candidate, she will get a reject.
The Process – Hormonal Stimulation, Egg Retrieval
medical image doctor
As soon as you get the approval and the intended parents choose you as a donor, the procedure begins.
It starts with the synchronization of donor and recipient menstrual cycles. The donor also undergoes hormonal stimulation of the ovaries so they can produce several eggs during one cycle. Egg donors regularly visit a fertility expert to monitor the growth of the follicles.
Ater that oocytes retrieval takes place. The operation lasts 15-20 minutes under intravenous anesthesia.
Facts You Should Know about Sunshine Egg Donation Program
If you have the necessary egg donor qualifications and decided to choose our agency, here are several facts about Sunshine you should know.
• Egg donation program does not change the usual course of your life. You can keep on your normal daily routine.
• No additional actions are needed. We will perform medical examinations and egg retrieval at one of our clinics during your appointments.
• It does not take much of your time. You will only have to make 2-3 visits to the clinic.
• Hormonal drugs used for stimulation affect only the current cycle. During the next period, your organism will recover, and you will be able to conceive a child.
• It makes no harm to your health – if you follow simple recommendations of the doctor, complications risks are lower than 0.5%.
• Your personal information is anonymous. At the same time, you do not receive information about the potential parents who will use the oocytes.
• The reward is guaranteed – regardless of the fertilization result.
There are also several important things about the compensation you should know. This information relates to all fertility clinics and agencies and contains average egg donation payment rates.
Egg Donor Compensation
The oocyte donor payment is negotiable. However, it should not be lower than $ 1 000, which is paid on the day of the oocytes collection.
Please note that the clinics can pay a meager compensation to the donor, within $400-700. Therefore, we advise you to apply only to an agency that values its donors and makes fair rewards.
The permissible number of procedures is 2-5 per year. The pauses between egg retrievals should be at least 2-3 menstrual cycles.
egg donor profiles
BECOME AN EGG DONOR
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There are thousands of couples that, for many months and even years, are trying to become parents to no avail. Unfortunately, there are more and more cases of infertility. According to some reports, today, 10% of couples experience problems with conception. How to get pregnant fast? What to do if you have PCOS, endometriosis, or
Don't wait another day to complete your family | {
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-1,846,208,738,146,327,300 | My son has cough and running nose. Please advise.
Q. My son has cough and running nose. Please advise.
Answered by
Dr. Chandra Prakash Tanwar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Aug 25, 2017
Hello doctor,
My son is 5 years old. Since yesterday, he has a cough and running nose. Yesterday, I gave him Zyrcold syrup.
#
Hello,
Welcome to icliniq.com.
• Your son is suffering from a cough and running nose from one day.
• I would like some more information:
1. Is this associated with shortness of breath?
2. Is this associated with whistling sounds?
3. What is the color of the sputum?
4. Does he have a fever or labored breathing?
5. Does he have a history of asthma in the past?
• Considering a short history, it seems to be an upper respiratory tract infection, which is usually viral. Management includes rest, proper hydration, and supportive treatment. You can continue the Zyrcold syrup (Cetirizine and Ambroxol).
• Levolin contains Levosalbutamol, which is a bronchodilator that is used in the case of a lower respiratory tract infection, which does not seem to be the case.
• You can give him steam inhalation.
Thanks and regards.
For more information consult an internal medicine physician online --> https://icliniq.com./ask-a-doctor-online/internal-medicine-physician
Was this answer helpful?
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• John Heitner ,
John.Heitner@gmail.com
Affiliation Department of Medicine, Division of Cardiology, New York Methodist Hospital, Brooklyn, New York, United States of America
• Geetha P. Bhumireddy,
Affiliation Department of Medicine, Division of Cardiology, New York Methodist Hospital, Brooklyn, New York, United States of America
• Anna Lisa Crowley,
Affiliation Cardiovascular Magnetic Resonance Center, Duke Medical Center, Durham, North Carolina, United States of America
• Jonathan Weinsaft,
Affiliation Cardiovascular Magnetic Resonance Center, Duke Medical Center, Durham, North Carolina, United States of America
• Salman A. Haq,
Affiliation Department of Medicine, Division of Cardiology, New York Methodist Hospital, Brooklyn, New York, United States of America
• Igor Klem,
Affiliation Cardiovascular Magnetic Resonance Center, Duke Medical Center, Durham, North Carolina, United States of America
• Raymond J. Kim,
Affiliation Cardiovascular Magnetic Resonance Center, Duke Medical Center, Durham, North Carolina, United States of America
• James G. Jollis
Affiliation Cardiovascular Magnetic Resonance Center, Duke Medical Center, Durham, North Carolina, United States of America
Clinical Application of Cine-MRI in the Visual Assessment of Mitral Regurgitation Compared to Echocardiography and Cardiac Catheterization
• John Heitner,
• Geetha P. Bhumireddy,
• Anna Lisa Crowley,
• Jonathan Weinsaft,
• Salman A. Haq,
• Igor Klem,
• Raymond J. Kim,
• James G. Jollis
PLOS
x
Abstract
Background
Detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Our objective was to assess specific visual parameters by cine-magnetic resonance imaging (MRI) in the determination of the severity of mitral regurgitation and to compare it to previously validated imaging modalities: echocardiography and cardiac ventriculography.
Methods
The study population consisted of 68 patients who underwent a cardiac MRI followed by an echocardiogram within a median time of 2.0 days and 49 of these patients who had a cardiac catheterization, median time of 2.0 days. The inter-rater agreement statistic (Kappa) was used to evaluate the agreement.
Results
There was moderate agreement between cine MRI and Doppler echocardiography in assessing mitral regurgitation severity, with a kappa value of 0.47, confidence interval (CI) 0.29–0.65. There was also fair agreement between cine MRI and cardiac catheterization with a kappa value of 0.36, CI of 0.17–0.55.
Conclusion
Cine MRI offers a reasonable alternative to both Doppler echocardiography and, to a lesser extent, cardiac catheterization for visually assessing the severity of mitral regurgitation with specific visual parameters during routine clinical cardiac MRI.
Introduction
Long-term outcomes of patients with mitral regurgitation have demonstrated increasing rates of heart failure, atrial fibrillation and sudden cardiac death. [1], [2] The mortality risk has been shown to be directly related to the severity of mitral regurgitation. [3] In addition, the severity of mitral regurgitation is a major determinant that leads to left ventricular dilatation and dysfunction. [4] Thus, detecting and quantifying the severity of mitral regurgitation is essential for risk stratification and clinical decision-making regarding timing of surgery. Echocardiography and cardiac ventriculography are well-validated techniques in assessing the severity of mitral regurgitation. [5], [6] Magnetic resonance imaging (MRI) has been shown to be able to assess mitral regurgitation, however, it lacks the validation that exists with echocardiography and cardiac ventriculography.
There are several MRI methods available to assess the severity of mitral regurgitation. Cine-MRI quantifies mitral regurgitation by comparing the difference between the right and left ventricular volumes in the absence of any other significant valvular regurgitant lesions. [7] Cine-MRI enhances the visual assessment of the severity of regurgitant jet as a signal loss, caused mainly from the turbulence of blood leading to the cancellation of the different phase angles of spins subjected to different velocities and acceleration. Flow velocity mapping can assess the severity of mitral regurgitation by quantifying the amount of blood that regurgitates across the mitral valve by using a special pulse sequence that takes advantage of the movement of blood.
Flow velocity mapping and volumetric assessment have been validated in prior studies comparing it to other imaging modalities, however, they require different pulse sequences and/or extra time in post processing. In a high volume cardiac MRI laboratory, this adds extra time to the overall study, thus, validation of the routine sequences used (cine-MRI) on a normal cardiac assessment for left ventricular function would be very beneficial. Higgins et al., validated the assessment of mitral regurgitation via an older gradient echo pulse sequence using the gradient-recalled acquisition by a steady-state (GRASS) technique. [8] However, there have been no studies to date that have validated assessment of the severity of mitral regurgitation using the newer cine pulse sequence SSFP (Steady-state free precession).
Our objective was to assess specific visual parameters by cine-MRI in the determination of the severity of mitral regurgitation and to compare the visual assessment of mitral regurgitation by cine MRI to previously validated imaging modalities: echocardiography and cardiac ventriculography.
We hypothesized that the visual assessment of mitral regurgitation by cine-MRI will be similar to the assessment of mitral regurgitation by echocardiography and left ventriculography in patients that have undergone all three imaging techniques for clinical assessment.
Materials and Methods
Study Population
We retrospectively evaluated patients who had undergone cardiac MRI, echocardiography and cardiac catheterization. A total of 68 patients underwent a cardiac MRI and echocardiogram within a median time of 2.0 days for either congestive heart failure or coronary artery disease. Of these 68 patients, 49 also had a cardiac catheterization, median time of 2.0 days between the cardiac catheterization and MRI. The reason for referral for each study varied greatly, ranging from the assessment of coronary artery disease to the assessment of valvular disease. The patients were chosen based upon retrospective assessment of our database for any patient who underwent both echocardiogram and cardiac MRI within 2 weeks.
Ethics Statement
The Institutional Review Board (IRB) of Duke University Health System approved the study. A written informed consent was obtained from all the study patients.
Study Design
All studies were reassessed for the severity of mitral regurgitation by consensus of three cardiologists at the same time, who were blinded to the patient data. The visual parameters used in assessing the severity of mitral regurgitation via all three modalities are listed in Table 1. A visual example of each severity for all three imaging modalities is presented in figure 1. Etiologies for mitral regurgitation included myxomatous disease, annular dilatation and ischemic cardiomyopathy.
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Figure 1. Examples of mild, moderate, and severe mitral regurgitation for each imaging modality.
https://doi.org/10.1371/journal.pone.0040491.g001
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Table 1. Visual assessment parameters for determining mitral regurgitation severity.
https://doi.org/10.1371/journal.pone.0040491.t001
Echocardiography
Complete Doppler echocardiography was performed using a Philips Sonos 7500 ultrasound scanning equipment (Andover, MA). The standard views were obtained including parasternal, apical, and sub-costal views with color, continuous and pulse wave Doppler. The mitral regurgitation was assessed using the comprehensive data from the echocardiogram including assessment of the color Doppler jet (size, vena contracta, zone of convergence, and other characteristics (i.e. central vs. eccentric), continuous wave Doppler across the mitral valve and pulse wave Doppler of the pulmonary veins. [9][11] In addition, left atrial size were also assessed by parasternal long axis view. [4].
MRI
Cardiac MRI was performed on a 1.5 Tesla scanner (Siemens Sonata) using a 6-element cardiac phase–array receiver coil. Steady-state free-precession (SSFP) cine images were acquired in multiple short-axis (every 1 cm through the entire left ventricle, with a slice thickness of 6 mm; gap between slices, 4 mm) and 3 perpendicular long axis views across the mitral valve. Typical parameters used were: repetition time, 3.0 ms; echo time, 1.5 ms; flip angle, 90°; temporal resolution, 35 ms/phase; in-plane resolution, 1.7×1.4 mm.
The characteristics used in the assessment of the severity of mitral regurgitation included: vena contracta size, jet intensity, jet area and length, the left atrial size (using a long axis view) and the left ventricular cavitary size (Figure 2). [12] The severity of mitral regurgitation was predominantly based upon the first four of the six criteria listed in table 1. The left atrial size and left ventricular end diastolic diameter was used as additional data in the visual assessment for discriminating the severity of regurgitation. This was an attempt to validate these visual assessment criteria.
Cardiac Ventriculogram
Cardiac ventriculography was obtained with a 6 F pigtail catheter inserted into the femoral artery and guided into the left ventricle. A power injector was used to fill the left ventricle. Standard ventriculography in the 30 degrees right anterior oblique position was obtained. For patients with an uncertain degree of mitral regurgitation, LAO views were also obtained. The severity of mitral regurgitation was based on assessment of left atrial opacification by Grossman’s criteria (see Table 1), determined by an interventional cardiologist. [13].
Statistical Analysis
The inter-rater agreement statistic (Kappa) was used to evaluate the agreement between echocardiography and cardiac catheterization, cine-MRI and echocardiography, and cine-MRI and cardiac catheterization. Since kappa does not take into account the degree of disagreement between observers and all disagreement is treated equally as total disagreement, for final analysis we chose to use weighted kappa, and assign different weights to subjects for whom the raters differ by i categories, so that different levels of agreement can contribute to the value of Kappa (K). The K value was interpreted as is shown in Table 2. [14].
Results
Baseline Characteristics
The baseline characteristics of the 68 patients are highlighted in Table 3. The mean age was 62±10 years, with 2 out of 3 patients having a history of hypertension. Nearly half of the patients had a history of myocardial infarction and congestive heart failure, with the majority having New York Heart Association (NYHA) class II or III heart failure.
Cine MRI Compared to Doppler Echocardiography
There was moderate agreement between cine MRI and Doppler echocardiography in assessing mitral regurgitation severity, with a kappa value of 0.47, confidence interval (CI) 0.29–0.65 (Table 4). Of the 29 patients diagnosed with mild or no mitral regurgitation by cine MRI, 28 of them had the same findings by echocardiography. Of the 22 patients diagnosed as having moderate or severe mitral regurgitation by Doppler echocardiography, 21 patients were found to have moderate or severe mitral regurgitation by MRI. Because of small sample size, only data for moderate and severe mitral regurgitation was reported in the tables, which is more relevant for clinical decision-making.
Cine MRI Compared to Cardiac Catheterization
There was fair agreement between cine MRI and cardiac catheterization with a kappa value of 0.36, (CI of 0.17–0.55) (Table 5). Of the 38 patients with mild mitral regurgitation by cardiac catheterization, 21 patients had mild mitral regurgitation as determined by MRI. The remaining 17 patients were diagnosed as having moderate or severe mitral regurgitation by MRI, indicating a higher threshold in assessing the severity of mitral regurgitation by MRI. All 11 patients who had moderate or severe mitral regurgitation by catheterization also had moderate or severe mitral regurgitation by MRI.
Doppler Echocardiography Compared to Cardiac Catheterization
There was good agreement between Doppler echocardiography and cardiac catheterization (kappa value of 0.66, CI 0.42–0.91) (Table 6). Of the 31 patients diagnosed as having mild mitral regurgitation by Doppler echocardiography, only one patient was found to have moderate to severe mitral regurgitation by cardiac catheterization. Furthermore, of the 14 patients with moderate or severe mitral regurgitation diagnosed by Doppler echocardiography, Five patients had mild mitral regurgitation with cardiac catheterization.
Stratification Based on Ejection Fraction and Left Atrial Size
To further consider potential mechanisms for discordance, we stratified patients based on left atrial (LA) size and ejection fraction (EF) in determining the severity of mitral regurgitation. When comparing MRI with echocardiography, there was evidence to suggest that the agreement between echocardiography and MRI improved as the left ventricular function declined and no difference was found when stratified for LA size. There was no difference in the severity of mitral regurgitation between MRI and cardiac ventriculography when stratified by EF (either less than or greater than 20%). However, the correlation was worse when stratified by LA size, with greater LA size having a worse correlation for the severity of mitral regurgitation between the two modalities. There was no difference in the assessment of mitral regurgitation between echocardiography and ventriculography when stratified for larger LA size or a lower EF.
Discussion
The results of our study demonstrate that visual assessment of mitral regurgitation by cine MRI is reasonably comparable to Doppler echocardiography and to a lesser extent cardiac catheterization. There was moderate agreement between MRI and Doppler echocardiography. The correlation between cine MRI and echocardiography was not outstanding, however, cine MRI was able to distinguish severe mitral regurgitation from mild to moderate, which helps in clinical decision making. There was only one patient who was diagnosed with moderate to severe mitral regurgitation by echocardiography who was not determined to have the same severity of mitral regurgitation by MRI. Only one patient with no or mild mitral regurgitation by MRI was found to have moderate mitral regurgitation by echocardiography. There was also a fair agreement between cine MRI and cardiac catheterization in assessing mitral regurgitation severity. Acquisition of multiple 4-chamber long axis views using SSFP in patients with mitral regurgitation seen in any one of the routine views might further increase the agreement.
This study found a good correlation between Doppler echocardiography and cardiac catheterization. These findings are consistent with previously published data validating both of these imaging modalities for assessing the severity of mitral regurgitation. [15][18] Mann et al., quantified mitral valve insufficiency in 60 patients and found very good correlation, r = 0.89, between the two modalities in estimating the severity of mitral regurgitation. [17].
MRI identified a higher number of patients with significant (moderate or severe) mitral regurgitation as compared to echocardiography and cardiac catheterization. Of the 39 patients diagnosed as having moderate to severe mitral regurgitation by MRI only 21 of these patients were determined to have similar disease severity by echocardiography. MRI detected all 11 patients who had significant mitral regurgitation by cardiac catheterization. The higher threshold of cine MRI in diagnosing moderate or severe mitral regurgitation as compared to echocardiography and cardiac catheterization may be secondary to the parameters used by MRI. These parameters may need to be adjusted to better correlate with other imaging techniques, as they have not been previously validated. Alternatively, this higher threshold may be more accurate, however outcome data (progression of left ventricular failure, and mortality) would be necessary to confirm this alternative explanation. Furthermore, cine MRI provides detailed information about entire mitral valve apparatus, papillary muscle abnormalities and right ventricular morphology, which has both therapeutic and prognostic implications in patients with mitral regurgitation. [19].
Cine MRI evaluates the severity of mitral regurgitation through the loss of signal created by the turbulence of protons in blood pool created in the left atrium. In patients who have increased left atrial pressures, there may be less of a gradient between the left ventricle and left atrium, which may lead to more severe mitral regurgitation being underestimated due to the lower turbulence created. However, similar pitfall applies to visual estimation of the regurgitant jet by color Doppler echocardiography. When adjusted for left atrial size, there was worse agreement between MRI and echocardiography and cardiac catheterization, respectively.
In left ventriculography, mitral regurgitation severity is assessed visually by the amount of contrast ejected into the left atrium during systole. In echocardiography, the velocity across the valve is assessed to determine the severity of mitral regurgitation. In addition, color Doppler imaging is similar to MRI in that both the modalities are looking at turbulent flow. However, compared to MRI, echocardiography looks at the velocity of both laminar and turbulent flow in assessing the severity of mitral regurgitation.
Flow velocity mapping and volume analysis are two other MRI techniques used in assessing the severity of mitral regurgitation. Neuhold et al., evaluated 46 patients with angiographically confirmed regurgitant lesions and found a good correlation with MRI using the volume analysis method. [20] In another study, Fujita et al., compared color Doppler echocardiography to velocity encoded cine MRI in grading mitral regurgitation and found that regurgitant fraction obtained by MRI correlated well with the echocardiographic severity of mitral regurgitation, r = 0.87. [21] Although both flow velocity mapping and volume analysis have been validated in previous studies, there are certain limitations to these techniques. They both require additional pulse sequences and flow velocity mapping requires fairly extensive time-consuming post processing. Evaluation of mitral regurgitation by visual assessment using a routine pulse sequence (SSFP) offers a simple alternative, particularly as SSFP is used on a routine basis in the standard evaluation of the heart. Therefore, developing a simple grading system, i.e. specific visual parameters for routine clinical use, will provide an easier and less time consuming tool for assessing mitral regurgitation severity.
Limitations
Mitral regurgitation is dependent upon the volume status and blood pressure of patients, which may potentially change in between each imaging study. We were unable to completely account for all loading conditions; however, the close proximity of these imaging tests minimizes this potential limitation.
This study is an attempt to validate the proposed visual assessment criteria for the severity of mitral regurgitation and has not been studied previously. We did not use a reference method to look at the reliability of cine MRI. Instead, comparison was made with the standard imaging methods. Larger clinical trials may be required to further validate the criterion before being used in the clinical setting.
SSFP sequence utilized to assess severity of mitral regurgitation has an inherently short echo time (TE). Using short TE sequences may not allow for adequate spin dephasing and potentially may decrease the accuracy of the test.
Severity of mitral regurgitation was obtained from consensus of three cardiologists, interpreting the images at same time, and we could not obtain the inter-observer variability. Similar method was followed for interpreting cardiac catheterization and Doppler echocardiography images.
Another possible limitation may be selection bias in finding patients who had all 3 tests, which included patients with heart failure and those undergoing viability and coronary artery disease assessment, as compared to the general valve disease population. Theses findings may be less applicable to patients not selected for multiple imaging procedures.
Conclusion
In order to determine the need and success of medical therapy, as well as, to decide on the correct timing for surgery, prudent assessment of valvular regurgitation is imperative. Cine MRI offers a reasonable alternative to both Doppler echocardiography and to a fair extent cardiac catheterization for assessing the severity of mitral regurgitation with specific visual parameters during routine clinical cardiac MRI.
Author Contributions
Conceived and designed the experiments: JH RK JJ. Performed the experiments: JH AC JW GB SH IK RK JJ. Analyzed the data: JH AC IK JJ. Contributed reagents/materials/analysis tools: JH AC JW GB SH IK RK JJ. Wrote the paper: JH GB IK RK.
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-5,736,717,932,228,474,000 | US4897347A - Multilayer analysis film for analyzing transaminase - Google Patents
Multilayer analysis film for analyzing transaminase Download PDF
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US4897347A
US4897347A US06773911 US77391185A US4897347A US 4897347 A US4897347 A US 4897347A US 06773911 US06773911 US 06773911 US 77391185 A US77391185 A US 77391185A US 4897347 A US4897347 A US 4897347A
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transaminase
analysis
layer
film
defined
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Harumi Katsuyama
Toshikazu Amano
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Fujifilm Corp
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• CCHEMISTRY; METALLURGY
• C12BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
• C12QMEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
• C12Q1/00Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
• C12Q1/48Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving transferase
• C12Q1/52Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving transferase involving transaminase
• GPHYSICS
• G01MEASURING; TESTING
• G01NINVESTIGATING OR ANALYSING MATERIALS BY DETERMINING THEIR CHEMICAL OR PHYSICAL PROPERTIES
• G01N33/00Investigating or analysing materials by specific methods not covered by the preceding groups
• G01N33/48Biological material, e.g. blood, urine; Haemocytometers
• G01N33/50Chemical analysis of biological material, e.g. blood, urine; Testing involving biospecific ligand binding methods; Immunological testing
• G01N33/52Use of compounds or compositions for colorimetric, spectrophotometric or fluorometric investigation, e.g. use of reagent paper and including single- and multilayer analytical elements
• G01N33/525Multi-layer analytical elements
• G01N33/526Multi-layer analytical elements the element being adapted for a specific analyte
• YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
• Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
• Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
• Y10S435/00Chemistry: molecular biology and microbiology
• Y10S435/805Test papers
Abstract
A multilayer analysis film for assaying transaminase in a coupled reaction system by a kinetic method comprises (1) a porous layer containing a transaminase substrate, (2) a coloring indicator layer for the detection of hydrogen peroxide, and (3) a transparent support, integrally laminated in this order. Pyruvate oxidase is located in a large excess in the uppermost porous layer where a rate-determining step receives maximum exposure to oxygen in the air. By the use of the analysis film, transaminase activity can be assayed with high sensitivity.
Description
CROSS-REFERENCE TO RELATED APPLICATION
This application is a continuation-in-part of U. S. Application Ser. No. 389,345, filed June 17, 1982, entitled "MULTILAYER ANALYSIS FILM FOR ANALYZING TRANSAMINASE", by Katsuyama et al, now abandoned.
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to an improved multilayer analysis film suitable for highly sensitive, quantitative analysis of transaminase activity.
2. Development of the Invention
Various transaminases are known as enzymes capable of transferring an amino group. Among these glutamate-pyruvate transaminase (GPT) and glutamate-oxaloacetate transaminase (GOT) blood concentrations may be indicative of liver diseases and, therefore, quantitative analysis of GPT and GOT activities is very important in the diagnosis of liver diseases.
GPT and GOT are transaminases which catalyze transamination between an amino acid and an α-keto acid to produce another amino acid, as shown by the following reaction schemes (1) and (2). ##STR1##
Enzyme assay may be classified into two methods; one is called an endpoint method for assaying an amount of substrate in which an enzyme-catalyzed reaction is quantitatively proceeded and after completion of the reaction, an amount of substrate or product changed is measured at the endpoint as a detectable species. The endpoint method thus involves a reaction system in which a detectable species, typically a dyestuff, is formed in an amount equivalent to the amount of substrate consumed in a fixed period of time, i.e., the substrate decreases with time to reach the endpoint of the enzyme reaction for a fixed period of time. Another method .is called the kinetic or rate-determining method for assaying enzyme activity which comprises measuring a detectable change of a physical amount with time; in this case, it is not required that the reaction be completed, unlike the endpoint method. More specifically, in the kinetic method a catalytic reaction proceeds due to interaction between the enzyme contained in a liquid sample and a substrate, and the amount of the reaction product increases or decreases with time in a linear relationship between the product produced and time. These two methods are explained in Method of Enzymatic Analysis, Hans Ulrich Bergmeyer, vol. 2, pages 726-773 (1974), published by Academic Press, Inc., New York, referring to measurement of transaminase activity. According to the Reitman-Frankel method (which is the endpoint method described in Amer. J. Clin. Pathol., vol. 28, page 56 (1956)), oxaloacetate produced after incubation for a fixed period of time is chemically converted into pyruvate; 2,4-dinitrophenylhydrazine is added to the pyruvate and the 2,4-dinitrophenylhydrazone formed is optically measured at 500 to 550 nm. On the other hand, according to the Karmen method (which is the kinetic or rate-determining method described in J. Clin. Invest., vol. 34, page 131 (1955)) as illustrated below, enzyme reaction (1') is immediately coupled with enzyme reaction (2'). In reaction (2'), wherein a rate of decreasing absorption of coenzyme NADH is measured at 340 nm. ##STR2##
In the past, the activities of transaminases have been measured by a color reaction in which a diazo dye is coupled with the pyruvate or oxaloacetate formed according to equations (1) or (2) (Japanese Patent Application (OPI) 40191/76) (the term "OPI" as used herein refers to a published unexamined patent application). The reaction system involved in the Japanese Patent Application supra belongs to the aforesaid endpoint method similar to the Reitmean-Frankel method. As an embodiment of this prior art method, a multilayer analysis film wherein the sequential reactions described above are intended to be separately conducted in two adjacent reagent layers has been proposed. The object is to reach equilibrium of the enzyme reaction of the first stage prior to beginning the coupling reaction of the second stage by conducting the two reactions at a suitable interval. Thus, this method runs counter to current needs in the art that reaction time (time required for assay) should be shortened as much as possible and, further, the sensitivity thereof is far from satisfactory.
There has also been proposed a method for the quantitative measurement of the activity of various transaminases where pyruvate is formed directly as shown in equation (1) above or indirectly from oxaloacetate formed according to equation (2) by way of a reaction in which another enzyme may or may not be involved, whereafter hydrogen peroxide - formed from the pyruvate by pyruvate oxidase (POP) according to equation (3)-, a color indicator composition and a peroxidase form a dye, according to equation (5). Thus, the resultant color level may be measured colorimetrically (for example, see Japanese Patent Application (OPI) 13068/80).
The measurement system of the present invention is a kinetic or rate-determining method similar to the Karmen method, in which applying several steps of conventional, enzymatically coupled reactions described hereinafter to reaction (1) or (2), the product produced (pyruvate in reaction (1) and oxaloacetate in (2)) is immediately converted into a detectable chemical species (NADH or a dye) and increase or decrease of the detectable chemical species is measured with time. In the rate-determining method utilizing several steps of coupled reactions, the enzyme activity of GOT or GPT should be reflected on the detectable chemical species to be actually measured.
The principle of the transminase assay used in the present invention which is described in Japanese Patent Application (OPI) 13068/80 is shown below. ##STR3## wherein: GOT: Glutamate-oxaloacetate transaminase
GPT: Glutamate-pyruvate transaminase
Pi : Inorganic phosphoric acid
POP: Pyruvate oxidase
FAD: Flavin adenine dinucleotide
TPP: Thiamine pyrophosphoric acid
M2+ : Bivalent metal
POD: Peroxidase
As is evident from the reaction schemes above, GOT enzyme reaction (2) is coupled with reactions (4), (3) and (5) in turn and, GPT enzyme reaction (1) is coupled with reactions (3) and (5) in turn. Namely, pyruvate formed according to the GPT-catalyzed reaction (1) or formed by GOT-catalyzed reaction (2) coupled with reaction (4) by the action of oxaloacetate decarboxylase, is converted into hydrogen peroxide according to POP-catalyzed reaction (3) which is further coupled with indicator enzyme reaction (5).
The POD enzyme reaction (5) where the thus produced hydrogen peroxide is a substrate, effects a coupling reaction between a hydrogen donor and a coupler to form a dye which is then subjected to a colorimetrical quantitative measurement.
In the aforesaid coupled reaction system of a kinetic method, it is important that the enzyme activity of GOT or GPT be reflected on the detectable species (dye) actually measured. In other words, an intermediate product should not accumulate but once it is formed, it should be immediately converted into a final product. For example, when a rate of reaction (3) is slower than that of reaction (4), reaction (3) cannot proceed but pyruvate which is the product of reaction (4) simply accumulates. This is fatal to the rate-determining method since the GOT activity is not reflected on the dye in reaction (5). Contrary to the rate-determining method, no fatal problem occurs with the endpoint method because the reaction finally reaches the endpoint anyhow; merely a longer time is required to complete the reaction.
As described above, GOT or GPT activity is assayed through a series of chemically coupled reactions which are conducted in an aqueous solution. However, precise control of the weight or volume of the components and troublesome handling of an aqueous solution are needed in order to perform these complicated reactions at high efficiency. In addition, the analysis procedures require a long time. Accordingly, this is not a satisfactory method for clinical assays in which both quickness and accuracy are needed.
The normal concentration of transaminase in healthy human blood is about 20 IU/1 at most, and the quantity of the substrate on which the enzymatic action of transaminase occurs during several tens of minutes for the measurement according to the method of the prior art is on the degree of 10-4 mole/1 under optimum condition. In a method for the colorimetric measurement of such trace amounts of a substrate using a coupled enzyme reaction, it is required--to maintain the accuracy of the results and to shorten the time for the analysis procedure--that: (1) each reaction fully proceed; (2) the dye formed have high absorbance; (3) the dye remain stable until it is photometrically measured; and (4) the dye formed not be lost by migration or diffusion prior to measurement in the case of a colorimetrical measurement using a film for quantitative analysis.
It is known that various oxidase enzymes, e.g., lactate oxidase or cholesterol oxidase, can be incorporated in a reagent layer or a spreading layer (see U.S. Pat. Nos. 4,166,763 issued to Esders et al and U.S. Pat. No. 3,983,005). However, the methods disclosed in these patents relate to endpoint colorimetry in which a dye is formed in an amount equivalent to substrate in a fixed period of time-, i.e., the dye is measured at the endpoint of the reaction. In these methods, there is no reason to give consideration to a rate-determining step. It is thus sufficient, as taught in U.S. Pat. No. 4,166,763, that 500 U/m2 of oxidase enzymes be present at maximum in a slide for the endpoint method. In view of these points, the present inventors have conducted extensive investigations and have found that the feed of oxygen, one of the substrates for the pyruvate oxidase, is a rate-determining step in the successive reaction system described above, and that the rate at which the hydrogen peroxide migrates from one layer of the multilayer film to another is much higher than that of migration rates of other substrates or products; the present invention has thus been accomplished.
SUMMARY OF THE INVENTION
It is an object of this invention to provide a multi-layer analysis film in which each of constituents used for the quantitative analysis of transminase activity and designed to produce hydrogen peroxide is present in a specified layer.
Another object of the present invention is to provide a multilayer analysis film in which transaminase activity is assayed in a simple manner with high accuracy by coupling with a known POP reaction system.
A further object of the present invention is to provide a method for the quantitative analysis of transaminase in a coupled reaction system by a kinetic method.
A multilayer analysis film per this invention has a structure wherein a porous layer containing substrate of transaminase, a color indicator layer for detecting hydrogen peroxide and a transparent support are integrally laminated, in this order. The multilayer analysis film is characterized in that:
(a) a pyruvate oxidase (hereafter often referred to as POP) is located in the analysis film where POP-catalyzed reaction (3) receives maximum exposure to oxygen in the air and therefore, POP is contained in the uppermost porous layer or an upper layer which is typically an enzyme layer located in contact with both the porous layer and the color indicator layer; and,
(2)the impregnation amount of POP is from 1,000 to 100,000 U/m2.
BRIEF DESCRIPTION OF THE DRAWINGS
FIGS. 1 to 9 are enlarged sections showing various embodiments of multilayer analysis films of the present invention.
FIG. 10 is a graph showing the color densities measured 10 minutes after incubation of analysis films for GOT analysis (A), (B) and (C) obtained according to Example 1, Reference Example 1 and Example 2, respectively, wherein enzyme activities (IU/1) are shown on the abscissa and optical densities at 550 nm are shown on the ordinate.
The numerals shown in the drawings have the following meanings:
1 is a porous layer containing TA (transaminase) substrate - POP, 11 is a porous layer containing a TA substrate, 12 is a POP enzyme layer, 2 is a color indicator layer, 21 is a color indicator layer containing a mordant, 22 is a color indicator layer containing a mordant - TiO2, 3 is a support, 40 is a light blocking layer containing TiO2 and 50 is a mordanting layer.
PREFERRED EMBODIMENTS OF THE INVENTION
As shown principally in the Karmen method of a kinetic system, the reaction for detection generally called indicator reaction which is coupled with the enzyme-catalyzed reaction should proceed immediately. The reaction for detection should always possess a reaction rate that is at least the same as that of the enzyme catalytic reaction; otherwise, a linear relationship is not obtained between the amount of detectable species and time. Phrased another way, any rate-determining step for producing a detectable species can no way be involved in steps for the reaction for detection. Noting such characteristic of the kinetic method, the production of the dye as the detectable species at high efficiency which results in high detection sensitivity can be achieved by determining the location and amount of POP enzyme. This is, of course, based on the finding that reaction (3) is rate-determining and depends on a concentration of oxygen; therefore, POP is located in the analysis film where POP-catalyzed reaction (3) receives maximum exposure to oxygen in the air.
The multilayer analysis film per this invention has a structure wherein the porous layer containing a substrate of transaminase, a color indicator layer for detecting hydrogen peroxide and a transparent support are integrally laminated, in this order. The uppermost porous layer further contains POP, but POP need not always coexist with the substrate and may be contained in another layer (referred to as an enzyme layer) which comes into fluid contact (through a gas or a liquid) with the porous layer and is laminated on the color indicator layer. In the present specification the term "fluid contact" refers to zones which are associated with one another in a manner such that, under conditions of use, a fluid, whether liquid or gaseous, can pass from one to the other.
As described above, when POP is located in the uppermost layer or in an upper part of the multilayer analysis film, oxygen which is one of the substrates for POP can be more efficiently fed from the air, in addition to oxygen dissolved in a test solution (see equation(3)). As a result, in a POD enzyme reaction (see equation (5)) coupled with the reaction of equation (3), hydrogen peroxide which is a substrate of POD is sufficiently and rapidly produced.
The hydrogen peroxide thus formed has a large mobility from the porous layer into the color indicator layer due to its low molecular weight, when the porous layer and the color indicator layer are in a wet state by application of a test solution. Thus the hydrogen peroxide immediately diffuses, migrates into and reach he indicator layer where a color-forming reagent such as a coupler reacts therewith to give a colored product.
In the multilayer analysis film of the present invention, it is important that feeding of oxygen from the air determines the overall reaction rate of the reaction system as a whole. It is also important that hydrogen peroxide having the largest multilayer mobility play to rapidly move from the porous layer to the color indicator layer. Therefore, POP may be placed anywhere as long as it permits performance of these functions; however, it is generally placed in the upper porous layer containing the substrate of transaminase or in a layer adjacent thereto toward the support side. Since these layers come or substantially come into contact with air, the reaction of equation (3) proceeds rapidly.
The reaction product or hydrogen peroxide is colorless and therefore, begins migration under conditions undetectable colorimetrically and immediately reaches the indicator layer where a detectable colored product is then formed. Per the present invention, it is very important that the multilayer migrant be undetectable.
In the prior art described above, the possibility exists that a coloring reaction product under migration will be colorimetrically measured unless analysis is carried out after a relatively long period during which the migration of the colored reaction product in the reaction layer is completed and fixed to a detection layer, since the colored product migrates from the reaction layer to the detection layer at a low migration speed. On the contrary, there is no such possibility in the present invention in which the migrant is undetectable.
Transaminases whose activity may be measured according to the present invention are those which are specifically described in the classification No. 2.6.1 of Enzyme Nomenclature, 1972 edition, published by Elsevia Co. (1973) approved by International Union of Biochemistry, such as glutamic-oxaloacetic transaminase (GOT), glutamic-pyruvic transaminase (GPT), L-Aspartate: 2-oxoglutarate aminotransferase (EC 2.6.1.1), L-Alanine: 2-oxoglutarate aminotransferase (EC 2.6.1.2), Alanine-glyoxylate transaminase (EC 2.6.1.44) and β-Alanine transaminase (EC 2.6.1.18).
An indirect reaction in which pyruvate is produced may be one in which another enzymatic reaction as shown by equation (4) is concerned or may be a non-enzymatic chemical reaction. In any case, any process in which an enzymatic or chemical reaction is used in combination with a transaminase reaction to produce hydrogen peroxide as a final product from pyruvate may be used. Among them, measurement of GOT and GPT activities are most important diagnostically.
The substance which is a substrate for the transaminase is only required to have an amino group therein, and since the relationship between a substrate - enzyme couple is well known by those in the art, no detailed explanation will be given.
Transaminase is an enzyme which promotes transfer of the amino group in an amino acid to an α-keto acid. The substrate for transaminase includes the amino acid and α-keto acid.
POP used in the multilayer analysis film of the present invention is usually activated by a POP activator in order to accelerate the reaction. Examples of the POP activator include coenzymes, inorganic phosphates, bivalent metal ions and the like.
The POP activator is generally employed in an amount of 10-9 to 10-5 mole per unit of POP.
Typical coenzymes include flavin adenine dinucleotide, thiamine pyrophosphate, etc.; typical inorganic phosphates include primary and secondary sodium phosphates, primary and secondary potassium phosphates, etc.; and, typical bivalent metal ions include Mg2+, Mn2+, Ca2+, Co2+ and the like.
The porous layer used in the present invention may be fibrous or nonfibrous. As a porous fibrous material, a paper such as a filter paper, a synthetic paper, a nonwoven fabric and polyethylene pulp, and cloth such as natural or synthetic woven fabrics, especially plain fabrics, may be used. Specific examples of these materials are described in detail in Japanese Patent Application (OPI) 164356/80 (corresponding to U.S. Pat. No. 4,292,272). In addition, a membrane filter or beads such as glass, polymers, ceramics and a mixture thereof may be used as the porous, non-fibrous material. Specific examples of such materials are described in Japanese Patent Publication No. 21677/78 (corresponding to U.S. Pat. No. 3,992,158).
The pore size of the porous layer is within the range of from 0.05 to 300 μm, preferably 0.1 to 100 μm.
The degree of porosity of the porous layer is generally within the range of from 25 to 85%, preferably 40 to 85%.
The porous layer has a thickness generally in the range of from 50 to 500 μm, preferably 100 to 400 μm.
The porous layer can also function as a definite area-spreading layer so that the amount of a liquid sample retained in the porous layer is determined by the definite area and the thus determined amount of the liquid sample is transferred to a layer therebeneath in the same amount and area as in the porous layer.
Such porous materials are impregnated with a solution containing a transaminase substrate or a mixture of a transaminase substrate and POP to obtain a porous layer. In the case that the porous layer contains only a transaminase substrate, POP may be coated to form a POP enzyme layer (an enzyme layer) adjacent the porous layer. The POP enzyme layer has generally a thickness of from 1 to 100 μm, preferably 5 to 50 μm.
The color indicator layer for the detection of hydrogen peroxide preferably has a thickness of 1 μm to 100 μm and, preferably 5 to 50 μm comprises a composition prepared by dispersion of a coupler and a hydrogen donor into a known hydrophilic binder such as gelatin, polyvinyl alcohol, polyvinyl pyrrolidone, agarose, sodium polyvinyl benzenesulfonate and the like.
Once an analyte is determined, the impregnation amount for components is correspondingly determined but generally in a range set forth below.
______________________________________ General Range Preferred Range______________________________________Substrate (g/m.sup.2) 0.5-500 1-150Coupler (g/m.sup.2) 0.01-5 0.1-3HydrogenDonor (g/m.sup.2) 0.01-5 0.1-3POP (U/m.sup.2) 1,000-100,000 1,000-50,000OxaloacetateDecarboxy-lase (U/m.sup.2) 500-100,000 1,000-50,000Coenzyme(g/m.sup.2) 0.01-10,000 0.1-5,000______________________________________
Preferably, a cationic dye forming system is selected as a color indicator system for the detection of hydrogen peroxide and most preferably, 4-aminoantipyrine or N,N-disubstituted-p-phenylenediamine as a hydrogen donor and a combination of an N,N-disubstituted-aniline derivative and an anionic polymer as a coupler are used. Such a system has many advantages, that is, efficiency of conversion into the colored reaction product is high, the cationic dye produced has high absorbance, the colored reaction product (dye) can be efficiently fixed and, thus, the sensitivity of measurement is remarkably high.
As the support, known water impermeable transparent film materials such as polyethylene terephthalate, cellulose esters (cellulose diacetate, cellulose triacetate, cellulose acetate propionate and the like), polycarbonate, polymethyl methacrylate or a glass plate having a thickness of about 50 μm to about 2 mm are conveniently used.
In addition, a transparent support as described above into which a pigment such as carbon black, titanium oxide, or copper phthalocyanine is dispersed or an opaque support such as a stripping paper may also be used. In this case, upon completion of the assay, the support is removed prior to the subsequent colorimetric measurement.
In addition to the fundamental structure described above (see FIGS. 1 and 2), the multilayer analysis film of the present invention may have other various structures or functional auxiliary layers such as a color masking, or light blocking or light reflecting, adherent and mordanting layers (1 to 50 μm, preferably 1 to 30 μm) which may be formed in a conventional manner. Representative embodiments of this invention having such auxiliary layers are shown in FIGS. 3 to 9.
The layer thickness of the radiation-blocking or light-reflecting layer is generally in the range of from 1 to 50 μm, preferably 2 to 10 μm.
The multilayer analysis film of the present invention may be prepared by, for example, bringing one layer into intimate contact with another layer, if necessary or desired, after wetting the surface of the layers with water or an aqueous solution of a surface active agent, and passing the layers through between pressure rolls to form a laminate.
Analytical operation can generally be conducted as follows: A calibration curve for the multilayer analysis film of the present invention is generated by spotting commercially available calibrator solutions containing from 0 to 800 IU transaminase/1 on the film, incubating the film for about 30 seconds to about 20 minutes at 37° C., and thereafter detecting the color density produced in the color indicator layer by spectrophotometry through a transparent support. A liquid sample, containing an unknown transaminase level, is then spotted on separate but identical samples of the film and the transaminase level is determined on each by use of the previously generated calibration curve.
In general, the total time of analysis is between about 3 to about 30 minutes.
The multilayer analysis film thus prepared of the invention has the following advantages:
(1) The time for the whole analysis is shortened because the feed of oxygen (i.e., exposure to the air) which is a rate-determining step of the reaction is carried out at a high efficiency.
(2) Remarkably high sensitivity is achieved, because hydrogen peroxide, which is a chemical species colorimetrically undetectable, is used as a primary migrant, i.e., the process from the beginning to the oxidase reaction is carried out in an upper layer where the distance of diffusion and migration is short, and the color-forming reaction is carried out in an indicator layer adjacent the transparent support having a high detection efficiency.
(3) High accuracy is obtained because the transaminase reaction product is converted into a detectable dye at a high efficiency.
(4) As a consequence of the above advantages, the range in which the transaminase activity may be quantitatively measured is expanded.
In the examples given below, layers were dried at 15° C. for 30 minutes and at 40° C. for 30 minutes, unless otherwise indicated.
EXAMPLE 1
On a colorless, transparent polyethylene terephthalate (PET) film (a photographic support) was applied a dye fixing layer having the following composition to give a dry thickness of 10 μm.
Composition of the coating liquid for the dye fixing layer:
______________________________________Gelatin 5.0 gPotassium polystyrene-4-sulfonate(molecular weight 340,000) 2.5 gSurfactant 10 G ®(a nonionic surface active agentproduced by Olin Chemicals Co.,p-octylphenoxypolyethoxyethanol) 0.50 gBis(vinylsulfonylmethyl) ether 0.20 gGlycerin 1 gWater 100 ml______________________________________
On the resulting dye fixing layer there was coated a coating liquid having the following composition to give a color indicator layer having a dry thickness of 15 μm. Composition of the coating liquid for the color indicator layer:
______________________________________N,N--(bis(β-hydroxyethyl)-m-toluidine 0.20 g4-Aminoantipyrine hydrochloride 0.24 gGelatin 15 gPOD(EC. 1.11.1.7; hereafter the same) 7500 unitsSurfactant 10 G ® 0.50 gBis(vinylsulfonylmethyl) ether 0.38 gWater 100 ml______________________________________
On the resulting layer there was then coated a coating liquid having the following composition to provide a light blocking layer having a dry thickness of 7 μm.
Composition of the coating liquid for the light blocking layer:
______________________________________Finely divided TiO.sub.2 powder 19.5 gGelatin 6.8 gSodium dioctyl sulfosuccinate 1.0 gWater 87 g______________________________________
Onto the resulting light blocking layer these was coated a coating liquid having the following composition to obtain a pyruvate oxidase layer (POP layer) having a dry thickness of 10 μm.
COMPOSITION OF THE COATING LIQUID FOR THE POP LAYER
______________________________________Gelatin 10 gPOP(EC. 1.2.3.3; hereafter the same) 5000 unitsFAD 4.1 mgTPP 92 mgMgCl.sub.2 47 mgSurfactant 10 G ® 0.50 gWater 100 ml______________________________________
A solution of a GPT substrate having the following composition was then prepared.
______________________________________Sodium α-ketoglutarate 3.8 gL-Alanine 35.6 gDisodium hydrogen phosphate 12H.sub.2 O 10.9 gSodium dihydrogen phosphate 3 gPolyacrylamide 2 gSurfactant 10 G ® 2 gWater 400 ml______________________________________
A filter paper for electrophoresis having a smooth surface (400 μm thick) was dipped in to the resulting GPT substrate solution and was passed between silicon rubber rolls spaced at intervals of 500 μm to be uniformly impregnated with the solution. Then, the filter paper was spontaneously dried on the surface of a flat glass plate.
The filter paper impregnated with the GPT substrate solution was used as a porous layer containing a TA substrate composition. The porous layer was pressed on the multilayer coated PET film previously wetted with an aqueous solution of Surfactant 10 G (2% V/V aqueous solution) and then dried to fix the same thereto. Thus, a multilayer analysis film (A) for the quantitative analysis of GPT was obtained.
REFERENCE EXAMPLE 1
In the multilayer analysis film for the quantitative analysis of GPT (A), instead of application of the POP layer, a coating liquid having the following composition prepared by the addition of POP to the color-forming reagent layer was formed to have a dry thickness of 18 μm. In this case, the amount of POP was 1.5 times that in Example 1 and, therefore, the amounts of the activator of pyruvate oxidase or FAD, TPP and MgCl2 were increased in proportion to that of POP. However, the amount of POD was the same as in Example 1 because the color to be finally measured is formed by the enzymatic reaction of POD with H2 O2 converted by the enzymatic reaction of POP.
Composition of the coating liquid for the POP-coloring reagent layer:
______________________________________N,N--Bis(β-hydroxyethyl)-m-toluidine 0.20 g4-Aminoantipyrine hydrochloride 0.24 gGelatin 15 gPOD 7500 unitsPOP 8000 unitsFAD 6.2 mgTPP 0.138 gMgCl.sub.2 70.7 mgSurfactant 10 G ® 0.50 gBis(vinylsuffonylmethyl) ether 0.38 gWater 100 ml______________________________________
On the resulting multilayer coated film, the filter paper impregnated with the GPT substrate composition for the above-mentioned porous layer containing the TA substrate composition was pressed while wet to obtain a multilayer analysis film (B) for the quantitative analysis of GPT.
Analysis films (A) and (B) thus obtained were cut to form specimens 0.5 cm2. Commercially available control serums to which various amounts of GPT enzyme were added were spotted on the TA substrate layer of the specimen.
Test Method:
The films described above were placed on a plastic slide frame to prevent water evaporation and were incubated at 37° C. Incubation was performed for 20 mins., in which optical density was measured at 30 second intervals. Data obtained 10 mins. after the measurement were plotted (FIG. 10).
Color density changes with the passage of time were measured on a reflection spectrophotometer.
The results obtained are shown in FIG. 10.
As seen from FIG. 10, the GPT analysis film (B) according to the prior art, although containing 1.5 times the amount of POP, is inferior to GPT analysis film (A) according to the present invention in color density and the analysis range of film (B) is narrower than that of film (A).
REFERENCE EXAMPLE 2
The following procedure was conducted to obtain GPT analysis film (B') in a manner similar to Reference Example 1.
(1) The amounts of FAD, TPP, MgCl2 and the POP activator were the same as in Example 1, respectively.
(2) 3400 Units of POP was added to the coloring reagent layer as such an amount of POP was in proportion to that of the POP activator.
(3) Other conditions were the same as those in Reference Example 1.
Thus, the same amount of POP was used in all Examples of analysis film (A) according to the present invention and comparative analysis films (B) and (B').
Coloration speed was observed with respect to comparative analysis films (B) and (B').
Samples--each 20 μl of a 10-3 M pyruvate aqueous solution--were spotted on analysis films (B) and (B') and coloration speed was measured using a reflection spectrophotometer in a manner similar to Reference Example 1. The color density of analysis film (B') was only 80% that of analysis film (B).
Similar results were obtained when the control serum contained 140 IU/1 of GPT.
From the results of Example 1 and Reference Examples 1 and 2, it can be seen that analysis film (A) according to the present invention, even if the amount of POP used is two thirds of that of analysis film (B), gave much higher color density than analysis film (B), and had a broader range of quantitative analysis and, accordingly, the above advantages of the present invention will be further increased when the same amount of POP activator as that of the comparative films is used.
EXAMPLE 2
Instead of the POP substrate layer of GPT analysis film (A) described in Example 1, an intermediate layer comprising only gelatin was coated to give a membrane of a 5 μm dry thickness.
Then, a filter paper for electrophoresis having a smooth surface (400 μm thick) was cut to 0.5 cm2 and was then wet and pressed (laminated) on the multilayer coated film in a manner similar to Example 1.
POP and coenzymes thereof were added to the GPT substrate composition of Example 1 to prepare a solution of GPT substrate-POP composition having the following composition.
SOLUTION OF GPT SUBSTRATE-POP COMPOSITION
______________________________________Sodium α-ketoglutarate 3.8 gL-Alanine 35.6 gDisodium hydrogen phosphate 12H.sub.2 O 10.9 gSodium dihydrogen phosphate 2H.sub.2 O 3 gPOP 40,000 unitsFAD 0.033 gTPP 0.74 gMgCl.sub.2 0.37 gGelatin 2 gSurfactant 10 G ® 5 gWater 400 ml______________________________________
The solution of GPT substrate-POP composition cooled to 0° C. (20 μl ) was spotted on the filter paper adhered to the multilayer coated film described above and was then subjected to rapid freeze drying in vacuo to obtain analysis film for GPT analysis (C).
A performance test of the analysis film for GPT analysis (C) was conducted similar to Example 1. The results are shown in FIG. 10.
EXAMPLE 3
In the analysis film for GPT analysis (C) described in Example 2, instead of the light blocking layer, a membrane filter cut in the form of a circle having a diameter of 9 mm (Fuji Microfilter® (mean pore size 5 μm) FM-500 produced by Fuji Photo Film Co.) was adhered by wet pressing similar to Example 2.
Then, 10 μl of the GPT-POP composition solution described in Example 2 was spotted thereon and the composite freeze dried to obtain an analysis film for GPT analysis (D).
By a method similar to Example 1, 10 μl of a commercially available control serum having a GPT activity of 105 IU/dl was spotted thereon and the composite incubated at 37° C. for 10 mins. The GPT activity was monitored by the coloration speed with the passage of time. The coloration increased linearly for more than 20 minutes and the speed was about three times that of the analysis film for GPT analysis (C).
EXAMPLE 4
A filter paper for electrophoresis (500 μm thick) was used instead of the membrane filter of Example 3 and was impregnated with the following GOT substrate-enzyme solution and dried per the method of Example 1, then wet pressed to adhere the same to the multilayer coated film described in Example 3.
______________________________________GOT substrate-enzyme solution:L-Aspartic acid 50 gSodium α-ketoglutarate 3.0 gDisodium hydrogen phosphate 12H.sub.2 O 10.9 gSodium dihydrogen phosphate 2H.sub.2 O 3.0 gPOP 40,000 unitsOxalaceate decarboxylase(EC.4.1.1.3) 50,000 unitsFAD 0.033 gTPP 0.74 gMgCl.sub.2 1 gTriton X-100 5 g(a nonionic surface active agentproduced by Rohm and Haas Co., Ltd.,p-octylphenoxypolyethoxy ethanol)Water 400 ml______________________________________
The resulting analysis film for GOT analysis was cut to yield a specimen 0.8 cm square which was then inserted in a plastic slide frame designed for a dry analysis film and was preheated for 2 minutes at 37° C.
Samples each 30 μl--of GOT solutions in physiological saline at concentrations of 53, 104, 210 and 401 IU/1 respectively, were spotted on the specimen, the opening spotted was sealed with an adhesive tape and then the specimen was incubated for 10 minutes at 37° C. and the color density measured using a reflection spectrophotometer. The results are given in Table 1.
TABLE 1______________________________________GOT Activity (IU/l) 53 104 210 401Reflection Density 0.75 1.14 1.42 1.68______________________________________
GOT activity was measured with high sensitiveness over the broad range of concentrations using the analysis film for GOT analysis of the present invention.
While the invention has been described in detail and with reference to specific embodiments thereof, it will be apparent to one skilled in the art that various changes and modifications can be made therein without departing from the spirit and scope thereof.
Claims (15)
What is claimed is:
1. A multilayer analysis film for transaminase analysis in a coupled reaction system which has formation of pyruvate by a kinetic method as part of the coupled reaction system, containing constituents for the quantitative analysis of transaminase, said film comprising a transanimase substrate, a pyruvate oxidase, an activator for the pyruvate oxidase and a color indicator for the detection of hydrogen peroxide, wherein a porous layer containing the transaminase substrate, a color indicator layer for the detection of hydrogen peroxide, and a transparent support are integrally laminated in this order, and the pyruvate oxidase and the activator for the pyruvate oxidase are contained in the porous layer or in an enzyme layer which is in contact with both the porous layer and the indicator layer, wherein the impregnation amount of the pyruvate oxidase is from about 4,698 to about 34,707 U/m2 and an amount of a detectable species produced in said coupled reaction system by a kinetic method has a specific relation with time.
2. The multilayer analysis film for transaminase analysis as defined in claim 1 wherein said porous layer or said enzyme layer contains oxalacetic acid and decarboxylase.
3. The multilayer analysis film for transaminase analysis as defined in claim 1 or 2 wherein said porous layer is a porous spreading layer.
4. The multilayer analysis film for transaminase analysis as defined in claim 1 or 2 wherein said porous layer has a definite area which determines the amount of a sample liquid and the transfer thereof to a layer therebeneath through the definite area.
5. The multilayer analysis film for transaminase analysis as defined in claim 1 wherein said activator for the pyruvate oxidase comprises a coenzyme, a source of an inorganic phosphoric acid and a bivalent metal.
