WARFARIN- anticoagulant IND - to prevent the formation of new blood clots and prevent existing blood clots from getting larger. -Mode of action of warfarin: Interferes with the synthesis of vitamin K-dependent clotting factors. HOW TO USE? -The strength and colour of the tablet 1 mg - Apo-Warfarin (brown), Coumadin (pink) 2 mg - Apo-Warfarin (lavender), Coumadin (purple) 3 mg - Orfarin (blue). 5 mg - Apo-Warfarin (peach), Coumadin (peach), Orfarin (pink). -Remind the patient not to remember the colour, remember the dose prescribed instead. The dosage and administration -Dose & duration based on indication and international normalised ratio (INR) target. -Must be taken at the same time every day. -If missed a dose for more than 8 hours, skip the dose and take the next dose (do not double the dose). -To inform healthcare professionals (dentist, surgeon, doctor, pharmacist) if patient is planning to get pregnant, tooth extraction, or when getting consultation for medication, supplement or herbal remedies. INR -To check how long it takes for your blood to clot. The higher your INR is, the longer it takes for your blood to clot. Target INR -The targeted INR is 2-3 except for stroke prophylaxis in patients with mechanical heart valves such as mitral valves (INR of 2.5-3.5). -Follow the scheduled blood test and the counselling appointment made to achieve targeted INR as suggested by the doctor. -Bring along anticoagulant booklet and all medications during the doctor/pharmacist appointment. Side effects of medication -Educate patient on symptoms of bleeding such as bruises of unknown cause, blood in urine/dark-coloured urine, black stools,gum bleeding or heavy menstrual bleeding. -Report to doctor and pharmacist if any sign or symptom of bleeding occurs. Drug-drug/food interactions -Consult doctor and pharmacist before starting, stopping or changing dose of any medication/supplement, irregardless ofwhether it is a prescription or over-the-counter medication including traditional medicines. -Monitor the intake of food which are rich in vitamin K such as green, leafy vegetables. Have consistent intake of vegetables and food with high content of high vitamin K. -Follow a balanced and consistent diet. -Review patient’s lifestyle such as alcohol consumption, smoking and stress. Advice to only consume small quantity of alcohol, -stop smoking and manage stress as these will affect the therapy. Pregnancy and breastfeeding -Advise women with childbearing age that warfarin can have adverse effects on fetal development (first trimester), therefore,need to inform doctor if planning to get pregnant. -Very little warfarin gets into the breast milk, therefore, it is safe to be taken if the mother is breastfeeding. Thank You.
Views: 10003 thomas Tan
Learn how to recognize Deep vein and Superficial vein thrombosis and what to expect.BLOOD CLOTS -- HOW TO RECOGNIZE 1)Superficial-reddness, mild burning if along the Saphenous vein. Other surface veins may have a visible or palpable lump usually feels like a hard cord or pencil under the skin. Could continue into a DVT You can expect to be put on coumadin and will have only minor impairment if at all. It can be deceptively symptom free until the entire Saphenous vein becomes like a cord most of the way from your thigh down to the ankle. You most likely will not experience any leg swelling but you should see the vein become more prominent and then become hardened. 2)Deep vein-If in calf, dorsa flex the foot. If sharp pain then suspect thrombosis. 3)Deep vein- If between the thigh and knee-Femoral vein Can be difficult to detect at first because it tends to become established before symptoms develop. Symptoms may present as a lower muscle pain or pulled groin muscle. Further these pains may not always be present. They can be intermittent at first misleading you into thinking it's just a pulled muscle.Experience feelings of fluid build up upon standing and weakness in Quads at first . Later a feeling of dizzyness AFTER mild exertion. A craving for sweets for energy. DO NOT attempt to treat with anti-inflammatory NSAIDs like Aleve or Ibuprofen. Tylenol okay to use. Take a couple of aspirin a day until you have a chance to get to a doctor's offc. Do the pinch test to see if you are dehydrated...if skin does not snap back immediately start drinking fluids now. One you first feeling fluid building up and/or dizzyness upon standing you are probably within three days of requiring admission to the ER at the hospital. You will know you have reached a critical stage when your thigh muscles become weak, feel more and more pressure each time you stand and you feel dizzy after walking just a few yards. At this point you must go to the ER but try to have a bowel movement and pee before you go....you probably won't be able to for the next week or so. Just the physical swelling will cause that.DO THESE THINGS RIGHT NOW (TODAY) BEFORE GOING TO THE HOSPITAL FIRST THING: Laxative-If you even think you may have a thrombosis-Start immediately on either All-Bran cereal or Mira-Lax with each meal SECOND THING: Plan ahead-Transport (911=$900)/meals, grocery shopping, business now SECOND THING: Buy a pair of thigh high compression stockings 20-30mm Hg-no Rx nec. WHAT TO EXPECT: At the ER they will put an IV line in you to keep fluids going into your body. Your leg diameter will continue to swell for the next few days. Be sure you ask for a doppler to confirm thrombosis. Your pain levels will increase...you won't be able to walk but a few meters without passing out from orthostatic hypotension. If you are on diuretics for BP CONTINUE THEM. ASK THE HOSPITAL DOC (DAY 1) IF YOU CAN HAVE SOMEONE BRING YOU 20-30 mm thigh high COMPRESSION STOCKINGS FOR IMMEDIATE USE. You will need measurements of your ankle, calf, and thigh at the widest part. You will only use these until about two or three weeks after you get home then order some stockings at 30-40mm for the next 4-6weeks and then go to 40-50mm. As soon as you can (when the 30-40mm began to stretch and lose compression.The hospital may give you some short knee high compression socks which are useless and just slow your progress or they may use a machine with a pressure cuff to stimulate circulation---they usually don't get the cuff adjusted tight enough to do any good....take some control here and do it yourself. Each day, Ask your hospital doc if your vital signs have returned to normal (such as kidney function). If so then don't let the hospital keep putting IV fluid into your body...that just makes your leg feel like it is going to burst plus it makes it almost physically impossible for you to use the toilet in your room no matter where it is. They will argue the IV is for your benefit. Tolerate what you can but take control. You will also feel your upper body begin to retain fluid as well. This will also make going to the toilet a lot more difficult. Until you can get the fluid in your body down (ask doc to use lasix for that) you will be in great pain and pretty immobile and severely constipated and unable to pee. You will be put on Coumadin or Warfarin accompanied with a few shots of Lovenox injections for about ten days. The Coumadin you may be on forever. You will also be given medication for pain.
Views: 362559 32f3245f4
What does norfloxacin mean? A spoken definition of norfloxacin. Intro Sound: Typewriter - Tamskp Licensed under CC:BA 3.0 Outro Music: Groove Groove - Kevin MacLeod (incompetech.com) Licensed under CC:BA 3.0 Intro/Outro Photo: The best days are not planned - Marcus Hansson Licensed under CC-BY-2.0 Book Image: Open Book template PSD - DougitDesign Licensed under CC:BA 3.0 Text derived from: http://en.wiktionary.org/wiki/norfloxacin Text to Speech powered by TTS-API.COM
Views: 5408 What Does That Mean?
How to Take Winstrol bodybuilding supplements Disclaimer:This Video only For Educational Purpose Winstrol is a brand name of the synthetic anabolic steroid, stanozolol. Although no longer available in the U.S. under the name of Winstrol, generic versions of stanozolol can still be found. Stanozolol is similar to testosterone and commonly used by veterinarians on debilitated animals (especially dogs and horses) to improve muscle growth, trigger red blood cell production, increase bone density and enhance appetite. It's approved by the U.S. Food and Drug Administration (FDA) for treating anemia and hereditary angioedema (swelling of blood vessels) in people, although a prescription is needed. Winstrol (stanozolol) is a banned performance-enhancing drug, but still used widely by track and field athletes as well as bodybuilders usually illegally. You should take stanozolol only with the permission and under the care of a physician. 1 Consult with your physician before taking any steroids. Anabolic (meaning protein and muscle building) steroids are powerful medicines with various health benefits, but all are considered controlled substances that require a prescription due to their potential for abuse and serious side effects. Your family doctor is not likely to prescribe anabolic steroids for you unless you suffer from angioedema, aplastic anemia (both blood disorders) or some muscle wasting condition. Wanting bigger muscles or greater strength is not a valid reason for an ethical doctor to write you a prescription for anabolic steroids. For hereditary angioedema, adult dosage recommendations usually start at 2 mg, three times day. If successful at reducing swelling, dosages are reduced after one to three months to 2 mg daily. For aplastic anemia, adult and childhood dosages typically start at 1 mg/kg per day and can be slowly increased from there. Winstrol comes in round pink tablets (meant to be taken orally) and in a serum meant to be injected directly into muscle tissue. Usage ranges from a few weeks to about six months at a time. 2 Take Winstrol with lots of water. If you are taking Winstrol orally (via tablets), remember to always drink a full glass of water with it. Drinking water helps the tablet dissolve quicker and also prevents stomach irritation. The pills contain a compound called c17 methyl, which helps the stanozolol from being destroyed in the stomach and liver so it can work on muscle growth; however, the downside to c17 methyl is that it irritates the stomach and is toxic to the liver. Drinking lots of water with the pills will help lessen the impact of c17 methyl on your body. Start with at least an 8-ounce glass of water with each pill you take. Avoid acidic juices as they may contribute to stomach irritation. Taken orally, stanozolol doesn't lose its potency (compared to injecting it) as much as some other anabolic steroids do. 3 Don't drink any alcohol while on steroids. All types of steroids, particularly anabolic steroids, are damaging to the liver because they are toxic (difficult or impossible to break down into harmless by-products) and stanozolol is no exception. As such, you shouldn't consume any alcoholic beverages (beer, wine, liquor) even in moderation while on anabolic steroids because alcohol (ethanol) is also toxic to the liver — combining the two is like a "double-whammy". Any potential benefits of moderate alcohol consumption (blood thinning, antioxidants) does not outweigh the potential negative side effects when combined with steroid medication. Don't let the lack of alcohol consumption impact your social outings. Switch to "virgin" cocktails, soda, seltzer water, and/or grape juice if your friends are drinking. 4 Don't take Winstrol with anticoagulant medication. Anticoagulant medications (also called blood thinners) such as heparin or warfarin reduce the body's ability to make a clot, which can be helpful for some cardiovascular diseases. Anabolic steroids, however, tend to increase your sensitivity to anticoagulants, which increases your risk of internal bleeding and bruising. As such, either don't combine the two different types of medication, or have your doctor decrease your anticoagulant medication to more appropriate levels. Antiplatelet drugs (such as aspirin) should also be avoided while you're on anabolic steroids. Blood thinners reduce the risk of heart attack and stroke, so they often take precedent over anabolic steroids if your doctor thinks the two can't be combined for safety reasons. SUBSCRIBE TO MORE VIDEOS WATCH MORE USEFUL VIDEOS : 11.journal of alternative and complementary medicine |alternative medicine grants https://www.youtube.com/watch?v=hejj7SFztFU ……………………………………………………………………………………… 12.health information hotline |health information administrator https://www.youtube.com/watch?v=eIlXgKu4w4Y
Views: 2946 health gym
Vit K helps in posttranslational γ carboxylation of glutamate residues There are 3 vitamers of vitamin K. 1. Phylloquinone (K1) – found in plants 2. Menaquinones (K2) – produced by intestinal bacteria 3. Menadione (K3) – a synthetic compound Vitamin K is the cofactor for γ-carboxylation of glutamate residues the following proteins to produce γ-carboxyglutamate (Gla): 1. Clotting factors – II, VII, IX, X, 2. Protein C, Protein S, Protein Z 3. Growth arrest-specific 6 (Gas6) protein 4. Osteocalcin a.k.a bone Gla protein 5. Periostin 6. Matrix Gla Protein 7. Transthyretin (Prealbumin) Mnemonic: cranial nerves carrying parasympathetic supply – III, VII, IX, X Vit K dependent clotting factors – II, VII, IX, X Clinical Correlation Menaquinone is synthesised by the intestinal flora. Intestine of newborn is sterile and the placental transport of vitamin K is poor. So, newborns, especially preterm ones are prone for bleeding. This is known as haemorrhagic disease of newborn. This is prevented by 1 mg injection of menadione at the time of birth. Warfarin acts as an anticoagulant by inhibiting the epoxide reductase • As you can see from the image, Vitamin K epoxide reductase (VKOR) is necessary for the regeneration of active vitamin K. • Warfarin inhibits epoxide reductase. • Vitamin K is the antidote in warfarin poisoning or toxicity.
Views: 363 Karthikeyan Pethusamy
Plasma, oh plasma. PCC is now the favorite child. See why Hippo LLSA Prep is everyone's favorite. Finish LLSA 2016 in under 20 min. Produced by Hippo Education studios: www.hippoed.com/em/llsa. Find out who we are and what we do.