6. The multilayer analysis film for transaminase analysis as defined in claim 5 wherein said coenzyme is flavin adenine dinucleotide and thiamine pyrophosphate.
7. The multilayer analysis film for transaminase analysis as defined in claim 1 wherein, of all components present, said hydrogen peroxide, once formed, has the highest multilayer mobility.
8. A method for the quantitative analysis of transaminase in a coupled reaction system which has formation of pyruvate by a kinetic method as part of the coupled reaction system, comprising the steps of:
(A) applying a liquid sample to a multilayer analysis film for transaminase analysis, containing constituents for the quantitative analysis of transaminase, said film comprising transaminase substrate, a pyruvate oxidase, an activator for the pyruvate oxidase and a color indicator for the detection of hydrogen peroxide, wherein a porous layer containing the transaminase substrate, a color indicator layer for the detection of hydrogen peroxide, and a transparent support are integrally laminated in this order, and the pyruvate oxidase and the activator for the pyruvate oxidase are contained in the porous layer or in an enzyme layer which is in contact with both the porous layer and the indicator layer, wherein the impregnation amount of the pyruvate oxidase is from about 4,698 to about 34,707 U/m2 and an amount of detectable species produced in said coupled reaction system by a kinetic method has a specific relation with time; and
(B) detecting color density in the indicator layer over the course of time so as to measure transaminase activity.
9. The method for the quantitative analysis of transaminase as defined in claim 8 wherein said porous layer or said enzyme layer contains oxalacetate and a decarboxylase.
10. The method for the quantitative analysis of transaminase as defined in claim 8 wherein said porous layer is a porous spreading layer.
11. The method for the quantitative analysis of transaminase as defined in claim 8 wherein said porous layer has a definite area which determines the amount of a sample liquid and the transfer thereof to a layer therebeneath through the definite area.
12. The method for the quantitative analysis of transaminase as defined in claim 8 wherein said activator for the pyruvate oxidase comprises a coenzyme, a source of an inorganic phosphoric acid and a bivalent metal.
13. The method for the quantitative analysis of transaminase as defined in claim 12 wherein said coenzyme is flavin adenine dinucleotide and thiamine pyrophosphate.
14. The method for the quantitative analysis of transaminase as defined in claim 8 wherein, of all components present, hydrogen peroxide, once formed, has the highest multilayer mobility, whereby the rate-determining step of the analysis is the step of converting pyruvate into hydrogen peroxide which is exposed to oxygen.
15. The method for the quantitative analysis of transaminase as defined in claim 8 wherein said detectable species is a dye.
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WO1994023062A1 (en) * 1993-04-02 1994-10-13 Xytronyx, Inc. Aminotransferase assay
US5462858A (en) * 1993-12-29 1995-10-31 Eastman Kodak Company Dry multilayer analytical elements for assaying transaminases
US6479015B1 (en) * 1998-03-03 2002-11-12 Pepex Biomedical, Llc Apparatus for monitoring a level of a chemical species in a body fluid
US6565738B1 (en) 1999-01-28 2003-05-20 Abbott Laboratories Diagnostic test for the measurement of analyte in abiological fluid
US20040014239A1 (en) * 2000-01-06 2004-01-22 Caliper Technologies Corp. Ultra high throughput sampling and analysis systems and methods
CN102323399A (en) * 2011-09-16 2012-01-18 苏州生物医学工程技术研究所 Multilayer film dry chemical reagent tablet for detecting alanine aminotransferase
CN103320498A (en) * 2013-05-24 2013-09-25 宁波美康生物科技股份有限公司 Detection reagent for aspartate aminotransferase
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US6565738B1 (en) 1999-01-28 2003-05-20 Abbott Laboratories Diagnostic test for the measurement of analyte in abiological fluid
US20040014239A1 (en) * 2000-01-06 2004-01-22 Caliper Technologies Corp. Ultra high throughput sampling and analysis systems and methods
CN102323399A (en) * 2011-09-16 2012-01-18 苏州生物医学工程技术研究所 Multilayer film dry chemical reagent tablet for detecting alanine aminotransferase
CN103320498A (en) * 2013-05-24 2013-09-25 宁波美康生物科技股份有限公司 Detection reagent for aspartate aminotransferase
CN103320498B (en) * 2013-05-24 2015-07-08 宁波美康生物科技股份有限公司 Detection reagent for aspartate aminotransferase
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JPS57208998A (en) 1982-12-22 application
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-4,385,677,742,548,967,400 | Rakovina prsu a vitln houby
Jak mohou vitln houby podpoit konvenn lbu rakoviny prsu?
Rakovina prsu je v souasn dob nejastji se vyskytujcm ndorovm onemocnnm u en v esk republice. Ron je diagnostikovno vce ne 7 000 novch ppad. Riziko toho onemocnn stoup s pibvajcm vkem. I pesto, e se poet nemocnch kad rok zvyuje, mrtnost kles. Dvodem jsou pedevm nov monosti konvenn lby, jako je chirurgick lba, biologick lba, chemoterapie i radioterapie. Na rozdl od ostatnch ndorovch onemocnn rakovina prsu postihuje eny v jejich nejhlubm nitru, ovlivuje jejich sebevdom, sebehodnocen a oslabuje pocit enskosti.
Jak pohl na rakovinu prsu nsk medicna?
Podle tradin nsk medicny existuje mnoho pin, kter jsou schopny spustit rakovinu prsu. Jednou z nejvznamnjch jsou nadmrn i potlaovan emoce a stres, kter zpsobuj tzv. stagnaci jatern Qi (energie). U vech en, se ktermi jsem hovoil v mordinaci, a kter trply tmto onemocnnm, jsem vidl tuto nerovnovhu. Systm Jater (kam pat i lunk, oi, nehty atd.) je citliv na stresov situace. Jednou z funkc Jater (podle nsk medicny) je ve v organismu zprchodovat. Pokud je tato funkce omezena, zane se energie Qi v tle zpomalovat a na uritch mstech pozdji blokovat. To vyvolv pocity napt. U en se energie Qi nejastji blokuje v oblasti krku (ttn lza), v prsou (adenomy, karcinomy), kolem aludku (trvic diskomfort) i v podbiku (myomy, cysty). Pozdji se zane shlukovat i hlen a krev, m postupn vznikne ndor. Pin je urit jet vce, nicmn stagnace jatern Qi hraje pi vzniku rakoviny prsu urit velkou roli.
Proto radm enm, aby si vily samy sebe, svho tla a svho zdrav. Aby ily a peovaly o sebe tak, aby se jejich jatern Qi neblokovala a ve v organismu voln proudilo. nsk medicna k, e zdrav lovk je pln Qi a krve a ve v nm voln proud. V praxi to znamen nepotlaovat emoce, kontrolovat nadmrn emoce a vyhbat se stresovm situacm.
Ne se lovk nau se svmi emocemi pracovat a zvldat je sm, me bt dobrm pomocnkem sms extraktu z vitln houby Hericium a nskch bylinek. inn pomhaj odblokovat energetick shluky, kter pedchzej tm vem onemocnnm. Uvoluje stagnaci energie Qi Jater a pomh pi nejrznjch somatizacch stres (kdy se stres zane projevovat jako tlesn pznak). Tato sms je fajn jako prevence, ale pokud se ndor ji objev, pak je teba poohldnout se po vitlnch houbch se silnjm a specifitjm inkem, kter se obvykle uvaj soubn s konvenn lbou. To znamen, e drazn doporuuji spolupracovat s pslunm onkologickm pracovitm.
Jak naemu tlu pomhaj vitln houby?
Liv inky hub vyuv nsk medicna ji po stalet. Jejich inky jsou zaloeny nejen na zkuenostech, ale dnes i na mnoha vdeckch studich, kter dokazuj, e houby maj vraznou schopnost modulovat nai imunitu. V organismu zvyuj a aktivizuj velk mnostv makrofg, T-lymfocyt i NK bunk (tzv. pirozench zabje). Tyto buky imunitnho systmu atakuj a ni rakovinn buky. inn ltky obsaen v houbch maj vedle toho schopnost i pmo zabjet ndorov buky a omezovat jejich dlen. A vneposledn ad eliminuj en rakovinnch bunk dle do tla, tzv. tvorbu metastz.
Vitln houby jako doplnk pi chemoterapii a radioterapii
Radioterapie i chemoterapie sice inn bojuje proti rakovinnm bukm, souasn m vak dopad na zdrav buky. Tento drastick zsah do tla m za nsledek oslabovn ji tak oslabenho organismu. Proto se jako doplnk k chemo a radioterapii doporuuj vitln houby. Pomhaj zmrnit negativn inky nron lby a zlepit kondici pacienta. Na rozdl od bnch bylinek neoslabuj psoben chemo ani radioterapie. Tento efekt prokazuje ada studi. Podvnm vitlnch hub je navc mon zmrnit negativn vedlej inky konvenn lby, jako je nava, nevolnost, padn vlas i pokozen kostn den. Jet jednou zdrazuji, e vitln houby je mon uvat soubn s chemo i radioterapi.
Jak vitln houby jsou u rakoviny prsu vhodn?
U rakoviny prsu (podobn i urakoviny plic) se obvykle doporuuje uvat kombinaci t vitlnch hub:
1. Maitake (Grifola frondosa, trsnatec lupenit)
Maitake je jednou z nejvznamnjch hub uvanch pi lb karcinomu prsu. Podle vdeckch studi obsahuje bioaktivn sloku (D frakci), kter je znm pro sv imunostimulan a protindorov inky. Tato sloka doke u rakovinnch bunk vyvolat apoptzu, tj. sebevradu rakovinov buky. Navc pomh navst inek zbylch dvou hub (Coriolu a Reishi) do prsou.
maitake
2. Coriolus (Coriolus versicolor, outkovka pestr)
Coriolusje vyuvn tradin nskou medicnou k lb cel ady onemocnn. Pomh pi nav, moduluje funkce imunitnho systmu a vneposledn ad m prokzan protirakovinn inky. Doke velmi efektivn a systematicky likvidovat jakkoliv patogenn buky v organismu a u jde o viry, bakterie, chlamydie, borelie i rakovinn buky. Spolu s Reishi m vrazn protizntliv inky. To zmiuji zmrn, jeliko spojitost mezi chronickmi znty a rakovinou je dnes ji vdecky prokzna.
coriolus
3, Reishi (Ganoderma lucidum, lesklokorka leskl)
Reishi je jednou z nejznmjch a nejuvanjch vitlnch hub. Jej lebn inky jsou znmy vce ne 4 000 let. Dky vysokmu obsahu polysacharid, triterpen a fytosterol je pouvna prv k lb ndorovch onemocnn a kjejich prevenci. Studie portugalskch vdc z roku 2011 zjistila, e pokud chceme psobit na rakovinn buky, tak nen smyslupln pout jen nkter sti houby (teba vysoce koncentrovan polysacharidy i triterpenoidy), ale je teba pout cel komplex ltek obsaench v tto houb. Prv tento komplex prodnch ltek m cytotoxick inky na rakovinn buky.
Jak tyto vitln houby uvat?
U onkologickch onemocnn doporuuji uvat 3-5 g ve uvedench vitlnch hub denn (myleno vech t hub dohromady). V praxi pouvm extrakty z vitlnch hub a to v 30% koncentraci, o ktr se domnvm, e je upodobnch problm optimln.
Pro lep efekt doporuuji uvat vitln houby 5 dn v tdnu a 2 dny udlat pauzu. Uvat vdy na lano (30 min ped jdlem nebo 1 hodinu po jdle). Pi dlouhodobm uvn doporuuji udlat po 3 mscch 1 tden pauzu.
Kombinace tchto t hub se podv po celou dobu konvenn lby a jet cca 2 msce po jejm ukonen. Posledn msc se dvky postupn sniuj a do ztracena.
Pokud je lba spn, doporuuji nasadit preventivn kru a uvat tuto kombinaci hub1-2x ron.
Ve vtin ppad pidvm jet Curcumin, co je extrakt z kurkumy dlouh. Kurkuma je veobecn znm jako koen, ale mlokdo u v, e m vznamn protindorov a protizntliv inky, a e z pohledu nsk medicny doke rozbjet blokdy, co je u ndor velmi dleit vlastnost.
Jak vybrat kvalitn vitln houby?
Vrobc produkt z vitlnch hub je cel ada. asto se pedhnj tvrzenmi, e maj ty nejsilnj, nejkvalitnj, nejinnj produkty. Tko se pak jako zkaznk v tto nabdce vyznat. Ne vdy jsou toti tato tvrzen pravdiv. Proto doporuuji vybrat produkty, kter pouvaj ve svch ordinacch lkai a praktici nsk medicny. Nedovol si doporuit produkt, kter nefunguje a nezlep stav pacienta.
Je opravdu kvalita houbov suroviny tak dleit?
Ano, u hub je extrmn dleit. Urit vte, e houby jsou schopn do sebe lehce nathnout rzn kodliviny. Hledejte tedy dodavatele, kter testuje houbovou surovinu na irok spektrum kodlivch ltek jakotk kovy, pesticidy, radioaktivitu apod. Dobr vrobce testuje surovinu i na polycyklick aromatick uhlovodky(PAHs), kter maj karcinogenn inky, mohou ovlivnit vvoj plodu a maj spojitost i skardiovaskulrnmi chorobami vizzde.
Autor: Milan Schirlo (terapeut tradin nsk medicny)
Nkter star lnky
Dti a seznn virov onemocnn
Dti a seznn virov onemocnn
Podzim a nstup zimy je obdobm astch virovch onemocnn dchacch cest. asto je nachlazen, kael, rma, chipka ppadn angna na dennm podku a jen odejde jedna nemoc, hned u je tu jin. To zn asi kad maminka.
st vce
Jsou medicinln houby vhodn i pro vae domc mazlky?
Jsou medicinln houby vhodn i pro vae domc mazlky?
Mon vs pekvap, e ve sv ordinaci em nejenom zdravotn problmy mch pacient, ale u nkolik let i obte jejich domcch mazlk - ps, koek, krlk, ale i ko a ovc. Proto jsem se rozhodl napsat tento lnek, kter vm medicinln houby pibl z pohledu svta zvat a jejich zdrav. Protoe urit se te ptte, zda by mohly houby pomoci i vaemu psovi nebo koice?
st vce
Jak nebt celoivotnm insomniakem?
Jak nebt celoivotnm insomniakem?
Insomniak je lovk trpc nespavost. Je to lovk, kter m bu problm usnout, nebo se v noci asto bud.
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8,985,706,808,224,353,000 | Thème 2 - S. Besteiro
Contribution of the apicoplast to the metabolism and survival of T. gondii in the context of acute and chronic toxoplasmosis
Toxoplasma gondii is a parasitic protist infecting a wide variety of warm-blooded animals and about one third of the human population. Although it remains essentially asymptomatic in immunocompetent individuals, this parasite can cause a life-threatening disease called toxoplasmosis in fetuses, newborns, and individuals with weakened immune systems. Our group studies how these obligate intracellular parasites multiply and persist in the host. We are targeting essential cellular processes, which are thus sometimes conserved among eukaryotes, but bearing enough differences to make them interesting potential therapeutic targets in the parasites.
Figure 1: The Toxoplasma gondii life cycle. The pathogenicity and virulence of Toxoplasma gondii. Sanchez SG, Besteiro S. Virulence. 2021 Dec;12(1):3095-3114. doi: 10.1080/21505594.2021.2012346.
Research project #1. The apicoplast as a drug target in the context of acute toxoplasmosis
As several other medically important parasites of the phylum Apicomplexa (ie malaria-causing Plasmodium), T. gondii contains an unusual organelle called the apicoplast. This organelle is a startling peculiarity that not only highlights the diversity of eukaryotic cell biology, but can also potentially be leveraged for therapeutic development. This four-membrane plastid was acquired by an unusual secondary endosymbiosis, in which an alga was engulfed by another eukaryote forming a new secondary plastid in the host. Although the apicoplast has lost its photosynthetic function, it houses several important metabolic pathways for generating: iron/sulfur cluster, hem, fatty acids (FASII), isoprenoids (Fig. 2).
Figure 2. Schematic representation of a Toxoplasma tachyzoite, with a four-membrane apicoplast and the main biochemical pathways it hosts.
Although the apicoplast is known as an important metabolic hub for many species of apicomplexan parasites, the metabolic pathways which are absolutely essential for parasite viability may vary depending on the parasite or the developmental stage. For instance, T. gondii has a complex life cycle involving several developmental stages that develop in felids (the definitive hosts, where sexual reproduction occurs), but also divide asexually in the many species of warm-blooded animals that can act as intermediate hosts. The two developmental forms found in intermediate hosts are the tachyzoite and the bradyzoite. Tachyzoites are rapidly dividing forms associated with the acute phase of toxoplasmosis. Upon control by a competent immune system, however, the parasites can differentiate into slowly-growing bradyzoites, establishing within tissue cysts and responsible for the chronic phase of toxoplasmosis.
The apicoplast is already targeted by anti-parasitic drugs (for instance through several prokaryotic translation inhibitors) and apicoplast-hosted hem, fatty acid and isoprenoid synthesis pathways have all been shown to contribute to the fitness of the tachyzoite stage. However, several metabolic pathways remain unexplored and unexploited as potential drug targets.
This research project aims at:
► identifying novel apicoplast-hosted parasite-specific functions
► assessing if they can be exploited to target the tachyzoite stage
Latest publication related to this project:
Pamukcu S, Cerutti A, Bordat Y, Hem S, Rofidal V, Besteiro S. (2021) Differential contribution of two organelles of endosymbiotic origin to iron-sulfur cluster synthesis and overall fitness in Toxoplasma. PLoS Pathog. 17(11):e1010096. doi: 10.1371/journal.ppat.1010096.
Research project #2. Contribution of the apicoplast to Toxoplasma persistence
As mentioned above, acute infection of intermediate hosts by T. gondii is associated with the rapid replication and spread of the tachyzoite forms within the body. This infection phase is often readily contained by the immune system. However, the parasites can differentiate into slowly growing bradyzoites, establishing within tissue cysts, primarily in the central nervous system and muscle. Although there are effective medicines available against tachyzoites, the persistent chronic form of the pathogen remains in the host throughout its life and can convert repeatedly back into tachyzoites, and hence lead to a severe pathology (i.e. encephalitis or retinitis) in the event of a weakened immune system. These bradyzoites forms are thus central to the pathology, yet there are no effective drugs against them so far.
In bradyzoites, where apicoplast function has been largely overlooked, we wish to determine the importance of the organelle for survival and persistence of this parasite stage. We are using stage-specific conditional knock-down or knock-out approaches to deplete apicoplast proteins in bradyzoites (Fig. 3).
Figure 3. Stage-specific depletion of an apicoplast marker (green) in in vitro-differentiated bradyzoites (arrowhead, cyst labelled by the Dolichos biflorus lectin –DBL, red-).
This research project aims at:
► generating genetic tools to investigate the function of essential genes in bradyzoites
► elucidating the contribution of the apicoplast to the persistence and reactivation of bradyzoites in vitro and in vivo (collaboration with the lab of Nicolas Blanchard, Université de Toulouse, France)
Latest publication related to this project:
Cerutti A, Blanchard N, Besteiro S. Pathogens. (2020) The Bradyzoite: A Key Developmental Stage for the Persistence and Pathogenesis of Toxoplasmosis. Cerutti A, Blanchard N, Besteiro S. Pathogens. 2020 Mar 21;9(3):234. doi: 10.3390/pathogens9030234. Pubmed
Other research projects
We are also interested in other aspects of the cell biology of Toxoplasma, including specific aspects of the cell division process, the cytoskeleton, as well as canonical and non-canonical functions of the autophagy machinery.
This includes:
► elucidating the physiological roles of parasite autophagy in the context of acute and chronic toxoplasmosis (collaboration with the lab of Vern Carruthers, Univ. Michigan, USA)
► identifying novel parasite-specific functions for the autophagy-related machinery at the apicoplast
Publications
Sakamoto H, Nakada-Tsukui K, Besteiro S. Cells. (2021) The Autophagy Machinery in Human-Parasitic Protists; Diverse Functions for Universally Conserved Proteins. 10(5):1258. doi: 10.3390/cells10051258.
Smith D, Kannan G, Coppens I, Wang F, Nguyen HM, Cerutti A, Olafsson EB, Rimple PA, Schultz TL, Mercado Soto NM, Di Cristina M, Besteiro S, Carruthers VB. (2021) Toxoplasma TgATG9 is critical for autophagy and long-term persistence in tissue cysts. Elife;10:e59384. doi: 10.7554/eLife.59384.
The role of host autophagy machinery in controlling Toxoplasma infection. Besteiro S. (2019) Virulence. Dec;10(1):438-447. doi: 10.1080/21505594.2018.1518102. Epub 2018 Sep 29. Pubmed
Nguyen HM, Liu S, Daher W, Tan F, Besteiro S. (2018) Characterisation of two Toxoplasma PROPPINs homologous to Atg18/WIPI suggests they have evolved distinct specialised functions. PLoS One. Apr 16;13(4):e0195921. Pubmed
Besteiro S. (2017) Autophagy in apicomplexan parasitesCurr Opin Microbiol. Dec;40:14-20. Pubmed
Nguyen HM, Berry L, Sullivan WJ Jr, Besteiro S. (2017) Autophagy participates in the unfolded protein response in Toxoplasma gondii. FEMS Microbiol Lett. 15;364(15). Pubmed
Di Cristina M, Dou Z, Lunghi M, Kannan G, Huynh MH, McGovern OL, Schultz TL, Schultz AJ, Miller AJ, Hayes BM, van der Linden W, Emiliani C, Bogyo M, Besteiro S, Coppens I, Carruthers VB. (2017) Toxoplasma depends on lysosomal consumption of autophagosomes for persistent infection. Nat Microbiol. Jun 19;2:17096. Pubmed
Nguyen HM, El Hajj H, El Hajj R, Tawil N, Berry L, Lebrun M, Bordat Y, Besteiro S. (2017) Toxoplasma gondii autophagy-related protein ATG9 is crucial for the survival of parasites in their host. Cell Microbiol. 19(6). Pubmed
Latré de Laté P, Pineda M, Harnett M, Harnett W, Besteiro S, Langsley G. (2017) Apicomplexan autophagy and modulation of autophagy in parasite-infected host cells. Biomed J. 40(1):23-30. Pubmed
Harnett MM, Pineda MA, Latré de Laté P, Eason RJ, Besteiro S, Harnett W, Langsley G. (2017). From Christian de Duve to Yoshinori Ohsumi: More to autophagy than just dining at home. Biomed J. 40(1):9-22. Pubmed
Lévêque MF, Nguyen HM, Besteiro S. (2016) Repurposing of conserved autophagy-related protein ATG8 in a divergent eukaryote. Commun Integr Biol. 9(4):e1197447. Pubmed
Lévêque MF, Berry L, Cipriano MJ, Nguyen HM, Striepen B, Besteiro S. (2015) Autophagy-related protein ATG8 has a noncanonical function for Apicoplast inheritance in Toxoplasma gondii. MBio.;6(6):e01446-15. Pubmed
Kong-Hap MA, Mouammine A, Daher W, Berry L, Lebrun M, Dubremetz JF, Besteiro S. (2013) Regulation of ATG8 membrane association by ATG4 in the parasitic protist Toxoplasma gondii. Autophagy. 9(9):1334-48 Pubmed
Besteiro S. (2012) Which roles for autophagy in Toxoplasma gondii and related apicomplexan parasites? Mol Biochem Parasitol. 184(1):1-8 Pubmed
Besteiro S. (2012) Role of Atg3 in the parasite Toxoplasma gondii : autophagy in an early branching eukaryote. Autophagy. 8 (3):435-7 Pubmed
Besteiro S, Brooks CF, Striepen B, Dubremetz JF. (2011) Autophagy protein Atg3 is essential for maintaining mitochondrial integrity and for normal intracellular development of Toxoplasma gondii tachyzoites. PLoS Pathog. 7(12):e100241 Pubmed
Other:
Lévêque MF, Berry L, Yamaryo-Botté Y, Nguyen HM, Galera M, Botté CY, Besteiro S. (2017) TgPL2, a patatin-like phospholipase domain-containing protein, is involved in the maintenance of apicoplast lipids homeostasis in Toxoplasma. Mol Microbiol. 105(1):158-174. Pubmed
Lévêque MF, Berry L, Besteiro S. (2016) An evolutionarily conserved SSNA1/DIP13 homologue is a component of both basal and apical complexes of Toxoplasma gondii. Sci Rep.;6:27809. Pubmed
Group members
Theme leader
Sebastien Besteiro
Research Associate (CR) INSERM
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LPHI Laboratory of Pathogens and Host Immunity
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34095 Montpellier cedex 5
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Treatment for arthritis focuses on relieving symptoms and improving mobility. Your doctor may recommend anti-inflammatory medications and/or pain relievers. They might also prescribe disease-modifying antirheumatic drugs (DMARDs) — drugs meant to slow or stop your immune system from attacking your joints. Your doctor may also recommend physical therapy to strengthen your joints and increase your range of motion. For more severe cases, surgery may be required.
Outer hip pain and lateral hip pain, though typically not cause for alarm (as the hip is not sitting near any major organs like the heart, lungs, kidneys, or liver), can be a sign of a serious bone condition, such as arthritis in the back, rheumatoid arthritis, osteoarthritis, or tendonitis but can also indicate a more serious bone condition like a fracture, labral tear, or conditions such as snapping hip syndrome or osteonecrosis.
Preventing hip flexor injury focuses on good flexibility, as well as making sure you warm up before you go full speed. Warm muscles are much less likely to be injured. So take the time to warm up and start slowly before you go all out. A good flexibility program will also help to reduce the tension on the muscles, and reduce your likelihood for injury.
“For millions suffering from lower back pain (LBP), most do not realize that tight hip flexors are also a source of what’s hurting us,” said Sherwin Nicholson, a medical research scientist with SN Health Resources. “If you neglect [your hip flexors and hamstrings], not only will they tighten up, but your back can suffer and anything that you do will become a chore instead of an activity.”
Keep it a one joint stretch. Many people want to jump right to performing a hip flexor stretch while flexing the knee. This incorporates the rectus and the psoas, but I find far too many people can not appropriately perform this stretch. They will compensate, usually by stretching their anterior capsule too much or hyperextending their lumbar spine.
Healthy Hip Flexors – Why is so important ? check our new article http://www.iron-body.eu/training/healthy-hip-flexors-why-is-so-important/ The hip flexor is a group of muscles that attach your femur, or thigh bone, to your pelvis and lumbar spine. The hip flexor allows you to raise your legs toward your torso. The muscles of the hip flexor are also responsible for keeping your hips and lower back strong, flexible and properly aligned.
Don’t medically investigate back pain until it’s met at least three criteria: (1) it’s been bothering you for more than about 6 weeks; (2) it’s severe and/or not improving, or actually getting worse; and (3) there’s at least one other “red flag” (age over 55 or under 20, painful to light tapping, fever/malaise, weight loss, slow urination, incontinence, groin numbness, a dragging toe, or symptoms in both legs like numbness and/or tingling and/or weakness).
If your hips are killing you, you probably spend a lot of time sitting—in the car, at work, on that SoulCycle seat—which puts your hips in near-constant "flexion", says Cori Lefkowith, NASM-certified personal trainer and owner of Redefining Strength in Orange County, California. Even running involves a repetitive flexion movement that can cause pain.
In order to treat this hip and leg pain, it is important to understand the causes of lower back pain. Amongst people below the age of 60, the most common cause of sciatica is a slipped or herniated disc, in the lower lumbar region of the spine. When a disc is swollen or has moved, it puts pressure on the sciatic nerve, causing discomfort and pain. This tends not to happen instantly, but instead generally develops over time. Other causes include:
Order any of our entry size supplements, and if you don’t like it, you can keep it. Notify us and we’ll give you a full refund right there on the spot. No complicated intake forms and no return necessary. We trust you, but to protect against fraud, the Keep-It™ guarantee is valid only for first time purchases of a product, and redeemable up to three months after purchase.
You're more likely to get a hip flexor injury if you've had one in the past, you don't warm up properly before engaging in athletic activity, your muscles are already tight or stiff, or your muscles are weak from being overused. If, while exercising, you try to do too much at once in too short an amount of time, you can also put yourself at risk for a hip flexor injury.
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3,415,208,046,885,869,600 | External validation of the United Kingdom-primary biliary cholangitis risk scores of patients with primary biliary cholangitis treated with ursodeoxycholic acid
Angela C. Cheung, Aliya F. Gulamhusein, Brian D. Juran, Erik M. Schlicht, Bryan M. McCauley, Mariza de Andrade, Elizabeth J. Atkinson, Konstantinos N. Lazaridis
Abstract
The United Kingdom-Primary Biliary Cholangitis (UK-PBC) risk scores are a set of prognostic models that estimate the risk of end-stage liver disease in patients with PBC at 5-, 10- and 15-year intervals. They have not been externally validated outside the United Kingdom. In this retrospective, external validation study, data were abstracted from outpatient charts and discrimination and calibration of the UK-PBC risk scores were assessed. A total of 464 patients with PBC treated with ursodeoxycholic acid were included. The median diagnosis age was 52.4 years, and 88% were female patients. The cumulative incidence of events was 6%, 9%, and 15% at 5, 10, and 15 years, respectively. Concordance (c-statistic) was 0.88, 0.85, and 0.84 using the 5-, 10- and 15-year risk scores, respectively, which was slightly lower than values observed in the United Kingdom validation cohort. Using the 5-year risk score, more events were observed than predicted (25 versus 16.8; P = 0.046); using the 10-year risk score, there was no difference between the observed and predicted number of events (35 versus 44.9; P = 0.14); conversely, using the 15-year risk score, fewer events were observed than predicted (46 versus 67.5; P = 0.009). Limiting evaluation by the 15-year UK-PBC risk score to those with >10 years of follow-up demonstrated no difference between observed and predicted events. Using the 5-year risk score, patients within the highest quartile had statistically significant worse event-free survival compared to the rest of the cohort: 82% versus 98% at 5 years, 73% versus 97% at 10 years, and 58% versus 93% at 15 years. Conclusion: In patients assessed at a North American tertiary medical center, the UK-PBC risk score had excellent discrimination and was reasonably calibrated both in the short and long term. (Hepatology Communications 2018;2:676-682).
Original languageEnglish (US)
Pages (from-to)676-682
Number of pages7
JournalHepatology Communications
Volume2
Issue number6
DOIs
StatePublished - Jun 2018
ASJC Scopus subject areas
• Hepatology
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Cite this | {
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903,502,138,794,076,700 | February 21, 2024
Process, dangers, outlook, and extra
A pleurectomy is a surgical process to take away half or all the pleura, a membrane that traces the lungs and chest cavity. The process treats empyema — an an infection of the pleural cavity — and different lung circumstances.
The pleural cavity is the house between the outer and interior layers of the pleura.
A pleurectomy includes the elimination of a part of the outer or interior pleura. A pleurectomy/decortication (P/D) includes eradicating each the interior and outer pleura, together with any tumors or fibrous tissue.
This text seems at pleurectomy procedures, the dangers, functions, what to anticipate, and extra.
Process, dangers, outlook, and extraShare on Pinterest
Design by MNT; Images Vichuda Sirisarakar/EyeEm/Getty Pictures & Georgiy Datsenk /EyeEm/Getty Pictures
Throughout a pleurectomy, surgeons take away the interior or outer pleura, or each.
Relying on the rationale for a pleurectomy, the surgical procedure could purpose to:
• relieve signs of sure circumstances by eradicating fluid buildup within the pleural cavity
• acquire biopsies to diagnose sure circumstances
• deal with cancers equivalent to mesothelioma by eradicating tumors within the case of a P/D
There are a lot of completely different strategies for performing a pleurectomy. They embrace:
• Partial pleurectomy: It is a process whereby surgeons take away extra tissue from the pleural cavity. This can be an emergency surgical procedure when there are lung problems. It might even be a deliberate operation for individuals with ongoing lung issues.
• P/D: On this approach, surgeons take away the interior and outer pleura and any tumors or fibrous tissue. They is not going to take away the diaphragm or the pericardium, the membrane that covers the guts.
• Extrapleural pneumonectomy: Surgeons will take away the interior and outer pleura, in addition to a part of the lung on the affected aspect. They can even take away the diaphragm and the pericardium.
• Prolonged P/D: Surgeons take away the interior and outer pleura and any tumors, in addition to the diaphragm and pericardium.
Not everyone seems to be eligible for a pleurectomy.
Candidates for this process have to be in comparatively good well being and shouldn’t smoke. In the event that they do, they might want to give up smoking nicely earlier than the operation.
Eligibility additionally will depend on the aim of the pleurectomy. For instance, if the purpose is to deal with mesothelioma, the most cancers should not have unfold too far out of the lungs. In any other case, surgeons could also be unable to take away all the most cancers cells, and the dangers of the surgical procedure would outweigh the advantages.
Earlier than surgical procedure, the individual will obtain common anesthesia in order that they are going to be unconscious.
Then, a healthcare skilled will intubate the individual, inserting a tube by their mouth and into the throat to assist them breathe throughout surgical procedure. Medical professionals will place the individual on their aspect to offer the surgeon easy accessibility to the working space.
Surgeons could use a keyhole surgical procedure methodology for the process. This includes the surgeon making a number of small incisions as a substitute of 1 giant lower and performing the surgical procedure by these small openings.
If the individual requires a extra advanced operation, surgeons could make an even bigger incision. They’ll slowly and thoroughly open the ribs earlier than eradicating elements or all the pleura.
Earlier than the operation, a crew of medical professionals will inform the individual precisely what is going to occur throughout their surgical procedure. They are going to be out there to reply any questions an individual could have about their particular process.
An individual’s surgical crew will advise on any steps they could want to soak up preparation for a pleurectomy. For instance, a physician could suggest an individual keep away from consuming something the night time earlier than the operation.
Moreover, in some instances, docs could advise that an individual cease taking sure medicines for a while earlier than the process.
These could embrace blood-thinning medicines or nonsteroidal anti-inflammatory medication. Folks should focus on any medicines that they take with a healthcare skilled.
Individuals who smoke and require a pleurectomy might want to give up smoking nicely earlier than the process, as smoking complicates lung ailments and may gradual an individual’s restoration after surgical procedure.
In accordance with Most cancers Analysis UK, most individuals will keep within the hospital for round 7–15 days following a pleurectomy, relying on the approach their surgeons use.
It states that it may possibly take an individual 4–8 weeks to totally get better after surgical procedure, that means it might be some time earlier than they’re able to return to work or resume their day by day actions.
Many research have demonstrated the effectiveness of a pleurectomy in prolonging the life of individuals with circumstances equivalent to mesothelioma.
Analysis additionally means that those that obtain a pleurectomy could have a greater high quality of life and fewer postoperative problems than those that had a process to take away the lungs.
As with every surgical procedure, a pleurectomy has some dangers and negative effects.
The dangers of a pleurectomy primarily relate to problems from the anesthesia, equivalent to respiration difficulties or allergic reactions. Different dangers embrace an infection, bleeding, and lung problems.
The negative effects relate extra to the results of the process itself. They embrace ache or discomfort within the chest space, swelling within the affected lung or chest cavity, and issue respiration attributable to decreased lung capability.
For most individuals, postoperative ache and discomfort will finally subside. A physician will possible prescribe ache remedy to make an individual extra comfy after surgical procedure.
The principle aim of this process is to enhance respiration and scale back ache by eradicating diseased tissue from the lung. Nonetheless, surgeons may use it to help diagnoses.
Different advantages of a pleurectomy embrace the next:
• stopping the lungs from collapsing and making respiration simpler
• bettering the standard of life for these with most cancers by decreasing shortness of breath, coughing and wheezing, and different signs
• helping with most cancers elimination and analysis
This surgical procedure can remedy some early cancers. Docs might also suggest it as a palliative process to alleviate signs if they can’t take away the entire tumor.
The prognosis for individuals present process a pleurectomy will depend on the underlying concern docs are utilizing the surgical procedure to deal with.
It normally doesn’t remedy the underlying situation. Nonetheless, it could enhance an individual’s high quality of life considerably.
Learn on to seek out solutions to some generally requested questions on a pleurectomy.
Is a pleurectomy a significant surgical procedure?
Sure, a pleurectomy is a significant surgical procedure.
Surgeons sometimes conduct this process when an individual is underneath common anesthesia. It may well take a number of hours.
The restoration time for one of these surgical procedure could also be as much as 8 weeks. After this time, an individual ought to typically have the ability to return to work or resume their day by day actions.
Can your lung collapse after a pleurectomy?
It’s doable for the lung to break down after a pleurectomy. The medical time period for a collapsed lung is pneumothorax.
In a 2019 research, 20 out of 71 individuals present process a P/D — 28.2% of the pattern — skilled a pneumothorax.
Can a lung develop again after surgical procedure?
An individual’s lung is not going to regenerate after a surgeon has eliminated it.
Can you reside with out pleura?
Sure. Though the pleura is a crucial membrane, individuals can dwell with out it.
The pleura is a skinny, double-layered membrane that traces the within of the chest cavity and covers the lungs. It supplies a protecting barrier between the lungs and chest wall and helps preserve them separated.
A pleurectomy is a process the place surgeons take away this lining to deal with numerous circumstances. It’s a main surgical procedure, and just some are eligible for this operation. | {
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The importance of postnatal pelvic floor exercises
woman with newborn baby
Having a baby leads to lots of changes in your body. And, while some things may never be quite the same again, there is plenty you can do to get yourself back into shape post-pregnancy.
One of the biggest physical problems women face after pregnancy is related to your pelvic floor muscles. These are the muscles around your bladder, vagina and back passage, which come under a lot of stress during pregnancy and labour.
This is why pelvic floor exercises for women are encouraged after birth, as they can play a significant role in your post-pregnancy recovery.
How important are postnatal pelvic floor exercises for women?
Your baby is supported in the pelvis by your pelvic floor muscles throughout pregnancy. Then, during delivery, these muscles become very stretched, which can subsequently lead to common pelvic floor problems – such as loss of bladder and/or bowel control, pelvic organ prolapse (when one or more of the organs in the pelvis slips from their normal position and bulges into the vagina) and reduced sensation or satisfaction during sex.
So, doing pelvic floor exercises after birth is very important – as it can help to protect you from these problems, both in the short and long term.
And postnatal pelvic floor exercises are still important even if you’ve had a caesarean, as - even though your pelvic floor has not been through the stress of a vaginal delivery - these muscles will still have stretched and weakened during your pregnancy.
How do you do postnatal pelvic floor exercises?
There are two types of pelvic floor exercises to do: fast and slow.
For the slow type, tighten your muscles around your back passage (anus), drawing them in as if you’re trying to prevent a bowel movement or wind.
At the same time, draw in your vagina as if you’re gripping a tampon, and your urethra as if to stop the flow of urine.
Hold each squeeze for about 10 seconds, or as long as you can, and then slowly relax the muscles and rest them before you do another. Aim to squeeze and rest for the same number of seconds.
For the fast type, tighten in the same way and then immediately release the muscles.
Try to do these exercises three times every day; each time do ten slow, followed by ten fast. To help you remember, you could do a set at each mealtime.
How soon can you start pelvic exercises after birth?
It is never too soon to start pelvic floor exercises after birth. It is not at all harmful and you can do it straight after delivery if you like.
What else should I know about pelvic floor exercises for women?
Women used to be advised to do postnatal pelvic floor exercises while having a wee, but current thinking is that this is not a good idea - as you may not empty your bladder completely. But sitting on the loo can be a good reminder to do your exercises - just make sure you wait until after you've finished.
If you need advice about your pelvic floor, then your postnatal check - at around six to eight weeks after the birth - is a good time to talk to your GP about it and get any help you need.
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7,531,460,786,477,204,000 | Healthy Eating
Do you know how many people die of being overweight or obese every year? How much money is spent on weight loss programs and diet pills every year?
Have you seen how many people are obese on the streets? Take a guess. What is your percentage? Too much. So many people are becoming obese every year around the world, from the powerful countries to the poor countries. This can be stopped. So many of these people can be working out in a YMCA, or at least jogging around the block or hopping on a bike or treadmill. Many people choose this and that can lead to a painful life and that is wrong. They can live such a healthier, happier life. There are many ways you can live healthy without working extremely hard. Just eat mostly fruits and vegetables, some meat, starches, and almost nothing from a restaurant. It is just fine to have snacks. Watch your calories and how much you think you burned too. People should stop lazing around on the couch watching TV and start exercising.
Some experiments that try to connect how obesity happens suggest Vitamin D deficiency, some say just bad eating habits, some say not eating enough, some say they can’t control it. Vitamin D deficiency can lead to Type 2 Diabetes, mainly because of insulin intolerance. It is also related to obesity, as when obese people’s blood has been taken, most of the time there have been low levels of Vitamin D and high levels of cholesterol. This doesn’t mean that Vitamin D deficiency causes obesity, but the two are linked. Inactivity can cause Coronary Heart Disease (narrowing of the blood cells that give the heart blood and oxygen), Hypertension (very high blood pressure), Type 2 Diabetes, Colon Cancer, depression and anxiety, and obesity. As the website http://www.mb.com.ph/articles/341925/overweight-people-eat-fewer-meals-others said, “Generally, though, "weight loss maintainers" consumed the fewest calories, at about 1,800 a day, compared with the normal weight and overweight subjects, who... [continues]
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(2012, 01). Healthy Eating. StudyMode.com. Retrieved 01, 2012, from http://www.studymode.com/essays/Healthy-Eating-896573.html
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7,516,065,362,425,411,000 | Andarine (S4) SARMs: The Key to Superior Muscle Growth
Khirul Alam
Andarine (S4) SARMs: The Key to Superior Muscle Growth
Andarine Dosage, Benefits, Muscle Growth, S4 SARMs, SARMs, Selective Androgen Receptor Modulators, Side Effects
Andarine (S4) is a Selective Androgen Receptor Modulator (SARM) known for boosting muscle growth and fat loss. It is popular among athletes and bodybuilders.
Andarine (S4) stands out as a potent SARM, offering significant muscle gains and fat-burning effects. It binds selectively to androgen receptors in muscles and bones, promoting lean muscle mass without the severe side effects of anabolic steroids. Users often report improved strength, endurance, and a more defined physique.
Despite its benefits, it is important to use it responsibly and be aware of potential side effects. Always consult a healthcare professional before starting any new supplement. Andarine (S4) can be an effective addition to a fitness regimen, enhancing performance and body composition.
Introduction To Andarine S4
Andarine (S4) is a Selective Androgen Receptor Modulator (SARM). It is popular for its muscle-building properties. Athletes and bodybuilders often use it. Understanding its origins and properties can help you decide if it’s right for you.
Origins And Development
Andarine S4 was developed by GTx Inc. They aimed to treat muscle wasting diseases and osteoporosis. Researchers found it had strong anabolic effects. This made it suitable for muscle growth and fat loss.
Clinical trials showed promising results. Despite its benefits, it was never approved for medical use. It remains popular in the fitness community.
Key Properties And Mechanism Of Action
Andarine S4 binds to androgen receptors in the body. This boosts protein synthesis and muscle growth. It mimics the effects of anabolic steroids without severe side effects.
• Muscle Growth: Andarine S4 helps build lean muscle mass.
• Fat Loss: It promotes fat oxidation, aiding in weight loss.
• Bone Density: It strengthens bones, reducing the risk of fractures.
Users often report increased strength and endurance. Andarine S4 is also known for its fast-acting results. Within weeks, noticeable changes in muscle definition occur.
Below is a table summarizing its key properties:
PropertyEffect
Muscle GrowthIncreases lean muscle mass
Fat LossPromotes fat burning
Bone DensityStrengthens bones
Andarine S4’s mechanism is unique. It selectively targets muscle and bone tissues. This minimizes unwanted effects on other organs. Users should always follow recommended dosages to avoid side effects.
Benefits Of Andarine S4 For Muscle Growth
Andarine S4, a popular SARM, offers numerous benefits for muscle growth. It helps in building lean muscle mass and enhances overall strength. This section explores the key advantages of using Andarine S4 for muscle development.
Increased Muscle Mass
Using Andarine S4 leads to a significant increase in muscle mass. This SARM helps your body build lean muscle efficiently. Muscle fibers grow thicker and stronger with consistent use. The anabolic properties of Andarine S4 are potent.
Bodybuilders and athletes notice rapid muscle gains. These gains are often more sustainable than other supplements. The muscle growth is clean, without excessive water retention.
Andarine (S4) SARMs: The Key to Superior Muscle Growth
Enhanced Strength And Endurance
Andarine S4 also boosts strength and endurance levels. Users report noticeable improvements in their lifting capacity. This SARM enhances muscle power and performance. Strength gains lead to better workout efficiency and results.
Endurance levels see a marked improvement. Longer training sessions become possible without fatigue. Athletes experience better stamina and recovery times. These benefits make Andarine S4 a favorite among fitness enthusiasts.
Comparative Analysis With Other Sarms
Andarine (S4) is a popular SARM known for its muscle-building properties. But how does it stack up against other well-known SARMs? This section offers a detailed comparison of Andarine with Ostarine and Ligandrol.
Andarine Vs. Ostarine
Andarine (S4) and Ostarine (MK-2866) are two of the most researched SARMs. Both are known for their muscle-building capabilities, but they have distinct differences.
AspectAndarine (S4)Ostarine (MK-2866)
Muscle GainModerateHigh
Fat LossEffectiveModerate
StrengthSignificantModerate
Side EffectsVision issuesMild
Ostarine is generally favored for its higher muscle gain potential. Andarine is better for fat loss and strength gains. Andarine may cause vision issues, while Ostarine has milder side effects.
Andarine Vs. Ligandrol
Andarine (S4) and Ligandrol (LGD-4033) are both potent SARMs. They offer unique benefits and cater to different goals.
AspectAndarine (S4)Ligandrol (LGD-4033)
Muscle GainModerateHigh
Fat LossEffective
Optimal Dosage And Cycle Guidelines
Understanding the optimal dosage and cycle guidelines for Andarine (S4) Sarms is crucial. This ensures you gain the best results while minimizing side effects. Below, we provide detailed insights on recommended dosages for beginners and cycle durations.
Recommended Dosage For Beginners
Beginners should start with a low dosage to gauge their body’s response. The recommended dosage is 5-10 mg per day.
Gradually increase the dosage by 5 mg each week. The maximum dosage should not exceed 25 mg per day.
WeekDosage (mg/day)
15 mg
210 mg
315 mg
420 mg
525 mg
Cycle Duration And Post Cycle Therapy
The typical cycle duration for Andarine (S4) is 8 weeks. After completing the cycle, it is important to undergo Post Cycle Therapy (PCT).
PCT helps to restore natural hormone levels. It also minimizes potential side effects.
1. Use a PCT supplement such as Clomid or Nolvadex.
2. Take the supplement for 4 weeks following the cycle.
3. Follow the recommended dosage on the PCT supplement label.
For better results, maintain a balanced diet and regular workout routine. This ensures you maximize the benefits of Andarine (S4) Sarms.
Side Effects And Safety Profile
Understanding the side effects and safety profile of Andarine (S4) SARMs is crucial before considering its use. This section will provide insight into common side effects and long-term safety considerations.
Common Side Effects
Like any supplement, Andarine (S4) SARMs may cause some side effects. Knowing these can help you make an informed decision.
• Vision Changes: Users often report a yellow tint in their vision. This is temporary and stops once the usage ends.
• Suppression of Natural Testosterone: Andarine may lower your body’s testosterone production. This can affect mood and energy levels.
• Headaches: Some users experience headaches, which can be managed with over-the-counter pain relievers.
• Muscle Cramps: Muscle cramps may occur, especially during intense workouts.
Andarine (S4) SARMs: The Key to Superior Muscle Growth
Long-term Safety Considerations
The long-term effects of Andarine (S4) SARMs are still being studied. Here are some potential concerns to be aware of:
• Liver Health: Prolonged use may impact liver function. Regular liver function tests are recommended.
• Hormonal Imbalance: Long-term use might cause hormonal imbalances. This can lead to various health issues.
• Bone Health: There’s a potential risk to bone health with extended use.
For a quick reference, here’s a summary table of common side effects and long-term considerations:
Side EffectDetails
Vision ChangesYellow tint in vision, temporary
Testosterone SuppressionMay lower natural testosterone production
HeadachesOccasional, manageable with pain relievers
Muscle CrampsPossible during intense workouts
Liver HealthPotential impact with prolonged use
Hormonal ImbalanceRisk with long-term use
Bone HealthPotential risk with extended use
Stacking Andarine With Other Supplements
Andarine (S4) is a popular SARM known for its muscle-building and fat-reducing properties. When combined with other supplements, its benefits can be enhanced. This practice, known as “stacking,” can maximize results. Below, we explore some effective combinations and necessary precautions.
Synergistic Combinations
Combining Andarine with other SARMs can offer significant advantages. For instance, pairing Andarine with Ostarine (MK-2866) can improve muscle mass and strength. Ostarine is known for its muscle-preserving qualities, making it a great addition.
Andarine and Cardarine (GW-501516) is another powerful combination. Cardarine boosts endurance, allowing for longer, more intense workouts. This combination helps in burning fat while maintaining muscle mass.
Adding a testosterone booster to the stack can further enhance results. Andarine may suppress natural testosterone production. Using a booster can help maintain hormonal balance.
Precautions When Stacking
Careful dosage management is crucial when stacking supplements. Overuse can lead to unwanted side effects. Always start with the lowest effective dose and monitor your body’s response.
Understand potential interactions between different supplements. Not all combinations are beneficial. Some may cause adverse reactions. Research each supplement thoroughly before adding it to your stack.
Regular health check-ups are essential when stacking. Monitoring liver function, cholesterol levels, and other health markers can prevent complications. Consult a healthcare provider for personalized advice.
SupplementBenefitPrecaution
Ostarine (MK-2866)Muscle PreservationStart with low doses
Cardarine (GW-501516)Increased EnduranceMonitor cardiovascular health
Testosterone BoosterHormonal BalanceConsult a doctor
Diet And Training Tips For Maximizing Results
Maximizing results with Andarine (S4) SARMs requires a strategic approach to diet and training. Combining the right nutrition with effective workouts can significantly enhance your gains. This section covers essential tips to help you achieve the best outcomes.
Andarine (S4) SARMs: The Key to Superior Muscle Growth
Nutritional Strategies
Proper nutrition is crucial for maximizing your results with Andarine (S4) SARMs. Here are some key strategies:
• High Protein Intake: Aim for at least 1 gram of protein per pound of body weight. This helps in muscle recovery and growth.
• Balanced Macronutrients: Ensure your diet includes a balance of proteins, carbs, and fats. This supports overall health and performance.
• Hydration: Drink plenty of water throughout the day. Proper hydration improves muscle function and recovery.
• Frequent Meals: Eat 5-6 small meals a day. This keeps your metabolism active and provides a steady flow of nutrients.
• Supplement Wisely: Consider supplements like BCAAs, multivitamins, and omega-3s. These support muscle recovery and overall health.
Effective Workout Routines
Your workout routine plays a significant role in maximizing results with Andarine (S4) SARMs. Here are some effective strategies:
1. Compound Exercises: Focus on compound movements like squats, deadlifts, and bench presses. These exercises engage multiple muscle groups, leading to better gains.
2. Progressive Overload: Gradually increase the weight and intensity of your workouts. This stimulates muscle growth and strength.
3. High-Intensity Interval Training (HIIT): Incorporate HIIT sessions into your routine. These boost your metabolism and promote fat loss.
4. Rest and Recovery: Ensure you get enough rest between workouts. Muscle recovery is crucial for growth and performance.
5. Consistency: Stick to your training schedule. Consistency is key to achieving long-term results.
Following these diet and training tips can help you maximize your results with Andarine (S4) SARMs. Stay committed and focused to achieve your fitness goals.
User Experiences And Testimonials
Andarine (S4) SARMs have gathered quite the following among fitness enthusiasts. Real users share their stories and outcomes. This section highlights their experiences.
Success Stories
Many users have shared their remarkable success stories with Andarine (S4). They report significant muscle gains and fat loss.
Here are some success stories:
• John, 28: Gained 10 pounds of muscle in 8 weeks.
• Sara, 32: Lost 5% body fat while maintaining muscle mass.
• Mike, 35: Improved strength and endurance significantly.
Comparing Expectations With Outcomes
Many users have expectations when they start using Andarine (S4). They hope for muscle growth, fat loss, and enhanced performance.
ExpectationOutcome
Muscle GrowthMost users see noticeable gains within 6-8 weeks.
Fat LossReports indicate a drop in body fat percentage.
Enhanced PerformanceUsers experience increased strength and endurance.
Overall, the outcomes often meet or exceed expectations.
Legal Status And Availability
Understanding the legal status and availability of Andarine (S4) SARMs is crucial. This information helps users make informed decisions. Let’s dive into the regulations across different countries and how to purchase Andarine S4 legally.
Regulations Across Different Countries
The legal status of Andarine (S4) varies globally. Each country has its own rules and regulations. Here is a quick overview:
CountryLegal Status
United StatesNot approved by FDA, legal for research purposes.
CanadaNot approved for human consumption, legal for research.
United KingdomClassified as a prescription-only medicine.
AustraliaIllegal without a prescription.
European UnionVaries by country, mostly for research use only.
Purchasing Andarine S4 Legally
Buying Andarine (S4) legally depends on your location. Here are some legal ways to purchase Andarine S4:
• Research Chemical Suppliers: Many countries allow purchase for research purposes.
• Prescription: In some countries, a prescription is required.
• Online Retailers: Ensure they comply with local laws.
Always check the local regulations before purchasing. This ensures you stay within the law. Remember, the legality can change, so stay updated.
Future Of Sarms And Andarine In Sports
The future of Selective Androgen Receptor Modulators (SARMs) like Andarine (S4) in sports is a topic of great interest. Researchers and athletes are curious about the potential benefits and risks. This section delves into the latest research advancements and ethical considerations in professional sports.
Andarine (S4) SARMs: The Key to Superior Muscle Growth
Research Advancements
Research in SARMs and Andarine is growing rapidly. Scientists aim to understand how these compounds affect muscle growth and athletic performance. Recent studies show promising results, especially for muscle mass and strength gains.
Table 1: Key Research Findings on Andarine (S4)
Research AspectFindings
Muscle MassSignificant increase in lean muscle mass
StrengthImproved strength levels in athletes
Bone DensityEnhanced bone density and strength
Side EffectsMinimal compared to traditional steroids
These findings are shaping the future of SARMs in sports. Researchers are optimistic but cautious. Long-term effects and safety are still under scrutiny.
Ethical Considerations In Professional Sports
Ethical concerns are a major challenge for SARMs like Andarine. The use of performance-enhancing drugs in sports raises questions about fairness and integrity. Governing bodies are debating whether SARMs should be allowed.
• Fair Play: Athletes using SARMs may have an unfair advantage.
• Health Risks: Long-term health risks are not fully understood.
• Regulations: Current regulations may need updates to address SARMs.
Professional sports organizations are taking a cautious approach. They aim to balance athlete performance with ethical standards. Ongoing research and discussions will play a critical role in shaping future policies.
In summary, the future of SARMs and Andarine in sports is complex. It involves a mix of scientific advancements and ethical considerations. Both aspects are crucial for the responsible use of these powerful compounds.
Frequently Asked Questions
Why Is Andarine Banned?
Andarine is banned due to its potential health risks and lack of FDA approval. It’s considered unsafe for human use.
Does Andarine Affect Testosterone?
Yes, Andarine can affect testosterone levels. It may suppress natural testosterone production, leading to potential hormonal imbalances. Users often take post-cycle therapy to restore levels.