Views: 661 Essentials of Emergency Medicine
For more info: https://draxe.com/gout-remedies/?utm_campaign=Youtube-Feb-2015&utm_medium=social&utm_source=youtube&utm_term=gout In this video, I’m going to share my top 6 home remedies for gout. Gout is caused by uric acid build up in the body. First, I want to go over the best diet to consume when treating gout. You want to eliminate all grains, sugars, alcohol and processed meat products from your diet. In addition, I would recommend consuming a lot of vegetables, fruits, bone broth and organic meats. My top 6 home remedies to get rid of gout naturally include: 1. Celery Seed Extract or Celery Juice 2. Black Cherry Juice or Extract 3. Nettles Tea (drink or supplement) 4. Fish Oil 5. Proteolytic Enzymes 6. Magnesium supplement For more natural remedies you can visit: https://draxe.com/section/natural-remedies/ *This content is strictly the opinion of Dr. Josh Axe, and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
Views: 1481425 Dr. Josh Axe
Video on How to Give a subcutanous injection shot, also called a Sub-Q shot, with insulin, lovenox, or heparin in the fat of the abdomen/belly. This demonstration is for nursing students, new nurses, and other health care professionals. This is an important nursing skill to learn, because nurses often have to give Sub-Q shots to patients. Learn common Sub-Q injection sites, techniques, tips, and more. Subscribe: http://www.youtube.com/subscription_center?add_user=registerednursern Nursing School Supplies: http://www.registerednursern.com/the-ultimate-list-of-nursing-medical-supplies-and-items-a-new-nurse-student-nurse-needs-to-buy/ Step-by-step instructions on how to give a subq injection: http://www.registerednursern.com/subcutaneous-injection-technique-how-to-give-a-subcutaneous-sub-q-injection/ Nursing Job Search: http://www.registerednursern.com/nursing-career-help/ Visit our website RegisteredNurseRN.com for free quizzes, nursing care plans, salary information, job search, and much more: http://www.registerednursern.com Check out other Videos: https://www.youtube.com/user/RegisteredNurseRN/videos Popular Playlists: "NCLEX Study Strategies": https://www.youtube.com/playlist?list=PLQrdx7rRsKfWtwCDmLHyX2UeHofCIcgo0 "Nursing Skills Videos": https://www.youtube.com/playlist?list=PLQrdx7rRsKfUhd_qQYEbp0Eab3uUKhgKb "Nursing School Study Tips": https://www.youtube.com/playlist?list=PLQrdx7rRsKfWBO40qeDmmaMwMHJEWc9Ms "Nursing School Tips & Questions": https://www.youtube.com/playlist?list=PLQrdx7rRsKfVQok-t1X5ZMGgQr3IMBY9M "Teaching Tutorials": https://www.youtube.com/playlist?list=PLQrdx7rRsKfUkW_DpJekN_Y0lFkVNFyVF "Types of Nursing Specialties": https://www.youtube.com/playlist?list=PLQrdx7rRsKfW8dRD72gUFa5W7XdfoxArp "Healthcare Salary Information": https://www.youtube.com/playlist?list=PLQrdx7rRsKfVN0vmEP59Tx2bIaB_3Qhdh "New Nurse Tips": https://www.youtube.com/playlist?list=PLQrdx7rRsKfVTqH6LIoAD2zROuzX9GXZy "Nursing Career Help": https://www.youtube.com/playlist?list=PLQrdx7rRsKfVXjptWyvj2sx1k1587B_pj "EKG Teaching Tutorials": https://www.youtube.com/playlist?list=PLQrdx7rRsKfU-A9UTclI0tOYrNJ1N5SNt "Personality Types": https://www.youtube.com/playlist?list=PLQrdx7rRsKfU0qHnOjj2jf4Hw8aJaxbtm "Dosage & Calculations for Nurses": https://www.youtube.com/playlist?list=PLQrdx7rRsKfUYdl0TZQ0Tc2-hLlXlHNXq "Diabetes Health Managment": https://www.youtube.com/playlist?list=PLQrdx7rRsKfXtEx17D7zC1efmWIX-iIs9
Views: 189315 RegisteredNurseRN
All gherelu nushke are there, any medicine should to taken according to doctor prescription. It is totally up to you. My knowledge is based on my personal studies All the political views are my own views. My others Channels LINKS are : Shiv Hari Bhajan : https://www.youtube.com/channel/UCSCjzdEH7sZVWuvkg7ApLYQ Bhajan Baaje : https://www.youtube.com/channel/UCnsIAaPFcrUdOAtAJ3fokEA Harsh Infotainment : https://www.youtube.com/channel/UCEwDnh3NHYTjHuEA4eYisbA this channel gives you perfect guidance whereas home remedies are concerned. these are my personal studies . before implementing youmshould also consult your doctorखून का थक्का Blood Clotting के लक्षण कारण और घरेलू उपचार Gyan The Treasure : https://www.youtube.com/channel/UCZ-xaW1wnqubpkOLvOVKKOg Vastu & Astrology : https://www.youtube.com/channel/UCbhc-xEKXBrPHPevA2ibJxQ Dharm अाैर Science : https://www.youtube.com/channel/UC_7ylmMqDS92eLK6NY76Y6w Difference & Similarities : https://www.youtube.com/channel/UCTIp54Q_dyw1o2etqsoeXiw What If ….कया हो अगर : https://www.youtube.com/channel/UCnsIAaPFcrUdOAtAJ3fokEA Parenting & Lifestyle : https://www.youtube.com/channel/UChx9OYduRzQsdvyQBRIAq8A Teej Tyohar - https://c.mp.ucweb.com/personal/index/58f59d88bae5476db984a49f3e5b5a8a?uc Guru Ka Gyan - https://c.mp.ucweb.com/personal/index/d4fd204f35014a458bb80deacbb4a925?uc Shreemad Home Remidies - https://c.mp.ucweb.com/personal/index/1ad6051206a446739f7e4fbf6f72035c?uc Ghar Ka Khana - https://c.mp.ucweb.com/personal/index/93f4321fdb504bec8e7ed24ae784b728?uc All gherelu nushke are there, any medicine should to taken according to doctor prescription. It is totally up to you. My knowledge is based on my personal studies All the political views are my own views. My other Channels link are : Shiv Hari Bhajan : https://www.youtube.com/channel/UCSCjzdEH7sZVWuvkg7ApLYQ Vastu & Astrology : https://www.youtube.com/channel/UCbhc-xEKXBrPHPevA2ibJxQ Ghar Ka Khana - https://www.youtube.com/channel/UCTnETM8SXLVChvnf6wAfyxg Bhajan Baaje : https://www.youtube.com/channel/UCnsIAaPFcrUdOAtAJ3fokEA Harsh Infotainment : https://www.youtube.com/channel/UCEwDnh3NHYTjHuEA4eYisbA All gherelu nushke are there, any medicine should to taken according to doctor prescription. It is totally up to you. My knowledge is based on my personal studies All the political views are my own views. My other Channels link are : Shiv Hari Bhajan : https://www.youtube.com/channel/UCSCjzdEH7sZVWuvkg7ApLYQ Vastu & Astrology : https://www.youtube.com/channel/UCbhc-xEKXBrPHPevA2ibJxQ Ghar Ka Khana - https://www.youtube.com/channel/UCTnETM8SXLVChvnf6wAfyxg Bhajan Baaje : https://www.youtube.com/channel/UCnsIAaPFcrUdOAtAJ3fokEA Harsh Infotainment : https://www.youtube.com/channel/UCEwDnh3NHYTjHuEA4eYisbA
Views: 146578 Shrimad Home Remedies
When you are ready for your recommended subcutaneous injection, recap and remove the mixing needle by twisting and replace it with a smaller subcutaneous injection needle (usually ½-inch needle). Alcohol wipes will be included with your injectable medications. You may use a clean tissue or other substitute wherever gauze pads are referenced. View this video for injection instructions. For questions regarding medication administration or to speak to our nurse or pharmacist, please call 877-334-1610.