How Long Does Andarine Stay In Your System?
Andarine can stay in your system for up to 48 hours. It has a half-life of about 4-6 hours. Always follow dosage guidelines and consult a healthcare professional.
Do Sarms Shut Down Testosterone?
Yes, SARMs can suppress natural testosterone production. The extent depends on the type and dosage of SARM used.
Conclusion
Andarine (S4) SARMs offer potential benefits for muscle growth and fat loss. Always consult a healthcare professional before use. Ensure you source from reputable suppliers to guarantee quality and safety. By staying informed and cautious, you can make the most of Andarine’s advantages while minimizing risks.
About the author
Khirul Alam
I'm Khirul Alam, aka NILOY FITNESS, a devoted bodybuilder and fitness expert. I write about fitness, bodybuilding, and mental health at Hercules Bodybuilding to inspire and help people reach their fitness goals. I'm committed to making a positive impact in the fitness community. | {
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8,534,111,543,733,282,000 | Peanuts
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Vitamin C performs a role in sustaining and repairing healthy connective tissue, in addition to its antioxidant properties. These taking lower than 60mg really helpful dose of vitamin C per day—about one orange—may be at nearly one-and-a-half instances the risk of creating extreme gingivitis; in comparison with those that devour thrice the really helpful dose. Gingivitis causes the gums to turn out to be purple, swollen and to bleed simply, and is the earliest stage of gum illness. Food labels now report the P.c Every day Values of key nutrients contained in one serving. Day by day Values are guidelines instructed by the FDA for many nutrients. Most Each day Values are primarily based on the earlier “Recommended Each day Allowances” or RDA’s. Some nutrition software packages will even calculate the % Day by day Values of nutrients in the meals you eat.
Most bronchial asthma assaults are caused by allergy symptoms to inhaled substances comparable to pollen, dust, and animal dander. They embrace: Allergens (substances to which some individuals are allergic) akin to pollens, foods, dust, mould, feathers, or animal dander (small scales from animal hair or feathers);Irritants within the air resembling dust, cigarette smoke, gases, and odors; Respiratory infections resembling colds, flu, sore throats, and bronchitis; An excessive amount of effort such as operating upstairs too fast or carrying heavy hundreds (although people with bronchial asthma can benefit from a reasonable amount of train);Emotional stress such as extreme fear or excitement; Weather equivalent to very cold air, windy weather, or sudden modifications in weather; Remedy equivalent to aspirin or related medicine and a few medication used to treat glaucoma and high blood pressure.
Using pure skincare merchandise is an effective first step in providing the skin with the right nutrients and building supplies to retain its well being and performance. So, what are the methods of Whitening Skin Care? An age outdated method was (and still is) with the usage of hydroquinone, a chemical used topically, which reduces the pigmentation within the pores and skin. Products made with hydroquinone are used for discolorations closer to the surface, within the dermis. A 2% energy is obtainable over the counter, while a four% power is obtainable only with a prescription. Laser therapies are supplied for deeper discolorations within the dermis.
How does Fatigue Nutrition work? By eating nutrient rich meals that the body must construct and repair itself. Timing the intake of food with fluids to charge the thoughts and physique for increased fatigue resistance. Consuming a wholesome breakfast is an efficient solution to start the day and may be necessary in reaching and sustaining a wholesome weight. There’s where the effort to remain bodily match and active gives tremendous payoff. Over the course of your life, in the event you keep lively, train, and keep optimum well being to your muscle tissue, you will note an amazing distinction within the price that your physique metabolizes food. As people age, their metabolism quite naturally slows down. The best method to forestall this from taking place is through exercise and staying fit.
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Leveraging the Diet and Microbiome for IBS Relief
August 10, 2022 7 min read
Leveraging the Diet and Microbiome for IBS Relief
Digestive disorders are among the most common chronic ailments experienced by individuals in modern society. Perhaps the most prevalent is irritable bowel syndrome (IBS), which is thought to affect 10 to 20% of adults in America. IBS is a gastrointestinal pathology characterized by a combination of symptoms that can include:
• abdominal pain
• visible mucus present in stool
• constipation
• diarrhea
• pain during defecation
• bloating
• abdominal distension
• rectal bleeding
Clinically, IBS is often classified into different subtypes based on symptomology.
• IBS-C: frequent constipation
• IBS-D: frequent diarrhea
• IBS-M: both hard to pass and watery stools
IBS preferentially affects women and individuals suffering from other gastrointestinal issues such as constipation and acid reflux, and although there is no clear-cut answer as to the mechanism underlying disease onset and progression, there are multiple factors that show a relationship to IBS symptom onset. These include:
• dietary triggers
• unfavorable changes to the gut microbiome (i.e. dysbiosis)
• bacterial or viral infections
• stress
Here, we will focus on the role of factors from the diet and microbiome that contribute to the development and persistence of IBS, and how these factors can be modulated to alleviate symptoms.
Diet and IBS
There are multiple suggested mechanisms by which dietary inputs can trigger the onset of IBS symptoms:
• FODMAPs
The consumption of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (also known as FODMAPs) in individuals with gut inflammation or dysbiosis is known to cause gastrointestinal discomfort [1]. FODMAPs cannot be digested by human digestive enzymes and, as a result, they spill over into the colon where they are metabolized by the microbiome. In individuals with inflamed dysbiotic guts, colon cells lose the ability to effectively import the short chain fatty acids (SCFAs) produced from the microbial breakdown of FODMAPs. The result is gas build up in the lower GI tract, which creates bloating, pain, distension, and changes to gut motility.
• Dairy products
Dairy products can cause issues for some individuals who lack the enzyme responsible for breaking down lactose as an adult. In this case, the undigested lactose can create an osmotic shift in the gut, which can lead to bloating and diarrhea [1].
• Fructose
A sugar found in fruits and honey—is transported with glucose from the gut into the bloodstream in a 1:1 ratio. Thus, if fructose consumption exceeds glucose consumption (as may occur with consumption of high fructose corn syrup), glucose can spill over into the large intestine where microbes feast upon it and generate gases that cause bloating [1]. Similarly, sugar alcohols like sorbitol, xylitol, and mannitol undergo somewhat slow absorption by the small intestine, which means that consumption of moderate-to-high quantities will result in passage into the colon where the microbiome breaks them down into gases [1].
• Allergens
Additionally, in individuals with sub-clinical food allergies, consumption of particular foods can trigger low-grade inflammation within the gut and incite IBS symptoms [1]. However, food allergy testing can be inaccurate or inconclusive in many cases. Thus, if an individual suspects that a specific food is inciting IBS symptoms, an elimination diet should be performed where the suspected food is avoided for at least two weeks and symptoms are closely monitored. If an individual is unsure if they have a dietary trigger, a food journal should be kept for at least two weeks with notes regarding any symptoms experienced each day to identify a potential trigger.
• Wheat Gluten
In clinical studies, wheat (gluten) was identified as a major trigger of sub-clinical gastrointestinal inflammation in a significant portion of IBS patients tested [2]. In fact, pre-clinical research suggests that gluten as well as other proteins in wheat have the potential to activate the innate immune system (i.e. inflammation), increase gut permeability, and create changes in gut motility [3]. The research also suggests that the presence of key bacteria in the microbiome, including Pseudomonas and Lactobacillus, can mitigate the negative effects of wheat consumption by breaking down these proteins before they can interact with immune cells [4]. Thus, targeted microbiome modulation may hold promise for individuals to mitigate the effects of dietary triggers on IBS flares.
Gut Microbiome and IBS
• Decreased Levels of Bifidobacteria
A 2019 systematic review of the IBS-microbiome literature found an association between certain microbiome signatures and IBS onset and severity [5]. The most prominent observation across all of the compiled studies was a decrease in the levels of Bifidobacteria and increases in the levels of Bacteroides and species of Enterobacteriaceae in patients with IBS.
Bifidobacteria play a crucial role in immune system regulation, gut health, and maintenance of a healthy, diverse microbiome. Bifidobacteria break down indigestible carbohydrates, like FODMAPs, fibers, and polyphenols, into the metabolites acetate and lactate. These two metabolites serve as important food sources for other beneficial bacteria in the gut including the butyrate-producing bacteria. Butyrate is not only the primary fuel source for colon cells, but also helps to maintain gut barrier integrity and spin down inflammation at the level of both the gut and the whole body. Declines in the levels of Bifidobacteria in the gut occur during aging, and are associated with the development of age-related diseases, most of which arise from low-grade inflammation sustained over decades. The anti-inflammatory activities that Bifidobacteria support by bolstering butyrate production help to mitigate this low-level inflammation and support a healthy aging process.
• Increased Levels of Bacteroides
Although species of Bacteroides often play a beneficial role in the gut, they can also act like pathogens in certain contexts. For instance, some species of Bacteroides can secrete a toxin known as fragilysin, which has been associated with the development of gastric disorders like ulcerative colitis [6]. Additionally, Bacteroides can also create factors known as hemolysins and cytolysins that can harm host cells [6]. Interestingly, the expression of these factors increases in oxygen-rich environments [6]. Bacteroides generally thrive in very low-oxygen environments; however, in the presence of gut inflammation, the oxygen content of the gut lining increases which may subsequently trigger the production of hemolysins and cytolysins that can further damage the cells of the colon.
• Increased Levels of Enterobacteriaceae
The most abundant species of Enterobacteriaceae in the colon is E. coli and, in general, high abundance of bacteria within this phylum is associated with weight gain, inflammation, and gastric disease.
Possible Solutions to Mitigate IBS
• Remove FODMAP?
Importantly, although reduced FODMAP intake can result in acute symptom relief, a low-FODMAP diet is associated with declines in the levels of Bifidobacteria and reductions in the total bacterial biomass of gut both—two markers that correspond closely with poor gut health [1]. Thus, the elimination of FODMAPs from the diet is not a viable solution to the problem, but only a temporary means to prevent acute discomfort. Instead, a focus on spinning down inflammation in the gut should be prioritized as this will help the colon to restore its ability to effectively burn butyrate. Once butyrate burning is optimized, dietary and supplemental strategies to bolster Bifidobacteria levels can be implemented. To learn about strategies to reduce gut inflammation and optimize for Bifidobacteria, check out our previous blog
• Optimize Your Gut Microbiome
Additionally, clinical research also suggests that IBS and inflammatory bowel disease (IBD) are both associated with increased gap size between the epithelial cells of the gut [7]. These gaps, known as tight junctions, are crucial for regulating intestinal permeability and preventing harmful microbes and toxins from leeching into the bloodstream. Thus, the optimization of Akkermansia muciniphila in the gut may be prudent for individuals with IBS, as Akkermansia play a major role in the maintenance of tight junction integrity. See our previous blog on the topic to learn about ways to boost your levels of Akkermansia.
Take-Aways
IBS is a disease characterized by various forms of gastric discomfort, and the mechanism by which it develops remains largely elusive. However, dietary triggers and unfavorable changes to the microbiome are likely two of the most prominent factors driving symptomology. Although a low FODMAP diet can provide acute relief, it is associated with poor markers of gut health, and should thus only be used in the short-to-moderate term. As a long-term solution, individuals may:
• identify any trigger food(s) via food journaling
• perform an elimination diet where any trigger(s) are avoided for at least 2-4 weeks and
• focus on implementing dietary and supplemental approaches to eliminate gut inflammation and optimize the microbiome.
Author:
Dr. Alexis Cowan, a Princeton-trained PhD specializing in the metabolic physiology of nutritional and exercise interventions.
Follow Dr. Cowan on Instagram: @dralexisjazmyn
References
1. Moayyedi, P., Simrén, M. & Bercik, P. Evidence-based and mechanistic insights into exclusion diets for IBS. Nat Rev Gastroenterol Hepatol 17, 406–413 (2020). https://doi.org/10.1038/s41575-020-0270-3
1. Fritscher-Ravens A, Pflaum T, Mösinger M, Ruchay Z, Röcken C, Milla PJ, Das M, Böttner M, Wedel T, Schuppan D. Many Patients With Irritable Bowel Syndrome Have Atypical Food Allergies Not Associated With Immunoglobulin E. Gastroenterology. 2019 Jul;157(1):109-118.e5. doi: 10.1053/j.gastro.2019.03.046. Epub 2019 May 15. PMID: 31100380.
1. Zevallos VF, Raker V, Tenzer S, Jimenez-Calvente C, Ashfaq-Khan M, Rüssel N, Pickert G, Schild H, Steinbrink K, Schuppan D. Nutritional Wheat Amylase-Trypsin Inhibitors Promote Intestinal Inflammation via Activation of Myeloid Cells. Gastroenterology. 2017 Apr;152(5):1100-1113.e12. doi: 10.1053/j.gastro.2016.12.006. Epub 2016 Dec 16. PMID: 27993525.
1. Caminero A, McCarville JL, Zevallos VF, Pigrau M, Yu XB, Jury J, Galipeau HJ, Clarizio AV, Casqueiro J, Murray JA, Collins SM, Alaedini A, Bercik P, Schuppan D, Verdu EF. Lactobacilli Degrade Wheat Amylase Trypsin Inhibitors to Reduce Intestinal Dysfunction Induced by Immunogenic Wheat Proteins. Gastroenterology. 2019 Jun;156(8):2266-2280. doi: 10.1053/j.gastro.2019.02.028. Epub 2019 Feb 22. PMID: 30802444.
1. Pittayanon R, Lau JT, Yuan Y, Leontiadis GI, Tse F, Surette M, Moayyedi P. Gut Microbiota in Patients With Irritable Bowel Syndrome-A Systematic Review. Gastroenterology. 2019 Jul;157(1):97-108. doi: 10.1053/j.gastro.2019.03.049. Epub 2019 Mar 30. PMID: 30940523.
• Zafar H, Saier MH Jr. Gut Bacteroides species in health and disease. Gut Microbes. 2021 Jan-Dec;13(1):1-20. doi: 10.1080/19490976.2020.1848158. PMID: 33535896; PMCID: PMC7872030.
• Sood R, Law GR, Ford AC. Diagnosis of IBS: symptoms, symptom-based criteria, biomarkers or 'psychomarkers'? Nat Rev Gastroenterol Hepatol. 2014 Nov;11(11):683-91. doi: 10.1038/nrgastro.2014.127. Epub 2014 Jul 29. PMID: 25069544.
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-5,219,637,016,541,823,000 | You can teach an old dog new tricks: angiopoietin-1 instructs Tie2pos myeloid cells to promote neovascularization in ischemic limbs
Authors
• Costanza Emanueli,
Corresponding author
1. Laboratory of Vascular Pathology and Regeneration, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom
2. Vascular Science, National Heart & Lung Institute, Imperial College of London, London, United Kingdom
• Tel: +44 117 342 3512/3904; Fax: +44 117 342 3512/3904;
Search for more papers by this author
• Nicolle Kränkel
1. University of Zurich, Institute of Physiology, Working Group on Cardiovascular Research, Zurich, Switzerland
2. Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
Search for more papers by this author
Abstract
See related articles in EMBO Molecular Medicine http://dx.doi.org/10.1002/emmm.201302695 and http://dx.doi.org/10.1002/emmm.201302752
Throughout life, the vasculature undergoes remodelling to adapt to the changing demands. The ability to grow new capillaries, adapt their caliber to higher flow and develop collaterals from obstructed arteries is essential to maintain or restore tissue perfusion. Better knowledge of the molecular and cellular details of postnatal blood vessel growth and remodelling is necessary to develop improved vascular regenerative therapies.
Despite the crucial roles of myeloid cells in immune defense and angiogenesis, we still lack a thorough understanding of their identity and functional regulation.
In this issue of EMBO Molecular Medicine, two complementary articles reinforce the notion that Angiopoietin-1 (Ang-1) and Tie2 receptor expressing monocytes/macrophages (TEM) team up to promote reparative vascularization in limb ischemia (LI; Hamm et al, 2013; Patel et al, 2013). The underpinning molecular mechanism is an inhibitory effect of Ang-1 (a natural ligand for Tie2) on the hypoxia inducible factor-1 α (HIF-1α) destabilizer factor prolyl hydroxylase 2 (PHD2) in TEM (Hamm et al, 2013; Fig. 1). It was already known that Ang-1 promotes angiogenesis in ischemic limbs (Shyu et al, 1998). Moreover, ex vivo priming with Ang-1 improves the vasculogenic potential of peripheral blood (PB) stem cells and increases their engraftment and therapeutic angiogenesis response after transplantation in a mouse model of LI (Kim et al, 2009).
Figure 1.
Molecular and cellular mechanisms initiating by Angiotensin-1 and leading to post-ischemic vascular repair. In ischemic tissues, the activity of the oxygen sensor PDH2 is reduced, permitting the HIFα-mediated transcription of pro-angiogenic genes, such as Ang-1 (red). In a feedback loop, Ang-1 after binding with its Tie2 receptor, represses PHD2. This leads to increased circulating and ischemic tissue-engrafted TEM and skews macrophages to the proangiogenic M2 type. TEM and M2 release pro-angiogenic/pro-arteriogenic factors (blue) acting on endothelial cells (EC) and vascular smooth muscle cells (VSMC) to promote cellular processes leading to formation of capillaries, arterioles and arterial collaterals. Additionally, Ang-1 and Ang-2 binding to Tie2 receptor regulates angiogenesis at EC level. Soluble Tie2 (sTie2) inhibits Ang/Tie2 signalling in ischemia, thus contrasting vascular repair.
Better knowledge of the molecular and cellular details of postnatal blood vessel growth and remodelling is necessary to develop improved vascular regenerative therapies.
TEM were known to infiltrate tumours and promote cancer angiogenesis in a paracrine manner (De Palma et al, 2005). These new studies (Hamm et al, 2013; Patel et al, 2013) suggest the possibility that TEM are utilized by both tumours and ischemic tissues to increase their incoming blood flow. TEMs differ from Tie-2neg tumour-associated myeloid cells by their pro-angiogenic function and gene expression signature, which resemble that of ‘alternatively activated/regenerative’ M2-like macrophages, rather than the ‘classically activated/inflammatory’ M1 macrophages (Pucci et al, 2009). However, due to the high plasticity of myeloid cells – including fast internalization or upregulation of surface receptors, e.g. during sample processing – direct conclusions from antigen makeup of the macrophage to its function should be made with caution.
PHD2 is an oxygen sensor and supports the degradation of α subunits of HIF complexes and hence inhibits the expression of HIF-1α -target genes, including Ang-1. Phd2−/− mice show diffuse hyperactive angiogenesis, angiectasia and enhanced recruitment of vascular smooth muscle cells (VSMCs) in subendocardial medium–sized vessels (Takeda et al, 2007). Moreover, PHD2 haplodeficiency (Phd2+/−) skews macrophages to M2 type, increases M2 macrophage engraftment and their release of arteriogenic factors in limb muscles, thus leading to enhanced VSMCs recruitment and growth and arterial collateralization under non-ischemic conditions in mice. Consequently, Phd2+/− mice are ‘preconditioned’ to better respond once LI is experimentally induced (Takeda et al, 2011).
Hamm et al (2013) elegantly show that Ang-1, via Tie2, down-regulates PHD2 expression. Moreover, they confirm the important role of TEM in post-LI vascular repair by using a ‘cell suicide’ system. To complement this set of information, the translational study of Patel et al has characterized TEMs in the PB of human patients with critical limb ischemia (CLI), compared to age-matched controls, younger healthy individuals and patients with intermittent claudication. TEM were robustly increased in the circulation of CLI patients and this was corrected after revascularization or limb amputation (Patel et al, 2013), suggesting that TEM (or their progenitors) are able to sense and respond to LI (Hamm et al, 2013; Patel et al, 2013). This is in line with the concept that ischemic events activate bone marrow (BM) changes, including an altered production and release of monocytic cells. Does CLI enhance the BM generation of TEMs and/or other pro-angiogenic cells or merely facilitate their egress? Are specific cell types released from the BM ‘ready-made’ and successively recruited to the ischemic limb, or are their receptor expression and downstream signalling altered once the cells encounter the ischemic area, thus helping them to engraft, survive, and sustain their function? These questions need further investigations.
TEM, Ang-1 and PHDs should be regarded as important cellular and molecular targets able to promote therapeutic neovascularization in CLI and other ischemic diseases.
Importantly, TEM from CLI patients show an enhanced proangiogenic potential in vitro and in mice with LI. However, this data needs to be reconciled with the incapacity of the CLI leg to heal. In addition to the vascular occlusion, neuropathy, gangrene and infections contribute to the CLI clinical scenario. Authors speculate on a defect of TEM recruitment in CLI. However, TEM were found infiltrated in the CLI leg, where the necrotic tissue showed twice as much TEM in comparison to the ‘normal’ area, which was co-amputated during surgery (Patel et al, 2013). This suggests that local ischemia activates mechanisms promoting TEM recruitment. It is otherwise possible that the CLI environment is not conducive for TEM to induce reparative neovascularization (Patel et al, 2013). Resident vascular cells might be compromised in their response to TEM-derived factors and ‘confused’ by contradictory commands derived from different infiltrating BM-derived subpopulations and locally dying cells, thus making the interaction with TEM more feeble or distorted. Additionally, increased circulating soluble Tie2 (sTie2) might counteract TEM functions in CLI patients (Patel et al, 2013). Overall, the above suggests that TEM function and recruitment process could be improved by systemic use of synthetic PHD2 inhibitory compounds, exposure to Ang-1 and/or reducing sTie2.
In mammals, there are 3 PHD isoforms (1,2,3), which share enzymatic properties but differ by their expression profiles. PHD1 inhibition induces hypoxia tolerance in ischemic muscles by reprogramming their glucose metabolism from oxidative to more anaerobic ATP production, thus conferring protection of myofibers (Aragones et al, 2008). Moreover, local PHD3 silencing proved able to induce therapeutic neovascularization in mouse LI (Loinard et al, 2009). Therefore, inhibition of the three PHD isoforms could have synergistic therapeutic effects in CLI.
In conclusion, TEM, Ang-1 and PHDs should be regarded as important cellular and molecular targets able to promote therapeutic neovascularization in CLI and other ischemic diseases. Further investigations allowing translation to interventional clinical trials should be developed.
The authors declare that they have no conflict of interest.
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-7,381,079,218,665,658,000 | Gerd Stomach Pain Bloating
But if your bloating is followed by high fever, vomiting, heartburn, stomach pain, diarreha or unexplained weight loss or blood in stools then it needs serious attention. To cure bloating permanently you have to focus on the root of problem.
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Stomach bloating and discomfort in your. You indicated that your symptoms were heartburn, chest pain, A healthy BMI is important for stomach bloating and GERD.
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This lasted for four years and worsened and seemed to age me from the stress of it, even smelling something spicy set her off, burning with acid indigestion to the point I couldn't breathe after associated with severe bloating and a painful lump that I swore was a tumor hanging on my stomach ( hence the Alien ). After several.
Your stomach pain and heartburn can be treated without surgery or antacids! Improve digestion, resolve stomach pain and heartburn, relieve pressure on the lower.
Do you have any of the following symptoms? Bloating, gas, belching, reflux, heartburn, burning in the stomach, constipation, or a heavy feeling in the stomach after.
For Coeliacs, eating gluten triggers a response in your small intestine which can.
Treatments for abdominal bloating and pain will address the underlying condition. Examples may include antibiotics for infections. If an intestinal obstruction is the.
. of stomach pain, heartburn, abdominal bloating, dizziness and vomiting. Results of animal testing published in international medical journals shows no effect on normal stomachs, but reduced acid excretions in patients suffering.
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WebMD Symptom Checker helps you find the most common medical conditions indicated by the symptoms Bloating or fullness, Distended stomach, Heartburn and Pain or.
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Sep 4, 2015. This phenomenon may be temporary or permanent, and is often cited as one of the causes of gastroesophageal reflux disease (GERD). However, hiatal hernia [ also referred to as hiatus hernia] is an anatomical abnormality, not a symptom, and its presence or absence does not equate with the symptoms of.
6/10 This Kombucha tonic is designed to help that bloated feeling after a big.
I have undiagnosed stomach pain and bloating, rather severe. sever enough to make me go to the hospital three times in two days and to my dr's.
Belching or passing gas (flatus) is natural and common. Excessive belching or flatus, accompanied by bloating, pain or distention, can occasionally interfere with.
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Discomfort ranging from a dull aching sensation to shooting pain is a common. patients with early stage stomach cancers have no symptoms so “listen” to your body when you feel anything out of the ordinary. Frequent heartburn.
Constant nausea, bloating, stomach pains and acid reflux. Posted 1 August 2014 at 21:45. It can cause acid reflux, stomach pain, bloating, vomiting, and even.
Hypochlorhydria: 3 Common Signs of Low Stomach. – SCD Lifestyle – Hypochlorhydria, or low stomach acid, is a commonly overlooked problem that is linked to other diseases like stomach cancer, asthma and rheumatoid arthritis. It's a serious problem that needs to be investigated. If you're having symptoms such as acid reflux, heartburn, burping, gas, bloating, or nausea after eating, then it's.
In addition to the pain in the upper abdomen described above, dyspepsia may cause bloating, nausea, burping, and a feeling of fullness that occurs soon after eating. Dyspepsia is often confused with GERD, where acid in the stomach refluxes (backs up) into the esophagus, the tube between the mouth and the stomach.
GERD: Acid Reflux Symptoms, Treatment & Heartburn. – Learn about gastroesophageal reflux disease (GERD, acid reflux, heartburn) symptoms like heartburn, chest pain, regurgitation, and nausea. Diet, causes, diagnosis.
Contrary to popular belief, everyday heartburn is a result of having too much stomach acid instead of too little. Before reaching for that antacid, find out a natural way to improve digestion and increase stomach acid to alleviate common symptoms like bloating, heartburn, gas, and even stress.
You are probably familiar with the gassy, abdominal pain referred to as bloating. You may even know that acid reflux is a result of some of the acidic.
"For Coeliacs, eating gluten triggers a response in your small intestine which can lead to diarrhoea, bloating. "However, if you have GORD, stomach acid is able to leak back up into the oesophagus causing acid reflux (heartburn).
Follow our expert guide for pain-free festive feasting. chest and bitter taste in your mouth – caused by excess stomach acid flowing back up your oesophagus – also known as ‘acid reflux’. Prevent it: “Avoid that festive nap straight after.
This includes abdominal bloating, discomfort or pain of the liver and excessive abdominal fat. It could also cause trouble in fatty food digestion and gallbladder.
“Although it’s less common than lactose intolerance, some people experience gas and bloating from fruit because their. Take note of any other bothersome.
Mar 15, 2017. stomach ache, IBS, period pain, cramps, PMS. Getty Images. “Like many 20- something women, I was suffering from IBS symptoms; I'd bloat, get an upset stomach and I had acid reflux. Unlike many young women, however, my IBS symptoms turned out to be something a lot more severe: ovarian cancer.
WebMD explains the common symptoms and types of heartburn and GERD and gives you helpful tips for distinguishing between the two.
I recently tried to stop taking my estogen for about a week and a half. I went back on it and for a week I have had stomach discomfort, bloating and constipation. I.
This is fairly typical — especially when so many health symptoms can be attributed to the likes of PMS, such as fatigue and bloating. that usually keeps digestive.
Papaya Extract For Indigestion Papaya extract worked great for me, even better than Tums (what the doctor recommended). It's natural, There is some enzyme that helps with the heartburn. You can even get papaya tablets, but I didn't find those to be as effective. AcidRelief360 ® Formula with GutGard ® is designed to support digestive health and relieve occasional
Gerd M Tter Get this from a library! Fremde Mütter, fremde Väter, fremdes Land : Gespräche mit Franz Josef Degenhardt, Gisela Elsner, Gerd Fuchs, Josef Haslinger, Hermann. Sidst opdateret den 22/2 2017: Navnet Voight stammer oprindeligt fra det centrale Tyskland, hvor man støder pÃ¥ navnet i forbindelse med gamle dages lokale. A rebuttal to Dr. B.M. Hegde’s Article
Stomach Bloating: How to Relieve Your Tight, Round Belly. – Abdominal pain, cramping, bloating, gas, diarrhea and constipation are all IBS symptoms. In a 2017 nationwide survey, Gastroesophageal reflux disease, or GERD,
Common Symptoms May Be More In the short term, people experience straightforward symptoms such as heartburn, queasy stomach, hunger-like pain, sense of fullness, gas or bloating. But in a lot of people, there are other.
Treatments for abdominal bloating and pain will address the underlying condition. Examples may include antibiotics for infections. If an intestinal obstruction is the.
BLOATING: GAS BUILDUP IN YOUR STOMACH AND INTESTINES When gas doesn’t pass through belching or flatulence, it can build up in the stomach and intestines and lead to bloating. With bloating, you may also have.
Find and save ideas about Stomach pain and bloating on Pinterest. | See more ideas. How to permanently heal chronic stomach pain and bloating with the GAPS Diet with suggested healing menu plan for quick results. Ranging from indigestion and irritable bowel syndrome to gastritis and GERD, an aching tummy.
Jan 14, 2014. Do you have any of the following symptoms? Bloating, gas, belching, reflux, heartburn, burning in the stomach, constipation, or a heavy feeling in the stomach after eating. You might be experiencing a condition known as hypochlorhydria ( hypo=low, chlorhydria=stomach acid). Often people mistake low.
WebMD Symptom Checker helps you find the most common medical conditions indicated by the symptoms Bloating or fullness, Distended stomach, Heartburn and Pain or discomfort and including Gas pains, Irritable. Symptoms of heartburn and GERD are a burning feeling in the chest, throat, or mouth, nausea, and more.
Dec 13, 2017. When it comes to tummy bloating, related symptoms vary. Many people also experience heartburn, constipation or abdominal pain. Stomach bloating may persist hours after a meal. Food allergies, acid reflux, lactose intolerance and other digestive disorders could be bloating culprits. If you're ready to get.
Upgrade Your Knowledge On Stomach Pain Bloating. Read Valuable Article Here.
Q When I’m stressed, I get pains in my stomach after eating and feel so bloated. so foods that are normally well tolerated may trigger indigestion and heartburn and cause cramping, bloating, diarrhoea or constipation. Irritable.
Your stomach pain and heartburn can be treated without surgery or antacids! Improve digestion, resolve stomach pain and heartburn, relieve pressure on the lower.
Help. About 5 yrs ago i developed very bad acid reflux. Lately I have also had severe gas and bloating after mostly the evening meal. My stomach does not settle down.
or heartburn, in the lower chest when stomach acid rises back up into your esophagus. And for people who suffer from it, the term "comfort food" takes on a whole new meaning because the act of eating can actually help reduce pain.
Acid reflux occurs when stomach contents moves backward into the esophagus. It’s also called acid regurgitation or gastroesophageal reflux (GERD). Acid reflux is a.
Jul 15, 2016. QUESTION FROM TEXAS: I have good control as long as I sleep elevated. After eating at night (early) I sometimes have bloating in my abdomen that causes GERD symptoms to begin. I had a CAT scan with contrast and they said all was good, but I know it's not. Before the CAT scan, I did eat very light.
When gas doesn’t pass through belching or flatulence, it can build up in the stomach and intestines and lead to bloating. With bloating, you may also have abdominal pain that can vary. beverages or smoke. Acid reflux or.
"However bloating can occasionally indicate serious health issues, such as tumours, so I’d always see a doctor," adds Dr Rakshit. Mild to severe upper stomach pain It could be a. Constant indigestion It could be acid reflux Acid reflux,
Anyone experiencing belching and bloating probably has a motility problem. But it’s not always the case. Heartburn can mimic angina and heart problems can imitate heartburn. So people who have more persistent stomach pain should.
Aug 14, 2017. You are probably familiar with the gassy, abdominal pain referred to as bloating. You may even know that acid reflux is a result of some of the acidic contents of the stomach leaking back up into the esophagus, where it burns or irritates the lining. But you may be unaware that bloating and acid reflux are.
Jun 12, 2013. Theories include problems with the immune system and an over-sensitive large colon. IBS is a syndrome of pain which occurs at least 12 weeks out of the year and is associated with other symptoms, including: Diarrhea or constipation that is ongoing, and sometimes alternating; Abdominal bloating.
Gaviscon® Helps Keep Acid Down For Hours! See Products, Info & More.
Mar 18, 2016. A sour stomach is a collection of dreadful symptoms in your upper gut, such as nausea, bloating, heartburn, acid reflux (GERD) and indigestion. If you're having an unpleasant feeling in your gut right now, I understand. As a teen, eating was a battle because I would get sour stomach and IBS symptoms.
by Michelle Sutton-Kerchner. Don't let heartburn and indigestion corrode your workout. Avoid painful flare-ups. Follow these preventative tips. Exercise often helps alleviate stomach pressure from bloating and gas. When constipation is an issue, the movement of exercise helps ease waste from the body. One study.
Natural Remedies For Acid Reflux And Indigestion Learn more from the experts at WebMD. Skip to. but natural heartburn remedies and lifestyle changes may be. But stopping the acid reflux can help prevent. Guidelines for the diagnosis and treatment of gastroesophageal. among others), PPIs provide greater control of acid reflux, without the risk, albeit small, of cardiac rhythm disturbances. Because GERD is
For more, visit TIME Health. Reflux is one of the most common. the part of the throat that is connected to the stomach. GERD comes with burning pain in the chest, bloating and discomfort in the gut. The other type of reflux involves the.
Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach.
Gastroesophageal reflux disease, or GERD, is a digestive disorder that affects the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach.
Abdominal Pain and Symptoms Chart. Abdominal pain — a dull ache, a burning sensation, or a sharp, stabbing pain — is one of the most common complaints in all of. | {
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740,061,363,606,738,200 | What Is The Difference Between Hunger And Appetite
by Patty Allen
Introduction
Whenever the stomach of a human being is empty, the body tells us to eat and gives us feelings of hunger. Depending on the appetite of the respective human being, food is consumed and hunger is satisfied. The desire to eat, which is also a response of the human brain, is known as appetite.
Caroline Ingalls. The main difference between hunger and appetite is the psychological drive of food to maintain homeostasis. Hunger is a biological need to eat. Appetite is a desire created by your environment.
When you are hungry, you look for food. Food is like fuel for our body, and our body signals us to get something from outside to maintain fuel levels. Food provides energy for activities. It is this hunger that keeps the body’s energy levels from dropping while it makes us eat. on.
What is appetite in the human body?
The expression of appetite and food intake in humans reflects the complex interplay between biological, psychological and environmental processes.
Appetite for food and drink is an individual’s momentary disposition to seek out and ingest edible or drinkable materials. The concept of having an appetite for food and drink has been widely misunderstood. It has often been assumed that appetite is a subjective phenomenon, deprived of a person’s consciousness.
Hunger against hunger. Appetite: what’s the difference? Hunger occurs when hypoglycemia occurs several hours after eating; it’s a protective mechanism that ensures your body is fueled properly. Appetite is the conditioned response to food: it’s a sensory reaction to how food looks or smells.
That’s because you have 5 different appetites. If you often find yourself staring at the refrigerator, there could be a good reason. Humans have five distinct appetites, scientists say, which work together to ensure we get specific amounts of the nutrients our bodies need to function efficiently: protein, carbohydrates, fat, sodium and calcium.
What is the difference between hunger and appetite Caroline Ingalls?
Hunger versus Appetite: what’s the difference? Hunger occurs when hypoglycemia occurs several hours after eating; it’s a protective mechanism that ensures your body is fueled properly. Appetite is the conditioned response to food: it is a sensory reaction to how food looks or smells.
Whenever a human’s stomach is empty, the body tells us to eat and gives us feelings of hunger. Depending on the appetite of the respective human being, food is consumed and hunger is satisfied. The desire to eat, which is also a response of the human brain, is known as appetite.
One way to tell if you are hungry or just hungry for food is to ask yourself if you would eat a food you are not passionate about not. about.
Again, hunger is all about maintaining homeostasis and giving your body the fuel it needs to maintain bodily functions such as thinking, digesting food, and breathing (yes, it burns calories), but also to live your best life and perform activities like walking, talking on the phone, surfing social media, and exercising. Now, technically, what is your appetite?
What does it mean when you’re hungry?
If you’re constantly hungry, then you know the pain and agony of living in a world that isn’t a 24/7 buffet. I mean, what’s a girl to do when she’s feeling insatiable all day? It can even be a little annoying to feel like this, especially after eating.
When you’re hungry, your stomach may “grow” and feel empty, or you may have a headache, feel irritable, or be unable to eat. to concentrate. Most people can go several hours between meals before feeling hungry again, although this is not the case for everyone.
Hunger is your body’s natural signal that it needs more food. When you’re hungry, your stomach may “grow” and feel empty, or you may have a headache, feel irritable, or be unable to concentrate.
To avoid this confusion, be sure to go outside after your meal and to give you time to digest. There’s nothing wrong with snacking all day if you’re hungry.
How do you know if you have an appetite for food?
Appetite is a person’s general desire to eat food. A person’s appetite can dictate how much food they want to eat, as well as the type of food they want to eat. Hunger occurs when the body recognizes that it needs more food and sends a signal to the brain to eat. Signs of hunger often include:
Common characteristics of a loss of appetite 1 Not being hungry 2 Feeling repelled by certain foods 3 Having trouble eating 4 Tiredness and weakness 5 Less enthusiasm for food-related events Diet 6 Weight Loss
Yes to Despite everything you’re doing, your appetite still hasn’t returned to normal, so you should definitely see a doctor to rule out any underlying medical conditions. Loss of Appetite: What Can Cause Loss of Appetite?
Eat foods that are high in calories and nutrients, especially those high in protein and healthy fats. Add calories to foods by using butter, oil, or condiments like peanut butter. You can also take meal replacement drinks. Eat smaller meals more often; it may be easier to give smaller portions when you don’t have an appetite.
What is the difference between hunger and appetite?
Hunger versus Appetite: what’s the difference? Hunger occurs when hypoglycemia occurs several hours after eating; it’s a protective mechanism that ensures your body is fueled properly. Appetite is the conditioned response to food: it is a sensory reaction to how food looks or smells.
Whenever a human’s stomach is empty, the body tells us to eat and gives us feelings of hunger. Depending on the appetite of the respective human being, food is consumed and hunger is satisfied. The desire to eat, which is also a response of the human brain, is known as appetite.
Caroline Ingalls. The main difference between hunger and appetite is the psychological drive of food to maintain homeostasis. Hunger is a biological need to eat. Appetite is a desire created by your environment.
Hunger is the need to eat. If you are hungry, you need food because your body is telling you to. It sends signals to you, like those stomach growls known as hunger pangs. Hunger cannot be controlled; it’s instinctive. And for some people, ignoring hunger can have serious consequences.
What makes you hungry?
How does hunger affect people? Hunger can seriously affect people. Here are some examples: High infant mortality rates: If babies don’t have enough to eat, many will die. People are more vulnerable to disease: people lack the strength to fight disease. World hunger refers to pockets of the human population that regularly do not have enough food to eat. For the third consecutive year, the number of people suffering from hunger is on the rise: in 2017, more than 821 million people faced chronic food deprivation.
Although hunger is on the rise, many people around the world developed don t I understand what it means to be hungry. Hunger can manifest itself in different ways: malnutrition, malnutrition and wasting.
And the signs that a child is struggling with hunger can often be hard to spot. According to the USDA, there is a strong link between hunger and chronic diseases such as high blood pressure, heart disease and diabetes. In fact, 58% of households receiving food from the Feeding America network have a member with high blood pressure.
Why do humans have appetites?
For some people, stress or pain can cause them to eat more food to cope with how they are feeling, but for others, these emotions have the opposite effect. Certain mental health conditions also affect appetite, including: Some research suggests that depression can increase or decrease a person’s appetite.
We might not have specific appetites for dozens of nutrients. “Another is that these nutrients are needed in very specific amounts. Third, certain components, like sodium, were often rare in our ancestral environments and we needed dedicated machines to search for them, for example in mineral deposits.’
Appetite, on the other hand, is a more complicated process. First of all, it is more associated with pleasure than with the survival instinct. Your body’s basic needs don’t necessarily drive your appetite.
That’s because you have 5 different appetites. If you find yourself staring at the fridge a lot, there could be a good reason. Humans have five distinct appetites, scientists say, which work together to ensure we get specific amounts of the nutrients our bodies need to function efficiently: protein, carbohydrates, fat, sodium and calcium.
What is the appetite for food and drink?
Appetite is a person’s general desire to eat food. A person’s appetite can dictate how much food they want to eat, as well as the type of food they want to eat. Hunger occurs when the body recognizes that it needs more food and sends a signal to the brain to eat. Signs of hunger often include:
A: Appetite suppressants are supplements that modulate your body’s desire to eat. An appetite suppressant modulates your body’s hormone levels and hopefully balances your desire to eat more with your actual energy expenditure. In this way, they may be particularly useful weight loss supplements for some people. Foods high in protein and healthy fats. These include lean meats, avocado, beans, nuts, and cheese. High fiber foods. Fiber-rich foods make a person feel full longer.
Certain mental health conditions also affect appetite, including: Some research suggests that depression can increase or decrease a person’s appetite. Some people associate food with a reward and may eat more to try to feel better. Binge eating involves periods of overeating, followed by feelings of guilt and shame.
Why do we have 5 different appetites?
Researchers at the Charles Perkins Center have found that humans and other animals have different appetites for different occasions. Scientists have found that humans and other animals have five different appetites. Appetite is actually a much more complex phenomenon than you might think.
We couldn’t have specific appetites for dozens of nutrients. “Another is that these nutrients are needed in very specific amounts. Third, certain components, like sodium, were often rare in our ancestral environments and we needed dedicated machines to search for them, for example in mineral deposits.’
Appetite, on the other hand, is a more complicated process. First of all, it is more associated with pleasure than with the survival instinct. Your body’s basic needs don’t necessarily drive your appetite.
You could say that hunger is a demand for the fuel your body needs to function. Appetite, on the other hand, is a more complicated process. First of all, it is more associated with pleasure than with the survival instinct.
Conclusion
While snacking all day may seem harmless (and seems to feed your hungry body), snacking all day does your body a disservice. According to Mintel, 94% of Americans snack at least once a day, and that number is growing.
However, studies have also shown that snacking can help reduce hunger ( , , ). In one study, when men ate a snack bar high in protein and fiber, they had lower levels of the hunger hormone ghrelin and higher levels of the satiety hormone GLP-1.
In fact, people often snack when appetizing foods are nearby – even when they’re not hungry. In one study, when obese or overweight people were asked why they chose unhealthy snacks, the most common response was temptation, followed by hunger and low energy (2).
Eat protein-rich snacks eat carbohydrate-rich snacks. Snacks may not be good for everyone, but they can definitely help some people stave off ravenous hunger. When you go too long without eating, you can get so hungry that you end up eating way more calories than you need.
Related Articles
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-7,175,596,924,442,931,000 | free catheter samples
What Is Urinary Retention?
Urinary retention can happen at any age, though it most commonly occurs in males aged 50+, and often due to an enlarged prostate (BPH). However, urinary retention can also occur in females, typically due to a condition known as cystocele – which is when the bladder sags or moves out of its normal position.
A condition known as rectocele can also cause urinary retention in both sexes when the bladder is pulled out of position by the colon.
In addition to age-based conditions, people of all ages, male or female, can have nerve disease or damage that can interfere with the bladder function.
Urinary retention is the inability to empty urine from the bladder and can be characterized as acute or chronic. Acute urinary retention usually occurs suddenly and temporarily. Individuals suffering from acute urinary retention are unable to empty their bladder at all — they can feel the urge to urinate, but can’t go at all.
This can be potentially life-threatening as pressure is built up in the bladder and may lead to a rupture. This causes a great deal of discomfort or pain in the lower abdomen. If you experience any of these symptoms, it is important to seek emergency medical attention immediately to release the buildup of urine.
Chronic urinary retention, on the other hand, typically lasts a long period of time. Individuals with chronic urinary retention are usually able to urinate, but cannot empty their bladder completely. It is extremely common for people with chronic urinary retention to be unaware of their condition as symptoms may not be as clear at first.
What Are The Symptoms Of Urinary Retention?
urinary retention symptons
Symptoms of chronic urinary retention include:
• Urinating frequently, often 8+ a day
• Difficulty starting your urine stream
• Weak urine stream and/or urine stream that starts and stops
• Feeling like you need to urinate again immediately after urinating
• Waking up several times during the night to urinate
• Bladder leakage throughout the day
• Inability to tell when your bladder is full
• Constant feeling of fullness/discomfort in your lower abdomen
• Urge incontinence, the involuntary expelling of urine associated with an urgent feeling to urinate.
If you experience any of these symptoms, it is important to seek medical attention from a urologist. If left untreated, it can lead to the development of other conditions, such as urinary incontinence, kidney disease, bladder damage, and/or urinary tract infections (UTIs).
Urinary Retention Facts
• Urinary retention is the inability to empty the bladder. Urinary retention can be acute or chronic, depending on a number of factors and an individual’s medical condition.
• Urinary retention is most common in men in their 50s and 60s because of prostate enlargement.
• Women may experience urinary retention with a condition called cystocele when the bladder sags or moves out of the normal position, or rectocele, where the bladder is pulled out of position by a sagging of the lower part of the colon.
• Causes of urinary retention include urethral obstruction due to conditions such as enlarged prostate (BPH) or urethral strictures, nerve damage that disrupt neurological signals between the bladder and the brain, post-surgery related issues, and certain medications.
• Symptoms of acute urinary retention are severe discomfort and pain, bloated lower belly, an urgent need to urinate but the inability to do so.
• Chronic urinary retention symptoms often include mild but constant discomfort, difficulty starting a stream of urine, weak flow of urine, the urge to urinate frequently, or feeling like you still need to urinate when you’re finished.
• Complications from urinary retention can include urinary tract infections (UTIs), bladder damage, and chronic kidney disease.
• Urinary retention diagnosis may include these tests to measure the effectiveness of the bladder’s ability to empty:
• Urine samples
• Bladder scans
• Cystoscopy
• X-ray and CT scan
• Prostate-specific antigen (PSA) blood test
• Prostate fluid sample test
• Urodynamic tests
bladder x-ray
What Causes Urinary Retention?
To understand the different causes of urinary retention, it is useful to understand the different parts of the urinary system and how they work together to help the body create, store and release urine:
Urinary Tract
• Kidneys filter waste products from the blood to make urine.
• Ureters are hollow, narrow tubes that carry urine from the kidneys to the bladder.
• The bladder is a muscular organ that stores and empties urine.
• The urethra carries urine from the bladder out of the body. In females, it is about 1 inch long, and about 8-10 inches long in males.
• Internal and external sphincters are sets of muscles that work to both keep urine in and push urine out.
Problems in any of these organs or the nerves that control them can cause urinary retention, but some of the more common causes of urinary retention include:
Urethral Obstruction
The primary function of the urethra is to carry urine out of the body, so any obstruction in this structure can cause both acute or chronic urinary retention, as the normal flow of urine is blocked. Acute urinary retention is caused by a sudden, complete obstruction of the urethra; whereas chronic urinary retention is caused by the progressive and often partial obstruction of the urethra.
Common causes of urethral obstruction include:
• Enlarged prostate
• Benign prostatic hyperplasia (BPH)
• Urinary tract stones
• Urethral strictures
• Bladder organ prolapse – cystocele, rectocele
• Tumors or cancers in the pelvis or intestine
• Severe constipation
• Blood clot in the bladder
• Foreign objects inserted in the urethra
• Urethral inflammation
Nerve Damage
Two things occur when you urinate: the muscles in the bladder wall contract to push urine out, and the brain sends signals down the spinal cord and surrounding nerves to contract the sphincters, causing the urethra to open and close, allowing the urine to leave the bladder.
If the nerves controlling the bladder and sphincters are damaged, the brain may not receive signals that the bladder is full, or that the sphincters need to relax, which can cause urinary retention.
Many events can interfere with the nerve functions of the bladder. Some common causes include:
• Spinal Cord Injuries
• Multiple Sclerosis
• Spina bifida
• Stroke
• Vaginal childbirth
• Diabetes
• Pelvic injury or trauma
• Heavy metal poisoning
• Parkinson’s disease
Surgery-Related Problems
It is common for patients to experience temporary or acute urinary retention after surgeries. This occurs due to anesthesia, which blocks pain signals in the nerves, which can impair overall bladder function. This, in combination with IV fluid administration, can sometimes cause urinary retention temporarily.
However, acute urinary retention usually disappears after the anesthesia has worn off, and the patient usually regains full bladder control.
Medication
A side effect of some medications can cause impaired function in the bladder muscles, making it difficult to push urine out of the bladder, causing urinary retention.
These medications may include:
• amphetamines
• antihistamines
• medication to treat Parkinson’s disease
• medication to treat urinary incontinence
• muscle relaxants
• nonsteroidal anti-inflammatory drugs (NSAIDs)
• pseudoephedrine
• some antipsychotics
• some older antidepressants
• some opioid pain medications like morphine
Treating Urinary Retention
Acute
Acute urinary retention is considered a medical emergency, and your doctor will place a catheter directly into the bladder to let out the urine. If this method of catheterization isn’t effective the doctor will create a small hole in the skin directly over your bladder and through the wall of the bladder. A suprapubic catheter would then be inserted directly into your bladder and the urine should quickly be drained.
Chronic
Chronic urinary retention affects hundreds of thousands of people every year, impacting their quality of life with constant symptoms and complications.
Below are the number of ways in which chronic urinary retention is treated.
Self-Catheterization for Urinary Retention
Self-catheterization, or the use of a catheter, such as an Intermittent catheter, is one of the most popular ways to alleviate the symptoms of chronic urinary retention.
CompactCath has revolutionized the catheter market by developing the smallest, most compact catheter. CompactCath is so small that it fits entirely in the palm of your hand!
Intermittent catheters require the individual to use a different catheter every time they need to urinate, typically 4 – 5 times per day.
compactcath one cath
free catheter samples
While intermittent catheters are the most popular, there are other urinary catheter options:
Urethral dilation and stents
Chronic urinary retention is often the cause of urinary stricture, or the narrowing of the urethra commonly due to injury or infection, which prevents urine from flowing through.
To widen or dilate the urethral stricture, stents, or small tubes, are inserted into the urethra. As they are inserted into the urethra, stents widen, opening up the stricture and increasing urine flow. Depending on the severity of the stricture, stents can either be inserted temporarily or remain in the urethra permanently. This procedure is used to widen the urethral stricture to allow more urine to flow through.
Cystoscope
When it’s determined that chronic urinary retention is caused by bladder stones or blood clots, a flexible, lighted tubular scope called a cystoscope will usually be inserted into the urethra to find and remove foreign objects from the urethra, bladder, and/or bladder outlet.
Urinary Retention Prescription Medication
Some medications that may help with urinary retention include:
• antibiotics to treat infections such as urinary tract infection, prostatitis, or cystitis
• medications that help urethral muscles relax, widening the channel and increasing urine flow
• medications that decrease the size of the prostate for men suffering from BPH
Behavior modifications
For less severe cases of urinary retention, some lifestyle/behavior modifications can be done to alleviate symptoms:
• Time and manage the daily intake of fluid
• Strengthen muscles in the pelvic floor
• Practice bladder retraining techniques.
Urinary Retention Surgery
Your doctor may suggest surgery as a treatment if other therapies were unsuccessful in treating urinary retention. Most surgeries to treat urinary retention are outpatient procedures and minimally invasive, reducing pain and speeding up recovery time:
• minimally invasive procedures via the urethra
• transurethral resection of the prostate, often called a TURP procedure to remove extra prostate tissue that’s blocking the urethra
• urethrotomy to permanently open urethral strictures
• removal of the prostate
If urinary retention is caused by a structural abnormality in a bladder organ, laparoscopic or open surgical procedures may be required to:
• remove part or all of the prostate due to cancer
• remove an abnormal uterus
• fix a cystocele or rectocele
• remove cancerous tissue or tumors in the bladder, urethra, or pelvic organs
About CompactCath
compactcath smallest catheter
For many with urinary retention, self-catheterizing becomes an essential part of daily life, requiring individuals to use a catheter multiple times a day. However, the bulky and uncomfortable nature of traditional intermittent catheters often causes inconvenience and embarrassment to catheter users, which can lead to infrequent usage and eventually increased the risk of infection and/or further complicated.
CompactCath has been designed to fit in one’s palm, providing a smaller, easier and more discreet experience than traditional catheters.
It is a compact intermittent urinary catheter that aims to reduce the inconvenience or embarrassment felt by some patients about self-catheterizing. It does this by minimizing catheter size, noisy packaging, and risk of developing infections and creating a mess.
CompactCath comes ready to use right out of the package. It is pre-lubricated, non-touch, has a drainage control mechanism, and lastly features an opaque packaging that brings users more privacy.
If you’d like to try a free catheter sample, click the button below:
free catheter samples | {
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6,519,431,676,081,492,000 | Why do you mark the patient standing up prior to Breast Reduction Surgery?
Why do you mark the patient standing up instead of laying down, prior to Inferior Pedicle Wise Pattern Breast Reduction Mammoplasty? Does it matter whether your laying on your back or are in a standing position when your being marked pre surgery? Or is it not that big of a deal, cause if your Surgeon's Board Certified, he is so skilled he can mark you in any position.
Doctor Answers 6
Markings
Marking is a personal thing. I prefer to mark the patient in the standing position because it takes gravity into account and allows me an opportunity to account for that as I try and provide the best symmetry. I have seen very skilled plastic surgeons who do not mark at all and get excellent results. I think whatever the surgeon you chose does routinely to get good results is important.
All the best,
Arun Rao Plastic Surgeon Tucson, Arizona
Tucson Plastic Surgeon
5.0 out of 5 stars 9 reviews
Breast Marking
I guess ever since the pyramids were built, breasts have been marked in the upright position. So part of the answer is that that is the way we always do it. But the other side of the answer is that when the patient is lying down we also assess and adjust the markings a bit. Breast reduction marking is very important. Another twist on this is that in the upright position the breasts are stationery and comparable to each other. The surgeon can clearly measure from the sternal notch, and the 6 th rib, and the ziphoid angle and the middle of the arm. All this becomes vague and hard to compare when reclined. Then again another answer is that for all the above reasons, marking in the upright position is just better. I usually have the patient sit upright and not stand. I have seen surgeons take over an hour to mark breasts. This is fine. Most of us take 10 to 15 minutes at most. My best, Dr C
Why Plastic Surgeons Mark Their Patients in the Standing Position Prior to Surgery.
I have performed approximately 2,000 breast reduction surgeries and I prefer to mark the patient in the standing position for the following reasons.
1. If marked in the supine position the breast fall to the side and this will give a distorted final determination of the new position of the nipple.
2. I prefer standing as opposed to sitting because I prefer the abdominal tissues (which are forced upward during sitting) to not effect the markings.
Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.0 out of 5 stars 7 reviews
Marking breasts before breast reduction surgery
Great question!
Although, all pre surgical markings are important, I also take into consideration what effects gravity has on the part in question when you are lying on the table. As you know, breasts tend to fall on the sides of the chest when lying on your back. I have made certain that with the Ultimate Breast Reduction technique, breasts are not subject to the forces of gravity.
Plastic surgeons need to look at all aspects of esthetic improvement. This not only requires having an esthetic eye, but technical ability and know-how.
Hope this helps.
Kind regards,
Dr. H
Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 177 reviews
Marking for Breast Reduction
I prefer to mark the patient sitting. This allows me to factor in the effects of gravity on the breasts.
Dr. ES
I mark patients while sitting...
Hi HappilyMarried33. There are many ways to mark patients, and none of them are right or wrong. I was trained to mark patients while they are sitting. This has worked well for me over the last 700 or so cases. Other surgeons probably have equally good results marking patients in other positions.
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2,268,635,272,291,388,000 | You asked: How can you tell if your pregnant without a urine test?