Views: 609399 Village Pharmacy
Free Audio Book ⇒ http://bit.ly/AudibleSED Tweet⇒http://bit.ly/TatRemovalTWT FB⇒http://bit.ly/TatRemoveFB Official Comment Thread: http://bit.ly/13jMTji More info! ⇊ Click below for more links! ⇊ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ My Instagram account: http://instagram.com/smartereveryday Patreon Support Link: http://www.patreon.com/smartereveryday Twitter: https://twitter.com/smartereveryday To help with understanding, we've created animated GIFs (we call them InfoGIFs) You can view them on the Smarter Every Day Tumblr http://smartereveryday.tumblr.com/ Dr. Lappert is a wicked smart dude. He taught me all about the PicoSure Laser. http://www.lappertplasticsurgery.com/ A huge thanks to Seejay and Leah at Timepiece Tattoo. They were open and welcoming to some random nerd who asked if he could hang out and film in their shop. Seejay and Leah Tattoo here http://timepiecetattoocompany.com/ The awesome piano music by "A Shell In The Pit" is called: "Explodeface, Destroyer of Worlds" It can be downloaded here. https://ashellinthepit.bandcamp.com/album/smarter-every-day-vol-ii Awesome graphic elements created by Graphic Designer Emily Weddle http://emilyweddledesign.com/ Animation of Emily's graphic elements by Craig Mederios http://Vimeo.com/CraigMederios Outro Music is "Bottles" by A Shell In The Pit. Download them here: http://ashellinthepit.bandcamp.com/track/minke-bottles ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ GET SMARTER SECTION: Tattoo color chemicals: http://chemistry.about.com/library/weekly/aa121602a.htm http://en.wikipedia.org/wiki/Tattoo_ink#Pigment_bases ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tweet ideas to me https://twitter.com/smartereveryday I'm also on Instagram, Facebook, and Reddit http://instagram.com/smartereveryday https://www.facebook.com/SmarterEveryDay http://www.reddit.com/r/smartereveryday If you like what I do and want to support my efforts to create Smart kids and Smarter Every Day here are a couple of links you can use to help. You will be notified when every single video is released! Patreon Support Link: http://www.patreon.com/smartereveryday Subbable Support Link: http://subbable.com/smartereveryday Warm Regards, Destin
Views: 11347322 SmarterEveryDay
Lovenox is a blood thinner, burns like hell, and leaves terrible bruising. However, after 7 IVF cycles I have learned some tricks to help with the pain and bruises. Here they are, I hope they help you, too. Note: This is not for training purposes and each patient has their own dosage, specific doctor's orders and techniques. This was done to show a friend how I personally do my own shots and I am not a doctor, just an IVF patient. Please direct all questions to your own RE.
Views: 516841 CavieJasper
Since my accident in 2010, I've given myself a million of these blood thinning injections to prevent blood clots from forming. Please note that I am not a medical professional and this video is not meant to be medical advice. I just wanted to show off my amazing abs and show people that you too can overcome your fear of needles and administer these shots yourself.
Views: 120558 Tony Meehan
Tel 01935 873 951 http://theveincarecentre.co.uk/ http://www.theveincarecentre.co.uk/contact email@example.com https://www.facebook.com/theveincarecentre https://www.iwantgreatcare.org/doctors/dr-haroun-gajraj Varicose Eczema - The Truth. Varicose Eczema is not a dermatological or skin condition, it is a vascular condition caused by superficial vein reflux. It is the precursor of a leg ulcer and should be treated by a vein specialist. http://www.theveincarecentre.co.uk/ The term varicose eczema is misleading for 2 reasons. Firstly, the root cause is superficial venous reflux which can cause complications without varicose veins appearing. Secondly, the term eczema suggests that the condition is primarily a disease of the skin. In fact, it is a vascular condition that should be treated by a vascular surgeon or a veins specialist (phlebologist) rather than a dermatologist or GP. Many people with superficial venous reflux develop severe complications without a single varicose vein. Many people with severe varicose veins have very few symptoms and do not develop complications. In fact, it appears that reflux that is diverted into tributaries under the skin which then become varicose may be prevented from continuing down the leg to cause skin changes such as varicose eczema. The treatment of varicose eczema should be directed to eliminating the venous reflux rather than using steroid creams. The prolonged use of steroid creams may help with the symptoms of itch and discomfort but they will thin the skin and make it more vulnerable to injury and ulceration. The reflux can be treated by non-surgical interventions under local anaesthetic such as VNUS Closure (radiofrequency or RFA), endovenous laser (EVL or EVLT), Venaseal by Sapheon (medical superglue) or Ultrasound guided foam sclerotherapy. Early treatment of varicose eczema prevents deterioration to leg ulceration. Dr Haroun Gajraj who is based in Bristol and in clinics around the SouthWest explains the significance of varicose eczema and how it should be treated. Tel 01935 873 951 http://theveincarecentre.co.uk/ http://www.theveincarecentre.co.uk/contact firstname.lastname@example.org https://www.facebook.com/theveincarecentre https://www.iwantgreatcare.org/doctors/dr-haroun-gajraj
Views: 150999 The VeinCare Centre
[This educational video advocates responsible, SAFE use of legal supplements. Please see my guide on How to Biohack Smart and Safe limitlessmindset.com/blog/1510-biohack-safe] This amino acid is an important aspect of your body's ability to generate energy through the mitochondrial metabolic process. Carnitine (Name when found in nature), L-Carnitine or ALCAR (Supplement name) is also an anti-aging agent. L-Carnitine has several positive effects on the mind; faster learning, improved memory (spatial, verbal), verbal critical abilities, and constructional thinking. Order ALCAR http://peaknootropics.com/shop/alcar/?affiliates=63 Capsuled ALCAR http://shrsl.com/vb5l L-Carnitine Amazon https://amzn.to/2Ej1rBK ALCAR Meta Analysis http://www.limitlessmindset.com/nootropic-ingredients/325-l-carnitine.html Recommended Daily: For cognitive improvement, the unpublished study suggested health people take up to a gram daily (two 500 Milligram doses). Generally, 20-200 Milligrams per day for those on an omnivorous diet, vegans and vegetarians may take as little as 1 Milligram per day. Elderly people dosing for memory empairment are given up to 1.5 Grams per day. Those recovering from heart attack may take up to 2-6 grams daily. Side Effects: Those dosing L-Carnitine take pretty high levels safely. WebMD advices that possible side effects include nausea, vomiting, stomach upset, heartburn, and diarrhea. Those who have history of seizures should not take L-Carnitine. Conflicts: The following drugs have moderate interactions with L-Carnitine; Acenocoumarol (Sintrom), Thyroid hormone, and Warfarin (Coumadin). Listen to this as a podcast on the go with the Castbox.FM smartphone app https://castbox.fm/channel/Limitless-Mindset-id1159858 Connect with Jonathan on Facebook https://www.facebook.com/limitlessmindset on Twitter http://twitter.com/#!/jroseland on Google+ https://plus.google.com/+JonathanRoseland on Gab.AI https://gab.ai/jroseland on Steemit https://steemit.com/@jroseland
Views: 235407 Limitless Mindset
Brands that I fully trust and recommend to my friends and family members: Verified Forskolin (http://verifiedforskolin.com) 3 simple but important steps to follow before purchasing forskolin: 1. Always check the label to make sure that the supplement was manufactured in the United States, Canada, Australia or Europe. Supplements coming from countries like China or India are usually of a lower quality and sometimes even dangerous. 2. Cheap is not the right state when it comes to buying weight loss supplements. Forskolin is expensive to manufacture and a bottle of it should cost at least $45-$55. If that amount of money is too much for you please just look for another supplement or follow a diet without weight loss supplements. 3. There are tons of brands that claim to be "Dr. Oz brands" out there. This is an absolute fraud sign because as you may already know Doctor Oz does not promote any particular brands Brands that I fully trust and recommend to my friends and family members: 1. Verified Forskolin This is the oldest brand of forskolin. They sure know what they are doing because their forskolin delivers results and it does it fast. I have witnessed hundreds of people change the way they look after putting their forskolin to work. The only problem is that due to recently being featured on TV they are often out of stock, feel free to visit their official website at http://verifiedforskolin.com The Benefits Scientific Benefits Of Forskolin Forskolin is obtained from the roots of the plant Plectranthus barbatus. This plant is in the mint family. Plectranthus barbatus grows in India, Nepal and Thailand. This plant has been used for a long time in traditional medicine in Asia. It was a popular remedy for treating disorders of the heart such as chest pain (angina) and high blood pressure. It was also used to treat respiratory problems such as asthma. Although enough research has not been done yet, there are a few studies that have been done that help to prove that forskolin is effective in treating some diseases as well as aid in weight loss. Here are some of the things that forskolin can help you with; 1. Weight loss There is a study that supports that forskolin supplement helps when it comes weight loss. This study also showed that it can help to aid in muscle building. In the small study that was done on obese and overweight men, they were all asked to take 250 milligrams of an extract that contained 10% forskolin two times a day. After a period of twelve weeks, it was discovered that these men had lost a lot of weight compared to the men who did not take the forskolin extract. This shows that that these extracts can help people who are struggling with weight problems lose weight. 2. Asthma Forskolin has long been used as a remedy for asthma. Today, there is some research that has been done to prove that it actually helps when used as a remedy for asthma. This extract appears to work the same way as certain drugs that are used to treat asthma. This is because it helps to boost the levels of AMP just like some of the drugs used to treat asthma. This compound helps to relax the muscles that are around the bronchial tubes, something that helps to make breathing easier. 3. Glaucoma There is a small study that proved that forskolin helps to relive pressure in the eyes. Glaucoma is a condition that is characterized by pressure in the eyes. Therefore, by reducing the pressure, it helps to relive the symptoms of glaucoma. Although this study was done on healthy people, it is expected that the same results will be observed when used by people with glaucoma. There is no doubt that forskolin is an extremely beneficial extract. This explains why it has become so popular in weight loss. It should be a product of choice if you want to enjoy all these benefits. Disclaimer: use supplements at your own risk. Actors were used for shooting this commercial. More information about forskolin and it's side effects can be found here: http://www.ncbi.nlm.nih.gov/pubmed/16... tags: forskolin forskolin weight loss warning forskolin side effects forskolin benefits review does forskolin work best forskolin for sale real forskolin diet mayo clinic report safety of forskolin is it safe to use forskolin side effect from forskolin pure forskolin supplement gnc forskolin brands coleus forskohlii where to get forskolin
Views: 1116624 LordBenas
The N Engl J Med image of the week shows an infant with “ambiguous” genitalia. You are offered congenital adrenal hyperplasia, hypospadias with cryptorchidism, preterm ovarian hyper-stimulation syndrome, Turner’s syndrome, and mixed gonadal dysgenesis. We go over the differential diagnosis. Whether noninvasive ventilation should be administered in patients with acute hypoxemic respiratory failure is debated. Therapy with high-flow oxygen through a nasal cannula may offer an alternative in patients with hypoxemia. Investigators performed a multicenter, open-label trial in which they randomly assigned patients without hypercapnia who had acute hypoxemic respiratory failure and a ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of 300 mm Hg or less to high-flow oxygen therapy, standard oxygen therapy delivered through a face mask, or noninvasive positive-pressure ventilation. We briefly discussed this study earlier, but since the high-flow therapy improved survival, I thought we should review it again. The Veterans Affairs Diabetes Trial previously showed that intensive glucose lowering, as compared with standard therapy, did not significantly reduce the rate of major cardiovascular events among 1791 military veterans (median follow-up, 5.6 years). I will review that 2009 paper for you. Now the same group reports the extended 7-year follow-up of the study participants. Somehow, they now claim there is a (slight) benefit, albeit the mechanisms are uncertain. The N Engl J Med review is on vasopressin antagonists (vaptans). This review is extremely clinically important, since chronic hyponatremia is common, what to do is uncertain, and tolvaptan costs $300 per tablet. The case of the week is a young man who visited Mexico recently. He develops coryza, conjunctivitis and a rash. The patient began to receive ceftriaxone and doxycycline empirically for coverage of bacterial and rickettsial infections, respectively. However, antibodies for Rocky Mountain spotted fever and murine typhus were negative. You call it. We inspect a special article on “The Clinical Genome Resource”. I am afraid that widespread genetic testing in the name of “personalized precision medicine” is here. You can tune in at www.clinicalgenome.org. Modifiable vascular and lifestyle-related risk factors have been associated with dementia risk in observational studies. In the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), a proof-of-concept randomized controlled trial, Finnish investigators aimed to assess a multidomain approach to prevent cognitive decline in at-risk elderly people from the general population. It seems that in Finland at least dementia is Finnished. The next investigators genotyped participants in five large statin trials for 27 SNPs that have been associated with premature cardiovascular risk. They generated a genetic risk score that ostensibly could identify individuals at increased risk for both incident and recurrent coronary heart disease events. People with the highest burden of genetic risk derived the largest relative and absolute clinical benefit from statin therapy. We inspect a novel Chinese vaccine against the EBOLA virus. Warfarin is the most widely used oral anticoagulant worldwide, but serious bleeding complications are common. The next group tested whether genetic variants (CYP2C9 and VKORC1) can identify patients with risk of bleeding with warfarin and, consequently, those who would derive a greater safety benefit with a direct oral anticoagulant rather than warfarin. These variants are relatively uncommon and have been tested before. In the same study, edoxaban was investigated. Patients with atrial fibrillation and at moderate to high risk of stroke were randomly assigned in a 1:1:1 ratio to receive warfarin, dose adjusted to an international normalised ratio of 2·0–3·0, higher-dose edoxaban (60 mg once daily), or lower-dose edoxaban (30 mg once daily). Dose reduction of exoxaban did not sacrifice efficacy in preventing stroke or systemic embolism compared with warfarin and resulted in even greater relative reductions in major bleeding. We end with a case report of a patient who looks like he has xanthogranulomatous pyelonephritis but the inflamed kidney ends up being a case of mucormycosis.