How can you find out your pregnant without a test?
The most common early signs and symptoms of pregnancy might include:
1. Missed period. If you’re in your childbearing years and a week or more has passed without the start of an expected menstrual cycle, you might be pregnant. …
2. Tender, swollen breasts. …
3. Nausea with or without vomiting. …
4. Increased urination. …
5. Fatigue.
How can you tell if your pregnant without peeing?
9. Tuna Juice. This test is considered to be one of the easiest and accurate home remedies for pregnancy test. All you need for this test is a container, canned tuna, white vinegar and sample of your urine collected first thing in the morning.
How can you tell if your pregnant by touching your stomach?
Your touch should be firm but gentle. Walk your fingers up the side of her abdomen (Figure 10.1) until you feel the top of her abdomen under the skin. It will feel like a hard ball. You can feel the top by curving your fingers gently into the abdomen.
IT IS INTERESTING: Can you not ovulate one month?
How can you detect early pregnancy?
In this article, we list 10 early signs that can indicate a woman should take a pregnancy test.
1. Missed period. Share on Pinterest Many women take pregnancy tests after missing their periods. …
2. Breast changes. …
3. Light bleeding. …
4. Cramps. …
5. Nausea and vomiting. …
6. Fatigue. …
7. Food aversions or cravings. …
8. Changes in bathroom habits.
How does your stomach feel in early pregnancy?
Some women experience feelings inside their stomachs in the early stages of pregnancy that replicate the sensation of their muscles being pulled and stretched. Sometimes referred to as ‘abdominal twinges’, these tingles are nothing to worry about.
What is the baking soda test in pregnancy?
The baking soda gender test is an at-home method that involves combining a pregnant woman’s urine with baking soda to see if it fizzes. Whether or not the urine fizzes is supposed to determine whether the baby is male or female. The baking soda gender test actually looks to determine the baby’s sex, not its gender.
What does a positive salt pregnancy test?
What a positive looks like. According to various sources, a positive salt pregnancy test will be “milky” or “cheesy” in appearance. The claim is that salt reacts with human chorionic gonadotropin (hCG), a hormone that’s present in the urine (and blood) of pregnant women.
What kind of breast pain indicates pregnancy?
Pregnancy: Your breasts during early pregnancy may feel sore, sensitive, or tender to the touch. They may also feel fuller and heavier. This tenderness and swelling will usually happen one to two weeks after you conceive, and it can last for a while as your progesterone levels rise due to your pregnancy.
IT IS INTERESTING: Do most twin pregnancies go full term?
How late should my period be before I take a pregnancy test?
You should wait to take a pregnancy test until the week after your missed period for the most accurate result. If you don’t want to wait until you’ve missed your period, you should wait at least one to two weeks after you had sex. If you are pregnant, your body needs time to develop detectable levels of HCG.
How early does your stomach get hard when pregnant?
Most women start to feel their uterus contract and periodically tighten some time during the second trimester, the point in their pregnancy between 14 to 28 weeks.
Is your stomach hard or soft in early pregnancy?
During the early stages of pregnancy, around 7 or 8 weeks, the growth of the uterus and the development of the baby, turn the the belly harder.
How long does it take for a woman to know she is pregnant?
The first sign of pregnancy is usually missing a period, about 2 weeks after you’ve conceived. This isn’t always reliable and if your periods aren’t regular you might not notice you’ve missed one. Some women have a bit of bleeding as the egg embeds. Many women also experience tender breasts.
How do you check pregnancy by hand pulse?
To do so, place your index and middle fingers on the wrist of your other hand, just below your thumb. You should be able to feel a pulse. (You shouldn’t use your thumb to take the measurement because it has a pulse of its own.) Count the heartbeats for 60 seconds.
IT IS INTERESTING: You asked: How early in pregnancy does your uterus start stretching?
What does pregnancy discharge look like?
What does it look like? Healthy vaginal discharge during pregnancy is called leukorrhea. It is similar to everyday discharge, meaning that it is thin, clear or milky white, and smells only mildly or not at all. However, pregnancy can cause the amount of discharge to increase.
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BACKGROUND:The number of gluten-free diet followers without celiac disease (CD) is increasing. However, little is known about the characteristics of these individuals. OBJECTIVES:We address this issue by investigating a wide range of genetic and phenotypic characteristics in association with following a gluten-free diet. METHODS:The cross-sectional association between lifestyle and health-related characteristics and following a gluten-free diet was investigated in 124,447 women and men aged 40-69 y from the population-based UK Biobank study. A genome-wide association study (GWAS) of following a gluten-free diet was performed. RESULTS:A total of 1776 (1.4%) participants reported following a gluten-free diet. Gluten-free diet followers were more likely to be women, nonwhite, highly educated, living in more socioeconomically deprived areas, former smokers, have lost weight in the past year, have poorer self-reported health, and have made dietary changes as a result of illness. Conversely, these individuals were less likely to consume alcohol daily, be overweight or obese, have hypertension, or use cholesterol-lowering medication. Participants with hospital inpatient diagnosed blood and immune mechanism disorders (OR: 1.62; 95% CI: 1.18, 2.21) and non-CD digestive system diseases (OR: 1.58; 95% CI: 1.42, 1.77) were more likely to follow a gluten-free diet. The GWAS demonstrated that no genetic variants were associated with being a gluten-free diet follower. CONCLUSIONS:Gluten-free diet followers have a better cardiovascular risk profile than non-gluten-free diet followers but poorer self-reported health and a higher prevalence of blood and immune disorders and digestive conditions. Reasons for following a gluten-free diet warrant further investigation.
Original publication
DOI
10.1093/ajcn/nqaa291
Type
Journal article
Journal
The American journal of clinical nutrition
Publication Date
12/11/2020
Addresses
Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. | {
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4,456,523,180,115,827,000 | top of page
Taking therapy for depression: Talk therapy and available alternatives
Updated: Jan 2, 2023
Developed by Dr Sigmund Freud, talk therapy or psychotherapy (psychological therapy for depression) helps in identifying issues that cause emotional distress and finding coping mechanisms that best suit an individual. During the session, a trained psychologist listens actively and non-judgementally, helping individuals seek answers to their problems. They hold the space for individuals to cry, shout, or think thereby, helping to process their pain.
Cognitive Behaviour Therapy (CBT)
CBT is a talk therapy, which is highly effective for treating conditions such as anxiety and depression.CBT uncovers the link between thoughts, feelings and beliefs. CBT is usually a short-term treatment which is one of the best therapy for depression. With the help of a psychotherapist, individuals understand harmful negative thought patterns and behaviors and replace them with constructive thoughts over some time. It can be used to treat conditions such as [1]:
• Panic disorders
• Post-traumatic stress disorders
• Anxiety disorders
• Social anxiety
• Substance abuse
• Addiction
• Phobias and eating disorders
The main advantage of talk therapy for depression and anxiety is that, unlike medications, therapies do not cause any side effects and CBT is a technique which is proven to offer long-term beneficial changes.
Manoshala offers CBT counselling via online (online therapy for depression) and offline sessions. We have 98 experts+ from institutions like Harvard, NYU, and Berkeley who provide services such as anger control therapy across India. By understanding the customers’ needs, our experts suggest personalised therapy sessions to manage anxiety effectively. Book a free 15-minutes pre-screening call with us to discuss your requirements.
Today, we are at a stage where psychological treatment is not just about talk therapies. Mental health research has evolved over the years to offer a wide range of alternatives that encompasses everyone.
What are the alternatives to talk therapies?
Creative art therapies
Using arts as the primary medium of intervention, creative art therapy focuses on different forms of expressive techniques that improve the emotional and well-being quotient of people. They offer benefits such as:
• Lowered stress
• Promotes relaxation
• Boosts self-esteem
• Increase self-awareness
• Promotes mindfulness
• Improved sense of control
• Acts as a gateway for self-expression
Manoshala offers creative therapies through art, music, drama and body movement. Our experts will help in channelising emotions in healthy ways through doodling, sketching, body tapping, lyrics writing, role-play activities, storytelling, etc.
Guided imagery
It’s a form of meditation and a relaxation technique that involves bringing one’s attention to an object, sound or experience. It is based on the premise that our body responds to our thoughts. If we think about stress-inducing situations, our body will respond with increased heart rate, blood pressure and so on. However, if we visualise calming scenarios, it will help the body to relax and be at ease. The benefits of guided imagery include2
• Lowered stress and anxiety
• Improved sleep
• Decreased pain
• Reduction in symptoms of depression
Acupuncture
It is the process of stimulating specific points by inserting needles in the body for improved functioning. Depending on the health condition, Acupuncture practitioners insert needles at varying depths and locations. It originates from Chinese medicine and is currently used as a complementary treatment. According to the study, Acupuncture and electroacupuncture for anxiety disorders: A systematic review of clinical research, acupuncture was effective in treating anxiety with lesser side effects compared to medication.
Hypnosis
It is a myth that hypnosis practitioners control the minds of the people. With guided suggestions, the mind becomes focused and the body is extremely relaxed. In this state, it allows an individual to process and explore deeper issues such as repressed memories, abuse and so on. According to a 2016 study, researchers at Stanford Medical School scanned the brains of 57 people and found that a hypnotized brain reported brain changes that made an individual more focused, lesser self-conscious and gave more physical and emotional control.
In the heightened state of relaxation, the mind is receptive to suggestions. A trained therapist provides suggestions, which can be beneficial to treat various phobias. For example, if someone is fearful of flying a plane, a therapist may plant a positive suggestion that helps them to fly confidently without fear.
Yoga
Originating from India, Yoga is a traditional practice for integrating the mind and body through breath and body movement. A combination of breathing techniques, meditation and physical exercise of yoga helps in improving concentration, focus and energy. According to the study, The efficacy of Yoga as a form of treatment for depression highlights that yoga is beneficial in managing the symptoms of depression. It offers benefits such as [5]:
• Lowered stress
• Improved mood
• Reduced blood pressure
• Lowered heart rate
• Improved energy
Aromatherapy
It is the process of using essential oils to provide therapeutic effects. Essential oils are derived from plants, fruits and flowers. Aromatherapy can complement meditation and yoga as inhalation of aromatic fumes brings awareness to the present, promoting mindfulness.
The usage of essential oils can have various mental health benefits. The National Cancer Institute studied the effect of massaging chamomile oil on cancer patients and found that it helped in decreasing anxiety in patients. Similarly, a 2013 study studied the effects of essential oil on women with urine incontinence and found that inhalation of clary sage, lavender or almond essential oils lowered blood pressure and respiratory rate during the bladder examination.
Meditation
When the body is exposed to stress or threat, it triggers a fight or flight response, causing the release of hormones including adrenaline and norepinephrine. Due to this, the body’s blood pressure increases and breathing becomes faster. However, meditation generates a relaxed state, which counteracts the fight or flight response. Practicing meditation 10 minutes a day can offer benefits such as [6]. Here are the benefits of meditation:
• Reduced stress and anxiety
• Good emotional health
• Improved self-awareness
• Improved attention span
• Increased empathy
• Improved sleep
• Improved cardiovascular health
Final thoughts:
Although many individuals benefit from therapies, it is not everyone’s cup of tea. It is difficult for some people to talk it out. However, the good news is that there are tons of other practices that improve the mental and emotional well-being of individuals. Although some of the techniques cannot be used as standalone treatment individuals can combine various therapies to understand what works for them. Seeking out help during times of emotional turmoil doesn’t have to be difficult anymore. It’s always what suits you the best!
References:
Commentaires
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The terms osmolality and osmolarity are easily confused by scholars. They have different meanings, and hence it is advisable for the scholars to take keen interest in understanding these two terms. It is evident that the two terms are derived from a biological term, osmosis. Osmolality can be referred to as the establishment of the concentration of urine depending on the atoms in it. It is measured in terms of milliosmoles/kilogram (mOsm/Kg) of the water. This is a term that is widely used in Kidney tests where urine is manufactured. Blood of the human beings is said to possess osmolality, and for an adult (normal), the osmolality should range between 28 –295 mOsm/kg of water. Osmolality can further be subdivided into two; Serum osmolality and Urine osmolarity.
Serum osmolality refers to the determination of the particles dissolved in the serum per kilogram of water. In a given solution, the less the solute particles in relation to the solvent, the lowly concentrated is the solution under scrutiny. The term low serum osmolality is used to refer to a serum that has fewer particles dissolved in it in relation to the solvent (level of water) and goes hand in hand with over hydration. A high serum osmolality indicates that there are more particles dissolved in the solvent i.e. there is a shortage of the solvent. Serum osmolality gives very crucial information regarding the hydration status around the body cells, since there must be harmony of the equilibrium between the membranes of the cell. It is paramount to note that serum osmolality indicates the condition of the hydration of the body. The standard value for this type of osmolality ranges between 270-300 mOsm/kg of water. Urine osmolality, on the other side, measures the particles dissolved in urine per Kilogram of water.
Renal disorders employ urine osmolality in their diagnosis and assessment of the hydration status. The standard value for this type of osmolality ranges between 500-800 mOsm/kg of water.
Osmolarity refers to the osmotic concentration of a given solution; it is objectively expressed as milliosmoles of solute for every liter of the given solution. Osmolarity measures the osmotic pressure itself. From the foregoing discussion, it is evident that the two terms are employed to discuss solution only that the takes different perspectives when it comes to analyzing each and every term keenly. There is a great similarity between the two terms; they both employ the term osmoles (a mole of any undissolvable element).
Despite the aforementioned similarities, the terms exhibit notable differences. These differences range from the obvious differences to the implied ones; osmolality refers to the osmoles of dissolved particles in a kilogram of water while osmolarity refers to the size of the osmoles of the liquid in a liter of the solution. It is, therefore, evident from the definition that the two terms differ right from their definations. Osmolarity deals with osmotic pressure in a solution unlike, osmolality which deals with the measurement of the number of particles in a given solution/fluid. This difference gives the two terms different areas of applicability with the concept of osmolality being employed in the kidney issues (urine osmolality). The manner in which the two units of measurements are expressed is different; osmolality measured in terms of milliosmoles/kilogram (mOsm/Kg) of the water while osmolarity is expressed as milliosmoles of solute for every liter of the given solution (mOsm/L). Unlike osmolarity osmolality is rather easy to compute.
Usually the units of expressing osmolarity are Osm/L, while Osm/kg is used as units of expressing osmolality. In measuring osmolality an osmometer is required as the instrument of measurement, and it uses the principle of freezing point dejection. In the measurement of the two, a gap exists which is commonly referred to as osmolar gap. Different units are used to present the values (calculated and measured), and this is mainly caused by the dissimilarity in measuring and calculation method. MO is the abbreviation used to represent measured osmolality, while the calculated osmolarity is denoted as CO. Both osmolality and osmolaroty re termed as equivalent based on their low concentration.
Tonicity is a term that is hard to avoid whenever the context at hand is medical. In fluid physiology, it is a term that is highly mistaken and can be defined from three perspectives; Effectiveness of osmolality, the test of the red cells and comparing it with plasma’s osmolality. It should be noted that all these different approaches of defining monotonicity do not exactly mean the same. The most relevant definition is the one that stresses the necessity of defining tonicity in reference to the membrane. Objectively, tonicity can be defined as osmolar gradient across at any give time that is considered crucial across the membranes.
Basically there are three types of tonicity:-
Hypertonic
This is a solution that is said to be highly concentrated; the tonicity of the crystalloids is higher compared to that of blood plasma. Whenever hypertonic crystalloid is being administered there occurs a shift of water molecules to the bloodstream emanating from extravascular space hence, increasing the volume of the intravascular. This shift, osmotic, occurs in the attempt of the body to neutralize the highly concentrated electrolytes in the IV fluid.
Hypotonic
This is a solution that is said to be lowly concentrated; the tonicity of the crystalloids is lower compared to that of blood plasma. The administering of the crystalloid in this case causes a shift of water to the space in the extravascular region from the space in the intravascular space, and finally finds its ways into the cells in the tissues.
Isotonic
This is a solution that is said to be equally concentrated; the tonicity of the crystalloids is equal compared to that of blood plasma. A shift of water (occurs between the cells and blood vessels) is not caused when administration to a normal patient (hydrated) is carried out. Basically in an isotonic solution the process of osmosis does not take place.
According to the medical dictionary, an osmole is defined as the number of particles that dissolves in a solution to make up a mole of particles which are osmotically active. It is a term that is highly employed in the field of biochemistry and the medical field. In chemistry, the term is used to define the constituent moles in a compound (chemical). It is a very important unit of measuring osmotic pressure of a given solution .
Electrolytes
This is a type of solute that dissolves in the solvent; it conducts electric current in the solution. Thais types of electrolytes can further be categorized into two: strong electrolytes and weak electrolytes.
In strong electrolytes, the solutes dissolve completely and hence the solution is the best in conducting electricity e.g. strong acids; Hydrochloric and Hydriodic. In weak electrolytes, on the other hand, the solutes do not dissolve completely but just a fraction. This solution can be referred to a semiconductor of electricity.
Example of electrolyte solute
NaCls Na+aq+Cl-aq
Colligative properties refer to the characteristics of a solution that depend on the molecules present not putting into consideration the kinds of molecules. These properties include; osmotic pressure, depression of the freezing point and elevation of the boiling point. Colligative properties were historically used to determine the molecular weight of a compound (unknown). It is worth noting that colligative property experiments exhibit different average molecular weights. There are four colligative properties to consider:-
1. Vapor Pressure Lowering (Raoult’s Law)
Vapor pressure of the solvent is the amount of pressure exerted by the vapor in the head space. Raoult’s Law quantifies the amount of vapor pressure lowering observed.
Raoult’s Law:
PA=XAPOA
Where PA - Partial pressure of the solvent vapor with the solute
XA – Mole fraction of the solvent
POA–Vapor pressureof the pure solvent
1. Boiling point Elevation
Boiling point refers to the point at which the pressure of the vapor in the liquid reaches 1 atm. It is said to be proportional to the concentration (molar) of solute particles.
1. Freezing Point depression
This colligative property builds on the boiling point elevation. The addition of nonvolatile solute results to the solution having lower freezing points than the pure solvent. The freezing point depression has a very small effect, and the technique employed is insensitive.
Source: (Turco, 1980) p.p 46
The size of the freezing point depression is comparative to the number of solute elements and a relationship can be established with the Morality of the solution.
DTf = Kf ? M
Where D Tf = freezing point depression
Kf = molar freezing point depression constant
M = molality of the solution
1. Osmotic Pressure
It appears to be a very convenient method of determining the average molecule weights of the polymer. Practical aspects of the polymer are considered by osmotic pressure.
Osmolality discrimination
In calculation of osmolality (serum) there arises the importance of calculating osmolality discriminant i.e. the variance of the actual (measured using osmometer) from the rated plasma osmolality (concentration of plasma’s ions summed with low molecule substances). Osmolality discriminant enables the approximation of the toxemy level and consequently the correct treatment is selected.
Description of the whole principle of 3WII Advanced osmometer
3WII Advanced osmometer provides quick, accurate, and conveniently obtained information that is needed to a wide range of body problems. This is a gadget used to determine the number average molecular weights of any particular solute whose Dalton counts 20000- 1000000. This gadget works on the principle that whenever a pure solvent in a solution is separated by a permeable membrane then a chemical potential difference is established. This chemical difference or chemical potential causes the solvent molecules to move from the region of higher concentration to the region of low concentration across the permeable membrane. This process continues until the system gets to equilibrium. When the solvent is contained in the fixed volume chamber this movement of the solvent molecules results to reduction of pressure in the solution or solvent chamber until it equates to osmotic pressure of the solution.
For instance, the UIC membrane osmometers have stainless cell that contain two membranes separated compartments, strain gauge and steel diaphragm and stable power supply. These types of osmometers make use of gauge detector whose main goal is to ensure high performance and versatility of the osmometer instruments. Lack of the familiar hydrostatic pressure addition systems enables the gadget to be more compact and it enables the machine to be able to give a narrow range of pressure (0-5 cmof water) required for molecular weight determination or even a wider range of pressure like ( 0-100 cm of water) convenient for oncotic pressure. May be, just to give some simple description of the 3WII Advanced osmometer, it is 0.5% full scale in accuracy, 0.02 cm of water in stability, and its response time is 5-30 minutes.
3WII Advanced osmometer is very useful and finds its application in two major areas; it is used in the emergence room for:-
i. alcohol intoxication: since ethanol increases the osmolality about 23 mosm/kg,
ii. Drug intoxication screening: even if glucose. BUN, and Na+ are normal, the serum osmolality would be increased.
iii. Head injury and shock: determination of I.V. therapy can be determined by serum or urine osmolality.
iv. Coma: renal impairment, drug overdose, or diabetes mellitus may result from high serum osmolality.
The other area is that osmometer may be used as a diagnostic machine that reflects the result:-
i. Renal malfunction Differential Diagnosis: that results in high osmolality.
ii. Hyper/hyponatremia Evaluation: that is with lipemic serum.
iii. Diabetes Insipidus: urine and serum osmolality palys important role in that assessment.
iv. Inappropriate ADH Syndrome: osmolality is used whether it is neurogenic or nephrogenic.
v. Osmolal Discriminant Evaluation: to figure out which causes the abnormal osmolality whether Na+, urea, or glucose.
Blood osmolality
The blood osmolality can be defined as the concentration of all types of chemical particles found in the blood. It is the amount of solute concentration per given unit of a given total volume of a certain solution. This concentration, therefore, causes osmotic pressure balances in the blood. Osmotic concentration can be defined simply as concentration of salt that produces certain osmotic pressure. This concentration of salts results from the process called osmoregulation. This is an active process that controls the osmotic pressure in the organism’s body fluids and hence controls the homeostasis in the organism. This is to mean that the fluids in the organisms are prevented from being so much diluted or so much concentrated. Blood can be defined as the red-coloured fluid that circulates through the heart, arteries, capillaries and veins. This fluid carries with it oxygen and nutrients to all parts of the body tissues. It also carries away all metabolic wastes away from these tissues. Blood contains plasma, which is yellow, portended cellular element.
The normal value of the blood osmolality ranges from 275 -295 mOsm/kg H2O. (Milliosmoles per kilogramof water). The blood osmolality can also be expressed in relation to osmoles. The value of the blood osmolality may vary from one laboratory to another .This may be because of using different measurement or because of the use of different samples. However, the doctors should tell the meaning of specific sample test. The test for osmolality is done through a blood test, that is, a sample of the blood is taken. A person whose blood is to undergo a test should not take any food material or any drugs especially Mannitol (a diuretic) that may interfere with the concentration of the chemical particles in the blood. The test for the blood osmolality is rather crucial as it helps to evaluate the body water content. Moreover, the doctor sometimes orders for this test to be done especially when a patient has a sign of hyponatremia, water loss, and poisoning by methanol and ethanol. Dehydration increases blood osmolality while over hydration reduces blood osmolality. The test can also be done to a person experiencing difficulties in producing urine. To a normally functioning body, increase in the osmolality stimulates releasing of ADH (antidiuretic hormone). This makes the kidney reabsorb more water resulting to more concentrated urine. The water that is reabsorbed by the kidney to the blood makes the blood osmolality fall or reduces to the normal. When the blood has low osmolality, the ADH (antidiuretic hormone) is suppressed and hence the kidney reabsorbs low volume of water. This condition makes the urine be diluted as it gets rid of the excess water content.
Clinical significance of the blood osmolality
Blood osmolality is of great importance and its significance in clinics is evident. In the clinics blood osmolalty is used to monitor the patient in different areas:
i. Post-Operative: I.V. therapy and trauma of surgery
This is a condition that results from electrolyte/metabolite imbalance. Clinical officers are able to establish whether the patients under examination/diagnosis are suffering from this condition by applying blood osmolality.
ii.Renal Dialysis:
In renal Dialysis serum osmolality is used and if an increase in serum osmolality is noted renal dialysis is carried out.
iii. ADH Therapy:
The response is measured quickly by measuring the blood osmolality.
iv. Insulin Therapy:
Insulin therapy is part and parcel of life of the people with type 1 diabetes. The pancreases of such people fail to produce insulin. Blood osmolality is very significant when it comes to this type of therapy. v. Burn Victims:
In this case serum osmolality is different due to dehydration, medication absorption, and thirst mechanism.
Finally, it is worth to note that osmolality can be used for a quality assurance because it just needs a small volume to get a quick and accurate osmolality.
Regulation of body water volume “formal“ gibbs-duham equation
The amount of water content in the blood or in the body is very important. It ensures proper fluid balance in the body. The whole mechanism of control of the water content or fluid balance in the body is called human homeostasis. It is scientifically proven that the amount of fluid taken in must be equal to the amount of fluid taken out. The body must be maintained at euvolemia. This is the condition of a normal state of the fluid volume. Water is very crucial for human survival. In fact, human being can function for 4-6 weeks without food but can go only for a few days without water. The amount of water required by the body in different people may vary due to either physical exercises or the environment and humidity conditions one is exposed to. For instance, in the United States of America (USA) an adult male should take an average of 3.7 litters of water while an adult female should take 2.7 liters a day. This includes even the water contained in the food and other items that one may consume per day. On the other hand, people in sub-Saharan countries are expected to take even double of the amount taken by a person in the USA. This conclusion, therefore, out rules the human conception that one should take two littres of water per day. It is, therefore, conclusive to say that the amount of water required by a person will depend on the environmental conditions one is exposed to.
In the process of osmoregulation, Gibbs Duham tried to explain or rather establish the relation between the changes that may occur in the thermodynamic system. The gibbs-duham equation is a criterion for thermodynamic consistency and finds application in chemical equilibria and phase equilibrium. He was able to establish that the properties of the thermodynamics are actually not independent but they are related.
Contributions of different drinks to changing blood osmolality
It is of great importance to note that different drinks have different water content and contribution towards Solute level in the blood. For instance, in sports there is a lot of sweating and therefore loss of many minerals such as chloride calcium and magntisum. This condition if not checked can lead to dehydration of the runner and eventually collapse. The serum osmolality has great importance to clinical services. It is mainly used for two main purposes. One is to establish the osmolar gap while the other is to find out the hyponatraemie condition level. The urine osmolality has a basic importance during testing of renal concentration. In addition, the osmolality in the faecal assist in the diagnosing causes of diarrhea. As mentioned earlier, the serum osmolality can be used to establish the cause of the hyponatraemia. That is a patient with serum sodium less than 1ess 30 mmol/l can also be identified to have pseudohyponatraemia especially when the concentration of lipids and proteins is high. Moreover, a patient with high osmolality may have reactive hyponatraemia mainly because of the excess solute resulting to low level of water in the cells. On the other hand, the osmolar gap is established through getting the osmolality by calculating and through measurement. The difference between the two results is the osmolality gap. The calculated osmolality can be obtained through the use of the following formulae:
osmolality = 2 x serum sodium + serum glucose + serum urea
(all the variables have to be in mmol/l
The expected or the normal difference between the calculated and the measured osmolality is supposed to be 10 mmol/l. When the value happens in excess of this expected difference, it may show that there is some existence of the exogenous agent. Presence of ethanol can lead to increased osmolality gap, however, existence of substances like methanol may not sufficiently lead to increased osmolality. When the amount of ethanol has been measured, then the calculated osmolality can be obtained through use of the following of the formulae:
Calculated osmolality = 2 x serum sodium + serum glucose + serum urea + 270 x ethanol
(All variables have be in mmol/l except ethanol which have be in mg/dl)
The faecal osmolality can be used to establish faecal osmolar gap. The calculated osmolality in this case must incorporate 2x (Na +k). If the established osmolality gap is more than 100 mmol/l,then the condition will be similar to that of the osmotic diarrhea. IF the established difference between the calculated and the measured osmolality is a normal faecal osmolality gap, then it shows that there is a secretory diarrhea and can be conclusively be said that there might be damage or irritation in gastro-intestinal mucosa. This experiment can be done from a faecal sample with a higher fluid content. Another important use of the osmolality can be established from the fact that the cell membrane is free permeable to water, and the difference between the osmolality in the excellular and the intracellular fluids is the same. This would simply mean that the intracellular osmolality can then be established from the plasma osmolality .This information become very important as the change in the osmolality of the intracellular fluids can be as a result of the changes of the osmolality of the excellular fluids. This change may have results to the problem in the normal functioning of the cells and the volume.
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-2,277,600,468,367,660,300 | What Is Neurotin?
What Is Neurotin?
Neurontin, also known by its generic name gabapentin, is an anti-epileptic drug used to treat seizures. It is also used in the treatment of diabetic neuropathy, or nerve pain, states WebMD, as well as restless legs syndrome.
According to Drugs.com, Neurontin is used to treat the nerve pain that is associated with shingles, or herpes zoster. Pregnant or breastfeeding women are advised against taking Neurontin as the medication passes through breast milk.
While Neurontin is very effective in treating nerve pain and reducing the number of seizures a patient has, stopping it suddently is not recommended as this can cause an increase in seizures, states Drugs.com. Neurontin should be tapered slowly under the direction of a physician.
While many patients take Neurontin without any problems, some experience side effects. Side effects of Neurontin that need to be addressed by a physician include flu-like symptoms, fever, swollen glands, shortness of breath, dark urine, confusion and jaundice. If a patient experiences any of these side effects, he should seek immediate medical treatment. Less severe side effects that commonly disappear after a short time include dry mouth, diarrhea, dizziness and swelling of the hands or feet, states Drugs.com. Drinking alcohol can increase the effects of Neurontin, and Neurontin is more difficult for the body to absorb if taken within two hours of ingesting an antacid. | {
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-8,459,310,520,197,126,000 | What is an auditory analyzer?
The organ of hearing, the auditory nerve and the centers of the brain that analyze auditory information (temporal lobes of the cerebral cortex).
Remember: The process of learning a person lasts a lifetime. The value of the same knowledge for different people may be different, it is determined by their individual characteristics and needs. Therefore, knowledge is always needed at any age and position. | {
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-4,761,382,086,257,945,000 | top of page
• Orthodontist Singapore
What are TMJ/TMD Disorders? (Part III)
Orthodontist Singapore, Braces Singapore, Dr Chua Ai Lian Orthodontic Clinic, Orthodontic Treatment Singapore, Retainers Singapore, Invisalign Singapore
Diagnosis of TMJ/TMD
TMJ/TMD has similar symptoms to other dental problems such as tooth decay, gum disease etc. To accurately diagnose, TMJ/TMD, the dentist will perform a physical examination. This examination involves observing for pain and tenderness in the jaw joints and listening for clicking, popping or grating sounds during jaw movement. The dentist will also check whether the jaws work as they should, whether or not the jaws get locked and whether there are any problems with the bite.
After the physical examination, the dentist will proceed to perform clinical diagnostics such as x-rays, MRI and CT scans to rule out other problems. The MRI scan reveals whether TMJ disc is in the correct position during jaw movement and the CT scan reveals the bony detail of the joint. The dentist may also refer the patient to other dental specialists such as an oral and maxillofacial surgeon for further care and treatment. The oral surgeon possesses expertise in surgery for the face, mouth and jaw area. The dentist may also refer the patient to an orthodontist.
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Inflammatory bowel disease (IBD)
Reviewed by the BabyCenter Medical Advisory Board
My child's doctor thinks she may have inflammatory bowel disease (IBD). What is this?
IBD is a disease in which parts of the intestines become inflamed and may develop ulcers, or sores. Symptoms include abdominal pain, diarrhea, and constipation, as well as weight loss, fever, exhaustion, and the urge to have a bowel movement even when the bowels are empty. Because IBD causes ulcers in the intestines, your child may also have blood in her stools. Experts don't know what causes this disease, but it's most likely at least partially inherited.
SYMPTOM GUIDE
Sick child with caring mom
Is it serious? Find out fast
There are two kinds of IBD: Ulcerative colitis affects the inner lining of the large intestine; Crohn's disease affects deeper layers of tissue, usually in the small intestine and the colon. But Crohn's can appear in any or all parts of the gastrointestinal tract, from the mouth to the anus. Current treatments can put these conditions into remission, but your child may have flare-ups throughout her life. About a million people in this country have IBD; 10 percent of them are under 18. About half of those with IBD have Crohn's, and the other half have ulcerative colitis.
How is it diagnosed?
If your pediatrician suspects that your child has IBD, she will refer her to a gastroenterologist who will look for evidence of inflammation and ulcers in the lining of your child's intestines. To do this he'll pass a tiny tube with a camera on it (an endoscope) through her anus into her colon. He may also take a tissue sample from her intestines so he can look for signs of inflammation under a microscope. The procedure is not painful, but her doctor may give her a mild sedative to calm her.
How is IBD treated?
It's often treated with a combination of medications. Steroids and drugs that suppress the immune system both reduce inflammation. Antibiotics help heal any infections in the gastrointestinal tract. Once the inflammation and other symptoms (such as diarrhea) are gone and the intestinal lining has healed, the disease is in remission. Your child may be kept on some medications to prevent a relapse.
The only way to "cure" ulcerative colitis is by surgically removing the entire colon. (Of course, this is considered only for severe and persistent cases. Your child may have a mild or manageable case.) There is no permanent cure for Crohn's disease. The goal for both conditions is to get them into remission and keep them there.
Member Comments
emily208 says
More support for parents and kids diagnosed with IBD can be found at www.meandibd.org and www.meandibd.blogspot.co.uk - by leading UK charity Crohn's and Colitis UK. Most information will be helpful for people worldwide.
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05.15.2013 | 10:51 AM
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-5,628,306,625,965,736,000 | Methamphetamine: Therapeutic use
Last modified: Monday, 1. June 2009 - 6:19 am
Until the 1970s, methamphetamines were used for a variety of medical conditions in the United States. However, with the growing abuse of these powerful drugs, the federal government imposed strict controls on their usage and prescription. Currently, the use of methamphetamines in medicine are restricted for only a few types of medical conditions, including weight reduction for obese patients, narcolepsy, and attention-deficit disorder (ADD).
Methamphetamines and amphetamines are both used for treatment of obesity since they decrease hunger in patients. It is thought that both methamphetamines and amphetamines decrease the urge to eat by affecting certain areas of the brain that are associated with appetite and eating behaviors. While methamphetamines work reasonably well in controlling hunger, they are not indicated for long-term control of obesity because tolerance to the drug develops rapidly. Therefore, more and more methamphetamine has to be taken in order to achieve appetite suppression. Patients usually take methamphetamines or amphetamines for a maximum of six to eight weeks at a time, during which period most people will lose 6-10 lbs (2.7-1.5 kg).
Narcolepsy is a rare condition in which people literally fall asleep, quite suddenly, with no conscious control. This may occur only once or twice a day, but may occur up to 100 times a day. Low doses of methamphetamine or amphetamine are given to these patients on a very controlled basis to help keep the multiple episodes of sleeping under reasonable control.
Attention-deficit disorder (ADD) is widely diagnosed in school-aged children, although the disorder is seen well into adulthood. It is characterized by impulsive behavior, inability to concentrate, and short attention span. Methamphetamines and amphetamines, when given to people with this disorder, have the paradoxical effect of increasing the attention span, decreasing hyperactive behavior, and increasing the ability to concentrate. There are several types of methamphetamine and amphetamine available to treat this condition, including long-lasting, once-a-day preparations.
Methamphetamine is also used in other medical situations. People with severe depression are sometimes given short courses of a stimulant such as methamphetamine or amphetamine. However, physicians need to be cautious when giving a person with depression methamphetamine, since there can be a “let-down” period after stopping the drug that may cause the depression to actually worsen. Methamphetamines are also sometimes used to treat severe cases of epilepsy or Parkinson’s disease in which the normally prescribed medications have failed.
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-7,757,021,164,538,964,000 | Medical
How to Deal with Stress
Stress is a normal physical response to some events that upset your balance in some way. When your body sense danger, your nervous system will respond by releasing a flood of stress hormones. These hormones take an automatic action as a response to stress.
This response is considered to be your body’s way to protect you. While working correctly, it helps you to stay focused, energetic, and alert. In case of emergency situations, stress can save your life as it gives you an extra power to defend yourself. For example, it urges you to slam on the brakes to avoid an accident.
It also helps you to be able to succeed when you meet challenges. It also sharpens your concentration when you’re attempting to study for an exam when you want to be playing a game instead.
When you get stressed out, you feel like your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. These physical changes increase your focused strength and speed your reaction to prepare you to either fight or flee from the upcoming dangerous situation. But beyond a certain point, stress will stop being helpful and starts to cause significant problems to your health, your mood, your ability of productivity, your relationships, and your life quality.
How do deal with stress?
It may seem that there’s nothing you can do about stress. There will never be more hours in the day, and your career and family responsibilities will always be demanding. In fact, the simple realization that you’re in control of your life is the beginning of being able to manage stress. Managing stress is all about taking charge of the way you handle problems, your thoughts, your emotions and your time schedule.
1 Stress management starts with identifying the sources of stress in your life. This isn’t an easy task as it sounds. In order to be able to identify the causes of anxiety, look carefully at your habits, thoughts, and the way of managing your time and problems.
Stress at work
2 Try to reduce your consumption amount of having nicotine and all drinks that have caffeine and alcohol as these three things are stimulants; they will increase your level of stress rather than reduce it.
3 Many types of manufactured foods such as bread can cause energy crashes in your body which may lead you to feel tired and nervous. In general, try to eat a healthy, well-balanced and nutritious food to keep you balanced and doesn’t rise up your blood pressure.
4 Try to begin thinking of how to solve your problems. That will help you to feel more in control and decrease your level of stress. You can do that by writing down the problem and coming up with as many possibilities of solutions. Decide on the good and bad options of each one and select the best solution.
5 Lacking of sleep is a major problem which leads to stress. Insomnia is also a result; stress causes the interruption of our sleep as thoughts might keep coming through our heads that could stop us from relaxing enough to fall asleep. Rather than depending on the medication, relax before going to sleep. Try taking a warm bath or reading a comic book for a few minutes to forget about the things that worry you. Try not to drink caffeine during the evening or doing any mentally demanding work before going to sleep.
I guess now you have a few ideas beyond the medications that can help you to relax. You should try some of these ways to be able to relieve your stress. If you reduced the amount of caffeine, nicotine, and alcohol, I assure you that you would be better. You can also think of more than one solution to the problem to be able to expand your mind and decrease your stress level. I hope these tips would be useful for you to be able to deal with your stress without any kind of pills. Good luck!
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6,483,945,553,490,102,000 | Why Do I Shake When I Lift Weights? Understanding the Science
Why Do I Shake When I Lift Weights? Understanding the Science
Introduction
Why Do I Shake When I Lift Weights: You’re not alone if you’ve ever shook or trembled when lifting weights. This phenomena frequently occurs to people during strength training sessions. Understanding the causes of why we shake when lifting weights can help allay fears and improve your workout regimen, even though it can be disconcerting. In this post, we’ll examine the numerous causes of muscle tremors and examine the science that underlies it.
The Role of Muscle Activation
Your muscles contract when you lift weights in order to produce the force needed to complete the movement. The load and the muscle fibers being used determine how strong these contractions are. muscular tremors, also referred to as shaking or trembling, can happen as a result of increased muscular activity during exercise. Small muscle fibers that are not typically used may also be activated as your muscles work harder to lift bigger weights, which might cause tremors.
Muscle Fatigue and Exhaustion
muscular exhaustion is another aspect of weightlifting that causes muscular tremors. As you continue to workout, your muscles progressively weaken and weary. Shaking or trembling occurs as a result of fatigued muscles’ inability to maintain a constant contraction. It’s crucial to understand that muscular exhaustion is a normal reaction to physical effort and that it shows your muscles are being stressed and strained to their absolute limits.
Neural Control and Motor Units
The way our nervous system regulates muscle activation may also contribute to muscular tremors. To activate the muscles, the brain transmits electrical impulses known as motor unit recruitment. The nervous system enlists more motor units to produce the required force during weightlifting as the load rises. Tremors may result from this enhanced recruitment, especially in people who are inexperienced or new to weightlifting.
Lack of Stability and Core Strength
Shaking while lifting weights might be caused by a lack of stability and core strength. Your core muscles are absolutely essential for maintaining balance and distributing force between your upper and lower bodies. Your foundation may be unstable as a result of weak or improperly engaged core muscles, which can cause trembling while performing weightlifting activities. Including core-strengthening workouts in your routine helps enhance stability and lessen swaying.
Hydration and Nutrition
For optimum muscular function and performance, proper nutrition and hydration are essential. Having muscle cramps and trembling when exercising might be caused by dehydration or an electrolyte imbalance. Before, during, and after your workouts, you must drink enough water to stay hydrated. A balanced diet that contains important nutrients like potassium, magnesium, and calcium can also assist prevent muscular imbalances and lessen shaking while lifting weights.
Breathing Techniques and Oxygenation
Your breathing technique has a big impact on how your body reacts to lifting weights. inhaling incorrectly, such as holding your breath or inhaling shallowly, can exacerbate muscle tension and make you tremble. Why Do I Shake When I Lift Weights You may improve oxygenation and ensure that your muscles receive a continuous supply of oxygen by concentrating on deep, controlled breathing. This keeps muscles functioning and lessens the possibility of shaking when doing out.
Psychological Factors and Anxiety
Last but not least, psychological elements like stress and worry might affect muscle tremors during weightlifting. The body’s stress reaction, which results in increased muscle tension and trembling, can be triggered by anxiety or the fear of failing. Anxiety can be reduced and a more relaxed condition encouraged during your weightlifting sessions by including relaxation techniques like visualization, meditation, or listening to soothing music.
Warm-up and Stretching
Muscle tremors during weightlifting can be significantly reduced with the use of effective warm-up and stretching programs. Before working out, performing a dynamic warm-up helps to boost blood flow to the muscles and gets them ready for the action. Additionally, it increases range of motion and flexibility, which lessens the possibility of muscular imbalances that can cause shaking. Utilizing targeted stretches that are particular to the muscles you’ll be training will improve muscular preparedness and lessen tremors. Always remember to warm up with controlled and gentle stretches to give your body time to become used to the motions and intensity.
Proper Form and Technique
To maximize results and reduce muscular tremors, good form and technique must be maintained. While lifting weights, poor alignment or posture might overwork some muscles, causing trembling or shaking. It is essential to understand and execute each exercise’s proper form, with an emphasis on activating the targeted muscles and avoiding compensatory movements. You can lessen your risk of shaking by seeking advice from a certified fitness expert or personal trainer to make sure you are employing the right form and technique. Keep in mind to begin with lesser weights and increase them gradually as your form and strength develop.
Gradual Progression and Recovery
Adopting a moderate progression strategy and placing emphasis on good recovery are two essential components of decreasing muscle tremors. It’s critical to give your body enough time between workouts to adjust and recover. Gradual progress can reduce shaking as muscles adapt and grow stronger. Additionally, adding rest days to your workout schedule enables sufficient muscle repair, lowering tiredness levels, and fostering healthy muscular function. Listen to your body, adjust intensity, prioritize rest and sleep for better recovery.
Conclusion
Why Do I Shake When I Lift Weights: It is typical to have muscle tremors while lifting weights, which can be caused by a variety of things. Shaking while weightlifting is caused by muscle activation, fatigue, stability, hydration, breathing, and psychological factors. Boost technique, optimize workouts, and banish worries through awareness of these factors. Always pay attention to your body, raise weights gradually, and, if required, get advice from a trained fitness expert. Accept the difficulty of weightlifting and see it as a chance for development and strength.
( For More Information Click Here ) Why Do I Shake When I Lift Weights
Muhammad Waseem
Welcome to Muhammad Waseem's author page! With a graduation degree and 2 years of experience, Muhammad shares valuable insights on health, fashion, makeup and lifestyle. Join the journey to optimal well-being and a vibrant life.
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-9,049,681,171,974,396,000 | Vasoactive intestinal peptide
Vasoactive intestinal peptide, also known as vasoactive intestinal polypeptide or VIP, is a peptide hormone that is vasoactive in the intestine. VIP is a peptide of 28 amino acid residues that belongs to a glucagon/secretin superfamily, the ligand of class II G protein–coupled receptors.[5] VIP is produced in many tissues of vertebrates including the gut, pancreas, and suprachiasmatic nuclei of the hypothalamus in the brain.[6][7][8] VIP stimulates contractility in the heart, causes vasodilation, increases glycogenolysis, lowers arterial blood pressure and relaxes the smooth muscle of trachea, stomach and gall bladder. In humans, the vasoactive intestinal peptide is encoded by the VIP gene.[9]
VIP
Available structures
PDBOrtholog search: PDBe RCSB
Identifiers
AliasesVIP, vasoactive intestinal peptide, PHM27
External IDsOMIM: 192320 MGI: 98933 HomoloGene: 2539 GeneCards: VIP
Gene location (Human)
Chromosome 6 (human)
Chr.Chromosome 6 (human)[1]
Chromosome 6 (human)
Genomic location for VIP
Genomic location for VIP
Band6q25.2Start152,750,797 bp[1]
End152,759,765 bp[1]
RNA expression pattern
PBB GE VIP 206577 at fs.png
More reference expression data
Orthologs
SpeciesHumanMouse
Entrez
Ensembl
UniProt
RefSeq (mRNA)
NM_003381
NM_194435
NM_011702
NM_001313969
RefSeq (protein)
NP_003372
NP_919416
NP_001300898
NP_035832
Location (UCSC)Chr 6: 152.75 – 152.76 MbChr 10: 5.64 – 5.65 Mb
PubMed search[3][4]
Wikidata
View/Edit HumanView/Edit Mouse
VIP has a half-life (t½) in the blood of about two minutes.[10]
FunctionEdit
In the bodyEdit
VIP has an effect on several tissues:
In the digestive system, VIP seems to induce smooth muscle relaxation (lower esophageal sphincter, stomach, gallbladder), stimulate secretion of water into pancreatic juice and bile, and cause inhibition of gastric acid secretion and absorption from the intestinal lumen.[11] Its role in the intestine is to greatly stimulate secretion of water and electrolytes,[12] as well as relaxation of enteric smooth muscle, dilating peripheral blood vessels, stimulating pancreatic bicarbonate secretion, and inhibiting gastrin-stimulated gastric acid secretion. These effects work together to increase motility.[13] It also has the function of stimulating pepsinogen secretion by chief cells.[14] VIP seems to be an important neuropeptide during inflammatory bowel diseases since the communication between mast cells and VIP in colitis, as in Crohn's disease, is upregulated.[15]
It is also found in the heart and has significant effects on the cardiovascular system. It causes coronary vasodilation[11] as well as having a positive inotropic and chronotropic effect. Research is being performed to see if it may have a beneficial role in the treatment of heart failure. VIP provokes vaginal lubrication in normal women, doubling the total volume of lubrication produced.[16][17]
In the brainEdit
It is also found in the brain and some autonomic nerves:
One region includes a specific area of the suprachiasmatic nuclei (SCN), the location of the 'master circadian pacemaker'.[18] See SCN and circadian rhythm below. VIP in the pituitary helps to regulate prolactin secretion; it stimulates prolactin release in the domestic turkey.[19] Additionally, the growth-hormone-releasing hormone (GH-RH) is a member of the VIP family and stimulates growth hormone secretion in the anterior pituitary gland.[20][21]
MechanismsEdit
VIP innervates on both VPAC1 and VPAC2. When VIP binds to VPAC2 receptors, a G-alpha-mediated signalling cascade is triggered. In a number of systems, VIP binding activates adenyl cyclase activity leading to increases in cAMP and PKA. The PKA then activates other intracellular signaling pathways like the phosphorylation of CREB and other transcriptional factors. The mPer1 promoter has CRE domains and thus provides the mechanism for VIP to regulate the molecular clock itself. Then it will activate gene expression pathways such as Per1 and Per2 in circadian rhythm.[22]
In addition, GABA levels are connected to VIP in that they are co-released. Sparse GABAergic connections are thought to decrease synchronized firing.[22] While GABA controls the amplitude of SCN neuronal rhythms, it is not critical for maintaining synchrony. However, if GABA release is dynamic, it may mask or amplify synchronizing effects of VIP inappropriately.[22]
Circadian time is likely to affect the synapses rather than the organization of VIP circuits.[22]
SCN and circadian rhythmEdit
Suprachiasmatic nucleus is shown in green.
The SCN coordinates daily timekeeping in the body and VIP plays a key role in communication between individual brain cells within this region. At a cellular level, the SCN expresses different electrical activity in circadian time. Higher activity is observed during the day, while during night there is lower activity. This rhythm is thought to be important feature of SCN to synchronize with each other and control rhythmicity in other regions.[18]
VIP acts as a major synchronizing agent among SCN neurons and plays a role in synchronizing the SCN with light cues. The high concentration of VIP and VIP receptor containing neurons are primarily found in the ventrolateral aspect of the SCN, which is also located above the optic chiasm. The neurons in this area receive retinal information from the retinohypothalamic tract and then relay the environmental information to the SCN.[22] Further, VIP is also involved in synchronizing the timing of SCN function with the environmental light-dark cycle. Combined, these roles in the SCN make VIP a crucial component of the mammalian circadian timekeeping machinery.[22]
After finding evidence of VIP in the SCN, researchers began contemplating its role within the SCN and how it could affect circadian rhythm. The VIP also plays a pivotal role in modulating oscillations. Previous pharmacological research has established that VIP is needed for normal light-induced synchronization of the circadian systems. Application of VIP also phase shifts the circadian rhythm of vasopressin release and neural activity. The ability of the population to remain synchronized as well as the ability of single cells to generate oscillations is composed in VIP or VIP receptor deficient mice. While not highly studied, there is evidence that levels of VIP and its receptor may vary depending on each circadian oscillation.[22]
The leading hypothesis of VIP function points to the neurons using VIP to communicate with specific postsynaptic targets to regulate circadian rhythm.[22] The depolarization of the VIP-expressing neurons by light appears to cause the release of VIP and co-transmitters (including GABA) that can in turn, alter the properties of the next set of neurons with the activation of VPAC2. Another hypothesis supports VIP sending a paracrine signal from a distance rather than the adjacent postsynaptic neuron.[22]
Signaling pathwayEdit
In SCN, there is an abundant amount of VPAC2. The presence of VPAC2 in ventrolateral side suggests that VIP signals can actually signal back to regulate VIP secreting cells. SCN has neural multiple pathways to control and modulate endocrine activity.[18][23]
VIP and vasopressin are both important for neurons to relay information to different targets and affect neuroendocrine function. They transmit information through such relay nuclei as the SPZ (subparaventricular zone), DMH (dorsomedial hypothalamic nucleus), MPOA (medial preoptic area) and PVN (paraventricular nucleus of hypothalamus).[18]
Social behaviorEdit
Ventromedial hypothalamus (VM), optic chiasm (OC), anterior pituitary (AP), and posterior pituitary (PP) are shown here.
VIP neurons located in the hypothalamus, specifically the dorsal anterior hypothalamus and ventromedial hypothalamus, have an effect on social behaviors in many species of vertebrates. Studies suggest that VIP cascades can be activated in the brain in response to a social situation that stimulates the areas of the brain that are known to regulate behavior. This social circuit includes many areas of the hypothalamus along with the amygdala and the ventral tegmental area. The production and release of the neuropeptide VIP is centralized in the hypothalamic and extrahypothalamic regions of the brain and from there it is able to modulate the release of prolactin secretion.[24] Once secreted from the pituitary gland, prolactin can increase many behaviors such as parental care and aggression. In certain species of birds with a knockout VIP gene there was an observable decrease in overall aggression over nesting territory.[25]
PathologyEdit
VIP is overproduced in VIPoma.[12]
In addition to VIPoma, VIP has a role in osteoarthritis (OA). While there is existing conflict in whether down-regulation or up-regulation of VIP contributes to OA, VIP has been shown to prevent cartilage damage in animals.[26]
See alsoEdit
ReferencesEdit
1. ^ a b c GRCh38: Ensembl release 89: ENSG00000146469 - Ensembl, May 2017
2. ^ a b c GRCm38: Ensembl release 89: ENSMUSG00000019772 - Ensembl, May 2017
3. ^ "Human PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
4. ^ "Mouse PubMed Reference:". National Center for Biotechnology Information, U.S. National Library of Medicine.
5. ^ Umetsu Y, Tenno T, Goda N, Shirakawa M, Ikegami T, Hiroaki H (May 2011). "Structural difference of vasoactive intestinal peptide in two distinct membrane-mimicking environments". Biochimica et Biophysica Acta (BBA) - Proteins and Proteomics. 1814 (5): 724–30. doi:10.1016/j.bbapap.2011.03.009. PMID 21439408.
6. ^ Juhász T, Helgadottir SL, Tamás A, Reglődi D, Zákány R (April 2015). "PACAP and VIP signaling in chondrogenesis and osteogenesis" (PDF). Peptides. 66: 51–7. doi:10.1016/j.peptides.2015.02.001. hdl:2437/208376. PMID 25701761. S2CID 8300971.
7. ^ Delgado M, Ganea D (July 2013). "Vasoactive intestinal peptide: a neuropeptide with pleiotropic immune functions". Amino Acids. 45 (1): 25–39. doi:10.1007/s00726-011-1184-8. PMC 3883350. PMID 22139413.
8. ^ Fahrenkrug J (2010-01-01). "VIP and PACAP". Cellular Peptide Hormone Synthesis and Secretory Pathways. Results and Problems in Cell Differentiation. 50. pp. 221–34. doi:10.1007/400_2009_24. ISBN 978-3-642-11834-0. PMID 19859678.
9. ^ Hahm SH, Eiden LE (December 1998). "Cis-regulatory elements controlling basal and inducible VIP gene transcription". Annals of the New York Academy of Sciences. 865 (1): 10–26. Bibcode:1998NYASA.865...10H. doi:10.1111/j.1749-6632.1998.tb11158.x. PMID 9927992. S2CID 24889373.
10. ^ Henning RJ, Sawmiller DR (January 2001). "Vasoactive intestinal peptide: cardiovascular effects". Cardiovascular Research. 49 (1): 27–37. doi:10.1016/s0008-6363(00)00229-7. PMID 11121793.
11. ^ a b Bowen R (1999-01-24). "Vasoactive Intestinal Peptide". Pathophysiology of the Endocrine System: Gastrointestinal Hormones. Colorado State University. Retrieved 2009-02-06.
12. ^ a b "Vasoactive intestinal polypeptide". General Practice Notebook. Retrieved 2009-02-06.
13. ^ Bergman RA, Afifi AK, Heidger PM. "Plate 6.111 Vasoactive Intestinal Polypeptide (VIP)". Atlas of Microscopic Anatomy: Section 6 - Nervous Tissue. www.anatomyatlases.org. Retrieved 2009-02-06.
14. ^ Sanders MJ, Amirian DA, Ayalon A, Soll AH (November 1983). "Regulation of pepsinogen release from canine chief cells in primary monolayer culture". The American Journal of Physiology. 245 (5 Pt 1): G641–6. doi:10.1152/ajpgi.1983.245.5.G641. PMID 6195927.
15. ^ Casado-Bedmar M, Heil SDS, Myrelid P, Söderholm JD, Keita ÅV (March 2019). "Upregulation of intestinal mucosal mast cells expressing VPAC1 in close proximity to vasoactive intestinal polypeptide in inflammatory bowel disease and murine colitis". Neurogastroenterology and Motility. 31 (3): e13503. doi:10.1111/nmo.13503. PMID 30407703. S2CID 53207540.
16. ^ Levin RJ (1991-01-01). "VIP, vagina, clitoral and periurethral glans--an update on human female genital arousal". Experimental and Clinical Endocrinology. 98 (2): 61–9. doi:10.1055/s-0029-1211102. PMID 1778234.
17. ^ Graf AH, Schiechl A, Hacker GW, Hauser-Kronberger C, Steiner H, Arimura A, Sundler F, Staudach A, Dietze O (February 1995). "Helospectin and pituitary adenylate cyclase activating polypeptide in the human vagina". Regulatory Peptides. 55 (3): 277–86. doi:10.1016/0167-0115(94)00116-f. PMID 7761627. S2CID 21864176.
18. ^ a b c d Achilly NP (June 2016). "Properties of VIP+ synapses in the suprachiasmatic nucleus highlight their role in circadian rhythm". Journal of Neurophysiology. 115 (6): 2701–4. doi:10.1152/jn.00393.2015. PMC 4922597. PMID 26581865.
19. ^ Kulick RS, Chaiseha Y, Kang SW, Rozenboim I, El Halawani ME (July 2005). "The relative importance of vasoactive intestinal peptide and peptide histidine isoleucine as physiological regulators of prolactin in the domestic turkey". General and Comparative Endocrinology. 142 (3): 267–73. doi:10.1016/j.ygcen.2004.12.024. PMID 15935152.
20. ^ Kiaris H, Chatzistamou I, Papavassiliou AG, Schally AV (August 2011). "Growth hormone-releasing hormone: not only a neurohormone". Trends in Endocrinology and Metabolism. 22 (8): 311–7. doi:10.1016/j.tem.2011.03.006. PMID 21530304. S2CID 23860010.
21. ^ Steyn FJ, Tolle V, Chen C, Epelbaum J (March 2016). "Neuroendocrine Regulation of Growth Hormone Secretion". Comprehensive Physiology. 6. pp. 687–735. doi:10.1002/cphy.c150002. ISBN 9780470650714. PMID 27065166. Missing or empty |title= (help)
22. ^ a b c d e f g h i Vosko AM, Schroeder A, Loh DH, Colwell CS (2007). "Vasoactive intestinal peptide and the mammalian circadian system". General and Comparative Endocrinology. 152 (2–3): 165–75. doi:10.1016/j.ygcen.2007.04.018. PMC 1994114. PMID 17572414.
23. ^ Maduna T, Lelievre V (December 2016). "Neuropeptides shaping the central nervous system development: Spatiotemporal actions of VIP and PACAP through complementary signaling pathways". Journal of Neuroscience Research. 94 (12): 1472–1487. doi:10.1002/jnr.23915. PMID 27717098. S2CID 30671833.
24. ^ Kingsbury MA (December 2015). "New perspectives on vasoactive intestinal polypeptide as a widespread modulator of social behavior". Current Opinion in Behavioral Sciences. 6: 139–147. doi:10.1016/j.cobeha.2015.11.003. PMC 4743552. PMID 26858968.
25. ^ Kingsbury MA, Wilson LC (December 2016). "The Role of VIP in Social Behavior: Neural Hotspots for the Modulation of Affiliation, Aggression, and Parental Care". Integrative and Comparative Biology. 56 (6): 1238–1249. doi:10.1093/icb/icw122. PMC 5146713. PMID 27940615.
26. ^ Jiang W, Wang H, Li YS, Luo W (August 2016). "Role of vasoactive intestinal peptide in osteoarthritis". Journal of Biomedical Science. 23 (1): 63. doi:10.1186/s12929-016-0280-1. PMC 4995623. PMID 27553659.
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-6,475,332,751,840,977,000 | What is a Tonometer and the Types of Methods
March 27, 2019
What is a Tonometer and the Types of Methods?
A tonometer is an instrument that measures the internal pressure of the eye, which is also known as intraocular eye pressure (IOP). An eye doctor (ophthalmologist) can use tonometry to diagnosis glaucoma - an eye condition where fluid accumulates in the patient’s eye, causing high eye pressure. The high pressure can damage the optic nerve at the back of the eye, and may even result in blindness if left untreated.
The IOP of 12 - 22 mmHg indicates that the patient is normal, and most people with the value above 20 mm Hg have a risk of glaucoma. However, eye pressure is unique to each person - so some people can develop glaucoma with the normal range of IOP readings.
People with glaucoma usually don’t have symptoms, but they can have problems with eyesight as they age. Therefore, it is essential to carry out a routine eye test, as it is the only way to determine if we have this eye condition. Early screening can help protect a patient’s eyesight, and prevent vision loss.
For most patients with glaucoma, they will only need eye drops to help decrease the pressure in their eye. In rare cases, laser treatment or surgery to help control their eye pressure and prevent blindness.
Tonometry Methods
There are different methods and tonometers to measure the pressure inside a patient’s eye. Here are several methods that are available:
Applanation Tonometry
Goldmann tonometry is the most common type of applanation tonometry and is considered as the gold standard IOP test for many practitioners. There are several Goldmann tonometers: Type R which is attached to a slit lamp and Type T which can be fitted to the slit lamp when desired.
Anaesthetic eye drops are given to the patient to numb their eyes. The eye doctor will use a thin strip of paper containing an orange dye (fluorescein dye) to stain the surface of the patient’s eye – this helps to increase the accuracy of the test. Cobalt blue light is shone into the eye to illuminate the fluorescein dye. The slit lamp moves towards the eye until the tip of the tonometer probe gently touches and indents the cornea. The Goldmann tonometer can measure the pressure by flattening your cornea slightly - the eye doctor will need to adjust the tension until they get a proper reading.
Impression Tonometry
Schiotiz tonometry is the most common type of impression tonometry, also referred to as indentation tonometry. The Schiotz tonometer detects the eye pressure by measuring the depth of corneal indentation that’s caused by a small metal plunger that rests on the cornea. The higher the pressure, the harder it is to push and indent the cornea – extra weights may be added to make the plunger push harder. A calibrated scale measures the movement of the plunger. Modern eye care practitioners rarely use indentation tonometry, whereas general practitioners and the military occasionally use this method.
Non-Contact Tonometry
Non-contact tonometry is also referred to as the "air puff" test, is also a mass screening device. A gentle puff of air is blown into the patient’s eye, and the cornea is flattened without any discomfort. The non-contact tonometer records the IOP by detecting the change in light reflected off the cornea. Non- contact tonometers are ideal for busy clinical environments and are a quick and simple way to examine high-pressure levels in the patient’s eye. Children or sensitive adults prefer this method because it doesn’t touch their eye – but results aren’t as accurate as using Goldmann tonometry.
Electronic Tonometry
An electronic tonometer is a portable instrument that resembles a writing pen. The eye doctor gently uses the electronic tonometer to flatten the patient’s cornea. This method is not as reliable or accurate as Goldmann tonometry, but it is ideal for a busy practitioner because of the ease of use and portability. Also, an electronic tonometer is used to measure the IOP in children and non-cooperative adults as it is a non-invasive method.
What Tonometer Should I Buy?
When deciding on what tonometer you should buy, it all boils down to the number of patients you’ll be treating and the level of diagnosis. If patients need a simple routine check-up, the non-contact tonometer and the electronic tonometer is ideal for rapid IOP analysis. For older adults or those who have signs and symptoms of any eye problems, the applanation tonometry would be a more reliable and accurate method to identify glaucoma. Ensure you have thought carefully what the best tonometer to purchase, or if you’re teaching ophthalmology at a college/university, make sure you buy the correct tonometer for your students to learn.
(NY Times) - Nonpharmacologic interventions to slenderize BP include: weight shrinkage after overweight or pot-bellied patients with a generosity thriving aliment, sodium stipulation, and potassium supplementation within the abstain; and increased physical endeavour with a structured performance program. Men should be limited to no more than 2 and women no more than 1 ensign hard stuff and work viagra without a doctor prescription beverage(s) per day. The usual burden of each lifestyle difference is a 4-5 mm Hg de-escalation in SBP and 2-4 mm Hg decrease in DBP; but abstain down in sodium, saturated plenteousness, and utter plenty and increment in fruits, vegetables, and grains may shrinking SBP not later than generally 11 mm Hg.
Updated: October 20, 2019 2:44
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7,063,612,573,837,198,000 | 01787 278750
07785 777014
It’s been a while since we’ve tackled one of those questions without a simple answer that children love to ask. And, as it’s the summer holidays, there’s still time for plenty more! So we thought it was time for a little research on something we all do every day without ever thinking about.
The easy – and obvious – answer is that we yawn when we’re tired. Or bored. Or both.
The traditional explanation for yawning is that we breathe less deeply when we’re tired or bored. This means that the body takes in less oxygen, leading to an increase of carbon dioxide levels in the blood. Which, in turn, causes us to yawn and so breathe more deeply, taking in more oxygen and releasing more carbon dioxide. As a result we feel more alert. Less tired and bored.
However, recent research has suggested that reduced oxygen levels may not be the trigger but simply a sign of something else. Of a rise in body temperature, particularly within the brain.
Our bodies are designed to function within a very narrow set of parameters, including body temperature. As our core body temperature increases, brain activity slows down, making us feel sleepy and less alert.
Yawning, quite simply, allows larger quantities of cool air to be taken in to the body so helping reduce body temperature. At the same time, more oxygen is also taken in. And both of these help to increase brain function and so makes us feel more alert.
While the new explanation may sound a bit like “two sides of the same coin”, it provides a more comprehensive answer for why we yawn. It also explains why people tend to yawn more when they’re in a warm room, regardless of whether they’re bored or tired. And why going outside into the fresher air usually helps stop it.
Yawning is also a way to release pressure within the inner ear, for example, due to a change in altitude or being bunged up with a cold. It stretches the eardrum which, in turn, opens the Eustachian Tube, so allowing pressure to equalise; with its tell tale “popping”. Chewing gum or having a voluntary yawn does the same thing.
As an aside, yawning has also been found to increase levels of dopamine – the so called “feel good” hormone – within the brain. And, there’s no doubt about it, we all feel better for a good yawn. Not to mention a good stretch.
While yawning is a natural part of life, excessive yawning has been linked to certain health problems, particularly of the Brain / Central Nervous System. However it should be stressed that these are rare and include Epilepsy, MS and tumours. Yawning can also be a side effect of some medication.
Yawning shares many characteristics with laughter. Both can occur voluntarily or involuntarily. And we all know how difficult they can both be to disguise! They’re contagious, with one person yawning triggering those around them.
As an aside, simply reading about yawning can be enough to trigger it. So the question is whether you’ve had a yawn – or two (!) – while reading this post?!? Finally, both laughter and yarning have been described as non verbal forms of communication, understood by all those around them.
So let’s finish with a few bizarre facts about yawning before we go, to amaze – and confuse (!) – your friends.
Did you know that babies in the womb yawn? That it’s not just humans who yawn, but many other animals too? In some animals, like guinea pigs, pronounced yawns showing the front teeth are used as a sign or anger or aggression. And, finally, that yawning is more contagious between family and close friends – and can be used to indicate how empathetic (or not) a person is.
And, before we finish, it seems only right to remind ourselves of what Little Red Riding Hood could have said about yawning:
“What big teeth you have Grandma.”
And, all together, with the reply:
“All the better to eat you with my dear.”
As always, the choice is yours.
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-497,066,849,542,351,900 | Lockdown weight gain: How to lose quarantine weight quickly and healthily
Woman working out in living room to avoid lockdown weight gain
Lockdown weight gain is an issue that has affected most of us, with research revealing that over 40% of adults in England gained weight during the pandemic.
It's safe to say that food was a comfort to many during the numerous UK lockdowns - with fancy home-cooked meals, banana-bread baking and the joy of FINALLY being able to order a takeaway again, being things the British public all indulged in during a difficult year. All this comfort eating (opens in new tab) however has had quite the universal impact on the population though. As one Public Health England survey found that adults across the country experienced an average weight gain of 3kg (or half a stone) during lockdown.
As a return to normalcy begins, many are seeking ways to remedy the effects from staying indoors. With lockdown ageing (opens in new tab) and quarantine weight gain two things many are keen to reverse. With this in mind, we asked the experts about diets that work fast (opens in new tab), how to up our fitness and lose fat from our bellies and bodies post lockdown.
How to reverse lockdown weight gain and lose quarantine weight
Personal trainer Daniel Carpenter from Common Purpose Club says that while it's easy to get tempted "by quick fixes and rapid weight loss programs", it’s not worth it in the long run. If you want to reverse lockdown weight gain for the long-term, you should avoid "a yo-yo pattern with diet and exercise."
Instead, he suggests thinking of weight loss “in months and years, as opposed to days and weeks.”
Here's what to do to reverse lockdown weight gain:
Make sure you’re in a calorie deficit
Being in a calorie deficit is the first step of weight loss and it basically means consuming fewer calories than your body needs to stay at its current weight.
“Ways to do this are monitoring food intake and ensuring you are eating in a calorie deficit.” Personal trainer Martin Hamer from The Training Room (opens in new tab) explains, “Include resistance training a minimum of twice a week to build some lean body mass. This will help you to expend more calories on a daily basis.”
You can use free apps like MyFitnessPal (opens in new tab) to track your calories quickly and easily.
And while the larger the deficit, the quicker the weight loss, it’s important to remember that the changes you make in your diet need to be sustainable to avoid just regaining the weight in future.
Young Woman tracking calories with Smartphone
Use your phone to track your calories. (Credit: getty)
To find out how many calories you need to eat to be in a calorie deficit, use a calculator like this one (opens in new tab), which uses details to work out the number of calories you should eat everyday for weight loss and maintenance.
Ensure you're being consistent
Progress doesn’t just happen overnight, no matter how hard you try, our experts say. “Consistency and adherence need to be the foundation for everything else.” PT Daniel says, “This means setting small and sustainable changes that are both familiar and predictable to you, the individual.”
If you were a keen gym-goer before the lockdown but weren’t one for online workouts at home, it’s also important to recognise that the consistency at which you’ll now exercise is likely to change.
“Prior to the pandemic, if you were exercising around 6 times per week, I would advice easing yourself in and setting a target of 3 workouts per week, to build your fitness levels and back to the way you were training previously.” Haydn Elliott, head trainer and co-owner of F45 Oxford Circus (opens in new tab), explains.
This way, you can keep up consistency by avoiding injury from overtraining and going too hard, too soon.
Woman running down the river, trying to lose lockdown weight
Get back into your exercise routine slowly.(Credit: Getty)
Get good quality sleep
Sleep has been a huge talking point throughout the lockdown, with insomnia and vivid dreams (opens in new tab) topping the list of sleep problems caused by the pandemic. Sleep is vital when you’re doing more day-to-day and will be key if you're trying to reverse lockdown weight gain.
As trainer Haydn explains, “When returning to more intense training structures, you must also focus on getting good quality sleep, at least 7-9 hours. Your body is going to really feel the effects of this increased intensity, so you need to give yourself time to recover.”
He adds, “As well as sleep, you must ensure that you are properly hydrating with several litres of water throughout the day and nourishing your body with an adequate protein intake.
“I would give this same advice to people who have never worked out before as well. People have been fairly inactive throughout the lockdowns, so everyone is starting their own journey again. Now is the time to leave your pride at the door and try to enjoy the process rather than getting too focused on aesthetics.”
Woman waking up
Getting a good night's sleep is crucial to help support healthy weight loss. (Credit: Getty)
Avoid the classic weight loss mistakes
Over the course of losing weight, lots of people find that their diets aren’t working (opens in new tab) and they’re just not losing any more weight. While this can be pinned down to many things, including entering a weight loss plateau - where the body has acclimatised to the calorie deficit - knowing the pitfalls to avoid in advance is a good step.
“One of the biggest pitfalls is overindulging and snacking when you don’t actually require the calories.” Trainer Hasit Jethwa says, “Higher carb intake and reduction in protein intake when you are sitting at home and/or working away is something you should be careful to avoid.
“Carbs are generally very easy and quick to consume, and it is what most people tend to do which leads to a surplus of calories, as you are not utilising them as much being less active.”
But going too far the other way is also a common mistake. “Don’t assume you can do what you did before lockdown and avoid comparing yourself to that; you’ll no doubt have lost strength if you have been away from training and gym equipment, and you’ll also have lost some endurance if you have not been doing cardiovascular work.” Hasit warns, instead take these points into account account and set small targets to progress.
He adds, "You’ll find that the more active you were before and during lockdown, the quicker you’ll be able to get back to where you once were.”
Change your mindset
While it can be difficult to brush away the looming post-lockdown pressure don’t attach your self worth to a number on the scale.
As PT Daniel says, “You are not just your weight. Wanting to lose weight to look and feel better, and become fitter and healthier, are endeavours that we highly encourage. But try (as best you can) to emotionally detach yourself from the weight on the scale.
“We understand this is really difficult, but just view your weight as a data point that provides feedback. You can use this feedback to adjust your daily practices. It’s a massive process of trial and error, but as long as you stick with it...you can’t fail!”
Psychologist and therapist Şirin Atçeken also told GoodtoKnow that as well as not putting pressure on ourselves as we leave lockdown in general, it's important to rebuild our confidence in ways that doesn't just involve weight loss.
"Exercise is excellent for good mental health, positive mental attitude and making us feel energised, but it can be difficult when we aren’t feeling our best. Make a small plan and understand what works for you." She says, "This could be regular walks, a 30 min exercise session, calorie counting or yoga. These activities will provide instant boosts of energy and motivation, and leave you feeling great, and more confident.
Friends walking down the road
Credit: Getty
"I would also recommend buying some new clothes, or readdressing your wardrobe and pull out your favourite clothes." Şirin says, "Loungewear is great, but it doesn’t do our mental health any favours, and makes us feel bigger than we are. Buying new clothes, or trying on existing ones that you haven’t had a chance to wear this past year will instantly boost your confidence, and help you rediscover your style, which is all part of the fun.
"It’s really important that you don’t link your self confidence and worth to your weight, and realise what great qualities you have. Write down on a piece of paper all of your great qualities - or better yet, get someone else to write them down, and you do the same for them. Whenever you feel low, or sad, look at the list to help perk you up and make you feel better."
Ask for help when you need it
Whether you’re itching to get back on the treadmill or looking to venture into the world of back garden HIIT workouts to help shift any unwanted lockdown weight gain, professional help can really make the difference.
Personal Trainer Daniel suggests asking an expert “who is experienced in helping people through the weight loss journey”. Not only will they help you create a plan but you’ll also “have someone to hold you accountable and provide advice or guidance when things get tough.” | {
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When I wean patients off of treatment, I do not change the dose but rather delay the treatment cycle to 16 weeks and monitor headaches in the last 4 weeks. If the patient remains well-controlled, I increase the treatment window to 20 weeks, and so on. I use this method to establish the level at which patients need reinjection to prevent breakthrough headaches.11-13
It is not always clear what is causing chronic migraines. BOTOX is a viable option for treating migraines, and it may be the most effective treatment for you. Migraines lead to extreme pain that impacts every aspect of life, from personal to professional. Migraines are debilitating and for some who suffer from the condition, bedrest is the only option. A BOTOX treatment for migraines is a simple procedure but could vastly improve your quality of life.
In two double-blind, placebo-controlled trials in patients with detrusor overactivity associated with a neurologic condition (NDO-1 and NDO-2), the proportion of subjects who were not using clean intermittent catheterization (CIC) prior to inject ion and who subsequently required catheterization for urinary retention following treatment with BOTOX 200 Units or placebo is shown in Table 9. The duration of post-injection catheterization for those who developed urinary retention is also shown.
Serious and/or immediate hypersensitivity reactions have been reported. These reactions include anaphylaxis, serum sickness, urticaria, soft-tissue edema, and dyspnea. If such reactions occur, further injection of BOTOX® Cosmetic should be discontinued and appropriate medical therapy immediately instituted. One fatal case of anaphylaxis has been reported in which lidocaine was used as the diluent and, consequently, the causal agent cannot be reliably determined.
Sarah of My Migraine Life is a mom living with chronic migraine and daily headaches who has tried a gamete of medications, alternative therapies and lifestyle changes. These experiences led her to write “My Migraine Life,” a website for people living with migraine and their caretakers devoted to telling stories, raising awareness, giving support, product reviews and more. My Migraine Life is a partner of the American Migraine Foundation.
Botox is so commonplace these days that you can get it done at some gyms and spas, but in these cases, you never know what you’re getting, how old the product is, with what it's mixed, and whether the injector knows what he or she is doing. Dr. Matarasso suggests only getting it done by what he calls the “core four”: a board-certified physician who is either a dermatologist, a plastic surgeon, an ear-nose-and-throat doctor, or an ophthalmologist.
Unlike some resurfacing or surgical procedures, after which there is possible pigmentation or scarring, when Botox is done correctly, it can be done on all skin tones. “This is a procedure [and] product that crosses all divides,” says Dr. Matarasso. “Men, women, Caucasian, African-American, Asian, Indian. I don’t think there is a demographic that has not enjoyed the benefit of this product.”
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The safety and efficacy of onabotulinumtoxinA for CM was demonstrated in the pivotal phase III Research Evaluating Migraine Prophylaxis Therapy (PREEMPT) trial. In this trial, patients were treated every 12 weeks whether or not their headaches had returned to baseline levels and the primary outcome period was after two treatment cycles. At baseline, these patients had more than 19 headache days, and after two treatment cycles, their headaches had been reduced by 8 to 9 days per 28 days. The responder rate analysis of the study population shows that about 25% of patients improved by 75% in terms of a reduction of migraine days. In my practice, I usually do three cycles 12 weeks apart, and only if there is no change in headache frequency after this, do I change treatments. In the pivotal trials, the first statistical separation from placebo occurred in the first 4 weeks. There is a small subgroup of patients who fail to respond to the first two treatments and only start to respond after the third treatment.4-10
The frontalis muscle attaches to the skin of the lower forehead and ascends to join the fronto-occipital aponeurosis. The action of the frontalis muscle involves elevation of the eyebrows to produce expressions such as surprise, and can cause deep transverse wrinkles on the forehead. The antagonists for brow depression are the corrugators, procerus, and orbicularis oculi muscles.
It is not always clear what is causing chronic migraines. BOTOX is a viable option for treating migraines, and it may be the most effective treatment for you. Migraines lead to extreme pain that impacts every aspect of life, from personal to professional. Migraines are debilitating and for some who suffer from the condition, bedrest is the only option. A BOTOX treatment for migraines is a simple procedure but could vastly improve your quality of life.
Unremarkable. I mean, that’s a good thing in the MRI-reading world, but I’d like to say my brain is freakin’ remarkable sometimes. Maybe I’m biased. Anyways. Shortly after those tests, the Botox arrived at the office and I was scheduled for my injections. To say I was scared is putting it lightly. Like I mentioned before, I have a complete irrational fear of new medication. Also, I didn’t want my face to look different! So I documented my wrinkles just to see how many would last (if you want, be my guest to check out my embarrassing video). I didn’t have to wait long and before I knew it, I was in a room with my mom, my boyfriend, a neurologist and three needles.
The most common severe adverse reaction associated with the use of BOTOX injection in patients with cervical dystonia is dysp hagia with about 20% of these cases also reporting dyspnea [see WARNINGS AND PRECAUTIONS]. Most dysphagia is reported as mild or moderate in severity. However, it may be associated with more severe signs and symptoms [see WARNINGS AND PRECAUTIONS].
Two double-blind, placebo-controlled, randomized, multi-center clinical studies were conducted in patients with urinary incontinence due to detrusor overactivity associated with a neurologic condition who were either spontaneously voiding or using catheterization (Studies NDO-1 and NDO-2). A total of 691 spinal cord injury (T1 or below) or multiple sclerosis patients, who had an inadequate response to or were intolerant of at least one anticholinergic medication, were enrolled. These patients were randomized to receive either 200 Units of BOTOX (n=227), 300 Units of BOTOX (n=223), or placebo (n=241).
Study 2 compared 3 doses of BOTOX with placebo and included 91 patients [BOTOX 360 Units (N=21), BOTOX 180 Units (N=23), BOTOX 90 Units (N=21), and placebo (N=26)] with upper limb spasticity (expanded Ashworth score of at least 2 for elbow flexor tone and at least 3 for wrist flexor tone) who were at least 6 weeks post-stroke. BOTOX and placebo were injected with EMG guidance into the flexor digitorum profundus, flexor digitorum sublimis, flexor carpi radialis, flexor carpi ulnaris, and bic eps brachii (see Table 27).
When asked how often he turns people away, Dr. Matarasso says: “I turned someone away today. I had a gentleman come in, he was an appropriate candidate anatomically, he had some deep lines in his forehead, but his expectations were unrealistic. He wanted every line erased, and I said, ‘No, you are going to look a little mask-like.’ I gave him a brochure and said, 'Go home and think about it.'”
When I wean patients off of treatment, I do not change the dose but rather delay the treatment cycle to 16 weeks and monitor headaches in the last 4 weeks. If the patient remains well-controlled, I increase the treatment window to 20 weeks, and so on. I use this method to establish the level at which patients need reinjection to prevent breakthrough headaches.11-13
In addition to glabellar lines, Botox is used to eradicate crow’s feet, frown lines, and lines and furrows in the forehead. Whereas treating crow's feet and forehead lines with Botox was for many years an off-label use, the toxin has since received FDA approval for both uses. Botox is also approved to treat a variety of medical conditions, including ocular muscle spasms, problems with eye coordination, severe armpit perspiration, migraine headaches, overactive bladder, urinary incontinence related to nerve damage from conditions such as multiple sclerosis and spine injury. Botox is being studied to determine if it might be useful in treating conditions such as knee and hip osteoarthritis, temporomandibular joint disorder (TMJ) and benign prostatic hyperplasia (BPH).
Prevention of contractures begins with finding out what is limiting a child from either actively (moving oneself) or passively (being moved by someone else) moving the joints through a full range of motion. In some cases, this can be due to destruction or abnormality of the bones around a joint. It can also be due to problems with the ligaments and tissue around that joint.
In 2016, the stock price of Tobira Pharmaceuticals stumbled on the release of the top-line data of the Phase 2b CENTAUR study of CVC therapy in NASH because the clinical trial missed its primary clinical outcome of improvement in NASH resolution without worsening of liver fibrosis. However, CVC therapy achieved its secondary clinical outcome of improvement in liver fibrosis without worsening of NASH resolution. The clinical efficacy of CVC on NASH liver fibrosis is currently being further researched in the ongoing Phase 3 AURORA clinical trial.
Botox is considered as an elective procedure which means that the insurance does not cover the cost. But in case of treating medical conditions, an insurance can cover the cost of the treatment but make sure to consult your doctor regarding the coverage. Botox injections can also be used to treat conditions such as excessive perspiration (hyperhidrosis), migraine and muscle spasticity.
Strabismus is caused by imbalances in the actions of muscles that rotate the eyes, and can sometimes be relieved by weakening a muscle that pulls too strongly, or pulls against one that has been weakened by disease or trauma. Muscles weakened by toxin injection recover from paralysis after several months, so it might seem that injection would then need to be repeated. However, muscles adapt to the lengths at which they are chronically held,[18] so that if a paralyzed muscle is stretched by its antagonist, it grows longer, while the antagonist shortens, yielding a permanent effect. If there is good binocular vision, the brain mechanism of motor fusion, which aligns the eyes on a target visible to both, can stabilize the corrected alignment.
The efficacy and safety of BOTOX for the treatment of primary axillary hyperhidrosis were evaluated in two randomized, multi center, double-blind, placebo-controlled studies. Study 1 included adult patients with persistent primary axillary hyperhidrosis who scored 3 or 4 on a Hyperhidrosis Disease Severity Scale (HDSS) and who produced at least 50 mg of sweat in each axilla at res t over 5 minutes. HDSS is a 4-point scale with 1 = “underarm sweating is never noticeable and never interferes with my daily activities”; to 4 = “underarm sweating is intolerable and always interferes with my daily activities”. A total of 322 patients were randomized in a 1:1:1 ratio to treatment in both axillae with either 50 Units of BOTOX, 75 Units of BOTOX, or placebo. Patients were evaluated at 4-week intervals. Patients who responded to the first injection were re-injected when they reported a re-increase in HDSS score to 3 or 4 and produced at least 50 mg sweat in each axilla by gravimetric measurement, but no sooner than 8 we eks after the initial injection.
How much is Botox is a frequent question we get in our dermatology offices. The cost of Botox runs typically about $400 – $600 per first treatment area, and up to $300 for each additional area. The most popular areas for Botox treatment are the glabella (those lines in between your eyebrows also known as the “11’s”), the crow’s feet are around the eyes and the horizontal lines on the forehead. When injected by a trained professional who has experience with facial aesthetics, Botox can also give the brows and eye area a mini eye lift. When Botox injections are performed by a trained, licensed and experienced medical expert, the results can be amazing. You will not appear frozen or as though you’ve had work done, when injected properly, Botox makes you look more relaxed, more rejuvenated and just better than before. It’s important to seek out a professional who knows about facial anatomy and can inject you in the exact right places.
Jump up ^ Arnon SS, Schechter R, Inglesby TV, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, Fine AD, Hauer J, Layton M, Lillibridge S, Osterholm MT, O'Toole T, Parker G, Perl TM, Russell PK, Swerdlow DL, Tonat K (February 2001). "Botulinum toxin as a biological weapon: medical and public health management". JAMA. 285 (8): 1059–70. doi:10.1001/jama.285.8.1059. PMID 11209178.
The idea of a needle going toward your forehead, in between your eyes, or at your eyebrows might be a little daunting, but rest assured, not only is Botox FDA-approved, but it’s a very common (and highly-requested) procedure. It’s commonly used for cosmetic reasons, but it also helps alleviate a slew of other health concerns.”Botox was first approved by the FDA in 1989 to treat blepharospasm of the eyelid, and now can treat hundreds of medical conditions, such as hyperhidrosis (excessive sweating) or chronic migraines,” dermatologist Jill S. Waibel, MD. She also notes that it was only approved for cosmetic purposes in 2002. “Since then, millions of people have had Botox done safely and effectively. It is important to remember that Botox is safest when used by a board certified dermatologist or a plastic surgeon.”
“ARMR is a longitudinal study. We’re collecting data over time, which will allow us to study changes in headache patterns, health care resource utilization, diagnostic and management strategies, development of co-morbidities and responses to therapies,” Dr. Schwedt says. The registry is comprised of multiple components: The first component is an online platform in which participants fill out a baseline and follow-up questionnaires and clinicians enter the participants’ headache diagnoses. There is also an ARMR headache diary mobile app in which participants share daily information about their migraine attacks, their level of function and their treatment, if any. The third component is a blood sample, which is processed and stored in the ARMR biobank and will be used for genetic analyses. Brain imaging data are collected in the ARMR Neuroimaging Repository, and electronic health record data are pulled and confidentially entered into a centralized ARMR database. “Oftentimes, research is done in silos,” Dr. Schwedt says. “So a group at one institution is doing their own work, collecting their own data, doing their own analysis. And a group at another institution is doing their own work. That isn’t the most efficient way to move forward in the field. We believe creating and sharing data from this large and comprehensive study is really going to improve the efficiency of research in the field.”
In cosmetic applications, botulinum toxin is considered safe and effective for reduction of facial wrinkles, especially in the uppermost third of the face.[23] Injection of botulinum toxin into the muscles under facial wrinkles causes relaxation of those muscles, resulting in the smoothing of the overlying skin.[23] Smoothing of wrinkles is usually visible three days after treatment and is maximally visible two weeks following injection.[23] The treated muscles gradually regain function, and generally return to their former appearance three to four months after treatment.[23] Muscles can be treated repeatedly to maintain the smoothed appearance.[23]
Study 3 compared 3 doses of BOTOX with placebo and enrolled 88 patients [BOTOX 360 Units (N=23), BOTOX 180 Units (N=23), BOTOX 90 Units (N=23), and placebo (N=19)] with upper limb spasticity (expanded Ashworth score of at least 2 for elbow flexor tone and at least 3 for wrist flexor tone and/or finger flexor tone) who were at least 6 weeks post -stroke. BOTOX and placebo were injected with EMG guidance into the flexor digitorum profundus, flexor digitorum sublimi s, flexor carpi radialis, flexor carpi ulnaris, and biceps brachii (see Table 27).
This is where Botox comes into play. When you get consistent Botox injections, you prevent potential wrinkle formations from getting deeper or worse. Botox limits the range of facial muscle movement (when done skillfully, your face will not get that frozen look) so that wrinkles don't worsen over time. If you have a bad habit of frowning or lifting your brows for no reason, consistent Botox injections can also help your face kick these bad habits and therefore prevent any potential lines from getting etched in your skin. Getting frequent Botox injections may also help relax your facial muscles so that you don't need as a high a dose or as frequent as an injection to maintain your results.
This product contains albumin, a derivative of human blood. Based on effective donor screening and product manufacturing processes, it carries an extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD). There is a theoretical risk for transmission of Creutzfeldt-Jakob disease (CJD), but if that risk actually exists, the risk of transmission would also be considered extremely remote. No cases of transmission of viral diseases, CJD or vCJD have ever been identified for licensed albumin or albumin contained in other licensed products.
Botox injections use onaboutlinumtoxin A, also known as the botulinum toxin, injected in small amounts to certain points in the head to treat migraine headaches, tension headaches, and chronic daily headaches. This treatment has been shown to be most effective for headaches that are located in the forehead and neck. Botox has also been used to treat the following conditions:
Botox often gets a bad rep for leaving patients looking a little frozen, but that's the fault of bad technique, not necessarily the procedure itself, explains Day. "In many places where it's not a trained aesthetic physician doing the injection, it's really just inject by number," she says. The problem with this is that no two faces, or even two sides of a face, are the same. "That cookie cutter, one-size-fits-all approach is what often gives these treatments a bad name," says Day.
The following adverse reactions with BOTOX 200 Units were reported at any time following initial injection and prior to re -injection or study exit (median duration of exposure was 44 weeks): urinary tract infections (49%), urinary retention (17%), constipation (4%), muscular weakness (4%), dysuria (4%), fall (3%), gait disturbance (3%), and muscle spasm (2%).
Jump up ^ Dodick DW, Turkel CC, DeGryse RE, Aurora SK, Silberstein SD, Lipton RB, Diener HC, Brin MF (June 2010). "OnabotulinumtoxinA for treatment of chronic migraine: pooled results from the double-blind, randomized, placebo-controlled phases of the PREEMPT clinical program". Headache. 50 (6): 921–36. doi:10.1111/j.1526-4610.2010.01678.x. PMID 20487038.
Migraine with visual aura involves visual effects that usually precede the headache and last at least 5 minutes. The visual aura is usually an expanding blinding spot or visual scintillations (shimmering objects in the visual field). Other aura features include reversible symptoms of speech and language difficulty such as word-finding problems and aphasia (inability to express words or comprehend words), sensory phenomena such as tingling in the extremities extending to the face, motor effects such as weakness, and brainstem problems such as unsteadiness and features of cranial nerve dysfunction. These aura symptoms usually last 5 to 60 minutes, can precede or start during the headache, and can also occur without a headache.
The migraines started later in life, before my lupus diagnosis. While sometimes they’d come out of the blue or I’d wake up with them, other times I’d see them coming. From a neurologist’s suggestion, I learned some of my “triggers” such as weather changes (specifically, drops in barometric pressure and incoming storms), hormonal changes and dairy. This past year I significantly reduced my dairy intake and although that didn’t eliminate the migraines, if I did eat dairy, I was sure to get one. Many of my migraines would also start as tension headaches. My neck is always extremely tight and eventually the constant tightness causes a migraine. Due to this, my old rheumatologist suggested taking a muscle relaxer at the beginning of a headache or before bed to keep my muscles from tensing up overnight and preventing a migraine. It worked sometimes… but definitely not enough.
BOTOX, highly diluted botulinium toxin, works to prevent migraine by blocking the release of a chemical in muscle cells that transmits the signal to contract to muscle fibers. Research into using BOTOX to treat migraines began after patients receiving it for other conditions reported improvement in their migraine symptoms. In 2010, after years of research and collecting clinical data, the FDA approved BOTOX for treating chronic migraines.
Each vial of BOTOX contains either 50 Units of Clostridium botulinum type A neurotoxin complex, 0.25 mg of Albumin Human, and 0.45 mg of sodium chloride; 100 Units of Clostridium botulinum type A neurotoxin complex, 0.5 mg of Albumin Human, and 0.9 mg of sodium chloride; or 200 Units of Clostridium botulinum type A neurotoxin complex, 1 mg of Albumin Human, and 1.8 mg of sodium chloride in a sterile, vacuum-dried form without a preservative.
Botox only lasts three to six months—and yet what's less commonly discussed is this: Facial muscles naturally weaken over time and going overboard in a certain area could have unwanted consequences. "If you do too much Botox on your forehead for many, many years, the muscles will get weaker and flatter," cautions Wexler, adding that the skin can also appear thinner and looser. Moreover, as your muscles become weaker, they can start to recruit surrounding muscles when you make facial expressions. "If one stops using their forehead muscles, they may start squinting using their nose and have wrinkles along the side of their nose," she explains. Translation: You need even more Botox for the newly recruited muscles, says Wexler. To avoid these kind of missteps, researching a doctor diligently is essential, as is approaching injectables conservatively, and asking questions about how the treatment will be tailored to your needs.
Vials of BOTOX have a holographic film on the vial label that contains the name “Allergan” within horizontal lines of rainbow color. In order to see the hologram, rotate the vial back and forth between your fin gers under a desk lamp or fluorescent light source. (Note: the holographic film on the label is absent in the date/lot area.) If you do not see the lines of rainbow color or the name “Allergan”, do not use the product and contact Allergan for additional information at 1-800-890-4345 from 7:00 AM to 3:00 PM Pacific Time.
"As we get older, we lose volume in our face and hyaluronic acid filler can be used as a replacement,” explains Wexler. "For younger women, injections can be used to treat areas with acne scarring or hollowness under the eyes." During your ‘20s, when the face is at its fullest and healthiest, it has been argued that a shadowy gaze can even be quite charming. But in other cases, hereditary dark circles can result in a persistently tired look, which is where a few drops of filler under the eyes may be useful. As top dermatologist David Colbert, M.D. is quick to note, however, too much Botox and filler distorts the face and as a result will make you appear older. “When the line is crossed everyone starts looking like they are related," he also cautions of a uniform cookie-cutter appearance that lacks character or individuality. Or worse. “It’s a snowball effect of people liking something, coming back too soon [for even more], and then it gets too heavy,” adds Wexler.
Two preparations of botulinum antitoxins are available for treatment of botulism. Trivalent (A,B,E) botulinum antitoxin is derived from equine sources using whole antibodies. The second antitoxin is Heptavalent (A,B,C,D,E,F,G) botulinum antitoxin, which is derived from equine antibodies which have been altered to make them less immunogenic. This antitoxin is effective against all known strains of botulism.
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Association between ceramides and coronary artery stenosis in patients with coronary artery disease
Abstract
Background
Coronary artery stenosis induces heart diseases including acute coronary syndrome (ACS). Some studies reported the ceramide species are associated with the ACS and major adverse cardia and cerebrovascular events (MACE). However, few studies investigated the association between plasma ceramide levels and the severity of stenosis, together with the onset of diseases. This aim of the present study was to investigate the association betweencertain ceramide species, coronary artery stenosis and acute coronary syndrome.
Methods
Five hundred fifty-three patients with definite or suspected CAD were recruited and received angiography. Subjects were assigned into 4 groups according to the severity of coronary artery stenosis. The measurements of 4 plasma ceramide species, namely, Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1), Cer (d18:1/24:0) were carried out by Liquid chromatography-tandem mass spectrometry (LC-MS/MS) and the ratio of Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1) to Cer (18:1/24:0), respectively, were calculated as index to evaluate the association between plasma ceramides levels and coronary artery stenosis. Multiple logistic regression analysis was used to establish the prognostic model for the prediction of ACS risk.
Results
After the adjustment by multiple clinical risk factors including age, gender, pre-existing myocardial/cerebral infarction, hemoglobin A1c% (HbA1c%), smoking and the diagnosis during index hospitalization, multiple logistic regression analysis showed that the high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, HbA1c%, unstable angina (UAP) and acute myocardial infarction (AMI) diagnosis (compared with atherosclerosis) during index hospitalization were associated with more severe coronary artery stenosis. Furthermore, the prognostic model was established after adjustment of risk factors and the area under curve (AUC) of receiver operating characteristics (ROC) for the prognostic model was 0.732 and 95% CI was 0.642–0.822.
Conclusion
The severity of coronary artery stenosis is associated with high ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0), female gender, HbA1c% and AMI. Although the reported prognostic model showed a good discrimination, further investigation on long term MACE is needed to evaluate the role of ceramide for the prediction of MACE risk.
Background
Acute coronary syndrome (ACS) refers to a spectrum of clinical presentations ranging from acute myocardial infarction (AMI) including ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) to presentations found in unstable angina (UAP). The high mortality of ACS is associated with rupture of an atherosclerotic plaque and partial or complete thrombosis of the infarct-related artery [1, 2]. Atherosclerosis results from the buildup of lipids, macrophages, T-lymphocytes, smooth muscle cells, extracellular matrix, calcium and necrotic debris in vessels. Therefore, the lipids (Low Density Lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride) and inflammation factors (cysteine protease inhibitor C and high-sensitivity C-reactive protein (hs-CRP)) combined with biomarkers of cardiac disease (brain natriuretic peptide (BNP), creatine kinase-MB (CK-MB) and cardiac troponin I (cTnl) etc.) are widely used in clinic diagnosis of ACS and evaluation of ACS risk.
Ceramide is a family of sphingomeric lipids composed of long chain bases of sphingosine and fatty acids heads. In the past few years, numerous studies have suggested that ceramides and other sphingolipids regulate cellular responses to extracellular stimuli and stress and they are involved in pathophysiological mechanism in many disease areas [3,4,5,6]. It has been proposed and confirmed by several researchers [7, 8] that plasma ceramide level increased drastically in the presence of high level of LDL cholesterol. Plasma ceramide levelis also positively associated with the levels of total cholesterol. More recent clinical studies [9,10,11,12,13,14] worldwide have rasied the theory that some specific plasma ceramides can be used as biomarkers, which are more precise than traditional lipid biomarkers for the prediction of adverse cardiovascular outcomes in patients with coronary artery disease (CAD) or the risk of acute coronary syndrome in healthy cohort. The plasma ceramides that have been studied as high-risk factors are Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1) and the ratios of these ceramides to Cer (d18:1/24:0) [15, 16]. Although these studies suggest that plasma ceramide may contribute to atherogenesis and correlate with the risk of coronary heart disease, the solid clinical evidence indicating the association between the plasma ceramides and the coronary artery stenosis and the incidence of ACS is still inadequate.
The present study investigated the association between plasma ceramide species, coronary artery stenosis and ACS in patients undergoing coronary artery angiography with established ACS and other CAD.
Method
Subject and sample
Five hundred fifty-three patients with suspected or definite ACS and other CAD who underwent angiography in Beijing Anzhen hospital between Mar.2018 and Aug.2018 were recruited. The exclusion criteria included moderate to severe chronic kidney disease, suspected aortic dissection, acute pulmonary embolism, familial hypercholesterolemia, drug abuse, alcohol dependence, history of percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), and history of stroke in the last 3 months before recruiting. In addition, the patients who needed emergency PCI were excluded in this study including patients were STEMI occurred within 24 h, non-STEMI with symptoms like chest pain and unstable hemodynamics. The diagnostic criteria were adopted from WHO criteria and ESC Guidelines [17,18,19]. Briefly, the criteria included electrocardiograph (ECG) and the presence or absence of serologic markers. ST elevations, ST depressions, T-wave inversions and pathological Q-waves may be observed both in AMI and UAP patients, but they were transient in UAP patients. Cardiac troponins elevation in peripheral blood was for the establishment of a diagnosis of AMI, whereas cardiac troponins may slightly increase in UAP but did not meet criteria for AMI. CK-MB was elevated in AMI but not in UAP. Both normal ECG and normal levels of cardiac troponins and CK-MB were presented in atherosclerosis.
All patients fasted overnight before the scheduled day for angiography. About 500 μL of plasma samples were collected from each participated patient in the morning before the coronary angiography surgery and stored at − 80 °C until analysis.
The clinic records included age, gender, history of cardiac and cerebrovascular infarction, smoking, alcohol assumption, history of medication and blood chemistry tests. The coronary stenosis severity was grated using semi-quantitative stenosis grading system based on angiographic images. The patients were contacted by phone up to 1 year after discharging to ascertain the incidence of MACE, which included myocardial infarction, stent thrombosis, target vessel revascularization, stroke and cardiac death. The workflow is presented in Fig. 1.
Fig. 1
figure1
Work flow of the study
The Ethics Committee of Anzhen Hospital approved the study protocol with the approval number 2017060X. All participants submitted their written informed consent for the participation in this research.
Angiography and grouping
Before coronary angiography, the arm or groin of patient was cleaned and numbed with 1% lidocaine, followed by puncturing the radial artery or the femoral artery. Then a catheter was put through the artery and carefully moved up into the coronary artery. Once the catheter was in place, contrast material (Iopromide, Bayer Schering Pharma AG, Berlin, Germany) was injected into the catheter. X-ray images were taken at different angles at the same time. The obtained angiographic films were assessed by experienced clinical cardiologist to get semi-quantify coronary artery stenosis.
The largest percentage of coronary artery stenosis in single vessel (left main artery, left anterior descending, right coronary artery or left circumflex artery) defined the severity of coronary artery stenosis. In all subjects, 93 out of 107 subjects with stenosis < 50% were single vessel CAD, while 10 and 4 subjects were 2 vessels and 3 vessels CAD, respectively. Most multi-vessel CAD patients (96.4%) were in group of stenosis > 50%, and only 2 out of 368 cases were single vessel CAD with stenosis > 75%. Therefore, the patients were assigned into 4 groups according to the severity of coronary artery stenosis: group 1: stenosis < 25% (n = 60); group 2: stenosis 25–50% (n = 47); group 3: stenosis 50–75% (n = 78); group 4: stenosis > 75% (n = 368). The representative angiographic images are shown in picture (Fig. 2).
Fig. 2
figure2
The representative image of coronary artery stenosis
Ceramide measurement
The LC-MS/MS conditions, method performance, and evaluation of the methodology are described in supplementary information (Additional file 1).
Statistical analysis
One way ANOVA followed by post-hoc test and Chi-square test were used to analyze the differences in main clinical and biochemical characteristics of patients. Kruskal-Wallis test and Mann-Whitney test were used for ceramide levels analysis. Multiple logistic stepwise regression analysis was used to evaluate the independent association between coronary artery stenosis and risk factors including plasma ceramide species. The prognostic association of individual ceramide species with MACE was modelled using logistic regression.
Result
Subject profile
A total of 553 patients with a primary diagnosis as coronary heart disease and underwent the coronary angiography were recruited. The clinical characteristics and part of chemistry profiles of the subjects are shown in table (Table 1).
Table 1 Clinical and Biochemistry characteristics of Patients
Plasma ceramide level in ACS and atherosclerosis
The patients were assigned into 4 groups according to coronary artery stenosis (stenosis < 25%, 25–50%, 50–75 and > 75%). Kruskal-Wallis test was used to analyze and compare the ceramide levels in group 1, 2, 3 and 4. There was no significant difference in levels of Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1), or ratios of Cer (d18:1/16:0), Cer (d18:1/18:0) or Cer (d18:1/24:1) to Cer (d18:1/24:0) between groups, except Cer (d18:1/16:0)/Cer (d18:1/24:0) ratio was significantly increased in group 1 compared to group 2 (P < 0.05, Fig. 3). Moreover, plasma ceramides levels were analyzed regarding different types of coronary artery diseases. It was found that 78.8% of patients admitted to hospital were diagnosed as UAP, 10.7 and 6.9% were diagnosed as AMI and atherosclerosis, respectively. The remaining cases included rheumatic heart disease, sinus tachycardia, pre-excitation syndrome and other heart diseases. The levels of plasma Cer (d18:1/16:0), Cer (d18:1/24:0), and Cer (d18:1/24:1)/ Cer (d18:1/24:0) ratio were significantly increased in AMI patients compared to those in UAP patient (Fig. 4), whereas there was no difference in ceramide levels or ratios between other groups. It is worthy to point that the incidence rates of established diseases were different in 4 groups (data not shown), which suggested that difference of established disease is a risk factor in coronary artery stenosis.
Fig. 3
figure3
Concentration of ceramides and ratio of ceramides to cer (d18:1/24:0). a. concentration of cer (d18:1/16:0) and cer (d18:1/18:0): there were no significant differences in cer (d18:1/16:0) or cer (d18:1/18:0) level between groups. b. concentration of cer (d18:1/24:1) and cer (d18:1/24:0): neither cer (d18:1/24:1) nor cer (d18:1/24:0) were significantly different between groups. c. ratio of ceramides to cer (d18:1/24:0): ratio of cer (d18:1/16:0) to cer (d18:1/24:0) was significantly increased in group with stenosis < 25% compared to group with stenosis 25–50% (P < 0.05), whereas there was no difference between other groups. There were no significant differences in ratios of cer (d18:1/18:0) or cer (d18:1/24:1) to cer (d18:1/24:0) between groups. (data is presented as mean ± SEM)
Fig. 4
figure4
Level of plasma ceramide species in ACS and atherosclerosis patient: a. concentration of cer (d18:1/16:0) and cer (d18:1/18:0): cer (d18:1/16:0) concentration wasonly significantly elevated in AMI compared to those in UAP (P < 0.05), whereas there was no different concentration of cer (d18:1/18:0) observed between groups. b. concentration of cer (d18:1/24:1) and cer (d18:1/24:0): there was no difference in cer (d18:1/24:1) concentration between groups, whereas cer (d18:1/24:0) concentration was significant increased in AMI compared to it in UAP and no difference compared to it in atherosclerosis(**P < 0.01). c. ratio of ceramides: there was only a significant increased ratio of cer (d18:1/24:1)/cer (d18:1/24:0) in AMI compared to it in UAP (P < 0.05). (data is presented as mean ± SEM)
Although no significant increase of plasma levels of ceramides were observed with severity of coronary artery stenosis, the incidences of UAP, AMI and atherosclerosis were different in subjects with different severity of stenosis. Those results suggested that the association between coronary artery stenosis and ceramide level was possibly adjusted by the diagnosis during index hospitalization. In addition, the average age of cohort was more than 55 years old and there were age-related disease conditions and life styles such as smoking habbit that could influence atherosclerosis besides ceramides. Thus, multiple logistic stepwise regression analysis was used to evaluate the independent association between plasma ceramide and severity of atherosclerosis after adjustment for established risk factors. The model was adjusted for age, gender, smoking, pre-existing myocardial/cerebral infarction, the presence of hypertension, lipids, hemoglobin A1c% (HbA1c%) and the diagnosis during index hospitalization. Covariates included in multiple regression model were selected as potential confounding factor based on their significance in univariate analyses or their biological plausibility. To enhance the power of the logistic stepwise regression analysis, the subjects were re-assigned into 2 groups in order to increase the number of sample in each group: group A with mild to moderate stenosis (group1 + group2, i.e. coronary stenosis < 50%) and group B with moderate to severe stenosis (group3 + group4, i.e. coronary stenosis > 50%). As shown in Fig. 5, only Cer (d18:1/24:1)/Cer (d18:1/24:0) ratio was significantly increased in group B compared to group A (P < 0.05) before logistic stepwise regression analysis.
Fig. 5
figure5
Concentration of ceramides and ratio of ceramides to cer (d18:1/24:0): There was a significant increased ratio of cer (d18:1/24:1)/cer (d18:1/24:0) in group of stenosis > 50% compared to group of stenosis < 50% (P < 0.05), whereas no difference was observed in other ceramides and ratios of ceramides between groups. (data is presented as mean ± SEM)
Logistic stepwise regression analysis was performed to analyze the effect of multiple factors on coronary artery stenosis with entry and exit criteria of 0.2 for stepwise selection. In model 1, the results show that high level of Cer (d18:1/24:1)/Cer (d18:1/24:0) (odds ratio (OR) 18.927, 95% confidence interval (CI) 1.902–188.380), female gender (OR 2.57, 95% CI 1.446–4.567), high level of HbA1c% (OR 1.37, 95% CI 1.012–1.854) and AMI compared with atherosclerosis (OR 436.227, 95% CI 45.285- > 999.999) were associated with more severe coronary artery stenosis (Table 2). In model 2, in addition to female gender (OR 2.609, 95% CI 1.401–4.859), high level of Cer (d18:1/24:1)/Cer (d18:1/24:0) (OR 25.152, 95% CI 2.360–268.084) and AMI compared with atherosclerosis (OR 436.9.8, 95% CI 44.311- > 999.999) were associated with more severe coronary artery stenosis, low level of LDL-C (OR 1.579, 95% CI 1.046–2.384) and UAP compared with atherosclerosis (OR 70.024, 95% CI 21.017–233.300) were also associated with more severe coronary artery stenosis (Table 2).
Table 2 Association between plasma ceramides and the severity of coronary stenosis after adjustment of multiple risk factors
MACE and the prognostic model
A total of 553 subjects were followed up for 1 year after angiography. The one-year incidence of MACE was 6.01% (6.32% in male and 5.24% in female), and the one-year mortality was 0.45%. The prognostic association of individual ceramide species with MACE was modelled using multiple logistic regression for binary outcomes (event, non-event). After clinical risk factors adjustment including concentrations of targeted ceramides, stenosis severity, infarction history, diagnosis during index hospitalization, gender, age, smoking, and HbAc1% inmultiple logistic regression model, the results showed that pre-existing infarction history was associated with MACE (OR 2.874, 95% CI 1.139–7.254, P = 0.025), whereas stenosis severity (OR 6.732, 95% CI 0.730–62.054, P = 0.092) and other factors were not. Receiver operating characteristics (ROC) for the prognostic model was shown in Fig. 6. The area under curve (AUC) was 0.732 and 95% CI was 0.642–0.822, which indicated that the established prognostic model gave a good discrimination.
Fig. 6
figure6
The ROC curve of prognostic model for prediction of MACE. AUC of ROC was 0.732 and 95% CI was 0.642–0.822
Discussion
The present study investigated three of the most reported ceramides in ACS studies, Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1), and their plasma ratios to Cer (d18:1/24:0) in patients with different severity of coronary stenosis. It was firstly found that the ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0) was significantly increased in subjects with stenosis > 50% compared to those with stenosis < 50% before logistic regression analysis. Moreover, the higher levels of Cer (d18:1/16:0), Cer (d18:1/24:0) and the higher ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0) were observed in AMI patients compared to UAP patients. These results are not consistent with the findings reported in a recent study [20], which investigated 12 ceramides species both in AMI patient and rat AMI model. This study found that only plasma Cer (d18:1/24:0) level was significantly increased in AMI subjects compared with sham and healthy control subjects, whereas no significant changes in other ceramide levels including Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1) was observed. However, it is worthy to point out that the present study only found certain ceramide differences between AMI patients and other cardial artery diseases pateints but not between AMI patients and the healthy control. A study in myocardial perfusion defects [14] found that only Cer (d18:1/24:1) was significantly increased in subjects with myocardial perfusion defects compared with those without myocardial perfusion defects in unadjusted model, whereas most targeted ceramides (Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/20:0), Cer (d18:1/22:0) and Cer (d18:1/24:1)) were associated with myocardial perfusion defects after adjustment for cardiovascular risk factors. In addition, the accumulating experimental and clinical evidences indicate that there is a potential role of distinct ceramide species in atherosclerotic plaque progression, vulnerability and ischemia-induced cardiomyocyte apoptosis. For example, the distinct plasma ceramides that are involved in endothelial damage and atherosclerotic plaque erosion/vulnerability can further induce thrombosis and AMI [9, 11, 13, 21,22,23,24,25,26]. All these evidences suggest that the specific ceramide species and ratio of ceramides are likely to be specifically involved in a certain type of myocardial ischemia or insufficient blood supply. Therefore, it is hypothesized that ceramides may facilitate the accurate diagnosis AMI, UAP and other coronary artery diseases. In the present study, it was observed that 56% of mild coronary artery stenosis (< 50%) were diagnosed as ACS (AMI: 1%; UAP: 55%). The pathophysiologic background about the mild coronary artery stenosis evokes ACS is not clear yet. A recent review [27] reported that the prevalence of myocardial infarction with normal coronary arteries (MINCA) and myocardial infarction in the absence of obstructive coronary artery disease (stenosis > 50%) are 1–15% of all myocardial infarctions. And those MINCA patients showed lower prevalence of dyslipidemia, hypertension, diabetes and other traditional risk factors for CAD. In this review, the authors summarized the possible mechanisms of MINCA including concealed atherosclerosis, inflammation, arteritis, catecholamine-induced cardiomyopathy and myocarditis.