Views: 3568 Clinical Journal Club
There are at least half a dozen correct ways to give a subcutaneous injection. This does not exactly follow the precise method detailed on the package, but is functionally equivalent. Even so, you should consult your health care professional before giving your clexane/lovenox injection, rather than blindly following some video you saw on youtube. The advantage of this technique is that, speaking from personal experience, it minimises pain and eliminates bruising. The disadvantage is that it's a less foolproof technique, and requires a little more understanding of what you're doing, as opposed to just following steps by rote. Basically, the only difference is that you pinch in a more gentle, rolling fashion. This means you can release the pinch without disturbing the tip of the needle, inject more steadily, and pull the skin taught at the end for a hygeinic seal. All other steps are the same. However, I would strongly advise practising under the supervision of a trained professional to make sure you are still getting the medication correctly delivered in an appropriate way. Ideally, you should have this supervision at first no matter what technique you are using. A person of reasonable intelligence will not need me to point out that before and after steps common to all injections have not been shown in this video. This is not meant to imply that it is ok to (for instance) inject yourself whilst your hands are smeared with dog faeces, or to dispose of your needles by tossing them into sandpits at kids' playgrounds. NEITHER OF THESE ARE CORRECT. However, I thought this was obvious enough not to waste your precious bandwidth by waffling on about it in the video. Feel free to leave your own tips in the comments. The goal of this video is to support and encourage. Differences are welcomed, but comments which run contrary to the spirit of the exercise will not be approved. For more tips and other IVF med videos, see also: http://ivfshootemup.blogspot.com
Views: 354795 beabeaonblogger
Naproxen /nəˈprɒksən/ (INN; brand names: Aleve, Naprosyn and many others) usually sold as the sodium salt naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) of the propionic acid class (which puts it in the same class as ibuprofen) and is commonly used for relief of a wide variety of pain, fever, swelling and stiffness. It is the preferred NSAID for long-term use in people with a high risk of cardiovascular (for example, heart attacks or strokes) complications, due to its relatively low risk of causing such complications. Naproxen has an intermediate risk of causing stomach ulcers as compared with ibuprofen, which is low risk, and indometacin, which is high risk. In order to reduce the risk of stomach ulceration, it is often combined with a proton-pump inhibitor (a medication that reduces the production of stomach acid) during long-term treatment, in those with pre-existing stomach ulcers, or a history of developing stomach ulcers while on NSAIDs. This video is targeted to blind users. Attribution: Article text available under CC-BY-SA Creative Commons image source in video
Views: 6105 Audiopedia
Movie: Awaara (1951) Director: Raj Kapoor Music Director: Shankar Jaikishan Singers: Lata Mangeshkar Lyrisict: Shailendra Enjoy this superhit song from the 1951 movie Awaara starring Raj Kapoor and Nargis. The movie was directed by Raj Kapoor and the music was composed by Shankar Jaikishan. From the latest Bollywood songs to the oldest, SUBSCRIBE now to http://www.YouTube.com/FilmiGaane To see all the latest music playlists that we've created just for you, click here - http://www.youtube.com/user/filmigaane/videos?sort=dd&flow=list&view=1 Connect with us on :- Facebook - http://www.Facebook.com/FilmiGaane Twitter - http://Twitter.com/FilmiGaane You can now watch all the superhit videos sung by none other than Lata Mangeshkar on your mobile phones. All you need to do is SMS the following from your AIRTEL & IDEA phones. AIRTEL: sms LATA to 54321 IDEA: sms SUB VABS4 to 54300 *charges apply . Download Filmi Gaane App - http://twd.bz/fg Sign up for Free and get daily updates on New Videos, exclusive Web Shows, contests & much more http://youtube.shemaroo.com/default.aspx Send us your feedback and suggestions at : email@example.com
Views: 2741515 Shemaroo Filmi Gaane
This video describes the effects of leaky mitral valves and their treatment. ======================= ***Visit Website: https://www.thekeyholeheartclinic.com ================ A leaky mitral valve is called mitral valve regurgitation. When this a severe, it will require treatment, most commonly by surgical repair. At The Keyhole Heart Clinic, we have been treating this condition for several years. In certain cases, we can even do this by avoiding breastbone division, which can lead to much quicker recovery. ============================== ***Click below to SUBCRIBE for more videos https://www.youtube.com/channel/UC-WPe3ECVAApb_XiI-s5Avg
Views: 9805 The Keyhole Heart Clinic
University of Washington Department of Atmospheric Sciences Outreach Presents... ***Cloud in a Bottle*** Clouds are fun to look at, but have you ever tried making one? This video shows what it takes to make a cloud: both in the atmosphere and in the lab. Want to learn more about the atmosphere? Check out our website: http://www.atmos.uw.edu/~outreach University of Washington: http://www.washington.edu UW College of the Environment: http://coenv.washington.edu/ UW Department of Atmospheric Sciences: http://www.atmos.washington.edu/
Views: 7608 UWAtmosOutreach
Actually, the tattoo of my barbed wire was done prior to my heart surgery and I was just looking to have one barb colored in red to honor my grandmother but the artist who did the work asked how long I had the tattoo and I told him only about 9 years, he looked shocked!!! It was faded so bad that it looked like it was at least 15-20 years old he said. So technically I got a cover up which is much harder to do and most often more painful. But the reason it faded is because he went to deep with the needle. Tattoos should never hurt unless you are having one that is on your bone. Tattoos on your feet will absolutely hurt no matter how good the artist but there is no reason to experience pain in your arm, shoulder, back or chest. The chest may hurt a little because it is a delicate area and you are going on to your breast plate but it will feel more like stinging than actual pain. It's perfectly fine to get a tattoo wherever you want no matter the circumstance. When I had my big chest tattoo done, it was a two session job and my pro time level was a 3.6, meaning that my blood was very thin and I should have bled like a stuck pig every time he put that needle into me but you know what, I didn't bleed, not a drop. He told me that he had healthy people he worked on that bled more than I did. So when a doctor tells you that you can't have a tattoo because you are on blood thinners it's because they read that out of a text book and know nothing about how tattoo's really work. So in my opinion, after everything I have through, and it's been a lot, I say if you want to get a tattoo then get one. Just make sure that you find the right person who knows what they are doing. And the advice he gave me on how to maintain and take care of the tattoo was far better than what the so called professional ever mentioned!!! Best of luck to you, I hope to here your stories, comments and thoughts and am curious if anyone else has gone and had tattoos while on blood thinners and wonder how it went. Please share your stories, love to hear from you.......