Although the present study found that ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0) was significantly higher in patients with stenosis > 50% compared with those in patients with stenosis < 50% before adjustment, it is common that patients with coronary artery stenosis suffer from other metabolic and cardiovascular diseases. In addition, ceramides have been proposed as novel biomarkers for several diseases [28] such as cancer, diabetes, Alzheimer’s disease, depression, multiple sclerosis, as well as coronary artery disease. Therefore, multiple risk factors including age, gender, pre-existing myocardial/cerebral infarction, HbA1c%, smoking, lipids, the presence of hypertension and the diagnosis during index hospitalization were adjusted in multiple logistic stepwise regression analysis and the results indicated that a high level of Cer (d18:0/24:1)/Cer (d18:0/24:0), high level of HbA1c%, female gender and AMI (compared with atherosclerosis) are significantly associated with more severe coronary artery stenosis. For the first time that the association between high level of Cer (d18:0/24:1)/ Cer (d18:0/24:0) ratio and more severe coronary artery stenosis is reported, and there was no association between any specific ceramide and severity of coronary artery stenosis found in the present study. Recently, Mantovani and colleagues [29] reported that a higher level of plasma Cer (d18:1/24:0), but not Cer (d18:0/24:1), was associated with a greater severity of LAD stenosis after adjustment for cardiovascular risk factors. However, Cer (d18:0/24:1)/Cer (d18:0/24:0) ratio was not investigated in this study. In addition, it is noteworthy that the patients underwent elective and urgent angiography were enrolled in Mantovani’s study, whereas patients who needed urgent angiography were excluded in present study. Therefore, ratio of AMI patients to all subjects in Mantovani’s study was possibly different from it in present study. As aforementioned, ceramides levels were higher in AMI than other CAD. Moreover, levels of plasma ceramides were higher in AMI patients with plaque rupture than those with plaque erosion [30]. It is suggested that AMI and plaque status underlying CAD correlate with levels of plasma ceramides and current diagnosis should be considered as covariate adjusted in logistic regression analysis.
The observed association between female gender and severe coronary artery stenosis was possibly resulted from estradiol-induced unbalance of ceramides. A recent study [31] using multivariable linear regression analysis revealed that Cer (d18:1/24:0) and Cer (d18:1/24:1) were increased over age in women. In women of all ages, but not in men, plasma Cer (d18:1/24:1) was negatively correlated with plasma estradiol. In addition, this study found that estradiol significantly decreased ceramide accumulation in in-vitro study, which supported the relationship between estradiol and ceramide.
The present study found that incidence of AMI had a more significant association with severity of coronary artery stenosis than atherosclerosis. As discussed above, some studies suggested that plasma ceramides regulate atherosclerotic plaque erosion, which may possibly result in AMI [9, 11, 13, 23, 26]. In addition, arecent study [20] reportedthat a higher concentration of plasma ceramides from patients with recent AMI compared with those without recent AMI. Consistently, the present study showed that the plasma levels of Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1), Cer (d18:1/16:0)/ Cer (d18:1/24:0) and Cer (d18:1/24:1)/Cer (d18:1/24:0) were significantly increased in AMI patients compared with UAP patients without adjusting risk factors. However, no significant difference in levels of plasma ceramides between AMI and atherosclerosis patients was observed without risk factor adjustment. Meanwhile, it is also worthy to point out that there was only 68 out of 69 AMI patients recruited in group with stenosis > 50% in present study, whereas 6 out of 38 atherosclerosis patients recruited in group with stenosis > 50%. Therefore, an indifferent ceramide level observed in present study may result from the small size of subjects.
The present study also investigated MACE in 1 year after index hospitalization. After adjusting concentrations of targeted ceramides and other risk factors in multiple logistic regression model, the present study found that pre-existing infarction was associated with MACE, whereas none of ceramide showed an independent association with MACE. This is not consistent with some recent studies [9,10,11, 32], which showed that specific plasma ceramides including Cer (d18:1/16:0), Cer (d18:1/18:0) and Cer (d18:1/24:1) predicted the development of MACE both in patients with ACS and healthy subjects, independently of cardiovascular risk factors. It is important to note that these findings were based on a long-term MACE investigation, which included a median follow-up of 4.6 years investigation in Laaksonen’s study. In addition, a study [12] reported that the risk of developing MACE in CAD patients with elevated levels of distinct plasma ceramides was potentially reduced by Mediterranean diet. Therefore, the dietary, medication and other factors should be investigated in the further study of MACE.
Study strengths and limitations
The present study was the first work to report the association between plasma ceramide level and these verity of coronary stenosisin patients with ACS. However, no association was established between plasma ceramide level and MACE. The limitation of the present study is the 1 year of follow-up MACE investigation period, which is probably inadequate to study the long-term effect of ceramide in CAD patients.
Conclusion
Three ceramides (Cer (d18:1/16:0), Cer (d18:1/18:0), Cer (d18:1/24:1)) and their ratios to Cer (d18:1/24:1) are mostly investigated in the pathologenesis study of ACS. These ceramides have been proposed to be used in clinical practice as ACS biomarkers. However, few study investigated these ceramide levels in patients regarding different severity of coronary stenosis and clinical diagnosis (i.e. AMI, UAP and astherosclerosis). The present study reported that Cer (d18:1/16:0), Cer (d18:1/24:0) and ratio of Cer (d18:1/24:1) to Cer (d18:1/24:0) were associated with the development of stenosis. Moreover, the association between Cer (18:0/24:1)/Cer (18:0/24:0) and severity of coronary artery stenosis with ACS, but not with other CAD were observed for the first time. These results indicated that plasma ceramides levels can be used to estimate the severity of stenosis and facilitate the diagnosis of ACS in clinical practice. However, this study did not establish the predictive effect of ceramide on MACE. Although a ceramide plasma test for the prediction of cardiac risk was available commercially since 2016 by the Mayo Medical Laboratories [33], the species of ceramides of interests vary from different ACS to coronary artery disease and myocardial ischemia/perfusion defects. Further study is needed to investigate the level of specific and/or de novo ceramides in pathogenesis of different ACS and other coronary artery diseases, as well as a long-term MACE investigation plan.
Availability of data and materials
The datasets used or analysed during the current study are available from the corresponding author on reasonable request.
Abbreviations
ACS:
Acute coronary syndrome
AMI:
Acute myocardial infarction
AUC:
Area under curve
BNP:
Brain natriuretic peptide
CABG:
Coronary artery bypass grafting
CAD:
Coronary artery disease
Cer:
Ceramide
CI:
Confidence interval
CK-MB:
Creatine kinase-MB
cTnl:
cardiac troponin I
ECG:
Electrocardiograph
HbA1c%:
Hemoglobin A1c%
HDL:
High-density lipoprotein
hs-CRP:
high-sensitivity C-reactive protein
IS:
Internal standard
LC-MS/MS:
Liquid chromatography-tandem mass spectrometry
LDL:
Low density lipoprotein
MACE:
Major adverse cardiavascular and cerebrovascular
NSTEMI:
Non-ST-segment elevation myocardial infarction
OR:
Odds ratio
PCI:
Percutaneous coronary intervention
ROC:
Receiver operating characteristics
STEMI:
ST-segment elevation myocardial infarction
TC:
Total cholesterol
UAP:
Unstable angina pectoris
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Acknowledgements
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Funding
The study was founded by “major chronic non-communicable diseases prevention and control research” key special project (grant number 2018YFC1312801).
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Lin Li, and Yong Zeng contributed to conception and design; Lili Zhang, Hongmei Wu, regarding the Acute coronary syndrome and Atherosclerosis; Wei Ni, and Caixia Li analyzed and interpreted the patient data; Lan Xie, and Zhenjie Wang contributed to drafted the background of manuscript; Chenchen Tu performed the representative angiography images and was a major contributor in writing the manuscript. All authors read and approved the final manuscript.
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Correspondence to Yong Zeng.
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Capital Medical University Affiliated Beijing Anzhen Hospital ethics committee has approved the study with the approval number 2017060X. All patients provided have submitted informed consent.
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Tu, C., Xie, L., Wang, Z. et al. Association between ceramides and coronary artery stenosis in patients with coronary artery disease. Lipids Health Dis 19, 151 (2020). https://doi.org/10.1186/s12944-020-01329-0
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Keywords
• Ceramide
• Coronary stenosis
• Acute coronary syndrome
• Acute myocardial infarction
• Major adverse cardiac and cerebrovascular events
• Liquid chromatography-tandem mass spectrometry | {
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-8,793,252,488,928,639,000 | NMN: Your Key to Cellular Rejuvenation
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The perfect amount of NMN supplements remains to be under examination, but typical dosages range from 250 mg to 1000 milligrams daily. NMN is often deemed risk-free, with handful of noted negative effects. Nonetheless, far more study is required to determine its long term security and efficacy.
Bottom line:
NMN supplements have emerged like a guaranteeing tool in the quest for endurance and increased well being. When study on his or her advantages is on-going, early on research propose that NMN may supply different pros, from dealing with ageing to maximizing metabolic and cardio health. As always, it’s essential to meet with a healthcare professional before beginning any new dietary supplement strategy. | {
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2,983,340,067,505,527,300 | “Massage Gun vs. Foam Roller: Which Is Right for You?”
Massage tools are devices or instruments designed to enhance the effectiveness and convenience of massage therapy. They come in various shapes, sizes, and functionalities, offering targeted relief and relaxation for different areas of the body. These tools are often used by both professionals and individuals for self-massage and self-care purposes.
One common type of massage tool is the foam roller. Foam rollers are cylindrical in shape and are typically made of dense foam or firm rubber. They are used to apply pressure and rolling motions to the muscles, promoting myofascial release and easing muscle tension. Foam rollers are particularly effective in targeting large muscle groups such as the back, legs, and hips.
Another popular massage tool is the handheld massage ball or trigger point ball. These small, often textured balls are used to apply direct pressure to specific trigger points or knots in the muscles. They are particularly beneficial for releasing tension and relieving pain in smaller muscle groups, such as the hands, feet, and shoulders.
Massage sticks or massage canes are tools with a long handle and rollers or knobs at the ends. They are designed to be held and maneuvered by the user to apply pressure and massage different areas of the body, including the back, neck, and legs. Massage sticks are effective in reaching areas that are challenging to access with hands alone and can help relieve tightness and discomfort.
Electric massagers are another category of massage tools that offer a range of features and functionalities. They typically include handheld devices with motorized heads that deliver various massage techniques, such as percussion, vibration, or kneading. Electric massagers are versatile and can be used on different body parts, providing customizable massage experiences.
Massage tools can be valuable additions to a massage therapy routine, as they offer convenience, versatility, and targeted relief. However, it is important to use these tools with caution and follow instructions to avoid injury or overstimulation. It is advisable to consult with a healthcare professional or a licensed massage therapist to ensure safe and effective usage.
Overall, Massage tools provide accessible and effective options for self-massage and self-care. They can help alleviate muscle tension, promote relaxation, and enhance overall well-being, making them popular choices for individuals seeking relief from everyday stress and discomfort.
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2,380,922,783,420,703,000 | HEALTH ENCYCLOPEDIA
Diseases & Conditions A - Z
powered by Talix
Acid-Fast Stain Tests
What Is an Acid-Fast Stain Test?
An acid-fast stain is a laboratory test performed on a sample of
• blood
• sputum, or phlegm
• urine
• stool
• bone marrow
• skin tissue
Your doctor can order this test to find out if you have tuberculosis (TB) or another type of bacterial infection.
TB was very common at one time. However, it’s now rare in the United States. According to the Centers for Disease Control and Prevention (CDC), only 3 cases of TB per 100,000 people were reported in the United States in 2014. This is the lowest rate since national reporting began in 1953.
The test involves adding a staining dye to a bacterial culture, which is then washed in an acid solution. After the acid wash, the cells of certain types of bacteria retain the dye either completely or partially. This test is able to isolate specific types of bacteria by their “acid fastness,” or their ability to remain dyed.
What Does the Acid-Fast Stain Test?
Based on the type of bacteria found in the culture, there are two types of results from this test. The results are either an acid-fast stain, or a partial or modified acid-fast stain. The type of results depends on the bacteria being tested.
Sputum, or phlegm, is often used to test for Mycobacterium tuberculosis, to find out if a patient has TB. This bacterium is completely acid-fast, which means the entire cell holds onto the dye. A positive test result from the acid-fast stain confirms the patient has TB.
In other types of acid-fast bacteria such as Nocardia, only certain parts of each cell retain the dye, such as the wall of the cell. A positive test result from a partial or modified acid-fast stain identifies these types of infections.
Nocardia isn’t common, but it’s dangerous. Nocardia infection starts in the lungs, and it can spread to the brain, bones, or skin of people with weak immune systems.
How Are the Samples Collected?
If a mycobacterial infection is suspected, your doctor will need a sample of one or more bodily substances. Your doctor will collect samples using some of the following methods:
Blood Sample
A healthcare provider will draw blood from your vein. They’ll usually draw it from a vein inside of your elbow by using the following steps:
1. The area is first cleaned with a germ-killing antiseptic.
2. Then, an elastic band is wrapped around your arm. This causes your vein to swell with blood.
3. They’ll gently insert a syringe needle into the vein. Blood collects in the syringe tube.
4. When the tube is full, the needle is removed.
5. The elastic band is then removed, and the puncture site is covered with sterile gauze to stop any bleeding.
This is a low-risk test. In rare cases, blood sampling can have risks such as:
• excessive bleeding
• fainting or feeling light-headed
• a hematoma, or blood pooling under the skin
• an infection, which is a slight risk any time the skin is broken
However, these side effects are uncommon.
Sputum Sample
Your healthcare provider will give you a special plastic cup for collecting your sputum. Brush your teeth and rinse your mouth as soon as you wake up in the morning (before eating or drinking anything). Don’t use mouthwash.
Collecting a sputum sample involves the following steps:
1. Take a deep breath and hold it for five seconds.
2. Slowly breathe out.
3. Take another breath and cough hard until some sputum comes up into your mouth.
4. Spit the sputum into a cup. Screw the cup’s lid on tightly.
5. Rinse and dry the outside of the cup. Write the date you collected the sputum on the outside of the cup.
6. If necessary, the sample can be refrigerated for 24 hours. Don’t freeze it or store it at room temperature.
7. Take the sample to where your doctor instructed you as soon as you can.
There are no risks involved with taking a sputum sample.
Bronchoscopy
If you’re unable to produce sputum, the doctor may collect it using a procedure called a bronchoscopy. This simple procedure takes about 30 to 60 minutes. Patients usually remain awake for the procedure.
First, your nose and throat will be sprayed with a local anesthetic to make it numb. You may also be given a sedative to help you relax or to put you to sleep.
A bronchoscope is a long, soft tube with a magnifying glass and light on the end. Your doctor will gently pass it through your nose or mouth and down into your lungs. The tube is about as wide as a pencil. Your doctor will then be able to see and take samples of sputum or tissue for biopsy through the scope tube.
A nurse will observe you closely during and after the test. They’ll do this until you’re fully awake and able to leave. For safety reasons, you should have someone else drive you home.
Rare risks of bronchoscopy include:
• an allergic reaction to sedatives
• an infection
• bleeding
• tearing in the lung
• bronchial spasms
• irregular heart rhythms
Urine Sample
Your doctor will give you a special cup to collect urine. It’s best to collect the sample the first time you urinate in the morning. At that time, the bacterial levels will be higher. Collecting a urine sample usually involves the following steps:
1. Wash your hands.
2. Remove the cup’s lid, and set it down with the inside surface up.
3. Men should use sterile towelettes to clean inside and around the penis and foreskin. Women should use sterile towelettes to clean the folds of the vagina.
4. Begin urinating into the toilet or urinal. Women should hold apart the labia while urinating.
5. After your urine has flowed for several seconds, place the collection container in the stream and collect about 2 ounces of this “midstream” urine without stopping the flow. Then, carefully replace the lid on the container.
6. Wash the cup and your hands. If you’re collecting the urine at home and cannot get it to the lab within one hour, refrigerate the sample. It can be refrigerated for up to 24 hours.
There are no risks associated with taking a urine sample.
Stool Sample
Make sure to urinate before providing a stool sample so that no urine will get into the sample. Collecting a stool sample usually involves the following steps:
1. Put on gloves before handling your stool. It contains bacteria that can spread infection.
2. Pass the stool (without urine) into the dry container that your doctor gave you. You may be given a plastic basin that can be placed under the toilet seat to catch the stool. Either solid or liquid stool can be collected. If you have diarrhea, a clean plastic bag can be taped to the toilet seat to catch the stool. If you’re constipated, you may be given a small enema to help you pass stool. It’s important that you don’t collect the sample from the water in the toilet bowl. Don’t mix toilet paper, water, or soap with the sample.
3. After collecting the sample, you should remove your gloves and throw them away.
4. Wash your hands.
5. Place the lid on the container. Label it with your name, your doctor’s name, and the date the sample was collected.
6. Place the container in a plastic bag, and wash your hands again.
7. Take the sample to the location your doctor instructed as soon as you can.
There are no risks associated with taking a stool sample.
Bone Marrow Biopsy
Bone marrow is the soft fatty tissue inside the larger bones. In adults, bone marrow is usually collected from the pelvis, which is the hip bone, or the sternum, which is the breastbone. In infants and children, bone marrow is usually collected from the tibia, or shinbone.
A bone marrow biopsy usually involves the following steps:
1. The site is first cleaned with an antiseptic, such as iodine.
2. Then, the site is injected with a local anesthetic.
3. Once the site is numb, your doctor inserts a needle through your skin and into the bone. Your doctor will use a special needle that draws out a core sample, or cylindrical section.
4. After the needle is removed, a sterile bandage is placed over the site and pressure is applied.
After the biopsy, you should lie down quietly until your blood pressure, heart rate, and temperature return to normal. You should keep the site dry and covered for about 48 hours.
Rare and uncommon risks of bone marrow biopsies include:
• persistent bleeding
• an infection
• pain
• a reaction to local anesthetic or sedative
Skin Biopsy
There are several methods of skin biopsy, including shave, punch, and excisional. The procedure is usually done at an outpatient clinic or a doctor’s office.
Shave Biopsy
The shave biopsy is the least invasive technique. In this case, your doctor simply removes the outermost layers of your skin.
Punch Biopsy
During a punch biopsy, your doctor removes a small round piece of skin about the size of a pencil eraser using a sharp, hollow instrument. The area may need to be closed with stitches afterward.
Excisional Biopsy
An excisional biopsy removes a larger area of skin. First, your doctor injects a numbing medicine into the area. Then, they remove the skin section and close the area with stitches. Pressure is applied to stop the bleeding. If they biopsy a large area, a flap of normal skin may be used to replace the skin that was removed. This flap of skin is called a skin graft.
The risks from skin biopsies include infection, excessive bleeding, and scarring.
Preparing for Your Test
No preparation is needed when taking blood, urine, or stool samples.
For bone marrow or skin biopsies, your doctor may instruct you not to eat or drink liquids before the procedure. Be sure to tell your doctor about any medications you’re taking. This includes:
• vitamins
• supplements
• herbal remedies
• over-the-counter medications
• prescription medications
You should also tell your doctor about any allergies you have, any previous reactions to medications or bleeding problems you’ve had, and if you’re pregnant.
What Happens in the Lab?
After the sample is collected, it’s sent to a laboratory where it's allowed to grow in a culture at room temperature for up to two days. During this time, any present bacteria grow and multiply. The culture is then stained with dye, heated, and washed in an acid solution.
Results of the Test
If your test results are normal and no acid-fast bacteria are found, this means you may not be infected with acid-fast bacteria, or with partial or modified acid-fast bacteria.
If the test is abnormal, it means you may be infected. Your doctor will advise you about your test outcome and the best course of treatment if any is needed.
Content licensed from:
Written by: Sandy Calhoun
Published on: Aug 07, 2012on: Jan 05, 2016
This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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2,351,666,646,954,856,400 | World Diabetes Day: What You Need to Know About Your Risk and Proven Prevention Strategies
TAGS: , , , ,
Today is World Diabetes Day. If you think this doesn’t pertain to you, we hope you’re right. But statistically, it affects someone very close to you. The International Diabetes Federation notes that 415 million adults were living with diabetes in 2015. According to the Journal of the American Medical Association, 1 in every 2 American adults has diabetes or is pre-diabetic. Think about that for a moment – half of all the adults in the U.S. are living with the disease, whether they are aware of it or not.
We at Zing are dedicated to helping people eat right and maintain their healthiest, most active lives possible. We feel the more people understand diabetes, the better they can combat and prevent the disease.
What Exactly is Diabetes?
Many of us know diabetes has something to do with blood sugar. The CDC defines it as:
“…the condition in which the body does not properly process food for use as energy. Most of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugars to build up in your blood. This is why many people refer to diabetes as “sugar.”
Diabetes is the seventh leading cause of death in the United States. It can lead to kidney failure, lower extremity amputation, heart disease and even blindness. 90-95 percent of those with diabetes are diagnosed with Type 2 Diabetes. Risk factors include obesity, sedentary lifestyles, family history, impaired glucose tolerance, age and race/ethnicity.
For those at higher risk due to factors they can’t control like family history, age, race or ethnicity, diabetes is still not a sure thing. No matter how many risk factors you may have – small changes to your daily habits can significantly decrease your chance of getting this chronic disease.
What is the Blood Sugar Roller Coaster and How Can I Get Off the Ride?
When we eat processed and sugary foods like white bread, chips, cookies, and “low-fat” and “fat-free” options of foods which are filled with hidden sugars, we’re setting ourselves up to ride the blood sugar roller coaster – and we are putting ourselves at higher risk of diabetes.
You only get energy from food up until a certain point. Once you cross this threshold, your blood sugar spikes, followed by a sharp decline. That drop is when you feel sluggish, foggy-brained, and you start craving more of the bad stuff. Once ingested, you might feel good for a little bit, but then the cycle repeats itself.
What’s worse, in addition to feeling miserable, you’re providing the ideal conditions for fat to build up in the body.
Once your blood sugar spikes, the body stops using food as fuel, and starts storing it as fat. Over time, this leads to obesity, which puts you at higher risk of diabetes.
Avoid this roller coaster by:
• Eating 4-5 smaller meals and healthy snacks throughout the day
• Include more fiber in your diet (Zing Bars are an excellent source!)
• Focus on low-glycemic carbs (whole wheat bread, whole wheat pasta, brown rice)
• Minimize refined carbs like sugar and white flour (white bread, crackers, cookies, muffins, refined breakfast cereal, soda and even large quantities of juice)
“The good news I tell my clients is that ‘starch’ and ‘carbs’ may be included in a meal plan – even if you are living with diabetes,” said Constance Brown Riggs, MSEd, RD, CDE, CDN. “For starches, I advise eating as many high-fiber choices as possible, as the fiber may help slow the digestion and absorption of carbohydrates.”
Studies show that the more you eat healthy, stay active, and maintain a healthy weight, the lower your risk of diabetes. If you have diabetes or prediabetes, we encourage you to make an appointment with a Registered Dietitian Nutritionist to learn what small changes you can make to create lasting differences in your health and energy levels. A small tip – a dietitian with the credentials “CDE” behind his or her name denotes they are a Certified Diabetes Educator and are specialists when it comes to helping you!
As professional nutritionists, we at Zing care very much about your health and wellbeing. Together, we can help reverse the growing number of people affected by diabetes and make the need for World Diabetes Day a thing of the past. Let’s start by fueling our bodies with the good stuff to regulate our blood sugar levels!
Please show your support today by Tweeting #Test2Prevent to encourage diabetes screening.
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Weight loss ramen, not very filling...
lose 5 pounds of fat in a month weight loss ramen
He says he always felt lethargic and sick to his stomach. This condition is known as the MSG symptom complex. However, if you eat the entire package, that amount doubles to 1, mg of sodium 2. Follow us on TwitterFacebookPinterest and Tumblr.
But he didn't add anything that didn't come with the product. The majority of instant noodles are low in calories, fiber and protein, but high in fat, carbs, sodium and some micronutrients. Choosing instant noodles that are lower in sodium or made from whole grains can give your instant noodles a healthy upgrade.
When you ingest that much sodium in a single sitting, your body overcompensates by retaining more water. The FDA recommends the average person consumes no more than 2, mg of salt per day.
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Prepare your ramen with extra water so that it has a lower calorie density, which means that it has fewer calories in the same weight loss ramen serving as when you use less water. A single serving of instant noodles contains mg of sodium. This can cause temporary water weight gain, leaving you feeling bloated and lethargic.
Additionally, some instant noodles are made using fortified wheat flour, which has shown potential in increasing micronutrient intake without changing the taste or texture of the final product His flatmates tolerated his mood swings, though Dooley says he wouldn't have been able to put up with himself.
They found that subjects, women in particular, who ate instant noodles at least twice a week had a 68 percent higher risk of metabolic syndrome—a combination of symptoms that raise the risk of diabetes and heart disease—than subjects who ate a more consistently natural diet.
Instant noodles are low in calories, which could help decrease calorie intake. There is evidence need to lose weight so bad that high sodium intake may have a negative effect on certain people who are considered salt-sensitive.
Calories and Carbohydrates To lose diet plan case study, you need to create a calorie deficit, which means burning off more calories than you consume. However, other studies have found no association between lose fat in face and MSG when people consume it in moderate amounts Health Concerns A good diet food is high in essential nutrients so that cant lose weight on low carb diet can meet your nutrient requirements without going best diet for burning fat your calorie limit, but ramen noodles are not high in calcium, iron, folate, potassium, most B vitamins or vitamins C, E or A.
Those who are black, over 40 years old or have a family history of high blood pressure are the most likely to be affected It's also important to note that instant noodles are low in fiber and protein, weight loss ramen may not make them the best option when it comes to weight loss.
weight loss ramen do fat cells die when you lose weight
So despite being low in calories, it may not benefit your waistline 2. Braden Kuo captured visual evidence of this in when he used a pill-sized camera to record the digestive tracts of volunteers who ate processed ramen noodles as well as fresh ones. A good diet food is low in calories, filling and nutritious, and ramen may not meet all of these criteria.
But cheating didn't go over well. Despite being relatively low in some nutrients like fiber and protein, instant noodles contain several micronutrients, including iron, manganese, folate and B vitamins. It's also worth noting that there are some special varieties available that are marketed as healthier options.
Is Ramen a Good Diet Food? A serving of pre-packaged lasagna, for example, contains calories, while a serving of canned spaghetti and meatballs has calories 34. Studies have shown that reducing sodium intake could be beneficial for those who are salt-sensitive.
McDougall's, Snoopy weight loss and Lotus Foods are just a few brands that sell some healthier varieties of instant noodles. My stomach felt like crap and my brain stopped working properly.
His first meal was sushi. Prepare your ramen with extra water so that it has a lower calorie density, which means that it has fewer calories in the same size serving as when you use less water.
Lower-sodium instant noodles are also available and can help bring down your sodium intake for the day. A study looked at the diets of 10, adults. Most instant noodles contain an ingredient known as monosodium glutamate MSGa common food additive used to enhance flavor in processed foods.
On the days the New Zealander successfully stomached his allotted three servings, he ingested 3, milligrams. Picking instant noodles made from whole grains, for weight loss ramen, can increase fiber content and boost feelings of fullness.
MORE IN Food & Drink
It was also associated with obesity, a sedentary lifestyle and intake of sugar-sweetened beverages Occasionally enjoying instant noodles is fine — as long as you're maintaining an otherwise healthy and alli weight loss diet pill diet. A bowl of ramen soup on hoodia slimming gel restaurant table.
Adding vegetables and a protein source can help round it out.
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Usually I can drink a dozen beers, but after two I was quite how long does it take to lose lower belly fat. What's more, frequent consumption is linked to poor diet quality and an increased risk of metabolic syndrome.
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It found that eating instant noodles at least twice per week increased the risk of metabolic syndrome in women I couldn't finish asking, "Would you do it again? The effects were not just physical. You can also use your instant noodles as a base and top them with some healthy ingredients to make a more well-rounded meal.
This Is What Happens to Your Body When You Eat Instant Ramen
Ramen is not high in these nutrients, and a cant lose weight on low carb diet has only 4. Find out what happens to your body right after drinking sodatoo. While the instant noodle consumers did have an increased intake of a few select micronutrients, they had a significantly decreased intake of protein, calcium, vitamin C, phosphorus, iron, niacin and vitamin A.
These individuals may be more susceptible to the effects of sodium and an increase in sodium intake may cause an increase in blood pressure Source But Dooley wasn't always able to consume his appropriated three-a-days.
Right -- for a full 30 days, Dooley planned to eat three servings of the packaged soup on which college students subsist.
1. How to lose belly fat if your obese weight loss pills that work without exercise face slimming treatment london
2. Instant noodles are low in calories, which could help decrease calorie intake.
3. However, if you eat the entire package, that amount doubles to 1, mg of sodium 2.
4. But he doesn't regret the experience, and looking back, he says he learned something about himself.
5. Are Instant Noodles Bad for You?
Food and Drug Administration. Because instant noodles are lower in calories, eating them could potentially lead to weight loss.
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One study looked at the effects of reduced salt intake in over 3, participants. Everything was shutting down, I couldn't take any more. One lose fat in face actually found that consuming iron-fortified milk and noodles can decrease the risk of anemia, a condition caused by iron deficiency 9.
Protein has been shown to increase feelings of fullness and decrease hunger, making it a useful tool in weight alli weight loss diet pill 56. And, perhaps most disconcerting of all, this quick-and-easy meal may stay with you much longer than you realize. A study compared the nutrient intake of 6, instant noodle consumers and non-instant noodle consumers.
Instant noodle intake may be linked to a higher intake of riboflavin and thiamine. Stein holds a master of science degree in nutrition and a master of public health degree from Michigan State University. However, ramen noodles can be part of a healthy weight-loss diet if you use them carefully, and a nutritionist can help you fit them into your meal plan.
However, they are low in nutrients, so don't use them as a staple in your weight loss ramen. In Indonesia, about half of instant noodles are fortified with vitamins and minerals, including iron. He does say he rotated flavors. Intake of instant noodles was cant lose weight on low carb diet with decreased levels of vitamin D.
Another study looked at vitamin D status and its relation to dietary and lifestyle factors in 3, young adults. One test-tube study found that MSG could cause swelling and death of mature brain cells It got to phen phen alternative point where I didn't even want to eat -- It didn't matter whether it was noodles or normal food. Ramen provides 27 g carbohydrates, and it is a high-glycemic food because it is a low-fiber, refined carbohydrate.
One study compared the diets of instant noodle consumers and non-instant noodle consumers.
Man Describes Immense Torture Of Eating Only Ramen For 30 Days
These may be made using whole grains or have lower amounts of sodium or fat. If you use the entire flavoring packet that comes with your ramen, you can easily get 1, mg sodium or more, and a high-sodium diet can raise your snoopy weight loss pressure. Additionally, the study found that instant noodle consumers had an diet plan case study intake of sodium and calories compared to the non-instant noodle consumers Some research has lose weight age 40 that regular consumption of instant noodles may be associated with poor overall diet quality.
In participants with high blood pressure, each 1,mg reduction in sodium intake led to a where can i buy bangkok diet pills. Nevertheless, other research has shown that dietary MSG likely has little effect on brain health, since even large amounts are not able to cross the blood-brain barrier There were headaches, too. Instant noodles may also increase the risk of developing metabolic syndrome, a condition that increases your risk of heart disease, diabetes and stroke.
Some research has also suggested MSG may negatively impact brain health. Add high-fiber vegetables, such as broccoli, water chestnuts or carrots, to make your ramen more filling.
• Man Describes Immense Torture Of Eating Only Ramen For 30 Days | HuffPost Life
• The FDA recommends the average person consumes no more than 2, mg of salt per day.
• How to lose chin fat naturally how to lose weight before weigh ins 3 month weight lose
• Calories and Carbohydrates To lose weight, you need to create a calorie deficit, which means burning off more calories than you consume.
Sufferers may experience symptoms how long does it take to lose lower belly fat as headaches, muscle tightness, numbness and tingling Overall, moderate your consumption, pick a healthy variety and add in some vegetables and a protein source. Recipes Using Instant Ramen. I got quite melancholy.
158kcal Ramen Recipe for Weight Loss Dite, Vegan Recipe
Some instant noodles are also fortified with additional nutrients. Finally, ramen noodles may contain acrylamide, which is a carcinogenic compound in many baked foods, according to the U. It was personal sacrifice I was willing to take and it was only for a month.
Instant noodles often contain MSG, which may cause adverse effects in high doses and could trigger symptoms in those with a sensitivity.
Any diets that actually work
The New Zealander was triggered to go down this noodle-y road after he had watched the documentary, " Super Size Me ," in which filmmaker Morgan Spurlock documents his own 30 days of eating nothing but food from McDonald's. How to Select the Healthiest Instant Noodles If you do enjoy the occasional cup of noodles, there are ways to make it healthier.
Ramen can make this difficult because it is high in calories, with calories per half-package serving, or nearly calories if you eat the whole package. Weight loss ramen Very Filling A good diet food is high in dietary fiber or protein, decreasing your hunger so that it is easier to limit your total calorie intake.
I kept losing count of the day. There are a couple different things that make ramen an unhealthy choice. Natalie Stein About the Author: Instant noodles are high in sodium, which may be associated with high blood pressure in individuals who are salt-sensitive.
With only 4 grams of protein and 1 gram of fiber per serving, a serving of instant noodles cant lose weight on low carb diet won't make much of a dent in your hunger or fullness levels. They Are Male weight loss pills uk lottery in Calories, but Also Low in Fiber and Protein With calories per serving, instant noodles are lower in calories than some other types of pasta 2.
Jim Scherer via Getty Images Dooley says he rotated between Maggi and Trident brand noodles in several flavors he doesn't care to recall, due to the nausea-inducing factor of where can i buy bangkok diet pills talking about ramen. MSG is also naturally found in products such as hydrolyzed vegetable protein, yeast extract, soy extract, tomatoes and cheese.
He published his results in a literally stomach-churning video. Fiber, on the other hand, moves slowly through the digestive tract, helping to promote feelings of fullness while enhancing weight loss 78. | {
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7,129,943,407,775,786,000 | US6296615B1 - Catheter with physiological sensor - Google Patents
Catheter with physiological sensor Download PDF
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US6296615B1
US6296615B1 US09/264,147 US26414799A US6296615B1 US 6296615 B1 US6296615 B1 US 6296615B1 US 26414799 A US26414799 A US 26414799A US 6296615 B1 US6296615 B1 US 6296615B1
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distal end
catheter
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catheter according
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Lynn M. Zwiers
Perry A. Mills
Mark J. Drexler
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• AHUMAN NECESSITIES
• A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
• A61BDIAGNOSIS; SURGERY; IDENTIFICATION
• A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
• A61B5/03Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs
• A61B5/036Detecting, measuring or recording fluid pressure within the body other than blood pressure, e.g. cerebral pressure; Measuring pressure in body tissues or organs by means introduced into body tracts
• AHUMAN NECESSITIES
• A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
• A61BDIAGNOSIS; SURGERY; IDENTIFICATION
• A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
• A61B5/04Measuring bioelectric signals of the body or parts thereof
• A61B5/0402Electrocardiography, i.e. ECG
• A61B5/0408Electrodes specially adapted therefor
• A61B5/042Electrodes specially adapted therefor for introducing into the body
Abstract
The disclosed embodiments present improved catheters with physiological sensors. In one embodiment, the catheter includes, generally, a pressure transducer/electronics assembly connected to a pressure transmission catheter. The pressure transmission catheter includes a hollow tube made from a low compliance material. The distal end of the hollow tube is filled with a gel-like material or plug which acts as a barrier between the catheter liquid and the target fluid. The hollow tube is partially filled with a low viscosity liquid and is in fluid communication with the gel-like material and the pressure transducer. The pressure of the target fluid is transmitted to the liquid in the hollow tube through the gel-like material and/or the wall of the distal tip and is fluidically transmitted to the pressure transducer. The pressure transmission catheter is capable of being inserted into a vessel lumen or inserted into a lumen of a therapeutic or diagnostic catheter for biomedical applications. This provides the ability to directly measure the pressure effects of the treatment catheter. In another embodiment, the distal end of the pressure transmission catheter may be electrically conductive so as to detect and transmit an electric signal. Thus, in this embodiment, the catheter can be used to detect a physiological signal.
Description
RELATED APPLICATION
The present invention is related to U.S. patent application No. 09/159,653, filed Sept. 24, 1998, title “IMPLANTABLE SENSOR WITH WIRELESS COMMUNICATION”
TECHNICAL FIELD
The described embodiments generally relate to catheters, and more particularly, to catheters capable of sensing physiological pressures, such as blood pressure, intracranial pressure, intrapleural pressure, bladder pressure, and pressure within the gastro-intestinal system, and of sensing an electric signal, such as an electrocardiogram.
BACKGROUND
U.S. Pat. No. 4,846,191, of Brian P. Brockway et al. (hereinafter the Brockway et al. '191 patent) discloses a pressure measurement device for sensing physiological pressures. The device consists generally of a pressure transducer with associated electronics and a pressure transmission catheter. The distal tip of the catheter senses the pressure of the target site and transmits the pressure fluidically through the catheter to be sensed by the pressure transducer.
In one embodiment of the Brockway et al. '191 patent, the pressure transmission catheter consists of a small diameter hollow tube which is filled with a low viscosity liquid. This liquid is in fluid communication with the pressure transducer at the proximal end of the hollow tube and a gel-like material at the distal end. The gel-like material provides a direct interface with the tissue or body fluid of which the pressure is to be measured.
Pressure measurement catheters such as described in the Brockway et al. '191 patent have been used to augment/support therapeutic treatments, as well as provide valuable information for diagnosis. For example, blood pressure measurements are very important when percutaneous therapeutic catheters affect blood pressure. Examples of therapeutic catheters include intra-aortic balloon catheters, angioplasty catheters, and perfusion catheters.
Taking one type of therapeutic catheter as an example, intra-aortic balloon catheters are designed to assist a failing heart through cyclic inflation-deflation of a balloon placed in the descending thoracic aorta, in counterpulsation to the heart. In a typical procedure, a guidewire (a thin flexible wire) is inserted through an incision into the common femoral artery and is directed through the delicate, tortuous and narrow vasculature. Once the guidewire is positioned, the intra-aortic balloon catheter is passed over the guidewire, utilizing the guidewire lumen of the catheter, until the balloon reaches the desired location.
The balloon is connected through a series of thin tubes to a control system which controls the balloon's inflation and deflation, repeatedly, in synchrony with a patient's heart beat. The action of the balloon assumes some of the load of the heart mainly by increasing systolic pressure which increases the flow of blood through the coronary arteries. In order to synchronize the balloon inflation/deflation with the heart beat, the patient's heart electric signal or electrocardiogram is detected using surface electrodes attached to the skin of the patient. These electrodes are connected to the control system of the intra-aortic balloon catheter. Inflation of the balloon occurs at a specified time relative to a reference signal on the patient's electrocardiogram.
The intra-aortic balloon catheter system of the Brockway et al. '191 patent, as described above, has its limitations. For example, the surface electrodes used to detect the patient's electrocardiogram for balloon inflation/deflation control have a limitation in that the signal can be relatively weak and noisy, leading potentially to spurious or unreliable responses. Further, the electrodes may become disengaged from the patient's skin due to lack of adhesion or being knocked off. Additionally, the patient typically has one set of surface electrodes attached for general monitoring; adding a second set of electrodes for controlling the intra-aortic balloon catheter adds further complexity and discomfort for the patient.
Blood pressure is typically used to calibrate the intra-aortic balloon catheter system. Ideally, this pressure should be measured in the vicinity of the catheter balloon. The electric signals sensed by the electrodes are used as the primary trigger for the catheter control system to pneumatically inflate the balloon, and the pressure signals are used to temporally calibrate balloon inflation to the electrical signals.
In the treatment modality of the Brockway et al. '191 patent, once the therapeutic catheter is placed, the guidewire is removed from the catheter's guidewire lumen. The guidewire lumen is then flushed with saline, or saline with anticoagulation agents such as heparin, in order to “fill” the guidewire lumen with a liquid. Once filled, the proximal end of the catheter is connected to a pressure transducer. In this respect, blood pressure upstream of the balloon is fluidically transmitted through the saline and detected by the pressure transducer.
This approach has its limitations for accurately measuring the pressure, especially with smaller balloon catheters having small guidewire lumens. Limitations may include high system compliance, the presence of air bubbles in the guidewire lumen, and possible blood coagulation in the guidewire lumen. Compliance is a property of this measurement system that provides a measure of resistance to deformation due to pressure. A system with high compliance will deform more than a low compliance system as pressure is increased. A high compliance system will tend to absorb rapid pressure changes that should be transmitted through the liquid in the lumen. This, in tun, reduces the accuracy of the pressure measurements as a result of lowering the frequency response. Excessive air bubbles and thrombus in the guidewire lumen can also result in dampening and loss of accuracy of the measured blood pressure signal. This can reduce the efficacy of the inflation of the balloon.
A further limitation of the system of the Brockway et al. '191 patent is that it is labor intensive. There is the additional preparation required by the user to fill the guidewire lumen just prior to use. Improper filling may lead to bubble formation in the catheter lumen. It is also necessary to flush the lumen to remove thrombus that may form, otherwise the pressure signal might be blocked altogether.
What is needed is an improved apparatus to obtain more reliable and higher quality measurements of blood pressure. An improved apparatus for sensing an electric signal is also needed.
SUMMARY
The disclosed embodiments present improved catheters with physiological sensors. In one embodiment, the catheter includes, generally, a pressure transducer/electronics assembly connected to a pressure transmission catheter. The pressure transmission catheter includes a hollow tube made from a low compliance material. The distal end of the hollow tube is filled with a gel-like material or plug which acts as a barrier between the catheter liquid and the target fluid. The hollow tube is partially filled with a low viscosity liquid and is in fluid communication with the gel-like material and the pressure transducer. The pressure of the target fluid is transmitted to the liquid in the hollow tube through the gel-like material and/or the wall of the distal tip and is fluidically transmitted to the pressure transducer. The pressure transmission catheter is capable of being used by itself or it can be inserted into a lumen of a therapeutic or diagnostic catheter for biomedical applications. This provides the ability to directly measure the pressure effects of the treatment catheter.
In another embodiment, the distal end of the pressure transmission catheter may be electrically conductive so as to detect and transmit electrical signals. Thus, in this embodiment, the catheter can be used to detect a physiological parameter manifested as an electrical current.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a partial cross-sectional side view of an embodiment of a pressure sensing catheter.
FIG. 2 is a partial cross-sectional side view of an embodiment of a pressure sensing catheter.
FIG. 3 is a partial cross-sectional side view of an embodiment of a pressure and electric signal sensing catheter.
FIG. 4 is a partial cross-sectional side view of an embodiment of a pressure and electric signal sensing catheter.
FIG. 5 is a partial cross-sectional side view of an embodiment of a pressure and electric signal sensing catheter.
FIG. 6 is a cross-sectional side view of an embodiment of a distal end of the pressure and electric signal sensing catheter of FIG. 5.
FIG. 7 is a partial cross-sectional side view of an embodiment of a distal end of a catheter with a physiological sensor.
FIG. 8 is a partial cross-sectional side view of an embodiment of a distal end of a catheter with a physiological sensor.
FIG. 9 is a partial cross-sectional side view of an embodiment of a distal end of a catheter with a physiological sensor.
FIG. 10 is a partial cross-sectional side view of an embodiment of a distal end of a catheter with a physiological sensor.
FIG. 11A is a partial cross-sectional side view of an embodiment of a distal end of a catheter with a physiological sensor.
FIG. 11B is a cross-sectional view at line 11B of the distal end of the embodiment of a catheter with a physiological sensor of FIG. 11A.
FIG. 12 is a partial cross-sectional side view of an embodiment of a distal end of a catheter with a physiological sensor.
FIG. 13 is a side view, partly in section, of an embodiment of a pressure and electric signal sensing catheter inserted within a lumen of a therapeutic catheter.
FIG. 14 is a representation showing an embodiment of a pressure and electric signal sensing catheter threaded through an intra-aortic balloon catheter lumen, the balloon catheter having first been inserted into the femoral artery and advanced up to the descending aorta.
DETAILED DESCRIPTION
In the following detailed description, reference is made to the accompanying drawings, which are not necessarily to scale, which form a part hereof, and in which is shown by way of illustrating specific embodiments in which the device may be practiced. These embodiments are described in sufficient detail to enable those skilled in the art to practice the device, and it is to be understood that the embodiments may be combined, or that other embodiments may be utilized and that structural and electrical changes may be made without departing from the spirit and scope. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope is defined by the appended claims and their equivalents. In the drawings, like numerals describe substantially similar components throughout the several views.
The present apparatus and methods will be described in applications involving biomedical applications. However, it is understood that the present apparatus and methods may be employed in other environments and uses.
One embodiment presents a pressure sensing catheter that can be inserted into and through a lumen of therapeutic/diagnostic catheters. FIG. 1 is a partial cross-sectional side view illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of a pressure sensing catheter 110. Pressure sensing catheter 110 comprises, generally, a pressure transducer/electronics assembly 173 and a pressure transmitting catheter 114.
Pressure transducer/electronics assembly 173 comprises a main housing 179 which contains transducer 142, sensor electrical connections 144, temperature compensation electronics 177, connected to cable 175. Transducer 142 comprises a housing 148, a pressure sensor 174, and an opening 146. Sensor 174 comprises, for example, a silicon diaphragm sensor or other appropriate sensor. Opening 146 provides for a gauge reference pressure. Gauge reference pressure (atmospheric pressure) is used for comparison to the measured pressure. Electronics 177 comprise temperature compensation circuitry which reduces the effect of temperature variation on pressure measurements. Cable 175 provides input power and also carries output signals to an electric control system for a therapeutic catheter or other such system.
Catheter 114 comprises a long, small-diameter hollow tube 120 having a distal end 122, a proximal end 124, and lumen 121 extending between the distal end 122 and proximal end 124. The proximal end 124 passes through luer lock connector 181 and housing 179 to attach to transducer 142 at tube adapter 147 with tube connector 128. Luer lock connector 181 is provided for connection to other apparatus, such as a therapeutic catheter having a mating Luer lock connector.
Distal end 122 of catheter 114 contains a thin-walled section 126 where the tube wall thickness is reduced. Tube 120 contains a first liquid 132, a second liquid 134, and a gel-like material 130. First liquid 132 is contained within proximal end 124 and is in fluid contact with pressure sensor 174 substantially filling transducer space 125. Gel-like material 130 is contained within distal end 122, but due to pressure and temperature fluctuations, may move slightly within distal end 122. Second liquid 134 fills the remaining space within hollow tube 120 and is in fluid communication with gel-like material 130 and first liquid 132. Thin-wall section 126 also provides the benefit of allowing an increased surface area of gel-like material 130 exposed to the body fluid while allowing the use of a thicker wall in all or some of the main portion of tube 120 in order to minimize compliance. This is especially relevant when the main portion of hollow tube 120 is constructed of a relatively compliant material such as a polymer. Thin-wall section 126 also provides a larger cross section of lumen 121 compared with proximal end 124. This reduces the movement of gel-like material 130 at distal end 122 caused by volumetric changes of first liquid 132 and second liquid 134.
First liquid 132 and second liquid 134 are low-viscosity, low-vapor-pressure liquids having a minimal compliance and are of a composition such that they are not soluble in each other. First liquid 132 is preferably non-corrosive, hydrophobic, and non-ionic since it may be in contact with the inner components of transducer 142. Further, first liquid 132 may be chosen to minimize leakage between sensor 174 and mount substrate 149.
In some embodiments, first liquid 132 will have the characteristic of being non-electrically conductive (i.e., non-polar and having high dielectric strength). A low-vapor-pressure liquid is desired to keep the amount of trapped air in the sensor to a minimum and to accommodate filling under vacuum. The low-vapor-pressurc liquid is back-filled into transducer 142, after liquid space 125 has been evacuated. A low vapor pressure allows a higher vacuum to be applied to pressure transducer 142, thereby lowering the amount of trapped air. If a fluorinated hydrocarbon liquid is used as first liquid 132, most or all of the remaining air will be absorbed into the liquid, since it will absorb more air than most other liquids. This will result in removing most of the air bubbles. Lowering the amount of trapped air bubbles reduces the compliance of the system and as a result improves frequency response. In some embodiments, first liquid 132 is non-polar, not soluble in second liquid 134, and hydrophobic, therefore protecting the pressure transducer die from a potentially polar second liquid 134, both electrically and physically.
Second liquid 134 may or may not be electrically conductive. Second liquid 134 preferably has a low thermal coefficient of expansion, low viscosity, and low density. The low thermal coefficient of expansion property helps to reduce expansion/contraction due to temperature fluctuations, and therefore reduces the movement of gel-like material 130 at distal end 122. Reduction of movement of gel-like material 130 is important in order to avoid the formation of a void in gel-like material 130 at distal end 122 which may promote the formation of thrombus during use and therefore result in loss of performance. Second liquid 134 should also be insoluble to gel-like material 130. Low viscosity and low density liquids enable catheter 114 to have a higher frequency response (i.e., bandwidth) due to the reduction of friction and momentum losses. The low density liquid also helps to minimize artifacts due to head pressure.
First liquid 132 and second liquid 134 may comprise, for example, water, saline, ineit fluorinated hydrocarbon, silicon oils, alcohols, and water solutions such as propylene glycol dispersed in water. Both liquids 132 and 134 must be non-toxic (in case of leakage). First liquid 132 may have a higher coefficient of thermal expansion than second liquid 134. In addition, first liquid 132 should have a low vapor pressure, low viscosity, and be non-corrosive. Since tube 120 contains substantially more second liquid 134, the two-liquid system overall will have a lower coefficient of expansion and a higher frequency response. This also greatly reduces the amount of movement of the gel-like material 130 due to thermal expansion/contraction of the liquids, resulting in improved patency. The use of two liquids also allows the use of a longer and smaller diameter tube 120 while maintaining a high frequency response and minimizing movement of gel-like material 130.
Gel-like material 130 is a relatively viscous and hydrophobic liquid/solid material. In one embodiment, gel-like material 130 is cross-linked and has a surface energy which increases its tendency to adhere to the inside walls of distal end 122. Any non-toxic and minimally thrombogcnic material capable of flowing as does a viscous liquid and exhibiting intramolecular forces which makes it less likely to migrate or be dislodged from distal end 122 is acceptable. Additionally, the gel-like material 130 may contain an anti-thrombogenic substance to prevent clot formation, such as, for example, heparin and warfarin.
In some embodiments, tube 120 can be made from any biocompatible material. Tube 120 may have an outside diameter of 0.5 mm and an inside diameter of 0.2 mm. The length of tube 120 depends on the particular use involved, but can range from about 5 mm to 4 meters. Tube 120 can be made from any number of materials that provide the general characteristics of pushability, flexibility, low compliance, biocompatibility, abrasion resistance, ability to contain first liquid 132 and second liquid 134, and in some embodiments, be electrically conductive. Relative stiffness of tube 120 will depend on the application. Tube 120 may be very stiff for use where a stiff probe is required, or relatively flexible when used, for example, within narrow vasculature or within the lumen of a therapeutic/diagnostic catheter. Materials for tube 120 may include 316 stainless steel, Nitinol, titanium, MP52, MP35N, polyamide, polyimide, impregnated plastic, polytetra fluoroethylene, polyethylene, polyurethane, polyvinyl chloride, or polypropylene.
Tube 120, when made from most metals, will have a very low compliance compared with a tube made from polymer materials. The use of metals, in turn, increases the frequency response of catheter 114. A metal tube 120 will also withstand higher torsional and longitudinal stress/strain. The use of metal further provides the benefit of a longer and smaller diameter tube 120 while maintaining good frequency response, due to the low compliance of the material.
In another embodiment, an antithrombotic coating is applied to pressure transmission catheter 120. This antithrombotic coating may contain, for example, heparin, and be attached to tube 120 using, for example, the Photolink® process (Surmodics, Eden Prairie, Minn.). This will increase the hemocompatibility of the system. Similarly, a lubricious coating (for example, Parylene C® by Union Carbide) may be applied to catheter 120 to reduce friction when sliding catheter 120 into the lumen of a therapeutic/diagnostic catheter. In another embodiment, distal end 122 may further comprise a noble metal (such as platinum-iridium) sleeve, ring, or coating. Such a material is known to be antithrombogenic and also radio-opaque. Radio-opacity may be a benefit while placing the catheter.
A removable cover 141 is provided to protect distal end 122 when packaged and prior to use. Gel-like material 130 is typically rather tacky and would get dirty if not protected. Cover 141 is removed just prior to catheter use. In one embodiment, removable cover 141 is comprised of silicone tubing that is removed by grasping and pulling off distal end 122. In another embodiment, cover 141 is comprised of a peel-away cover that can be separated into pieces longitudinally to facilitate removal.
FIG. 2 shows a side view in partial cross-section illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of a pressure sensing catheter 210. This embodiment is similar to the embodiment shown in FIG. 1. For convenience, similar components are not described here. In this embodiment, hollow tube 220 comprises a metal material. Therefore, tube 220 contains liquid 234 which is in fluid contact with pressure sensor 274 and gel-like material 230.
Liquid 234 has a low thermal coefficient of expansion, low viscosity, low density, and minimal compliance. Liquid 234 is preferably non-corrosive, and non-ionic since it may be in contact with metallic components of transducer 242. Further, liquid 234 may be chosen to minimize Icakage through the joint between transducer 242 and mount substrate 249. Liquid 234 may comprise, for example, water, saline, inert fluorinated hydrocarbon, silicon oils, alcohols, and water solutions such as propylene glycol dispersed in water. Liquid 234 should be non-toxic (in case of leakage) and also be insoluble to gel-like material 230.
FIG. 3 shows a side view in partial cross-section illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of a pressure and electrical signal sensing catheter 310. This embodiment is similar to the embodiment shown in FIG. 1. For convenience, similar components are not described here.
In this embodiment, hollow tube 320 comprises an electrically conductive material. Further, catheter 310 includes electrical connections 378 coupled to proximal end 324 of hollow tube 320. Hollow tube 320 is also coated with electrical insulation layer 338. Since hollow tube 320 is electrically conductive, it may be used as an electrode to sense and transmit an electric signal. It may be desired to restrict the electrical signal sensing portion of electrode 336 to distal end 322. Electric insulation layer 338 covers substantially the entire length of tube 320 except for a portion of tube 320 at distal end 322 or other portion of interest. This portion is identified as electrode 336. Electrode 336 senses an electrical signal which is electrically transmitted along tube 320 to electric insulation layer 378. Layer 338 may be a coating, a film, or a tube-like component and may be comprised of, for example, Parylene, silicon nitride, silicon oxide, or Teflon.
External connection 383 is provided as an attachment site for external devices, such as, for example, an indifferent electrode. External connection 383 is connected to temperature compensation electronics 377 through electrical connection 344. Electrical signals are then able to be communicated to outside devices though cable 375.