Views: 8350 The Medical Mystery
Cryoprecipitate, also called "Cryoprecipitated Antihaemophilic Factor", "Cryoprecipitated AHF", and "cryo" for short, is a frozen blood product prepared from plasma. To acquire cryoprecipitate, thawed fresh frozen plasma should be centrifuged and the precipitate should be collected. It is often transfused as a four to six unit pool instead of as a single product. Many uses of the product have been replaced by factor concentrates, but it is still routinely stocked by many hospital blood banks. This video is targeted to blind users. Attribution: Article text available under CC-BY-SA Creative Commons image source in video
Views: 4263 Audiopedia
The N Engl J Med image of the week shows a transverse CT of a cervical vertebra from a 25 year-old after a high-speed motor vehicle collision that caused neck hyperextension. You are offered “hangman’s fracture”, fractured odontoid process, “clay-shoveler’s fracture”, flexion “teardrop” fracture, and “Jefferson fracture”. We review these cervical spine injuries and learn that most persons executed by hanging do not develop a hangman’s fracture. Using case–control samples from Sardinia, Italy, investigators performed a genome-wide association study in multiple sclerosis followed by TNFSF13B locus–specific association testing in systemic lupus erythematosus (SLE). Extensive phenotyping of quantitative immune variables, sequence-based fine mapping, cross-population and cross-phenotype analyses, and gene-expression studies were used to identify the causal variant of soluble B-cell activating factor (BAFF) and to elucidate its mechanism of action. Signatures of positive selection were also investigated. We learn that mutated BAFF is hyperactive through failed microRNA regulation, increasing the risk of autoimmune disease. The investigators speculate that the mutation arose as a protection from malaria. Cardiologists investigated the safety of uninterrupted dabigatran versus warfarin in patients undergoing ablation of atrial fibrillation. They randomly assigned patients scheduled for catheter ablation of paroxysmal or persistent atrial fibrillation to receive either dabigatran (150 mg twice daily) or warfarin (target international normalized ratio, 2.0 to 3.0). Ablation was performed after 4 to 8 weeks of uninterrupted anticoagulation, which was continued during and for 8 weeks after ablation. The investigators claim that dabigatran was safer than warfarin in terms of major bleeding. Adalimumab, a fully human anti–tumor necrosis factor α monoclonal antibody, is effective in the treatment of juvenile idiopathic arthritis (JIA). Investigators tested the efficacy of adalimumab in the treatment of JIA-associated uveitis. The primary end point was the time to treatment failure. Adalimumab beat placebo. Glycosylphosphatidylinositol anchored high density lipoprotein binding protein 1 (GPI-HBP1) also known as high density lipoprotein-binding protein 1 is a protein on capillary endothelium that is involved in chylomicron processing. A deficiency in GPIHBP1 prevents lipoprotein lipase from reaching the capillary lumen. Patients with GPIHBP1 deficiency have low plasma levels of lipoprotein lipase, impaired intravascular hydrolysis of triglycerides, and severe hypertriglyceridemia (chylomicronemia). During the characterization of a monoclonal antibody–based immunoassay for GPIHBP1, investigators encountered two plasma samples (both from patients with chylomicronemia) that contained an interfering substance that made it impossible to measure GPIHBP1. That finding raised the possibility that those samples might contain GPIHBP1 autoantibodies. We learn that autoantibodies directed at GPIHBP1 can cause hypertriglyceridemia. The N Engl J Med review is about physical abuse of children. The mystery-challenge patient is a 41 year-old man hearing loss, seizures, weakness, and dementia. The lactic acid level was initially normal but subsequently increased and remained elevated; the highest level was 8.3 mmol per liter (75 mg per deciliter; reference range, 0.5 to 2.2 mmol per liter [5 to 20 mg per deciliter]). That finding gives away the diagnosis. In the Lancet, we begin with an excellent review about Crohn’s disease. We inspect a trial of risankizumab (remember last week and psoriasis) that addresses interlelukin-23. We then review a cohort study of children with Crohn’s disease identifying prognostic risk factors. Currently, the fetal heart rate is continually monitored throughout labor. A computerized algorhythm was developed to improve the prognostication of risk. We learn that computerized interpretation of fetal heart rate during labor is of no value. Back then (1960’s) we just used our ears for monitoring fetal heart rate. We inspect coronary atherosclerosis in an indigenous South American Tsimane tribe. These people eat an “ideal” (low fat, low sugar, low calories, probably low-salt, all the right unsaturations etc.”) diet. Their blood pressures and blood values are wonderful. They also never get fat. They also work hard physically every living day. They were shoved through a CT to measure coronary calcium and they had none! Not emphasized in the paper, but available in the literature, is that the Tsimane have a life expectancy similar to Europeans in the 18th century, probably due to parasitic infestations and other vicissitudes of life. The second Lancet review is on ulcerative colitis, the other spectrum of inflammatory bowel disease. We close with a case of pyodermatitis-pyostomatitis vegetans.
Views: 67 Clinical Journal Club
This is a composite presentation of two journal club sessions. The N Engl J Med image of the week shows an abdominal plain roentgenogram with a peculiar gas collection in the left upper quadrant. You are offered small bowel obstruction, emphysematous pyelonephritis, paralytic ileus, renocolic fistula and splenic abscess. We review all these conditions. Zika virus (ZIKV) infection has been linked to the Guillain–Barré syndrome as we learned from a Lancet paper over a year ago. From November 2015 through March 2016, clusters of cases of the Guillain–Barré syndrome were observed during the outbreak of ZIKV infection in Colombia. Investigators characterized the clinical features of cases of Guillain–Barré syndrome in the context of this ZIKV infection outbreak and investigated their relationship with ZIKV infection. This confirmatory report sustains the earlier Lancet paper. The prevalence of pulmonary embolism among patients hospitalized for syncope is not well documented, and current guidelines pay little attention to a diagnostic workup for pulmonary embolism in these patients. Investigators performed a systematic workup for pulmonary embolism in patients admitted to 11 hospitals in Italy for a first episode of syncope, regardless of whether there were alternative explanations for the syncope. The diagnosis of pulmonary embolism was ruled out in patients who had a low pretest clinical probability, which was defined according to the Wells score, in combination with a negative d-dimer (fibrin breakdown products) assay. In all patients, computed tomographic pulmonary angiography or ventilation–perfusion lung scanning was performed. Among patients who were hospitalized for a first episode of syncope and who were not receiving anticoagulation therapy, pulmonary embolism was confirmed in 17.3% (approximately one of every six patients). The rate of pulmonary embolism was highest among those who did not have an alternative explanation for syncope. Sclerostin is produced by the osteocyte and has anti-anabolic effects on bone formation. Romosozumab, a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. Investigators enrolled 7180 postmenopausal women who had a T score of –2.5 to –3.5 at the total hip or femoral neck. Patients were randomly assigned to receive subcutaneous injections of romosozumab (at a dose of 210 mg) or placebo monthly for 12 months; thereafter, patients in each group received denosumab for 12 months, at a dose of 60 mg, administered subcutaneously every 6 months. One year of romosozumab treatment in postmenopausal women with osteoporosis resulted in a lower risk of vertebral and clinical fractures than the risk with placebo. Bisphosphonates would have been a more interesting comparator. The reviews are on chronic cough and Graves’ disease. The patient of the week is a 20 year-old man with gynecomastia and visual field defects. In the Lancet, we first learn that nasal chondrocyte-based autologous cartilage can be used to repair femoral condyle cartilage. We also discover that edoxaban is as good as enoxaparin-warfarin in patients undergoing cardioversion for atrial fibrillation. Next, we find that whole-brain radiotherapy in patients with brain metastases from nonsmall-cell lung cancer increases survival by only five days. Finally, platelet function monitoring with treatment adjustment did not improve the clinical outcome of elderly patients treated with coronary stenting for an acute coronary syndrome, who received prasugrel. The reviews are about rheumatoid arthritis and gout. We close with an animated quiz (from N Engl J Med). A 43 year-old Asian man develops left upper quadrant pain that is severe, recurrent, and evidently intractable. The problem resides on chromosome 2.
Views: 115 Clinical Journal Club
The N Engl J Med image of the week shows a computer-constructed CT image of a lower thoracic and abdominal aorta along with branches. Tracing the course of the aorta is revealing. You are offered Takayasu’s arteritis, aortic dissection, polyarteritis nodosa, abdominal aortic aneurysm, and microscopic polyangiitis. Ralph Kettritz and I published a paper on this condition if you care to look it up. Alfred Blalock (1899-1964) removed a thymus containing a tumor and made the observation that thymic removal improved myasthenia gravis. Eighty years later, we inspect a randomized trial of thymectomy in patients with myasthenia gravis and learned that Blalock had a point indeed. Polycystic ovary syndrome (PCOS) is a common cause for infertility and can be treated with in vitro fertilization. The transfer of fresh embryos is generally preferred over the transfer of frozen embryos for in vitro fertilization (IVF), but some evidence suggests that frozen-embryo transfer may improve the live-birth rate and lower the rates of the ovarian hyperstimulation syndrome and pregnancy complications in women with PCOS. Chinese investigators randomly assigned 1508 infertile women with the polycystic ovary syndrome who were undergoing their first IVF cycle to undergo either fresh-embryo transfer or embryo cryopreservation followed by frozen-embryo transfer. After 3 days of embryo development, women underwent the transfer of up to two fresh or frozen embryos. Amazingly, frozen beat fresh. Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus the anti-XA compound oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. Betrixaban was safe, looked better than placebo, but the differences were vanishingly small. Fabry’s disease, an X-linked disorder of lysosomal α-galactosidase deficiency, leads to substrate accumulation in multiple organs. Migalastat, an oral pharmacologic chaperone, stabilizes specific mutant forms of α-galactosidase, increasing enzyme trafficking to lysosomes. The faulty-folded protein is folded correctly by binding to migalastat, enabling lysosomal placement of the enzyme. The primary end point was the percentage of patients who had a response (≥50% reduction in the number of globotriaosylceramide inclusions per kidney interstitial capillary) at 6 months. The placebo-controlled study was “negative” albeit interesting and promising. The N Engl J Med review is on Raynaud’s phenomenon, a common and difficult to manage condition. The case-of-the-week is a 66 year-old man ingesting 12 different medicines who develops hypercalcemia and a urinary pH of 9 (enough said). A “sounding-board” paper on salt intake by CDC pundits applies Austin Hill’s criteria for evaluating “whether or not an association is causal” to current salt-intake policies. Hill had developed these criteria and applied them to the issue of smoking and lung cancer in 1964. We next inspect a review of the Ebola epidemic and the risk for recurrence. Leber’s optic atrophy is caused by a mutant retinoid isomerohydrolase (RPE65) gene. Safety and efficacy have been shown in a phase 1 dose-escalation study involving a unilateral subretinal injection of a recombinant adeno-associated virus (AAV) vector containing the RPE65 gene (AAV2-hRPE65v2) in individuals with inherited retinal dystrophy caused by RPE65 mutations. We inspect a study of the same patients who now had their other eye injected with AAV2-hRPE65v2. Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. Investigators aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. Total-body CT did not lead to improved outcomes compared to more conservative imaging. The global economic crisis has been associated with increased unemployment and reduced public-sector expenditure on health care (PEH). Invesitgators estimated the effects of changes in unemployment and PEH on cancer mortality, and identified how universal health coverage (UHC) affected these relationships. Bad times leads to more cancer rather than less. We next inspect the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) in six metropolitan areas in the USA. Yes, air polution contributes to atherosclerosis. The Lancet reviews are on hemochromatosis and Guillain Barré syndrome. We close with an HIV-positive patient with bloody stools and tenesmus in the form of a UK quiz.
Views: 76 Clinical Journal Club
This video will show you how to properly prepare the injection site and utilize the syringe to inject Lovenox into your abdomen. (stomach) I have posted this video for anyone who may find themselves in need of regular injections of Lovenox or any other blood thinner. I had a Cardiac Ablation procedure at the Mayo Clinic in Minnesota and am now prescribed Lovenox to prevent my blood from clotting while I recover. The prescription I have is for 100mg of Lovenox. PLEASE NOTE: All information is intended for educational and informational purposes only. PLEASE CONTACT your physician and/or pharmacist for medical/prescription advise.
Views: 133440 nowbroadcasting
Matricaria chamomilla, commonly known as chamomile, Italian camomilla, German chamomile, Hungarian chamomile, wild chamomile or scented mayweed, is an annual plant of the composite family Asteraceae. M. chamomilla is the most popular source of the herbal product chamomile, although other species are also used as chamomile. This video is targeted to blind users. Attribution: Article text available under CC-BY-SA Creative Commons image source in video
Views: 208 Audiopedia