FIG. 4 shows a side view in partial cross-section illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of a pressure and electrical signal sensing catheter 410. This embodiment is similar to the embodiment shown in FIG. 3. For convenience, similar components are not described here. In this embodiment, hollow tube 420 comprises a metal material.
Therefore, tube 420 contains liquid 434 which is in fluid contact with pressure sensor 474 and gel-like material 430.
Liquid 434 will have the characteristic of being non-electrically conductive (i.e., non-polar and having high dielectric strength). Additionally, liquid 434 should have a low thermal coefficient of expansion, low viscosity, low density, and minimal compliance. Liquid 434 is preferably non-corrosive, hydrophobic, and non-ionic since it may be in contact with metallic components of transducer 442. Further, liquid 434 may be chosen to minimize leakage through the joint between transducer 442 and mount substrate 449. Liquid 434 may comprise, for example, water, saline, inert fluorinated hydrocarbon, silicon oils, alcohols, and water solutions such as propylene glycol dispersed in water. Liquid 434 should be non-toxic (in case of leakage), and also insoluble to gel-like material 430.
FIG. 5 shows a side view in partial cross-section illustrating generally, by way of example, but not by way of limitation, one embodiment of portions of a pressure and electrical sensing catheter 510. Catheter with physiological sensor 510 is comprised generally of a pressure transducer/electronics assembly 573 and pressure and electric signal transmission catheter 514. Assembly 573 comprises pressure transducer 542, electronics 577, including temperature compensation circuitry which compensates for variations in ambient temperature, and appropriate electrical connections 544, all housed in main housing 579. Assembly 573 terminates with electrical cable 575 which provides input power and also carries output signals to an electric control system for a therapeutic catheter or other such systems. Catheter 514 comprises a small diameter hollow tube 520 having a distal end 522 and a proximal end 524. The proximal end 524 enters assembly 573 through Luer lock 581. Hollow tube 520 is comprised of an electrically non-conductive material, such as, for example, polyethylene. The electrical characteristics of this embodiment are accomplished by embedding a conductor within hollow tube 520, such as shown in FIG. 6, for example.
FIG. 6 shows a side view in partial cross-section illustrating generally, by way of example, but not by way of limitation, one embodiment of the distal portion of the catheter with physiological sensor 510 (as shown in FIG. 5). In this embodiment, hollow tube 520 comprises an electrically non-conductive material, and further includes an electrically conductive distal end 522, filar coil 645, electrical connection 639, and tube joint 637. Coil 645 is embedded in tube 520 and runs substantially the entire length of tube 520. At distal end 522, coil 645 terminates at connection 639 and is in electrical communication with electrode 635. At proximal end 524 (as shown in FIG. 5), coil 645 connects with sensor electrical connection 543. Electrode 635 is a separate electrically conductive tube that is attached to distal end 522 by ajoint 637. The electrode 635 senses an electrical signal which is electrically transmitted along filar coil 645 to connection 543 (as shown in FIG. 5). In other embodiments, electrode 635 may be an integral part of tube 520, such as, for example, by dispersion of an electrically conductive material molded into tube 520, and by a deposited layer of electrically conductive material. In other embodiments, coil 645 may, for example, be a slender wire that is embedded in, lying outside, or lying inside tube 520. Other methods to electrically communicate an electric signal from electrode 635 to connection 543, may, for example, include depositing an electrically conductive material as a strip to the outside of tube 520 and as a dispersion of electrically conductive material molded along length of tube 520.
The catheter with physiological sensor may be made from certain materials or used in certain circumstances that require the distal end of the catheter to be made more rugged than that provided by an unmodified hollow tube distal portion, with or without a thin-wall section. A ruggedized feature may be required to resist distal end kinking or collapse. FIG. 7 illustrates generally, by way of example, but not by way of limitation, one embodiment of distal end 722 of a catheter showing ruggedizing feature 790. Distal end 722 can be used with the various catheter embodiments shown and described herein. Ruggedizing feature 790 can be attached to distal end 722, over which a compliant membrane 789 is placed. In another embodiment, ruggedizing feature 790 may be slid over thin wall section 726 to add support to distal end 722, in which case compliant membrane 789 is not needed. In another embodiment, ruggedizing feature 790 is created directly from hollow tube 720 by laser cutting, photo etching, other etching process, molding, or by machining, leaving a mesh-like pattern. Compliant membrane 789 is then placed on the ruggedized feature, for example, by sputtering, vapor deposition over a mandrel temporally placed in the lumen, dipping, casting over molding, or by sliding over a compliant tube, such as heat shrink tubing. In another embodiment, the fabrication process does not cut completely through thin wall section 726 but leaves thin compliant areas surrounded by areas of thicker, more rigid material.
Ruggedizing feature 790 comprises a support structure made from a relatively rigid material as compared with thin wall section 726. Ruggedizing feature 790 provides a distal tip 722 that is more resistant to kinking and collapse, while allowing the compliant portion spanning the spaces within ruggedized feature 790 of thin wall section 726 to respond to pressure, transmitting the pressure to second liquid 734 and to gel-like material 730.
In another embodiment, tube 720 is fabricated of a polymer, such as, for example, a 60 D hardness urethane that is very flexible. In this embodiment, ruggedizing feature 790 may be fabricated from a much harder polymer or from metal.
FIG. 8 illustrates generally, by way of example, but not by way of limitation, one embodiment of distal end 822 of a catheter showing ruggedizing feature 892. Distal end 822 can be used with the various catheter embodiments shown and described herein. Distal end 822 is comprised of multiple lumens 891. The inner portion of these structures is formed by ribs 890 which act to increase resistance to collapse and kinking of distal end 826. Thin wall sections 822 are compliant and transfer the outside pressure to second liquid 834 and gel-like material 830 contained within the lumens 891. In some embodiments, the distal 2-4 mm of feature 892 is filled with gel-likc material 830, while the remaining portion is filled with second liquid 834.
FIG. 9 illustrates generally, by way of example, but not by way of limitation, one embodiment of distal end 922 of the pressure transmission catheter showing ruggedizing feature 992. A stent-like insert 993 is placed within relatively compliant thin wall section 926, to provide a reinforcing structure that provides resistance to kinking and collapse of distal end 922. Stent 993 may be fabricated from a metal tube (for example, nickel titanium alloy (Nitinol), titanium, 316 stainless steel, or platinum) that is, for example, laser cut, etched, or machined to form openings through which thin wall section 926 is directly exposed to second liquid 934 and gel-like material 930. Stent 993 may alternately be formed, for example, from a wire, a plastic, polymer (for example, acetal resin, polytetra fluorethane, polyethylene, polyurethane, polypropylene, polyamide, polyimide, or acetyl butadiene styrene) and other relatively rigid materials. Stent openings 994 are sized appropriately such that thin wall section 926 can efficiently transfer the dynamic components of the pressure signal into second liquid 934 and gel-like material 930 in order to obtain a high-fidelity reproduction of the desired pressure signal. In other embodiments, stent 993 is placed on the outside of thin wall section 926. In other embodiments, stent 993 is molded directly into the distal end.
It may be desired to use the catheter with physiological sensor as a guidewire. It may also be desired to use the catheter with physiological sensor as a stand-alone diagnostic catheter; that is, used without first placing a therapeutic catheter within the vasculature. For these uses, the catheter with physiological sensor must be able to traverse narrow, tortuous vasculature (such as coronary arteries). Because of this, it may be desired that the catheter distal tip be very flexible and resilient to kinking, as well as non-injurious to the vasculature. FIG. 10 illustrates generally, by way of example, but not by way of limitation, one embodiment of distal end 1022 of the pressure transmission catheter showing flexible tip feature 1088. In one embodiment, flexible tip feature 1088 consists of a spring-like feature 1097 tenninating in a smooth head 1098. The spring-like feature 1097 is attached to distal end 1022, for example, by wrapping over, sliding inside, and/or molded into distal end 1022. In one embodiment, flexible tip feature 1088 is up to 3 cm long.
FIG. 11 illustrates generally, by way of example, but not by way of limitation, one embodiment of distal end 1122 of the pressure transmission catheter showing flexible tip feature 1188. Flexible tip feature 1188 comprises a spring-like feature 1197, a smooth head 1198, and a cone-shaped insert 1195. Cone-shaped insert 1195 is perforated with numerous holes 1196 to allow gel-like material 1130 movement and to allow gel-like material 1130 to be exposed to the pressure environment. The cone-shaped insert 1195 is inserted into distal end 1122.
FIG. 12 illustrates generally, by way of example, but not by way of limitation, one embodiment of distal end 1222 of pressure transmission catheter showing flexible tip feature 1288. This embodiment is similar to the embodiment shown in FIG. 10. For convenience, similar components are not described here. In this embodiment, thin-wall section 1226 has the addition of numerous slits 1299 in the portion that is filled with gel-like material 1230. The addition of slits 1299 is to allow more of the gel-like material 1230 to respond to the pressure environment, and to allow the tip to be more flexible.
FIG. 13 shows a side view in partial cross-section illustrating generally, by way of example, but not by way of limitation, and an environment in which it is used, one embodiment of portions of a catheter with physiological sensor 1310 which comprises generally a pressure transducer/electronics assembly 1373 and pressure transmission catheter 1314. Pressure transmission catheter 1314 is shown as used with a therapeutic/diagnostic catheter 1350. Transmission catheter 1314 is inserted into lumen 1356 of therapeutic/diagnostic catheter 1350. This is done by inserting distal end 1322 of pressure transmission catheter 1314 into lumen 1356 and slidably moving through lumen 1356 until distal end 1322 projects beyond distal end 1351 of the therapeutic/diagnostic catheter.
In one embodiment, the therapeutic/diagnostic catheter 1350 includes an electrode 1372 with connection 1376 to external connection 1383. Electrode 1372 is attached or made part of catheter 1350 such that when catheter 1350 is in use, electrode 1372 can be used to sense a reference physiological, electrical signal needed for particular therapies and diagnoses. In this embodiment, the signal from reference electrode 1372 is compared with the signal from the catheter electrode. Providing reference electrode 1372 on catheter 1350 negates the need for the use of extemal electrodes to measure, for example, an electrocardiogram (ECG) that are prone to inaccurate measurement, noise, and disconnection. Reference electrode 1372 may be provided on catheter 1350, for example, by attachment, as a molded in place part or feature, or as a deposition or coating.
FIG. 14 illustrates generally, by way of example, but not by way of limitation, and an environment in which it is used, one embodiment of potions of a pressure and electrical sensing catheter 1410 with a typical therapeutic catheter 1450, in this case an intra-aortic balloon catheter (e.g., Profile® 8 FR. Intra-Aortic Balloon (IAB) Catheter, Datascope Corporation, Fairfield, N.J.). An opening is typically made in one of the femoral arteries 1460 into which is inserted a guidewire (not shown), which is long, thin, and flexible. The guidewire is threaded up through the abdominal aorta 1464 to the descending thoracic aorta 1468. Once the guidewire is correctly placed within the vasculature, therapeutic catheter 1450 is threaded over a guidewire (not shown) and advanced to the treatment site. The guidewire is then removed. Pressure transmission catheter 1414 is advanced through a lumen of catheter 1450 until distal end 1422 projects beyond distal end 1451 of catheter 1450. This allows the pressure and electrical measurements to be taken on the upstream (high pressure) side of intra-aortic balloon catheter balloon 1452. The pressure transmission catheter 1414 terminates at the pressure transducer/electronics assembly 1473 which is connected through cable 1475 to the intra-aortic balloon catheter control system 1454. The intra-aortic balloon catheter 1450 terminates at control system 1454. Catheter electrode 1436 senses an electric signal from the heart 1470, e.g., an electrocardiogram signal, which is used by control system 1454 to trigger inflation and deflation of balloon 1452. Balloon 1452, when inflated, displaces blood in the artery. If timed correctly, this results in an increase in systolic pressure and increased perfusion of the coronary arteries (not shown). The pressure measurements are used to calibrate control system 1454 to take into account the time lag between the electrical impulse from the heart 1470 and cardiovascular response.
Some disclosed embodiments of the catheter with physiological sensor provide a prefilled catheter-based pressure sensing system that can traverse a lumen of a diagnostic/therapeutic catheter. Previous pressure sensing catheters, especially those used with intra-aortic balloons, are not suitable because they are either too large, too compliant to provide accurate pressure measurements, too expensive, too inconvenient to use, and/or have other limitations, particularly those associated with being non-prefilled. Prefilling provides the added assurance of high quality control, reduced preparation time prior to use, and greatly reduced likelihood of air bubbles in the lumen. Additionally, a less complex and more accurate and reliable system for detecting electrical signals is provided for treatments requiring the detection of such signals.
Existing devices gather control data using separate electrodes. These electrodes sense an electric signal to control therapeutic catheters, such as the inflation/deflation of an intra-aortic balloon catheter. These separate electrodes are prone to electrical interference, are not precise in electrical detection, and are prone to environmental affects and accidental disconnection. These separate electrodes typically must be placed away from the target site, and therefore do not precisely measure the desired signals. Some embodiments of the disclosed pressure and electrical sensing catheter provide the ability to gather pressure measurements beyond the intra-aortic balloon catheter balloon location during the entire treatment period as well as providing electrical signals to the balloon control system, making separate electrodes unnecessary. Since the catheter electrode is placed at the target site, the desired electrical signal is measured, minimizing multiple signals and electrical noise associated with surface skin electrodes. In some embodiments, the catheter electrode is also an integral part of the catheter and therefore cannot be accidentally disconnected.
The disclosed embodiments provide an apparatus that obtains blood pressure measurements that are reliable and of high quality. Such an improved catheter capable of providing reliable high-fidelity blood pressure signals could also open up the possibility of implementing closed loop control, climinating the need for manual adjustments of the timing of balloon inflation based on observation of the measured blood pressure waveform. Some embodiments of the pressure sensing catheter embodied here are also useful as diagnostic catheters for measurement of left ventricular pressure of the heart. For example, a guiding catheter containing a lumen of sufficient size to accommodate the disclosed pressure sensing catheter could be directed transvascularly into the left ventricle. The guiding catheter could be any of a series of standard catheters that are currently used for crossing the aortic valve retrograde into the left ventricle.
In another embodiment, the distal tip of the catheter with physiological sensor incorporates a flexible tip to allow the catheter to be guided into narrow, tortuous vasculature, such as coronary arteries, with or without a guiding catheter. This would allow the catheter to assess stenosis severity by measuring fractional flow reserve.
In some embodiments, the catheter with physiological sensor has an advantageously very low compliance. The catheter can be fabricated with a compliant thin wall distal end, and all or most of the thin-wall distal end can be exposed to the body fluid. By using a compliant material on the distal end, the pressure signal can be transmitted through the compliant material into the catheter lumen and transmitted by the catheter liquid. In embodiments where the pressure transducer and main portion of the catheter have a significant compliance, the thin wall compliant distal end design results in better frequency response than can be achieved if the pressure signal were transmitted to the lower-viscosity catheter liquid through only the viscous gel-like material.
In some embodiments, the catheter with physiological sensor may be used such that pressure measurements may be taken beyond the therapeutic/diagnostic catheter lumen tip as well as at some point between the distal and proximal ends of the catheter. For example, an opening in the therapeutic/diagnostic catheter could be made at a point along its length through which pressure measurements may be taken.
CONCLUSION
It is to be understood that the above description is intended to be illustrative, and not restrictive. Many other embodiments will be apparent to those of skill in the art upon reviewing thc above description. The scope of the invention should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.
Claims (75)
What is claimed is:
1. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end;
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material; and
a ruggedized tip disposed at the distal end of the hollow tube.
2. The catheter according to claim 1, wherein the hollow tube comprises a material selected from the group consisting of polyamide, polyimide, impregnated plastic, polytetra fluorethylene, polyethylene, polyurethane, polyvinyl chloride, and polypropylene.
3. The catheter according to claim 1, wherein the hollow tube comprises a metal selected from the group consisting of 316 stainless steel, Nitinol, titanium, MP35N, and MP52.
4. The catheter according to claim 1, wherein the distal end further comprises a thin-wall portion.
5. The catheter according to claim 1, wherein the at least one liquid is selected from the group consisting of water, saline, fluorinated hydrocarbon, silicone oils, alcohols, and propylene glycol dispersed in water.
6. The catheter according to claim 1, wherein the gel-like material comprises a non-toxic and minimally thrombogenic material.
7. The catheter according to claim 1, wherein the gel-like material further comprises an anti-thrombogenic substance selected from the group consisting of heparin and warfarin.
8. The catheter according to claim 1, wherein at least a portion of the hollow tube is electrically conductive.
9. The catheter according to claim 8, wherein the hollow tube is substantially covered with an insulating material.
10. The catheter according to claim 1, wherein the distal end includes an electrically conductive portion which acts as an electrode for detecting an electric signal.
11. The catheter according to claim 10, and further including a conductor that is coupled to the electrically conductive portion and disposed along the length of the hollow tube.
12. The catheter according to claim 1, wherein the ruggedized tip comprises ribs dividing the lumen into a plurality of lumens at the distal end.
13. The catheter according to claim 1, wherein the ruggedized tip comprises a stent inserted into the lumen at the distal end of the hollow tube.
14. The catheter according to claim 13, wherein the stent comprises a braided wire tube.
15. The catheter according to claim 13, wherein the stent comprises an expanded metal mesh tube.
16. The catheter according to claim 1, wherein the distal end further comprises a plurality of semi-circumferential elongated holes.
17. The catheter according to claim 1, wherein the ruggedized tip comprises:
a mesh-like feature formed in the distal end of the hollow tube; and
a compliant membrane disposed over the outer surface of the mesh-like feature.
18. A guidewire catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end;
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material; and
a flexible tip disposed at the distal end of the hollow tube.
19. The catheter according to claim 18, wherein the hollow tube comprises a material selected from the group consisting of polyamide, polyimide, impregnated plastic, polytetra fluorethylene, polyethylene, polyurethane, polyvinyl chloride, and polypropylene.
20. The catheter according to claim 18, wherein the hollow tube comprises a metal selected from the group consisting of 316 stainless steel, Nitinol, titanium, MP35N, and MP52.
21. The catheter according to claim 18, wherein the distal end further comprises a thin-wall portion.
22. The catheter according to claim 18, wherein the at least one liquid is selected from the group consisting of water, saline, fluorinated hydrocarbon, silicone oils, alcohols, and propylene glycol dispersed in water.
23. The catheter according to claim 18, wherein the gel-like material comprises a non-toxic and minimally thrombogenic material.
24. The catheter according to claim 18, wherein the gel-like material further comprises an anti-thrombogenie substance selected from the group consisting of heparin and warfarin.
25. The catheter according to claim 18, wherein at least a portion of the hollow tube is electrically conductive.
26. The catheter according to claim 25, wherein the hollow tube is substantially covered with an insulating material.
27. The catheter according to claim 18, wherein the distal end includes an electrically conductive portion which acts as an electrode for detecting an electric signal.
28. The catheter according to claim 27, and further including a conductor that is coupled to the electrically conductive portion and disposed along the length of the hollow tube.
29. The catheter according to claim 18, wherein the distal end further comprises a plurality of semi-circumferential elongated holes.
30. The catheter according to claim 18, wherein the flexible tip comprises:
a coil having a first end and a second end; and
a rounded head,
wherein the rounded head is coupled to the first end of the coil, and the second end of the coil is coupled to the distal end of the hollow tube.
31. The catheter according to claim 18, wherein the flexible tip comprises:
a coil having a first end and a second end;
a rounded head;
a cone-shaped insert having a plurality of holes; and
wherein the rounded head is attached to the first end of the coil, and the second end of the coil is attached to the cone-shaped insert and wherein the cone-shaped insert is inserted into the distal end of the hollow tube.
32. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end;
at least two liquids disposed within the hollow tube to provide a pressure communication link between the gel-like material and the pressure transducer.
33. The catheter according to claim 32, wherein the at least two liquids comprise:
a first liquid in communication with the pressure transducer; and
a second liquid which substantially fills the lumen and is in communication with the gel-like material and the first liquid, and wherein the first liquid and the second liquid are not soluble with each other.
34. The catheter according to claim 32, wherein the hollow tube comprises a material selected from the group consisting of polyamide, polyimide, impregnated plastic, polytetra fluorethylene, polyethylene, polyurethane, polyvinyl chloride, and polypropylene.
35. The catheter according to claim 32, wherein the hollow tube comprises a metal selected from the group consisting of 316 stainless steel, Nitinol, titanium, MP35N, and MP52.
36. The catheter according to claim 32, wherein the distal end further comprises a thin-wall portion.
37. The catheter according to claim 32, wherein the at least two liquids are selected from the group consisting of water, saline, fluorinated hydrocarbon, silicone oils, alcohols, and propylene glycol dispersed in water.
38. The catheter according to claim 32, wherein the gel-like material comprises a non-toxic and minimally thrombogenic material.
39. The catheter according to claim 32, wherein the gel-like material further comprises an anti-thrombogenic substance selected from the group consisting of heparin and warfarin.
40. The catheter according to claim 32, wherein at least a portion of the hollow tube is electrically conductive.
41. The catheter according to claim 40, wherein the hollow tube is substantially covered with an insulating material.
42. The catheter according to claim 32, wherein the distal end includes an electrically conductive portion which acts as an electrode for detecting an electric signal.
43. The catheter according to claim 42, and further including a conductor that is coupled to the electrically conductive portion and disposed along the length of the hollow tube.
44. The catheter according to claim 32, and further including a ruggedized tip including ribs separating the lumen into a plurality of lumens at the distal end.
45. The catheter according to claim 32, wherein the distal end further comprises a stent inserted into the lumen of the distal end of the hollow tube.
46. The catheter according to claim 45, wherein the stent comprises a braided wire tube.
47. The catheter according to claim 45, wherein the stent comprises an expanded metal mesh tube.
48. The catheter according to claim 32, wherein the distal end further comprises a plurality of semi-circumferential elongated holes.
49. The catheter according to claim 32, and further comprising a flexible tip comprising:
a coil having a first end and a second end;
a rounded head; and
wherein the rounded head is coupled to the first end of the coil, and the second end of the coil is coupled to the distal end of the hollow tube.
50. The catheter according to claim 32, and further comprising a flexible tip comprising:
a coil having a first end and a second end;
a rounded head;
a cone-shaped inset having a plurality of holes; and
wherein the rounded head is attached to the first end of the coil, and the second end of the coil is attached to the cone-shaped insert and wherein the cone-shaped insert is inserted into the distal end of the hollow tube.
51. A system, comprising:
a sensing catheter that includes a sensor for sensing a physiological parameter;
the sensing catheter including an electrical output signal related to the sensed physiological parameter;
a control system coupled to the electrical output signal of the sensing catheter;
a therapeutic catheter includinig at least one input that receives an input from the control system based on the output signal of the sensing catheter; and
wherein the therapeutic catheter includes a hollow tube having a lumen for receiving the sensing catheter and placing the sensor of the sensing catheter in a position to sense the physiological parameter.
52. The system of claim 51, wherein the therapeutic catheter comprises an intra-aortic balloon catheter having a balloon and wherein the control system provides a feed-back control loop that controls the inflation/deflation of the balloon based on signals from the sensing catheter.
53. The system of claim 52, wherein the signals from the sensing catheter include a pressure signal.
54. The system of claim 52, wherein the signals from the sensing catheter include an electrocardiogram (ECG) signal.
55. The system of claim 51, wherein the sensing catheter includes:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the proximal end in communication with the pressure transducer;
a gel-like material positioned in the lumen at the distal end; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
56. The system of claim 51, wherein the therapeutic catheter further includes a reference electrode coupled to an exterior of the hollow tube of the therapeutic catheter.
57. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, wherein the hollow, metal tube comprises a metal selected from the group consisting of 316 stainless steel, Nitinol, titanium, MP35N, and MP52, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
58. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material, wherein the at least one liquid is selected from the group consisting of water, saline, silicone oils, alcohols, and propylene glycol dispersed in water.
59. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end, wherein the gel-like material comprises a non-toxic and minimally thrombogenic material; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
60. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end, wherein the gel-like material further comprises an anti-thrombogenic substance selected from the group consisting of heparin and warfarin; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
61. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, wherein the hollow tube is substantially covered with an insulating material, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
62. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, a portion of the distal end comprising at least one rib separating the lumen into a plurality of smaller lumens, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
63. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the distal end, the pressure transducer coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end;
a stent coupled to the distal end of the hollow tube; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
64. The catheter according to claim 63, wherein the stent coupled to the distal end of the hollow tube comprises a stent coupled to the lumen of the distal end of the hollow tube.
65. The catheter according to claim 63, wherein the stent coupled to the distal end of the hollow tube comprises the stent coupled to the outer surface of the distal end of the hollow tube.
66. The catheter according to claim 63, wherein the stent coupled to the distal end of the hollow tube comprises a stent imbedded into the distal end of the hollow tube.
67. The catheter according to claim 63, wherein the stenit comprises a braided wire tube.
68. The catheter according to claim 63, wherein the stent comprises an expanded metal mesh tube.
69. The catheter according to claim 63, wherein the stent comprises a perforated tube.
70. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end, the hollow tube further comprises a plurality of holes proximate the distal end, the pressure transducer is coupled to the proximal end;
a gel-like material positioned in the lumen at the distal end and at the plurality of holes; and
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material.
71. The catheter according to claim 70, wherein the plurality of holes are of semi-circumferential elongated shape.
72. The catheter according to claim 70, wherein the plurality of holes form a mesh-like structure.
73. The catheter according to claim 70, further comprising a compliant membrane disposed over the plurality of holes.
74. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end;
a gel-like material positioned in the lumen at the distal end;
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material; and
a flexible tip comprising:
a coil having a first end and a second end;
a rounded head; and
wherein the rounded head is coupled to the coil first end of the coil, and the second end of the coil is coupled to the distal end of the hollow tube.
75. A catheter, comprising:
a pressure transducer that provides a signal which varies as a function of pressure;
a hollow, metal tube having a distal end, a proximal end, and a lumen extending between the proximal end and the distal end;
a gel-like material positioned in the lumen at the distal end;
at least one liquid which fills the lumen and is in communication with the pressure transducer and the gel-like material; and
a flexible tip comprising:
a coil having a first end and a second end;
a rounded head;
a cone-shaped insert having a plurality of holes; and
wherein the rounded head is attached to the first end of the coil, and the second end of the coil is attached to the cone-shaped insert and wherein the cone-shaped insert is inserted into the distal end of the hollow tube.
US09/264,147 1999-03-05 1999-03-05 Catheter with physiological sensor Expired - Lifetime US6296615B1 (en)
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US09/825,130 US6659959B2 (en) 1999-03-05 2001-04-03 Catheter with physiological sensor
US10/077,566 US20020120200A1 (en) 1997-10-14 2002-02-15 Devices, systems and methods for endocardial pressure measurement
US10/420,388 US7481774B2 (en) 1999-03-05 2003-04-22 Catheter with physiological sensor
US11/084,625 US20050182330A1 (en) 1997-10-14 2005-03-16 Devices, systems and methods for endocardial pressure measurement
US11/223,587 US20060064135A1 (en) 1997-10-14 2005-09-08 Implantable pressure sensor with pacing capability
US11/728,190 US20080064966A1 (en) 1997-10-14 2007-03-22 Devices, systems and methods for endocardial pressure measurement
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-8,852,550,693,193,022,000 | Locomotor- and Reward-Enhancing Effects of Cocaine Are Differentially Regulated by Chemogenetic Stimulation of Gi-Signaling in Dopaminergic Neurons
Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt
Dopamine plays a key role in the cellular and behavioral responses to drugs of abuse, but the implication of metabotropic regulatory input to dopaminergic neurons on acute drug effects and subsequent drug-related behavior remains unclear. Here, we used chemogenetics [Designer Receptors Exclusively Activated by Designer Drugs (DREADDs)] to modulate dopamine signaling and activity before cocaine administration in mice. We show that chemogenetic inhibition of dopaminergic ventral tegmental area (VTA) neurons differentially affects locomotor and reward-related behavioral responses to cocaine. Stimulation of Gi-coupled DREADD (hM4Di) expressed in dopaminergic VTA neurons persistently reduced the locomotor response to repeated cocaine injections. An attenuated locomotor response was seen even when a dual-viral vector approach was used to restrict hM4Di expression to dopaminergic VTA neurons projecting to the nucleus accumbens. Surprisingly, despite the attenuated locomotor response, hM4Di-mediated inhibition of dopaminergic VTA neurons did not prevent cocaine sensitization, and the inhibitory effect of hM4Di-mediated inhibition was eliminated after withdrawal. In the conditioned place-preference paradigm, hM4Di-mediated inhibition did not affect cocaine-induced place preference; however, the extinction period was extended. Also, hM4Di-mediated inhibition had no effect on preference for a sugar-based reward over water but impaired motivation to work for the same reward in a touchscreen-based motivational assay. In addition, to support that VTA dopaminergic neurons operate as regulators of reward motivation toward both sugar and cocaine, our data suggest that repeated cocaine exposure leads to adaptations in the VTA that surmount the ability of Gi-signaling to suppress and regulate VTA dopaminergic neuronal activity.
OriginalsprogEngelsk
Artikelnummere0345
TidsskrifteNeuro
Vol/bind5
Udgave nummer3
Antal sider26
DOI
StatusUdgivet - 2018
Antal downloads er baseret på statistik fra Google Scholar og www.ku.dk
Ingen data tilgængelig
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389,600,482,060,098,750 | 15 49.0138 8.38624 1 0 4000 1 https://motherofnature.net 300 true 0
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Everything You Must Know About Hydrogen Peroxide And Cancer!
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There is no doubt that one of the deadliest conditions in our modern era is cancer, and scientists have been struggling to find the right treatment for it for many years – or so that is what they want everyone to believe.
Cancer is a disease which starts out in our bodies as a tumor, and it can be kick-started by anything toxic, acidic, and processed, such as unhealthy foods, environmental toxins, radioactive exposure and many other factors. It’s found in cosmetics, makeup, toothpaste, soaps, shampoos, and can even be lurking in your refrigerator. But many experts assume that the cure for this deadly disease was found many years ago, just hidden away from the public, since why waste thousands of dollars when you can end it with a few dollars and some water. Yes, you read that right.
Most of us are familiar with the fact that cancer thrives in an acidic body environment, where the organs are flooded with processed salt, sugar, animal fat and artificial food. In this type of an acidic body, the brain and heart struggle to filter out the toxins found in the conventional forms of food such as pesticides, hormones, antibiotics, herbicides, bleach, ammonia, heavy metals and other, which is why oncologists tell chemo patients not to eat alkalizing foods such as kale, as it will interfere with the treatment.
But if there is one right way to fight an acidic body – it’s with alkalizing foods. Not only do alkalizing foods help boost the function of your organs, detoxify and alkalize your body, but they also help the good cells. As one study highlighted, the most overlook solution to the most complicated problem is often the simplest one. Taking in mind that all pathogens, parasites and viruses are anaerobic, they all thrive in the absence of oxygen and the presence of glucose, alkalizing the body is the right way to go to put an end to this disease.
And one of the best additional help you can get in the fight is hydrogen peroxide. Dripping a couple of drops of this solution in a glass of water every day will end cancer for good. The key is to get enough hydrogen peroxide inside the cancer cells.
Clinical studies have demonstrated that the spread of cancer is inversely proportional to the amount of oxygen around the cancer cells, meaning that the more oxygen there is, the slower this disease will spread, and if they get enough oxygen, they will die out. Well, hydrogen peroxide makes the perfect solution for this situation, as cancer cells do not have the mechanism to break it down and stop it from doing its function.
In other words, the cure for cancer is simple – get enough hydrogen peroxide into the cancer, and believe it or not, science has known this for 50 years. In fact, Dr. Otto Warburg, a Nobel prize winner, demonstrated this over 50 years ago, as the basic difference between normal cells and cancer cells. While both derive energy from glucose, the normal cells need oxygen to thrive, while cancer cells don’t need it, as they live solely from glucose.
In addition to this, hydrogen peroxide along with several other oxygen therapies have been proven safe and effective. It is also important to pay attention to the type of hydrogen peroxide you buy, as the 35% for grade type is the only one recommended for internal use.
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-5,936,869,322,187,573,000 | Explore BrainMass
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Fat absorption in the human GI tract
This content was STOLEN from BrainMass.com - View the original, and get the already-completed solution here!
Short description of how fat is absorbed in the GI tract and how it enters the bloodstream is briefly exemplified.
© BrainMass Inc. brainmass.com December 20, 2018, 5:21 am ad1c9bdddf
https://brainmass.com/biology/digestive-system/fat-absorption-human-gi-tract-325453
Solution Preview
Discuss the normal physiology of fat digestion and absorption and its relationship to malabsorption syndromes.
? Digestion Site: small intestine
? Enzymes: lipases
? Fat is pretreated with bile salts (in duodenum)
? Have polar and nonpolar regions to emulsify fat
? Increases number of triglyceride ...
Solution Summary
The expert discusses how fat is absorbed in the GI tract. How it enters the bloodstream is briefly exemplified.
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-5,464,574,906,481,824,000 | DNA Testing 101 - How does DNA testing work? | KnowYourDNA
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DNA Testing 101 - How does DNA testing work?
Joel
Writer: Joel
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Updated on: March 5, 2021
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KnowYourDNA is reader-supported. This means we may receive a commission when you buy something from one of the links on this page.
To the end consumer, DNA testing is reasonably straightforward; follow the instructions on the kit and let the service tell you about your genetics. However, advanced technologies power affordable at-home DNA testing, something that would have been impossible only a few decades ago. This guide will run through DNA testing 101:
• What DNA is
• How it works
• Who should undergo a DNA test
• How to do a DNA test
• What to do immediately after
The concept of genetics started over 150 years ago, with experiments on pea plants by Gregor Mendel. The field has evolved into a refined science with humongous strides, especially over the last two decades. The first human DNA test was completed in June 2000 at the cost of an estimated $150 million
DNA Testing 101 - How does DNA testing work? 4
What is DNA?
Let’s begin with an overview of what DNA is. DNA is…
• One of the building blocks for human life
• Contained within every living cell
• A chemical blueprint that directs the actions and growth of each cell
• Packaged into, and protected by your 46 chromosomes
• •Inherited from your parents
Every cell in your body contains DNA. Those genes were copied in equal measure from each of your parents, but the combination of your genes is unique unless you are an identical twin. It’s the inheritance of DNA that results in some traits or disease being genetic. It’s also how you can trace your DNA backward and explore your ancestral roots.
GoalTrace Father’s LineTrace Mother’s LineFind Family
TestY-DNA testmtDNA TestAutosomal
We took every DNA test so you don't have to. Read our 2021 review of the best DNA tests.
Who should undergo a DNA test?
There isn’t a right or wrong type of person to undergo DNA testing.
Genetic testing is safe and it’s an option for anyone who wants to learn more about themselves regarding health or heritage.
However, before taking a DNA test, it’s important to understand the pros and cons of genetic testing and to fully understand what a test might reveal. For some, genetic testing opens a Pandora Box they would’ve been happier leaving sealed.
At-home DNA testing is fun and informative, so if you believe that learning about health risks or exploring ancestry could be painful or difficult for you, it’s probably better to forego testing.
How to do a DNA test?
DNA test kits vary from company to company, but most follow a general procedure:
How to Take an At-Home DNA test
1. Order Your Kit
You’ll want to research your options and narrow down the selection based on customer reviews and your personal needs. Most services let you order online and receive your test kit in the mail.
2. Receive the Collection Kit
Once you receive the kit, it’s time for DNA collection. You’ll take a cheek swab or spit into a tube. Each kit comes with a set of instructions to follow for DNA collection and submitting your sample.
3. DNA Lab Receives and Process Your DNA Sample
The testing lab extracts DNA from the cells you submitted and scans them for thousands of variations throughout your genome.
4. Analyze Your DNA Data
This final step makes it possible for you to learn more about yourself from the sample you submitted. The testing company will provide you with results based on medical research and its database of other samples. Depending on the test you used, you’ll gain access to information about your medical risks and your ancestral lineage.
Once you get your DNA data -
DNA Testing 101 - How does DNA testing work? 5
We’ve compiled a list of dos and don’ts for anyone undergoing a DNA test:
Do:
Protect your data
Make sure you know how your DNA data will be managed, secured and whether or not a company will share it. Your DNA is a blueprint of you and you should do everything you can to protect it. Every service has an option to download your raw DNA data and then delete it from their database. Once you’ve done this, consider deleting it from their system.
Download all of your data
You never know what is going to happen to DNA testing companies or data. Considering that it is your data, even if you can’t understand or decipher it, you should always have your backup. Every service has an option to download your raw DNA data for an extra level of safe-keeping.
Upload your data to other reputable DNA sites
Manually sharing your test results with other databases helps you get a more comprehensive look into your results. Just remember exposing your DNA data to more parties means you’ll need to take further precautions.
If you’ve opted for health-related analysis, explore your outcomes
At-home testing is not meant to be diagnostic. If you learn about a health concern, don’t panic. Share your results with your doctor and discuss your options. You should never use at-home DNA testing alone to make important health decisions.
Review your shared matches
Your DNA test results can be used to confirm suspected relations or explore your family tree. It’s rare, but you could find long-lost relatives or notable ancestors as a result of DNA testing.
DNA Testing 101 - How does DNA testing work? 6
Don't:
Give too much weight to the results
At-home DNA testing is cheap, easy, and fun. It can also provide important information. But you shouldn’t be making important health decisions or significantly changing your life based on results.
It’s also important to remember that DNA tests like 23andMe don’t take your lifestyle into account. You might already be managing your genetic risk for certain diseases, so there’s no need to worry.
View your DNA test results as a starting point for improving things, but don’t see it as the end-all-be-all for informing your decisions.
Assume the results are static
Companies regularly update their algorithms based on current science. They also update their databases as more people submit their results. Checking on results periodically can give you new information. Weigh these updates against whether or not you delete your results for security reasons.
Draw hard lines with ethnicity results
DNA testing results can point you in the right direction regarding ethnicity, but won’t give you a complete picture. Again, these tests are a good starting point but don’t provide all of the information you’ll need.
Leave your data with the site indefinitely.
Despite the potential to learn more from database updates, it’s still a good idea to delete your raw data once you’ve downloaded it. Data breaches and leaks occur and you should do what you can to protect your personal information.
What Can You Learn from Your Genes and DNA Tests?
Most people take a DNA test to learn more about their ethnic heritage. A significant portion of test takers are also using tests to learn more about their genetic health risks. There is also a growing number of people using tests to learn more about their genetic predispositions concerning fitness, diet, and lifestyle.
DNA testing offers information with a wide range of uses.
But not all tests are created equally.
Some less-than-scrupulous tests claim to offer predictions about a child’s athletic ability or their potential for learning. Marketing claims include things like help with career profiling or the ability to pinpoint things about your personality. Experts claim these tests do little more than harm consumer confidence in legitimate DNA testing.
Which genetic tests should you take seriously?
The larger, well-known companies including 23andMe and Ancestry are classified as recreational. However, they are reliable and provide professional scientific assessment of test samples. They use data to track patterns and interpret genetic relations.
But some of these companies are forming alliances that experts view as questionable. When a company like 23andMe works with a wellness company that is unregulated, it could lead the industry down a risky path.
There is also concern that people will misuse the legitimate information they have or give it too much weight. For example, if a DNA test tells you about a genetic tendency to be overweight, are you more likely to give up on your efforts to maintain a healthy weight?
Could DNA testing give people an excuse to be less responsible about their health?
This is one of the reasons why people are encouraged to discuss their DNA test results with a doctor. Having a professional interpret your results and help you apply them to lifestyle changes ensures the genetic information revealed through testing is used in the most effective way.
How accurate is the DNA test?
It depends on whether you are talking about ancestry or health accuracy. In either case, there’s no easy answer. Let’s consider this question about accuracy based on your reason for taking a DNA test.
Ancestry Accuracy
DNA testing is great for finding a closely related family member. Most tests can reveal first and second cousins or closer relatives who have taken the same test as you.
But modern-day tests fall short of revealing specific information about your ancestry and ethnicity if it goes beyond close relations. You won’t discover specific locations where your ancestors lived by taking a test but might find out the general region from which they lived.
Health accuracy
For 23andMe to include genetic health reports, it underwent a lengthy FDA approval process. The company had to show its results could be reproduced 99% of the time in clinical labs.
Unfortunately, not all of the results are not immediately actionable or even understandable. 23andMe offers tutorials before allowing you to see health-related risks and predispositions, but that doesn’t mean you should base important health decisions on your results.
The best you can do is get general information from your results and discuss them with your doctor.
What are the most popular DNA testing services:
CompanyDatabase SizeSales (est)
Ancestry.com15 million14 million units sold
23andMe10 million5 million
Family Tree DNA1 millionUnknown
MyHeritage DNA2.5 millionUnknown
AfricanAncestry.comUnknownUnknown
Living DNAUnknownUnknown
National Geographic DNAUnknownUnknown
HelixUnknownUnknown
What about DNA Paternity Testing?
One of the first things to come to mind when thinking about DNA testing are issues related to paternity. Genetic testing companies provide information that can be used to determine paternity. However, most of the at-home tests available won’t hold-up in court.
Anyone interested in using DNA paternity testing should conduct a test as usual. Provide a sample of DNA from the child and the potential father to the genetic testing company. The results should show whether or not and how closely the two are related.
DNA paternity tests provide useful information for families that have questions about paternity.
If you are interested in DNA tests before a baby is born, you’ll need to discuss your options with your doctor. There are tests available that are safe for testing during pregnancy, but you need a safe and effective method for collecting DNA.
What to Know Before Taking a DNA Test
There are several things to keep in mind if you decide to use DNA testing:
1. Know what the test involves, how you’ll provide a sample, and what you can expect in return.
2. Understand that DNA testing has a “dark side.” There might be information in your results you never wanted to learn.
3. Review tips for choosing the best DNA testing service based on your needs.
4. Understand the limits of DNA testing and how your results can mislead you.
5. Consider scheduling an appointment with your doctor to review your results if you want to know more about how to use your results to make lifestyle improvements.
Finally, don’t expect perfect accuracy and know that the information you gain from taking a DNA test isn’t failsafe. Be open-minded and curious, but don’t consider your DNA test results canon.
Cheap DNA Kits (all under $60). Read our 2021 Guide.
@ 2021 by Know Your DNA. All right reserved.
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6,039,233,504,060,310,000 | Symptoms & Causes
Causes and Symptoms of Muscle Strain
By |
Have you ever experienced pain in the body with simply making movements and working hard all throughout the day? It is nothing but one of the reflections that the muscles in the body are being strained. There is only a limit to which the muscles of the body can take the physical pressure of day to day life. If you cross that limit, it actually moves ahead to muscle strains and pains. This is what exactly leads to pains and aches in the body whether we talk about the knee or the foot or even the back and the neck.
causes-and-symptoms-of-muscle-strain
It might not be a very serious health issue when we talk about muscle strain, but it is surely something that if exists for a prolonged period of time can lead to complications. To actually treat muscle strains in an effective way, it is important to know about the causes and the signs and symptoms associated with it. The guide below will help you with this information in the right manner.
Causes of Muscle Strain:-
See More: Urine Infection Causes
Lack of Warming Up:
In simple cases, where a person actually forgets to warm up before adhering to any kind of physical activity or exercises can be one of the causes that leads to a lot of muscle strain. This is one of the most prevalent reasons for the crisis.
Low Flexibility:
Those who have low levels or lack of flexibility in the body are again those people who are highly prone to the issues of muscle strain. This is again one of the well-proven causes for muscle strain according to various professionals.
Over Exertion:
Any kind of pressure and too much stress on the muscles in the form of work or daily chores or even certain sporty activities like running, waling, hiking and biking can lead to muscle strains. This happens when there is overexertion and pressure on the muscles and more than it can take.
See More: Abortion Symptoms
Awkward Postures:
There can be incidents where the person adheres to bad postures may be due to certain reasons or even unconsciously. Like for example, those who sleep in a bad posture or position can actually face muscle strain. This is again a day to day cause of the crisis that might occur without conscious efforts.
Heavy Lifting:
Heavy lifting again leads to a lot of pressure in certain body parts and causes muscles strains over there. Heavy lifting of objects is undoubtedly one of the most prevalent issues and causes associated with straining.
Lack of Movement:
Lack of movement of any of the muscles of the body leads to stiffness and finally to muscles strain and pains. This causes muscles strain without any doubts. It is important that even if works sitting in one position the entire day, they try to make movements from time to time. This helps in relaxing the muscles and the strain.
See More: What Are The Causes Of Knee Pain
Symptoms of Muscle Strain:-
Stiffness:
In many cases, one of the signs of muscles strains comes in the form of stiffness that gives you a lack of movement in the area.
Weakness:
There is extreme weakness of the muscles that have been strained with stress and pressure. This is something you will be able to associate with once you experience muscle strain.
Spasms:
Sudden muscle contractions that are painful is how we define muscle spasms. This is one of the symptom that you will surely go through in the case of muscle strains.
Sudden Pains:
There is nothing we can identify as gradual pain when we talk about the signs of muscle strain. In the case of strain on the muscles, the pains are usually severe and all of a sudden. This differentiates it from other kinds of muscular pains. It is one of the common signs to know about.
Swelling:
The affected area where you experience muscle strain is usually sore and undergoes swelling. The severity of the swelling might differ for people as well as according to the level of strain but a minimum amount of swelling visibility is definitely there. | {
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3 mins read
Boost Your Workout with High-Intensity Interval Training
Boost Your Workout with High-Intensity Interval Training
Introduction
High-Intensity Interval Training (HIIT) has taken the fitness world by storm, and for good reason. This innovative approach to exercise offers a multitude of benefits, from torching calories to improving cardiovascular health. In this article, we’ll delve into the world of HIIT, exploring its principles, benefits, and how you can incorporate it into your workout routine for maximum results.
What is HIIT?
At its core, HIIT involves alternating between short bursts of intense exercise and brief periods of rest or lower-intensity activity. Unlike steady-state cardio, which involves maintaining a consistent level of effort over an extended period, HIIT pushes your body to its limits in short, explosive bursts. This approach not only maximizes calorie burn during the workout but also boosts your metabolism, leading to continued calorie expenditure even after you’ve finished exercising.
The Benefits of HIIT
One of the primary draws of HIIT is its efficiency. With HIIT, you can achieve significant results in a fraction of the time compared to traditional steady-state cardio. Research has shown that just a few minutes of HIIT can be as effective as much longer sessions of moderate-intensity exercise. This makes HIIT an ideal option for those with busy schedules who still want to prioritize their fitness.
Improved Cardiovascular Health
HIIT isn’t just about burning calories; it’s also about improving heart health. The intense bursts of activity followed by brief recovery periods help to strengthen your heart and improve its efficiency. Over time, regular HIIT workouts can lead to lower blood pressure, improved cholesterol levels, and reduced risk of heart disease.
Increased Fat Loss
If you’re looking to shed excess body fat, HIIT may be the answer. The high-intensity nature of HIIT workouts causes your body to burn a significant number of calories both during and after exercise. Additionally, HIIT has been shown to increase fat oxidation, or the breakdown of fat stores for energy, helping you achieve a leaner physique more effectively than steady-state cardio alone.
Preserved Muscle Mass
One concern with traditional steady-state cardio is the potential for muscle loss, especially when performed in excess. HIIT, on the other hand, has been shown to preserve muscle mass while promoting fat loss. This is crucial for those looking to achieve a lean, toned physique, as maintaining muscle mass is essential for a strong and healthy body composition.
Versatility and Variety
One of the great things about HIIT is its versatility. HIIT workouts can be tailored to suit individuals of all fitness levels, from beginners to seasoned athletes. Whether you prefer bodyweight exercises, sprint intervals, or circuit training, there’s a HIIT workout to suit your preferences and goals. Plus, the endless variety of HIIT exercises ensures that you’ll never get bored with your workouts.
Getting Started with HIIT
Ready to incorporate HIIT into your workout routine? Start by selecting a few high-intensity exercises that target different muscle groups. Examples include sprinting, burpees, jump squats, and mountain climbers. Perform each exercise at maximum effort for 20-30 seconds, followed by 10-15 seconds of rest
3 mins read
Pure Barre Pro Techniques and Tips for Improvement
Pure Barre Pro Techniques and Tips for Improvement
Introduction
Welcome to the world of Pure Barre, where strength, grace, and endurance converge in a ballet-inspired fitness regimen. Whether you’re a newcomer or a seasoned Pure Barre enthusiast, there’s always room for improvement. In this article, we’ll explore some pro techniques and tips to help you elevate your Pure Barre practice to the next level.
Understanding the Basics
Before diving into advanced techniques, it’s crucial to have a solid understanding of the basic principles of Pure Barre. Familiarize yourself with the foundational positions and movements, such as the plié, relevé, and tuck. Pay attention to your alignment and posture, ensuring that each movement is executed with precision and control.
Focus on Form
Form is everything in Pure Barre. While it may be tempting to push yourself to the limit, sacrificing form for intensity can lead to injury and compromise your results. Instead, focus on maintaining proper alignment and engaging the correct muscles with each movement. Quality over quantity is key—focus on executing each exercise with impeccable form, even if it means performing fewer reps.
Engage Your Core
Your core is the powerhouse of Pure Barre. It provides stability and support for your entire body, allowing you to execute movements with control and precision. Practice engaging your core throughout your entire workout, whether you’re performing planks, leg lifts, or arm exercises. By strengthening your core, you’ll improve your overall stability and balance, enhancing the effectiveness of your Pure Barre practice.
Find Your Edge
Pure Barre is all about pushing your limits while respecting your body’s boundaries. As you become more comfortable with the basic exercises, challenge yourself to go deeper into each movement. Sink lower into your pliés, lift higher into your relevés, and tuck tighter into your seat work. Listen to your body and find your edge—pushing yourself just beyond your comfort zone without overexerting yourself.
Embrace the Shake
If you’ve ever taken a Pure Barre class, you’re familiar with the infamous “shake.” That trembling sensation in your muscles is a sign that you’re challenging your body in new and meaningful ways. Embrace the shake as a sign of progress and growth—it means you’re working hard and pushing yourself to new heights. Instead of fearing the shake, welcome it as a badge of honor and a testament to your dedication to self-improvement.
Incorporate Props
Props can add an extra dimension to your Pure Barre practice, intensifying your workout and targeting specific muscle groups. Experiment with resistance bands, hand weights, and small balls to add variety and challenge to your routine. Incorporating props can help prevent plateaus and keep your body guessing, ensuring continued progress and improvement over time.
Mind-Body Connection
Pure Barre is as much about mental focus as it is about physical strength. Cultivate a strong mind-body connection by staying present and focused throughout your workout. Visualize the muscles you’re targeting with each movement and concentrate on engaging them fully. By fostering a deep connection between your mind and body, you’ll enhance the effectiveness of your Pure Barre
3 mins read
Achieve Peak Fitness Expert Tips for Tip-Top Performance
Achieve Peak Fitness Expert Tips for Tip-Top Performance
Introduction
Achieving peak fitness is the ultimate goal for many individuals striving to optimize their health and well-being. Whether you’re an athlete training for competition or simply looking to improve your overall fitness level, expert tips can help you reach your peak performance. In this article, we’ll explore a range of expert tips for achieving tip-top fitness and maximizing your athletic potential.
Set Clear Goals
The first step to achieving peak fitness is setting clear, specific goals that align with your aspirations and abilities. Whether your goal is to run a marathon, compete in a bodybuilding competition, or simply improve your strength and endurance, defining your objectives provides clarity and motivation to guide your training efforts.
Focus on Consistency
Consistency is key when it comes to achieving peak fitness. Make exercise a regular part of your routine by scheduling workouts at the same time each day and sticking to your plan, even on days when motivation is low. Consistent effort over time leads to gradual improvements in fitness and performance, helping you reach your goals more effectively.
Prioritize Recovery
In the pursuit of peak fitness, it’s important not to overlook the importance of rest and recovery. Allow your body adequate time to recover between workouts, incorporating rest days and active recovery activities such as stretching, yoga, or light cardio. Proper rest and recovery are essential for preventing injury, reducing fatigue, and maximizing performance.
Fuel Your Body
Nutrition plays a crucial role in supporting peak fitness and performance. Fuel your body with a balanced diet rich in lean protein, complex carbohydrates, healthy fats, and essential vitamins and minerals. Prioritize nutrient-dense foods that provide sustained energy and support muscle recovery and repair, and stay hydrated by drinking plenty of water throughout the day.
Incorporate Strength Training
Strength training is a cornerstone of peak fitness, helping to build muscle, increase strength, and improve overall performance. Incorporate a variety of strength training exercises into your routine, targeting all major muscle groups with compound movements such as squats, deadlifts, bench presses, and rows. Gradually increase the intensity and resistance of your workouts over time to continue challenging your muscles and promoting growth.
Mix Up Your Workouts
Avoid plateauing in your fitness journey by mixing up your workouts and incorporating variety into your routine. Experiment with different forms of exercise, such as cardio, strength training, flexibility training, and functional movements, to keep your body guessing and prevent boredom. Incorporating cross-training activities can also help reduce the risk of overuse injuries and improve overall fitness and athleticism.
Listen to Your Body
One of the most important aspects of achieving peak fitness is learning to listen to your body and honor its signals and limitations. Pay attention to how you feel during workouts, and adjust your intensity, duration, and frequency accordingly. Push yourself to challenge your limits, but also know when to dial back the intensity or take a break to prevent burnout or injury.
Seek Professional Guidance
If you’re serious about achieving peak fitness, consider seeking guidance
3 mins read
Effective 3-Day Split Routine Elevate Your Training
Effective 3-Day Split Routine Elevate Your Training
Introduction:
In the realm of fitness, crafting an effective workout routine is akin to constructing a sturdy foundation for a building. Without it, progress falters, and goals remain elusive. Among the plethora of workout splits, the 3-day workout split stands out as a balanced approach to achieving strength, muscle growth, and overall fitness. Let’s delve into the intricacies of this regimen and unlock its potential for transforming your physique.
Understanding the 3-Day Workout Split:
At its core, the 3-day workout split revolves around dividing your weekly training sessions into three distinct workouts, each targeting different muscle groups. This structure allows for adequate rest between sessions while ensuring comprehensive coverage of all major muscle groups. By strategically distributing your training volume across the week, you can optimize muscle recovery and growth.
Maximizing Efficiency with Compound Movements:
Central to the effectiveness of any workout split are the exercises chosen to stimulate muscle growth and strength development. In the realm of the 3-day split, compound movements reign supreme. Exercises like squats, deadlifts, bench presses, and overhead presses engage multiple muscle groups simultaneously, maximizing efficiency and yielding superior results in less time.
Balancing Volume and Intensity:
Achieving optimal progress in your fitness journey requires striking a delicate balance between training volume and intensity. With the 3-day workout split, this balance is paramount. By carefully modulating the number of sets, repetitions, and weight lifted, you can tailor your workouts to your individual goals and fitness level. Whether your aim is hypertrophy, strength, or endurance, customization is key.
Customizing Your Split for Specific Goals:
One of the greatest strengths of the 3-day workout split lies in its adaptability to various fitness objectives. Whether you’re a seasoned lifter aiming for muscle hypertrophy or a beginner looking to build a foundation of strength, this regimen can be tailored to suit your needs. By adjusting exercise selection, rep ranges, and training frequency, you can optimize your split for maximum results.
Ensuring Adequate Rest and Recovery:
In the pursuit of fitness excellence, it’s easy to fall into the trap of overtraining. However, rest and recovery are just as crucial to progress as the workouts themselves. With the 3-day split, built-in rest days provide the body with ample time to repair and rebuild muscle tissue, preventing burnout and reducing the risk of injury. Remember, progress is not solely measured by the intensity of your workouts but also by the quality of your recovery.
Implementing Progressive Overload:
To continue making gains and breaking through plateaus, progressive overload is essential. This principle involves gradually increasing the demands placed on your muscles over time, whether through added weight, extra repetitions, or decreased rest periods. With the 3-day workout split, incorporating progressive overload ensures continual adaptation and sustained progress towards your fitness goals.
Staying Consistent and Adapting as Needed:
Consistency is the cornerstone of success in any fitness endeavor. While the 3-day workout split provides a solid framework for your training, it’s essential to remain flexible and adapt as needed. Listen to your body, adjust
3 mins read
Recharge Your Fitness Routine Energizing Strategies
Recharge Your Fitness Routine Energizing Strategies
Unleash Your Potential: The Ultimate Fitness Journey
Embarking on the Path of Fitness Mastery
Are you ready to take charge of your health and transform your life? It’s time to embark on the ultimate fitness journey and unleash your full potential. In this article, we’ll explore proven strategies, expert advice, and insider tips to help you maximize your fitness and achieve your goals.
Setting the Foundation: Fitness Fundamentals
Before diving headfirst into your fitness journey, it’s essential to lay down a solid foundation. Start by understanding the basics of fitness, including proper nutrition, effective workout techniques, and the importance of rest and recovery. Building a strong foundation will set you up for long-term success and prevent injuries along the way.
Igniting Your Motivation: Finding Your Why
Motivation is the fuel that will drive your fitness journey forward. Take some time to reflect on why you want to improve your fitness and what goals you hope to achieve. Whether it’s to boost your energy levels, lose weight, or improve your overall health, having a clear understanding of your “why” will keep you motivated during the inevitable challenges ahead.
Crafting Your Fitness Plan: Mapping Out Your Strategy
With your foundation in place and your motivation ignited, it’s time to craft your fitness plan. Start by setting specific, achievable goals that align with your aspirations. Break down your goals into smaller milestones and create a detailed plan of action to reach them. Whether you prefer high-intensity interval training, strength training, or yoga, choose activities that you enjoy and that fit your lifestyle.
Maximizing Your Workouts: Strategies for Success
To maximize your workouts and see results, it’s essential to train smart. Incorporate a variety of exercises into your routine to target different muscle groups and prevent boredom. Focus on proper form and technique to avoid injuries and ensure you’re getting the most out of each movement. And don’t forget to challenge yourself by progressively increasing the intensity of your workouts over time.
Fueling Your Body: The Power of Nutrition
Nutrition plays a crucial role in fueling your fitness journey and supporting your overall health. Focus on eating a balanced diet rich in whole foods, including plenty of fruits, vegetables, lean proteins, and healthy fats. Stay hydrated by drinking plenty of water throughout the day, especially before, during, and after your workouts. And consider working with a registered dietitian to develop a personalized nutrition plan that meets your specific needs.
Listening to Your Body: The Importance of Rest and Recovery
In the midst of pushing yourself to reach your fitness goals, it’s essential to listen to your body and prioritize rest and recovery. Give yourself permission to take rest days when needed, allowing your muscles to repair and rebuild stronger than before. Incorporate activities like yoga, stretching, and foam rolling into your routine to promote flexibility and reduce muscle soreness. And prioritize getting quality sleep each night to support your body’s recovery process.
Staying Consistent: The Key to Long-Term Success
Consistency is the key to
3 mins read
Complete Upper Body Transformation Effective Routine
Complete Upper Body Transformation Effective Routine
Are you ready to take your fitness journey to the next level? Dive into a comprehensive full upper body workout routine that promises to sculpt, strengthen, and define your muscles. Let’s explore the key components and benefits of this effective workout plan.
Setting the Stage: Understanding the Importance of Upper Body Workouts
Before diving into the routine, it’s crucial to understand why focusing on your upper body is essential for overall fitness. Your upper body comprises several major muscle groups, including the chest, back, shoulders, and arms. Strengthening these muscles not only improves your physique but also enhances your functional strength for daily activities.
Warm-Up: Preparing Your Muscles for Action
Every effective workout begins with a proper warm-up to prepare your muscles for the upcoming challenges. Start with dynamic stretches and mobility exercises to increase blood flow and flexibility in your upper body. This helps prevent injuries and ensures that your muscles are ready to perform at their best during the workout.
Chest: Building Strength and Definition
The chest is a focal point of many upper body workouts, and for a good reason. A strong chest not only enhances your upper body aesthetics but also contributes to overall upper body strength. Incorporate exercises like push-ups, bench presses, and chest flyes to target different areas of the chest muscles and achieve a balanced development.
Back: Developing a Strong and Powerful Back
A well-developed back is essential for posture, stability, and functional strength. Include exercises such as pull-ups, rows, and deadlifts to target the various muscles of the back, including the latissimus dorsi, rhomboids, and erector spinae. Strengthening your back muscles not only improves your physique but also reduces the risk of back pain and injury.
Shoulders: Enhancing Stability and Definition
Strong shoulders are crucial for maintaining upper body stability and functionality. Incorporate overhead presses, lateral raises, and upright rows to target the deltoid muscles from different angles. Balanced shoulder development not only improves your overall upper body aesthetics but also enhances your performance in various activities, such as lifting and throwing.
Arms: Sculpting Your Biceps and Triceps
No upper body workout routine is complete without targeting the arms. The biceps and triceps are key muscles that contribute to arm strength and definition. Incorporate exercises like bicep curls, tricep dips, and hammer curls to target these muscles effectively. Strong and well-defined arms not only look impressive but also improve your performance in everyday tasks.
Core: Strengthening Your Foundation
While the focus of this workout routine is on the upper body, it’s essential not to neglect your core muscles. A strong core provides stability and support for all movements, including those involving the upper body. Incorporate core exercises such as planks, Russian twists, and bicycle crunches to strengthen your abdominal muscles and improve overall core stability.
Cool Down: Recovery and Relaxation
After completing the workout, take time to cool down and allow your muscles to recover. Perform static stretches targeting the muscles worked during the workout to improve flexibility and reduce muscle soreness.
3 mins read
Smith Gym Building Better Bodies, One Workout at a Time
Smith Gym Building Better Bodies, One Workout at a Time
Where Fitness Dreams Take Flight
Elevate Your Workouts
Tired of the same old gym routine? Welcome to Smith Gym, where every workout is a journey of discovery. Our state-of-the-art facility and expert trainers are here to help you elevate your fitness game to new heights. Say goodbye to boring workouts and hello to excitement, challenge, and results.
Unleash Your Potential
At Smith Gym, we believe that everyone has the potential to achieve greatness. Whether you’re a seasoned athlete or a complete beginner, our inclusive and supportive environment is designed to help you unlock your full potential. With our personalized approach to training, you’ll discover strengths you never knew you had and push yourself to new limits.
Discover the Power of Smith Gym
Step inside Smith Gym and feel the energy pulsating through the air. From the moment you walk in, you’ll sense the passion, dedication, and determination that defines our community. Our world-class facilities and cutting-edge equipment provide the perfect backdrop for your fitness journey, while our team of experienced trainers is here to guide and motivate you every step of the way.
Ignite Your Fitness Journey
Ready to take your fitness journey to the next level? Look no further than Smith Gym. Our dynamic classes and innovative training programs are designed to ignite your passion for fitness and keep you motivated and inspired. Whether you’re looking to build strength, improve endurance, or just have fun, we’ve got something for everyone. Get ready to sweat, smile, and see results like never before.
Your Path to Fitness Excellence
At Smith Gym, we’re committed to helping you achieve your fitness goals, whatever they may be. Whether you’re training for a marathon, trying to lose weight, or just looking to improve your overall health, our team of expert trainers is here to support you every step of the way. With our personalized approach to fitness, you’ll get the guidance, motivation, and accountability you need to succeed.
Transform Your Body
Are you ready to transform your body and your life? At Smith Gym, we believe that anything is possible with the right mindset and the right support. Our comprehensive approach to fitness includes strength training, cardio, flexibility, and nutrition, so you can build a strong, healthy body from the inside out. Say goodbye to fad diets and quick fixes – at Smith Gym, we’re all about sustainable, long-term results.
Embrace Fitness Innovation
At Smith Gym, we’re constantly pushing the boundaries of what’s possible in the world of fitness. From cutting-edge equipment to innovative training techniques, we’re always on the lookout for the latest advancements to help you reach your goals faster and more efficiently. With our commitment to innovation, you’ll always have access to the most effective tools and strategies for maximizing your fitness potential.
Achieve Your Goals with Smith Gym
Whatever your fitness goals may be, Smith Gym is here to help you achieve them. Whether you want to lose weight, build muscle, improve your athletic performance, or just feel better in your
3 mins read
Best At-Home Exercise Routine for Full Body Toning
Best At-Home Exercise Routine for Full Body Toning
The Ultimate Full Body Workout Guide for Home Fitness Enthusiasts
Introduction: Getting Started with Home Workouts
Embarking on a journey towards a fitter, stronger you doesn’t always require a gym membership or fancy equipment. In fact, some of the most effective workouts can be done right in the comfort of your own home. With the right guidance and motivation, you can sculpt your entire body, boost your fitness levels, and achieve your health goals without ever stepping foot outside. Let’s dive into the ultimate full body workout guide tailored for home fitness enthusiasts.
Setting Up Your Home Gym: Creating Your Fitness Sanctuary
Before you begin your full body workout journey, it’s essential to set up your home gym space. Designate an area in your home where you feel comfortable and motivated to exercise. Clear out any clutter, invest in a quality exercise mat, and ensure adequate ventilation and lighting. Having a dedicated space for your workouts will help you stay focused and committed to your fitness routine.
Warm-Up: Preparing Your Body for Exercise
Every effective workout begins with a proper warm-up to prepare your body for the physical demands ahead. Spend 5-10 minutes engaging in dynamic stretches and light cardio exercises such as jogging in place, jumping jacks, or high knees. This will increase blood flow to your muscles, improve flexibility, and reduce the risk of injury during your workout.
Upper Body Workout: Sculpting Strong Arms, Chest, and Back
Start your full body workout with a focus on your upper body muscles. Incorporate exercises such as push-ups, dumbbell curls, tricep dips, and shoulder presses to target your arms, chest, shoulders, and back. Aim for 3-4 sets of each exercise, performing 8-12 repetitions with proper form and technique.
Lower Body Workout: Building Power and Stability
Next, shift your focus to your lower body muscles to build strength, power, and stability. Incorporate exercises such as squats, lunges, deadlifts, and calf raises to target your glutes, quadriceps, hamstrings, and calves. Remember to maintain proper form throughout each exercise and engage your core for stability and balance.
Core Strengthening: Developing a Strong and Stable Midsection
No full body workout is complete without targeting your core muscles. A strong core is essential for maintaining good posture, improving balance, and preventing lower back pain. Incorporate exercises such as planks, Russian twists, bicycle crunches, and leg raises to engage your abdominals, obliques, and lower back muscles.
Cardiovascular Conditioning: Boosting Endurance and Fitness Levels
Incorporating cardiovascular exercises into your full body workout routine is crucial for improving endurance, burning calories, and enhancing overall fitness levels. Include activities such as jumping rope, high-intensity interval training (HIIT), burpees, and mountain climbers to elevate your heart rate and torch fat.
Cool Down: Restoring Your Body and Mind
After completing your full body workout, it’s essential to take time to cool down and allow your body to recover. Spend 5-10 minutes performing static stretches to help relax your muscles and improve flexibility. Focus on stretching all major muscle groups, holding each stretch
3 mins read
Unlock Your Back Potential Effective Workout Plans
Unlock Your Back Potential Effective Workout Plans
Unlocking the Secrets of Good Back Workouts: A Comprehensive Guide
Understanding the Importance of Back Workouts
A strong and healthy back is essential for overall fitness and functionality. It plays a crucial role in supporting the spine, maintaining proper posture, and facilitating movement in everyday activities. Incorporating effective back workouts into your fitness routine can help strengthen the muscles of the back, improve posture, and reduce the risk of injury.
The Basics of Back Anatomy
Before diving into back workouts, it’s essential to understand the anatomy of the back. The back is comprised of various muscle groups, including the latissimus dorsi, rhomboids, trapezius, erector spinae, and rear deltoids. Each of these muscles plays a unique role in stabilizing and moving the spine, shoulders, and upper body.
Choosing the Right Exercises for Your Back
There are numerous exercises that target the muscles of the back, each with its own set of benefits and variations. Some of the most effective back exercises include:
1. Deadlifts: A compound exercise that targets the lower back, hamstrings, and glutes while also engaging the core muscles for stability.
2. Pull-Ups/Chin-Ups: Excellent for targeting the latissimus dorsi and upper back muscles, pull-ups and chin-ups also engage the biceps and forearms.
3. Rows: Whether performed with a barbell, dumbbells, or a cable machine, rows are effective for targeting the muscles of the upper back, including the rhomboids and rear deltoids.
4. Lat Pulldowns: Similar to pull-ups, lat pulldowns target the latissimus dorsi muscles but provide a more accessible option for beginners or those with limited upper body strength.
5. Good Mornings: A compound exercise that targets the erector spinae and hamstrings, good mornings help improve lower back strength and stability.
Designing Your Back Workout Routine
When designing a back workout routine, it’s essential to include a variety of exercises that target different areas of the back and incorporate both compound and isolation movements. Aim to include at least 3-4 back exercises in each workout, focusing on proper form and technique to maximize effectiveness and minimize the risk of injury.
Sample Back Workout Routine:
1. Deadlifts: 3 sets of 8-10 repetitions
2. Pull-Ups: 3 sets to failure
3. Bent Over Rows: 3 sets of 10-12 repetitions
4. Lat Pulldowns: 3 sets of 10-12 repetitions
5. Hyperextensions: 3 sets of 12-15 repetitions
Perform this workout routine 2-3 times per week, allowing for adequate rest and recovery between sessions. As you progress, you can increase the intensity of your workouts by adding weight, increasing the number of sets and repetitions, or incorporating advanced variations of exercises.
Tips for Maximizing Your Back Workout
To get the most out of your back workouts and see optimal results, consider the following tips:
• Focus on mind-muscle connection: Concentrate on engaging the muscles of the back during each exercise to ensure they are working effectively.
• Use proper form and technique: Maintain proper posture and alignment throughout each exercise to prevent injury and maximize muscle activation.
• Gradually increase intensity: Continuously challenge your muscles by gradually increasing the weight, reps, or sets in your workouts.
• Allow for adequate
3 mins read
Pulse Gym Building Better Bodies, One Workout at a Time
Pulse Gym Building Better Bodies, One Workout at a Time
Experience the Pulse Gym Difference
Your Ultimate Fitness Destination
At Pulse Gym, we believe that fitness is not just a destination but a journey. Our gym isn’t just a place to work out; it’s a community, a sanctuary, and a catalyst for transformation. Step through our doors, and you’ll immediately sense the energy, the motivation, and the dedication that permeates every corner. From state-of-the-art equipment to expert trainers and a supportive atmosphere, Pulse Gym is where your fitness journey truly begins.
Revitalize Your Routine at Pulse Gym
Are you tired of the same old workout routine? At Pulse Gym, we’re here to shake things up and inject new life into your fitness regimen. Say goodbye to boredom and hello to excitement with our diverse range of classes and workout options. Whether you’re into high-intensity interval training, strength training, yoga, or spin classes, we’ve got something for everyone. Our experienced instructors are dedicated to helping you reach your goals and pushing you to achieve your personal best.
Empowering Your Fitness Journey
At Pulse Gym, we believe in the power of empowerment. We’re not just here to help you lose weight or build muscle; we’re here to empower you to take control of your health and transform your life. Our supportive community of fellow members and passionate trainers will be with you every step of the way, cheering you on and celebrating your victories. With our personalized approach to fitness, you’ll not only see results but also gain the confidence and strength to tackle any challenge that comes your way.
Redefining Your Fitness Experience
Gone are the days of boring, monotonous workouts. At Pulse Gym, we’re redefining what it means to exercise by making fitness fun, engaging, and enjoyable. From exhilarating group classes to innovative training programs, we’re constantly pushing the boundaries to give you the best possible fitness experience. Our cutting-edge facilities and top-of-the-line equipment ensure that you have everything you need to reach your goals and surpass them.
Where Strength Meets Endurance
At Pulse Gym, we believe that true fitness is about more than just physical strength; it’s also about mental endurance and resilience. That’s why we offer a holistic approach to fitness that focuses on building both strength and endurance, inside and out. Our trainers will push you to your limits, helping you break through barriers and reach new heights of physical and mental performance. With our guidance and support, you’ll discover a strength and resilience you never knew you had.
Fueling Your Fitness Passion
Passion is the driving force behind everything we do at Pulse Gym. We’re passionate about fitness, passionate about health, and passionate about helping you become the best version of yourself. Our team of dedicated trainers and staff are here to fuel your passion for fitness and inspire you to achieve greatness. Whether you’re a seasoned athlete or a complete beginner, we’ll meet you where you are and help you unleash your full potential.
Building Better Bodies, One Workout at a Time
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• There's a small worm called Loa Loa Filariasis. This parasite can survive in one environment exclusively- namely, underneath the skin and inside the eyes of human beings. Children and the elderly in tropical regions (usually the poorest) are the most widely affected. A painful, slow death is virtually certain. The worm can actually live in the host for 17 years before the host finally dies.
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1,361,290,408,209,807,400 | KETO DIET
HISTORY
The ketogenic diet became popular as a therapy for epilepsy in the 1920s and 30s. It was developed to provide an alternative to non-mainstream fasting, which had demonstrated success as an epilepsy therapy. However, the diet was eventually largely abandoned due to the introduction of new anticonvulsant therapies. Although it emerged that most cases of epilepsy could be effectively controlled using these medications, they still failed to achieve epileptic control in around 20% to 30% of epileptics. For these individuals, and particularly children with epilepsy, the diet was re-introduced as a technique for managing the condition.
The role of fasting in the treatment of disease has been known to mankind for thousands of years and was studied in detail by ancient Greek physicians and ancient Indian physicians. An early treatise in the Hippocratic Corpus, “On the Sacred Disease,” describes how alterations in diet played a role in epilepsy management. The same author also describes in “Epidemics” from the collection, how a man was cured of epilepsy when he abstained completely from consuming food or drink.
The first modern scientific study into fasting as a cure for epilepsy was conducted in France, in 1911. At the time, potassium bromide was used to treat epileptics, but this agent slowed patients’ mental capabilities.. Instead, twenty epilepsy patients followed a low-calorie, vegetarian food plan that was combined with fasting. Two patients showed significant improvements, although most could not adhere to the dietary restrictions. However, the diet was found to improve the patient’s mental abilities compared with the effects of taking potassium bromide.
Also during the early 20th Century, an American called Bernarr Macfadden, popularised the idea of fasting as a means of restoring health. His student osteopath, Hugh Conklin, introduced fasting as a treatment method for controlling epilepsy. Coklin proposed that epileptic seizures were caused by a toxin secreted in the intestine and suggested that fasting for 18 to 25 days could cause the toxin to dissipate. His epileptic patients were put on a “water diet,” which he reported cured 90% of children with the condition and 50% of adults. Analysis of the study that was performed later showed that, in fact, 20% of Coklin’s patients became seizure-free, while 50% demonstrated some improvement. The fasting therapy was soon adopted as part of mainstream therapy for epilepsy and in 1916, Dr McMurray reported to the New York Medical Journal that he had successfully treated epileptic patients by prescribing a fast, followed by a diet free of starch and sugar since 1912.
It was in 1921 that endocrinologist Rollin Woodyatt noted that three water-soluble compounds, acetone, β-hydroxybutyrate and acetoacetate (together called ketone bodies) were produced by the liver as a result of starvation or if they followed a diet rich in fat and low in carbohydrates. Russel Wilder from the Mayo Clinic called this the “ketogenic diet” and used it as a treatment for epilepsy, also in 1921.
Further research in the 1960s showed that more ketones are produced by medium-chain triglycerides (MCTs) per unit of energy because they are transported quickly to the liver via the hepatic portal vein, as opposed to the lymphatic system. In 1971, Peter Huttenlocher devised a ketogenic diet where 60% of the calories came from MCT oil, which allowed more protein and carbohydrates to be included compared with the original ketogenic diet, meaning parents could prepare more enjoyable meals for their children with epilepsy. Many hospitals also adopted the MCT diet in place of the original ketogenic diet, although some used a combination of the two.
The Ketogenic Diet: A Detailed Beginner’s Guide to Keto
The ketogenic diet (or keto diet, for short) is a low-carb, high-fat diet that offers many health benefits.
In fact, over 20 studies show that this type of diet can help you lose weight and improve your health.
Ketogenic diets may even have benefits against diabetes, cancer, epilepsy and Alzheimer’s disease.
Here is a detailed beginner’s guide to the keto diet.
What Is a Ketogenic Diet?
Ketogenic Diet 101
The ketogenic diet is a very low-carb, high-fat diet that shares many similarities with the Atkins and low-carb diets.
It involves drastically reducing carbohydrate intake and replacing it with fat. This reduction in carbs puts your body into a metabolic state called ketosis.
When this happens, your body becomes incredibly efficient at burning fat for energy. It also turns fat into ketones in the liver, which can supply energy for the brain.
Ketogenic diets can cause massive reductions in blood sugar and insulin levels. This, along with the increased ketones, has numerous health benefits.
SUMMARYThe keto diet is a low-carb, high-fat diet. It lowers blood sugar and insulin levels, and shifts the body’s metabolism away from carbs and towards fat and ketones.
Different Types of Ketogenic Diets
There are several versions of the ketogenic diet, including:
• Standard ketogenic diet (SKD): This is a very low-carb, moderate-protein and high-fat diet. It typically contains 75% fat, 20% protein and only 5% carbs.
• Cyclical ketogenic diet (CKD): This diet involves periods of higher-carb refeeds, such as 5 ketogenic days followed by 2 high-carb days.
• Targeted ketogenic diet (TKD): This diet allows you to add carbs around workouts.
• High-protein ketogenic diet: This is similar to a standard ketogenic diet, but includes more protein. The ratio is often 60% fat, 35% protein and 5% carbs.
However, only the standard and high-protein ketogenic diets have been studied extensively. Cyclical or targeted ketogenic diets are more advanced methods and primarily used by bodybuilders or athletes.
The information in this article mostly applies to the standard ketogenic diet (SKD), although many of the same principles also apply to the other versions.
SUMMARYThere are several versions of the keto diet. The standard (SKD) version is the most researched and most recommended.
Ketogenic Diets Can Help You Lose Weight
A ketogenic diet is an effective way to lose weight and lower risk factors for disease.
In fact, research shows that the ketogenic diet is far superior to the often recommended low-fat diet.
What’s more, the diet is so filling that you can lose weight without counting calories or tracking your food intake.
One study found that people on a ketogenic diet lost 2.2 times more weight than those on a calorie-restricted low-fat diet. Triglyceride and HDL cholesterol levels also improved.
Another study found that people on the ketogenic diet lost 3 times more weight than those on the diet recommended by Diabetes UK.
There are several reasons why a ketogenic diet is superior to a low-fat diet, including the increased protein intake, which provides numerous benefits.
The increased ketones, lower blood sugar levels and improved insulin sensitivity may also play a key role.
SUMMARYA ketogenic diet can help you lose much more weight than a low-fat diet. This often happens without hunger.
Ketogenic Diets for Diabetes and Prediabetes
Diabetes is characterized by changes in metabolism, high blood sugar and impaired insulin function.
The ketogenic diet can help you lose excess fat, which is closely linked to type 2 diabetes, prediabetes and metabolic syndrome.
One study found that the ketogenic diet improved insulin sensitivity by a whopping 75%.
Another study in people with type 2 diabetes found that 7 of the 21 participants were able to stop using all diabetes medications.
In yet another study, the ketogenic group lost 24.4 pounds (11.1 kg), compared to 15.2 pounds (6.9 kg) in the higher-carb group. This is an important benefit when considering the link between weight and type 2 diabetes.
Additionally, 95.2% of the ketogenic group were also able to stop or reduce diabetes medication, compared to 62% in the higher-carb group.
SUMMARYThe ketogenic diet can boost insulin sensitivity and cause fat loss, leading to significant health benefits for people with type 2 diabetes or prediabetes.
Other Health Benefits of Keto
The ketogenic diet actually originated as a tool for treating neurological diseases such as epilepsy.
Studies have now shown that the diet can have benefits for a wide variety of different health conditions:
• Heart disease: The ketogenic diet can improve risk factors like body fat, HDL cholesterol levels, blood pressure and blood sugar.
• Cancer: The diet is currently being used to treat several types of cancer and slow tumor growth.
• Alzheimer’s disease: The keto diet may reduce symptoms of Alzheimer’s disease and slow its progression.
• Epilepsy: Research has shown that the ketogenic diet can cause massive reductions in seizures in epileptic children.
• Parkinson’s disease: One study found that the diet helped improve symptoms of Parkinson’s disease.
• Polycystic ovary syndrome: The ketogenic diet can help reduce insulin levels, which may play a key role in polycystic ovary syndrome.
• Brain injuries: One animal study found that the diet can reduce concussions and aid recovery after brain injury.
• Acne: Lower insulin levels and eating less sugar or processed foods may help improve acne.
However, keep in mind that research into many of these areas is far from conclusive.
SUMMARYA ketogenic diet may provide many health benefits, especially with metabolic, neurological or insulin-related diseases.
Foods to Avoid
Any food that is high in carbs should be limited.
Here is a list of foods that need to be reduced or eliminated on a ketogenic diet:
• Sugary foods: Soda, fruit juice, smoothies, cake, ice cream, candy, etc.
• Grains or starches: Wheat-based products, rice, pasta, cereal, etc.
• Fruit: All fruit, except small portions of berries like strawberries.
• Beans or legumes: Peas, kidney beans, lentils, chickpeas, etc.
• Root vegetables and tubers: Potatoes, sweet potatoes, carrots, parsnips, etc.
• Low-fat or diet products: These are highly processed and often high in carbs.
• Some condiments or sauces: These often contain sugar and unhealthy fat.
• Unhealthy fats: Limit your intake of processed vegetable oils, mayonnaise, etc.
• Alcohol: Due to their carb content, many alcoholic beverages can throw you out of ketosis.
• Sugar-free diet foods: These are often high in sugar alcohols, which can affect ketone levels in some cases. These foods also tend to be highly processed.
SUMMARYAvoid carb-based foods like grains, sugars, legumes, rice, potatoes, candy, juice and even most fruits.
Foods to Eat
You should base the majority of your meals around these foods:
• Meat: Red meat, steak, ham, sausage, bacon, chicken and turkey.
• Fatty fish: Such as salmon, trout, tuna and mackerel.
• Eggs: Look for pastured or omega-3 whole eggs.
• Butter and cream: Look for grass-fed when possible.
• Cheese: Unprocessed cheese (cheddar, goat, cream, blue or mozzarella).
• Nuts and seeds: Almonds, walnuts, flax seeds, pumpkin seeds, chia seeds, etc.
• Healthy oils: Primarily extra virgin olive oil, coconut oil and avocado oil.
• Avocados: Whole avocados or freshly made guacamole.
• Low-carb veggies: Most green veggies, tomatoes, onions, peppers, etc.
• Condiments: You can use salt, pepper and various healthy herbs and spices.
SUMMARYBase the majority of your diet on foods such as meat, fish, eggs, butter, nuts, healthy oils, avocados and plenty of low-carb veggies.
A Sample Keto Meal Plan For 1 Week
To help get you started, here is a sample ketogenic diet meal plan for one week:
Monday
• Breakfast: Bacon, eggs and tomatoes.
• Lunch: Chicken salad with olive oil and feta cheese.
• Dinner: Salmon with asparagus cooked in butter.
Tuesday
• Breakfast: Egg, tomato, basil and goat cheese omelet.
• Lunch: Almond milk, peanut butter, cocoa powder and stevia milkshake.
• Dinner: Meatballs, cheddar cheese and vegetables.
Wednesday
• Breakfast: A ketogenic milkshake.
• Lunch: Shrimp salad with olive oil and avocado.
• Dinner: Pork chops with Parmesan cheese, broccoli and salad.
Thursday
• Breakfast: Omelet with avocado, salsa, peppers, onion and spices.
• Lunch: A handful of nuts and celery sticks with guacamole and salsa.
• Dinner: Chicken stuffed with pesto and cream cheese, along with vegetables.
Friday
• Breakfast: Sugar-free yogurt with peanut butter, cocoa powder and stevia.
• Lunch: Beef stir-fry cooked in coconut oil with vegetables.
• Dinner: Bun-less burger with bacon, egg and cheese.
Saturday
• Breakfast: Ham and cheese omelet with vegetables.
• Lunch: Ham and cheese slices with nuts.
• Dinner: White fish, egg and spinach cooked in coconut oil.
Sunday
• Breakfast: Fried eggs with bacon and mushrooms.
• Lunch: Burger with salsa, cheese and guacamole.
• Dinner: Steak and eggs with a side salad.
Always try to rotate the vegetables and meat over the long term, as each type provides different nutrients and health benefits.
SUMMARYYou can eat a wide variety of tasty and nutritious meals on a ketogenic diet.
Healthy Keto Snacks
In case you get hungry between meals, here are some healthy, keto-approved snacks:
• Fatty meat or fish
• Cheese
• A handful of nuts or seeds
• Cheese with olives
• 1–2 hard-boiled eggs
• 90% dark chocolate
• A low-carb milkshake with almond milk, cocoa powder and nut butter
• Full-fat yogurt mixed with nut butter and cocoa powder
• Strawberries and cream
• Celery with salsa and guacamole
• Smaller portions of leftover meals
SUMMARYGreat snacks for a keto diet include pieces of meat, cheese, olives, boiled eggs, nuts and dark chocolate.
Tips for Eating Out on a Ketogenic Diet
It is not very hard to make most restaurant meals keto-friendly when eating out.
Most restaurants offer some kind of meat or fish-based dish. Order this, and replace any high-carb food with extra vegetables.
Egg-based meals are also a great option, such as an omelet or eggs and bacon.
Another favorite is bun-less burgers. You could also swap the fries for vegetables instead. Add extra avocado, cheese, bacon or eggs.
At Mexican restaurants, you can enjoy any type of meat with extra cheese, guacamole, salsa and sour cream.
For dessert, ask for a mixed cheese board or berries with cream.
SUMMARYWhen eating out, select a meat-, fish- or egg-based dish. Order extra veggies instead of carbs or starches, and have cheese for dessert.
Side Effects and How to Minimize Them
Although the ketogenic diet is safe for healthy people, there may be some initial side effects while your body adapts.
This is often referred to as the keto flu and is usually over within a few days.
Keto flu includes poor energy and mental function, increased hunger, sleep issues, nausea, digestive discomfort and decreased exercise performance.
To minimize this, you can try a regular low-carb diet for the first few weeks. This may teach your body to burn more fat before you completely eliminate carbs.
A ketogenic diet can also change the water and mineral balance of your body, so adding extra salt to your meals or taking mineral supplements can help.
For minerals, try taking 3,000–4,000 mg of sodium, 1,000 mg of potassium and 300 mg of magnesium per day to minimize side effects.
At least in the beginning, it is important to eat until you’re full and avoid restricting calories too much. Usually, a ketogenic diet causes weight loss without intentional calorie restriction.
SUMMARYMany of the side effects of starting a ketogenic diet can be limited. Easing into the diet and taking mineral supplements can help.
Supplements for a Ketogenic Diet
Although no supplements are required, some can be useful.
• MCT oil: Added to drinks or yogurt, MCT oil provides energy and helps increase ketone levels.
• Minerals: Added salt and other minerals can be important when starting out due to shifts in water and mineral balance.
• Caffeine: Caffeine can have benefits for energy, fat loss and performance.
• Exogenous ketones: This supplement may help raise the body’s ketone levels.
• Creatine: Creatine provides numerous benefits for health and performance. This can help if you are combining a ketogenic diet with exercise.
• Whey: Use half a scoop of whey protein in shakes or yogurt to increase your daily protein intake.
SUMMARYCertain supplements can be beneficial on a ketogenic diet. These include exogenous ketones, MCT oil and minerals.
A Ketogenic Diet Is Great, but Not for Everyone
A ketogenic diet can be great for people who are overweight, diabetic or looking to improve their metabolic health.
It may be less suitable for elite athletes or those wishing to add large amounts of muscle or weight.
And, as with any diet, it will only work if you are consistent and stick with it in the long term.
That being said, few things are as well proven in nutrition as the powerful health and weight loss benefits of a ketogenic diet.
@healthqueries.in
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9,030,329,986,691,699,000 | How Does FasterEFT Work – The Science Behind FasterEFT
Many people are confused about how saying a bunch of words, and tapping on certain meridian points can lead to such remarkable physical and emotional results?
The results can be hard to believe, especially when you hear things like cancer, diabetes, chronic pain, Lyme disease, OCD, PTSD being cured, just through Faster EFT tapping.
Faster Emotionally Focused Transformations (FasterEFT), is a mind-based system, founded on Neurology and Biology.
Emotions affect both our physical and mental wellbeing.
So it follows that once your turbulent emotions are healed and cleaned up, you’ll have overall wellbeing.
The foundation belief in Faster EFT is that there is no disruption of energy, unlike traditional EFT.
In fact, everything in your life and body is functioning as it should.
According to the way the brain has developed in order to survive in the environment, depending on your life’s experiences.
In Faster EFT, the tapping is used to disrupt the signal between the brain and the major organs of the body that trigger the fight or flight response while changing neural pathways in the neocortex of the brain.
The Faster EFT Tapping Basic Recipe doesn’t just deal with energy disruptions, which only fixes the outer issue of the problem.
Read: How to do the Faster EFT Tap – The Basic Recipe
It deals with the root cause of the problems, eliminating them completely.
Faster EFT recognizes that experiences are recorded in the subconscious for future reference.
This is how we learn to walk, drive, take a shower, eat, wash the dishes, type etc. without needing to consciously concentrate on every movement and decision.
Regular EFT specifically believes that negative emotions have nothing to do with memories, and are caused only by a disruption in the body’s energy system.
The FasterEFT Tapping Basic Recipe interrupts that signal between the brain and the organs by focusing on the meridian points connected to those organs.
This rewrites the reference or memory associated with that trigger.
For example, if Tom feels angered by the loud music and wanted to change that automatic response, he could use the Faster EFT Tapping Basic Recipe to disrupt the production of the chemicals that cause the feeling of anger when he hears the loud music.
And change the meaning of the loud music in his subconscious from “rude” or “disruptive” (or whatever they learned it means) to fun and enjoyment.
This will then result in an automatic feeling of enjoyment and fun when Tom hears that loud music in the future.
The Neuroscience of FasterEFT
While the brain is a complex organ and neuroscientists still don’t know everything about it (and may never find out), the research and studies that have been carried out in the field of neuroscience have given us a reasonable “working knowledge” of how the brain works to a certain level.
In other words, science has given us enough knowledge to enable us to use our brains more effectively to significantly improve our day-to-day lives.
We don’t know everything about how our phones work, but using the “Quick Start” guide we can learn enough to operate the phone more efficiently and make use of the applications we need.
A Quick Start Guide for Your Brain
The brain can be divided into many different sections, each of which produces specific functions; but for the quick start guide all you need to know are three of these sections.
The three parts that make up your human brain for the purposes of this quick start guide are:
1. The neocortex;
2. the limbic brain and;
3. the cerebellum.
How does FasterEFT work at the physical level?
The Neocortex
This is where you do your thinking.
The neocortex is made up of billions of neurons or nerve cells; and each time you have a thought, connections are made between specific neurons.
When you have the same thought over and over again, the neurons are “wired” by a substance that allows that connection to become more permanent.
This is how we learn information intellectually.
Thoughts that refer to the same topic will be wired in “gangs” or communities – forming neural networks.
When you cease to think a certain thought, the connection weakens or atrophies.
This is how we forget information.
However, because the connection was present, depending on how long ago it was made, and the type of connection, it will take less time to rewire it – and as a result, relearn that information.
The Limbic Brain
The limbic brain is also known as the chemical brain, and is basically our “drug lab”.
It is where chemicals are produced in response to the connections that are being made in the neocortex.
When we have a thought, and a connection is made in the neocortex, the limbic brain is triggered to produce certain chemicals that will produce sensations that match that thought.
In other words, when you think a sad thought, your limbic brain will produce chemicals that cause the sensations of sadness in your body.
When you think a happy thought, your limbic brain will produce chemicals that cause the sensations of happiness in your body.
The Cerebellum
This is the oldest part of the human brain, and it is the seat of the unconscious.
This is the part of the brain that allows you to carry out actions without needing to think about each aspect.
It is also the part of the brain that produces your automatic reactions to triggers and stimuli.
When someone “pushes your buttons” it is your cerebellum that responds with the automatic reaction – triggering chemicals to be produced in your limbic brain and the other organs in your body that cause an emotional response.
When you learn something, you will learn it using thought initially (through connections in your neocortex), which will cause a chemical response in the limbic brain and other organs.
When this is repeated over and over, the connection in your neocortex becomes “wired” – allowing faster transfer of the information between the neurons.
And as the repetition continues, the combination of the wired connection in the neocortex and the repeated flooding of matching chemicals through your bloodstream causes the cerebellum to record that specific event.
However, the cerebellum does not need repetition in order to record events, responses, and conditions.
Since its primary function is your survival it is designed to prioritize any information that it considers a threat to your well-being.
In other words, you will only need to be exposed to the pain of putting your hand on a hot stove once for that connection to be made in your brain.
A strong fight-freeze-or-flight response to a threat will usually be recorded in your cerebellum the first time it happens.
From then on, whenever you encounter that threat again your subconscious will trigger your brain to signal your organs to produce the fight or flight chemicals – which will put your body into a state of emergency.
You will experience state as fear, anxiety, anger, hurt or any other stress emotion.
Read: Emotional Baggage: How it affects your Health and what You can do about it
Note:
The threat does not necessarily need to be real.
Since your subconscious does not have the ability to reason, use logic, or distinguish right from wrong or true from false, it responds based purely on the data it already contains – whether that data is correct, logical and reasonable or not.
Related: Faster EFT Tapping for Stress and Anxiety
Let’s take an Example:
Mary is an 8-year-old child, and experiences a stressful situation in school – the teacher asks her to recite information she doesn’t know and then scolds her in front of the rest of the class for her failure.
Mary’s body goes into a state of fight-freeze-or-flight – the stress response – and the cerebellum is triggered to record the event as a threat.
The brain makes a connection between the situation (being the center of attention) and the fight-freeze-or-flight stress response.
The exact connection will depend on the data already held in her subconscious.
This may result in a fear of public speaking, or social anxiety, or a range of other possibilities – depending on what other memories she holds and continues to collect.
As you go through your life, your subconscious is constantly referring to the records it holds and triggering the brain and body to respond accordingly.
Read: How Faster EFT Tapping Helped Someone Lose 100lbs!
How does FasterEFT work with respect to the tapping points?
The Faster EFT Tapping Basic Recipe has only FIVE steps, that takes only 30 seconds to do.
Anyone of any age can learn this simple technique and use it whenever they want, wherever they are with lasting results.
It may seem a little strange at first, but after a couple of round of using the Faster EFT Tapping Basic Recipe, you’ll feel more comfortable.
The following illustration is pretty straightforward and we’ll give a brief explanation of it as well.
For now, just identify each of these Faster EFT Tapping points on your body and follow along!
Step #1: Aim
Notice how you know you have the problem.
You don’t need to know what the emotions or feelings are, just notice how you know they’re there.
What do you feel?
Where in your body do you feel it?
What do you see or hear?
How do you know it’s a problem?
Step #2: Tap
Use two fingers to tap the following points, while focusing on the feeling of your fingers on your skin:
• between your eyebrows
• beside your eye
• under your eye
• just below your collarbone
While you are tapping, say “Let it go”.
You can also add “It’s safe to let it go”.
Note: It doesn’t matter which side you tap – you can do either side or both if you like.
Step #3: Peace
Grab your wrist, take a deep breath, blow it out, and say “peace” – and go to a peaceful memory for a moment.
Step #4: Check
Go back to your problem and take notice of how it’s changed.
Do you feel different?
Is the intensity of the feeling different?
Does the memory look or sound different?
Just notice.
Step #5: Repeat
Repeat steps two to four until the feeling or memory has “flipped” – in other words, the negative memory has been replaced by a positive memory.
How does FasterEFT work at the Physical Level?
Neuroscientist, Dr. Joe Dispenza points out that in the neocortex of the brain, nerve cells that fire together wire together.
This means that the more you think and react in the same ways you’ve always done, the more automated your thinking and reactions become.
He goes on to stress that in order to change your automatic responses, you need to consciously become aware of your habitual thinking (metacognition), and make different choices in the moment.
When you cease to use a specific connection and use a different connection instead, you literally rewire the neocortex of your brain.
Read: Top 5 Faster EFT Health Success Stories for October 2017
How does FasterEFT work at the Emotional Level
Consistent FasterEFT tapping “rewires” the neocortex.
This causes a change in automatic thought patterns – and, as a result, in emotional states.
However, there may be a faster and more direct way to make these changes.
FasterEFT has been designed to change memories that cause negative emotions into positive memories.
By changing a memory from negative to positive, the resulting positive chemical responses produce a very different effect on the body.
In addition to this, the changes in the neocortex are an automatic result since all changes in thought patterns cause restructuring in the neocortex.
FasterEFT not only causes the user to think differently – using new connections in the neocortex – it does this with the original memory or record instead of with the current thought process alone.
In other words, instead of working with the neocortex (and by association, with the limbic brain) alone, it is designed to work with the subconscious – the part of you that is in charge of your automatic reactions and responses.
The result is: very fast, significant changes in the brain and in the automatic responses of the body.
Instead of the repetition that is needed in order to change the neural pathways on a more permanent basis (rewiring), the changes are made using the cerebellum – the part of the brain responsible for automated and instinctual reactions and responses, as well as emotional memory.
Read: How to use FasterEFT tapping when people hurt your feelings
Try it yourself
Since it doesn’t cost anything, and you don’t need any special equipment or an expert in order to use it, you can carry out your own experiment, and test it for yourself.
Persistence is essential.
Don’t stop until it’s changed – even if it doesn’t feel like it’s going to change – it will, as long as you keep going until it does.
Good luck and let us know how it goes!
Here are a few resources to get you started:
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The post How Does FasterEFT Work – The Science Behind FasterEFT appeared first on Eutaptics® FasterEFT Trainings.
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3,175,490,381,464,481,000 | Catecholaminergic polymorphic ventricular tachycardia
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Catecholaminergic polymorphic ventricular tachycardia
Classification and external resources
OMIM 604772 611938
DiseasesDB 33816
GeneReviews
Catecholaminergic polymorphic ventricular tachycardia (CPVT), also called familial polymorphic ventricular tachycardia (FPVT) or catecholamine-induced polymorphic ventricular tachycardia, is a disorder characterized by an abnormal heart rhythm (arrhythmia). Thought to affect as many as one in ten thousand people, it is estimated to cause 15% of all unexplained sudden cardiac deaths in young people.
First recognized in 1975, this condition is due to mutations in genes encoding a calcium channel or proteins related to this channel. All mutated proteins participate in the regulation of calcium ion flow in and out of the sarcoplasmatic reticulum of cardiac cells. Therefore, reduced electrical stability of cardiomyocytes may cause the heart to enter a life-threatening state of ventricular arrhythmia as response to the natural release of catecholamines from nerve endings on the heart muscle and from the adrenal glands into the circulation. This rhythm disturbance prevents the heart from pumping blood appropriately. Ventricular tachycardia may self-terminate or degenerate into ventricular fibrillation, causing sudden death unless immediate cardiopulmonary resuscitation is applied.
Signs and symptoms[edit]
The most common symptom is dizziness or syncope which often occurs during exercise or as a response to emotional stress.
Age at onset[edit]
CPVT typically start manifesting during the first or second decade of life. The majority of events occur during childhood with more than 60% of affected individuals having their first episode of syncope or cardiac arrest by age 20.
Triggers[edit]
Symptoms are typically precipitated ("triggered") by exercise-induced ventricular arrhythmias during periods of physical activity or acute emotional stress.
Diagnosis[edit]
Affected patients demonstrate no structural problems of the heart upon echocardiographic, CT or MRI imaging.
CPVT diagnosis is based on reproducing irregularly shaped ventricular arrhythmias during ECG exercise stress testing, syncope occurring during physical activity and acute emotion, and a history of exercise or emotion-related palpitations and dizziness with an absence of structural cardiac abnormalities.[1]
Because its symptoms are usually only triggered when the body is subjected to intense emotional or physical stress, the condition is often not detected by the traditional methods of electrophysiologic examination such as a resting electrocardiogram.[2][3][4][5]
Molecular Genetics[edit]
CPVT can be caused by mutations in either one of at least five genes, four of which are currently known. Mutations in two genes cause CPVT inherited by an autosomal dominant (AD) inheritance pattern while the other ones follow autosomal recessive (AR) inheritance
Type OMIM Gene Locus Inheritance
CPVT1 604772 RYR2 1q42.1-q43 AD
CPVT2 611938 CASQ2 1p13.3-p11 AR
CPVT3 614021 - unknown- 7p22-p14 AR
CPVT4 614916 CALM1 14q32.11 AD
CPVT5 615441 TRDN 6q22.31 AR
• The Ryanodine receptor (RYR2) is involved in intracardiac Ca2+ handling; Ca2+ overload triggers abnormal cardiac activity.[6]
• Calsequestrin (CASQ2) is a calcium buffering protein of the sarcoplasmic reticulum.
CPVT1 (RYR2)[edit]
Mutation of the Ryanodine receptor isoform 2 (RYR2) gene has been linked to catecholaminergic polymorphic ventricular tachycardia (CPTV).[7] Under normal physiological conditions, RYR2 mutation has no discernable effect on calcium induced-calcium release from the sarcoplasmic reticulum (SR).[7] Ryr2 is normally activated by increased cytosolic calcium, but under stressful conditions such as increased beta adrenergic activation, RYR2 is activated by luminal calcium in association with increased SR calcium loading.[7][8][9] The increased luminal calcium activation occurs because of a phenomenon termed store-overload induced calcium release (SOICR).[10] SOICR leads to spontaneous and inappropriate action potentials, generating arrhythmias.[11][12][13] A Ryr2 mutation may increase sensitivity to luminal calcium activation, therefore increasing calcium release from the SR under store-overload conditions and thus triggered arrhythmias.[14][15]
RYR2 mutations have been well characterized and been found to occur primarily in 4 major domains.[7] Mutations in domains III and IV of the protein (amino acid range from 3778 to 4201 and 4497 to 4959 respectively) occur in 46% of reported mutations.[7] Mutations occur less frequently in domains I and II (amino acid 77-466 and 2246-2534 respectively).[7] Causative RYR2 mutations outside these four domains are very rare, occurring in as little as 10% of reported cases.[16] Ryr2 mutations are most often single nucleotide substitutions resulting in a different amino acid substitution, however some in-frame substitutions and duplications have been documented [16][17] . It is commonly accepted that more severe mutations have not been linked to CPTV as they are more likely to underlie different cardiac pathologies.[7]
Recent findings have characterized the pathology of RYR2 mutations and how they relate to SOICR as a matter of the intrinsic properties of the ryanodine channel. Two theories propose the underlying mechanism, domain unzipping and FKBP12.6 unbinding.[7] Firstly, domain unzipping refers to the separation of the N-terminal domain's interaction with the central domain; destabilizing the receptor.[18][19] The mutation would compromise the stability of the Ryr2's closed state and increase its sensitivity to stimuli like luminal and cytosolic calcium.[7][18][19] Domain unzipping coincides with the specific Ryr2 domain mutations associated with CPTV [20] . The second theory of FKBP12.6 is more controversial [20] . FKBP12.6 is a RYR2 binding protein that stabilizes the receptor. FKBP12.6 binding to RYR2 is regulated by RYR2 phosphorylation via PKA that results in the dissociation of FKBP12.6, rendering Ryr2 more sensitive to cytosolic calcium activation [21] . However, as mentioned above, evidence has been conflicted in determining FKBP12.6's role in CPTV.[7] So far the literature concludes that FKBP12.6 may play a role in certain CPTV mutations but not others, further research needs to clarify this protein's role.[7]
CPVT2 (CASQ2)[edit]
Mutations in the Calsequestrin isoform 2 (CASQ2) gene has been linked to CPVT.[22] Under normal physiological conditions, CASQ2 is the major luminal Ca2+ binding protein in the sarcoplasmic reticulum (SR) [22][23][24][25][26][27][28] ), which in the main Ca2+ storage organelle in cardiac muscle. CASQ2 is also associated with regulating SR Ca2+ release when bound to triadin, junctin and RYR2, forming a complex [24] .[22] This cytosolic to luminal Ca2+ activation process that RYR2 regulates is termed store-overload induced calcium release (SOICR). CASQ2 is responsible for initiating and terminating this process.[23] CASQ2 acts in low levels of SR Ca2+, where CASQ2 monomers inhibit RYR2 by forming the triadin-junctin-RYR2 complex, however at high levels of SR Ca2+, CASQ2 monomers form polymers and dissociate from the RYR2 channel complex, removing the inhibitory response activating the channel to spontaneously release Ca2+.[23][26] A mutation, specifically R33Q and D307H in CASQ2 tend to alter the Ca2+ binding capacity or alter the interactions between CASQ2 and RYR2 channel complex, potentially affecting the response of RYR2.[23][26]
Mutations in the CASQ2 gene have been classified into 12 CPVT associated mutations: 4 are nonsense mutations causing shortening of proteins, and 8 are missense mutations. R33Q and D307H reduce CASQ2 protein to 5% and 45% of normal levels respectively, which reduces SR Ca2+ buffering and binding capacity.[23][24][27][28] The most severe missense mutation, D307H, converts aspartic acid (negatively charged) to a histidine within a Ca2+ chelating region. This disrupts Ca2+ binding to CASQ2, but the specific mechanism behind this mutation is still undetermined.[27][28] The missense mutation R33Q causes a substitution of glutamine for arginine, decreasing the total amount of Ca2+ stored in the SR, thus increasing the Ca2+ buffering system causing Ca2+ leak through RYR2, where the mechanism behind this mutation is proposed to interact with triadin and/or junction forming "polar zippers".[26][27]
There are two major theories as to what is occurring when CASQ2 is deficient. It was found that decreased CASQ2 is associated with high levels of calreticulin (CRT).[24] In the absence of CASQ2 signal, CRT levels increase and provide some compensatory SR Ca2+ binding activity. CRT levels decrease significantly after birth and high levels are only present in the developing heart, leading to the theory of caused bradycardia and sinus node dysfunction which is found in CPTV patients.[24] With the absence of CASQ2, it was also found that RYR2 activity remained high in diastole since CASQ2 could not provide the inhibitory response, causing a prolonged Ca2+ leak which triggers early action potentials.[22][24][25] With reduced SR Ca2+ buffering capacity, is a faster recovery of SR free Ca2+ after each Ca2+ release, resulting in higher levels of SR free Ca2+ and SR Ca2+ loading, both increasing trigger activity and SOICR recurrence [23] .[24] The exact mechanisms by which the mutations occur in the CASQ2 gene are still under investigation. Research underway is analyzing strategies to target RYR2 inhibition and approaches to increasing SR Ca2+.[24]
Treatment[edit]
Medication[edit]
Medications to treat CPVT include beta blockers and verapamil.[29]
Flecainide inhibits the release of the cardiac ryanodine receptor–mediated Ca2+, and is therefore believed to medicate the underlying molecular cause of CPVT in both mice and humans.[30]
Implantable cardioverter-defibrillator[edit]
Implantable cardioverter-defibrillators are used to prevent sudden death.
Sympathectomy[edit]
In recent reports, left cardiac sympathetic denervation and bilateral thoracoscopic sympathectomy have shown promising results in individuals whose symptoms cannot be controlled by beta blockers.[4][31][32][clarification needed]
See also[edit]
References[edit]
1. ^ Napolitano, Carlo; Silvia G. Priori (May 2007). "Diagnosis and treatment of catecholaminergic polymorphic ventricular tachycardia" (PDF). Heart Rhythm. 4 (5): 675–8. doi:10.1016/j.hrthm.2006.12.048. PMID 17467641. Archived from the original (PDF) on November 3, 2013. Retrieved 2008-12-17.
2. ^ Iyer, Vivek; Antonis A. Armoundas (2006). "Proc. IEEE Eng Med Biol Soc". Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Cardiovascular Research Center, Massachusetts General Hospital: IEEE. Suppl: 6761–4. doi:10.1109/IEMBS.2006.260941. ISBN 1-4244-0032-5. PMID 17959506. |contribution= ignored (help)
3. ^ Liu, N; Ruan Y; Priori SG (July–August 2008). "Catecholaminergic polymorphic ventricular tachycardia". Progress in Cardiovascular Diseases. 51 (1): 23–30. doi:10.1016/j.pcad.2007.10.005. PMID 18634915.
4. ^ a b Wilde, Arthur; Zahurul A. Bhuiyan; Lia Crotti; Mario Facchini; Gaetano M. De Ferrari; Thomas Paul; Chiara Ferrandi; Dave R. Koolbergen; Attilio Odero; Peter J. Schwartz (2008-05-08). "Left cardiac sympathetic denervation for catecholaminergic polymorphic ventricular tachycardia". New England Journal of Medicine. 358 (19): 2024–9. doi:10.1056/NEJMoa0708006. PMID 18463378. Retrieved 2008-12-17.
5. ^ "Interview with Michael J. Ackerman, M.D., Ph.D." (PDF). Hannah Wernke Memorial Foundation. Retrieved 2009-02-09. [dead link]
6. ^ Wehrens XH, Marks AR (November 2004). "Sudden unexplained death caused by cardiac ryanodine receptor (RyR2) mutations". Mayo Clin. Proc. 79 (11): 1367–71. doi:10.4065/79.11.1367. PMID 15544013. [dead link]
7. ^ a b c d e f g h i j k Priori, S. G.; Chen W. S. (2011). "Inherited dysfunction of Sarcoplasmic Reticulum Ca2+ Handling and Arrythmogenesis". Circ. Res. 108 (7): 871–883. doi:10.1161/circresaha.110.226845. PMC 3085083free to read. PMID 21454795.
8. ^ Lakatta, EG (1992). ". Functional implications of spontaneous sarcoplasmic reticulum Ca2+ release in the heart". Cardiovasc. Res. 26 (3): 193–214. doi:10.1093/cvr/26.3.193. PMID 1423412.
9. ^ Lakatta, E. G.; Guarnieri T. (1993). "Spontaneous myocardial calcium oscillations: are they linked to ventricular fibrillation?". Journal of Cardiovascular Electrophysiology. 4 (473–489).
10. ^ Laver, DR (2007). "Ca2+ stores regulate ryanodine receptor Ca2+ release channels via luminal and cytosolic Ca2+ sites". Biophys. J. 92 (10): 3541–3555. Bibcode:2007BpJ....92.3541L. doi:10.1529/biophysj.106.099028. PMC 1853142free to read. PMID 17351009.
11. ^ Bers, DM (2002). "Calcium and cardiac rhythms: physiological and pathophysiological". Circ Res. 90 (1): 14–17. PMID 11786512.
12. ^ Pogwizd, SM; Bers DM (2004). "Cellular basis of triggered arrhythmias in heart failure". Trends Cardiovasc. Med. 14 (2): 61–66. doi:10.1016/j.tcm.2003.12.002. PMID 15030791.
13. ^ Schlotthauer, K; Bers DM (2000). "Sarcoplasmic reticulum Ca2+ release causes myocyte depolarization. Underlying mechanism and threshold for triggered action potentials". Circ. Res. 87 (774–778).
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Further reading[edit]
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