Archive for October, 2014

Sexual Impotence: The Method of the Couple`s theraphy

Friday, October 31st, 2014 | Permalink

There exists the risk of producing a pharmacological erection that will last for several hours or days. This major complication of the method is unpredictable and does not depend on the drug injected (phenoxibenzamine, first time used, which is more aggressive than phentolamine). The apparition of the erection pharmacologically extended (EFP) until a duration of about four hours, which represents a real non-anoxic priapism, does not depend on the dosage injected either. The smallest dose of injected papaverine, responsible for priapism, was of five milligrams. Couple`s theraphy

This complication does not depend on the schedule and the frequency of the IIC. EFP can be triggered after several hours from the injection, which was even inefficient over the erection or can happen after several auto-injections which previously have been like clockwork. The incidence of the apparition of the EFP on various series of treatment Viagra Canada is appreciated to be between five-ten percent (according to several authors). The EFP’s prophylaxia, even though is not certain, and consists in the following:

  • Starting with a small dosage of erectogene substance;
  • Not reinjecting immediately the substance in case of failure;
  • To avoid using a medicinal association of erectogene substances;
  • To supervise for a while the subject after IIC and to inform the patient of the risk of the apparition of the secondary EFP.

The treatment of the erection that is pharmacologically produced, according to P. Bondil, Nauen J. L.. The prudency obliges us to treat any erection that is pharmacologically extended which is painful or before its duration touches four hours (when the priapism is considered non-anoxic). The treatment consists in decompressional puncture, followed by success of failure. In case of failure, at puncture appears either red blood (non-anoxic priapism), either black blood (anoxic priapism). In case of non-anoxic priapism, it is recommended IIC of anti-erectogene substances, such as metaraminol (alpha-stimulant). The metaraminol is usually effective but has a great risk, the one of possibly appearing some hypertensive flares, sometimes deadly. To prevent this risk, some authors recommend using certain erectogene alpha-stimulants, harmless, such as ephedrine or phenilephrine. In case of failure of the intracav-ernous injection with anti-erectogenic substances, when the anoxic priapism installs, it is recommended surgical treatment to avoid the ischemic necrosis of the cavernous bodies. Actually, the EFP treatment is the same as for any priapism and it is inconsistently effective and especially potentially dangerous.

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Clinical applications of VKA therapy in Canadian HealthCare Mall

Wednesday, October 29th, 2014 | Permalink

Trisodium-citrate concentration, storage time, storage temperature, evacuated tube effects, inadequate sample, variations in manual technique Canadian Health Care Mall

From nonuse of MNPT, error in MNPT due to (1) unrepresentative selection; (2) technical faults (see above); (3) nonuse of geometric mean

Incorrect choice of IRP; poor distribution of coumarin test samples across treatment range; inadequate numbers of test samples in ISI calibration; incorrect transformation of PTR of test plasmas to INR.

3.    Drift of ISI since original calibration

4.    Instrument (coagulometer) effects on INR at local site

5.    Lupus anticoagulant effects on some thromboplastin reagents

6.    Lack of reliability of the INR system when used at the onset of

warfarin therapy and for screening for a coagulopathy in patients with liver disease

7.    Relative lack of reliability of INR > 4.5 as these values excluded from ISI calibrations instrument-specific ISI. The mean normal plasma PT is not interchangeable with a laboratory control PT, however, the use of other than a properly defined mean normal PT can yield erroneous INR calculations, particularly when less responsive reagents are employed. The mean normal PT should be determined with each new batch of thromboplastin with the same instrument used to assay the PT.

The concentration of citrate that is used to anticoagulate plasma affects the INR. In general, higher citrate concentrations (3.8%) lead to higher INR values, and underfilling the blood collection tube spuriously prolongs the PT because excess citrate is present. Using collection tubes containing 3.2% concentrations of citrate for blood coagulation studies and adequately filling tubes can reduce this problem.

Clinical applications of VKA therapy

The clinical effectiveness of VKAs in the treatment of a variety of disease conditions has been established by well-designed clinical trials. VKAs are effective for the primary and secondary prevention of venous thromboembolism, for the prevention of systemic embolism in patients with prosthetic heart valves or atrial fibrillation, for the prevention of acute myocardial infarction in patients with peripheral arterial disease and in men who otherwise are at high risk, and for the prevention of stroke, recurrent infarction, or death in patients with acute myocardial infarction. Although effectiveness has not been proven by a randomized trial, VKAs are also indicated for the prevention of systemic embolism in high-risk patients with mitral stenosis.

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Optimal therapeutic range

The optimal target range for warfarin is not the same for all indications. Not only is it likely to be influenced by the indication for its use, but also by patient characteristics. Thus, in patients who are at very high risk of bleeding it might be prudent to sacrifice some efficacy for safety. Bleeding, the most feared and major complication of oral anticoagulant therapy, is closely related to the intensity of anticoagulation.

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The sponsor had no role in the design of the study. Canada healthcare

Sunday, October 26th, 2014 | Permalink

This continued inflammation and airspace destruction in ex-smokers with GOLD stage IIb COPD-E could likely be more extensive if these subjects continued to smoke, and thus it remains important that smokers with COPD should quit smoking. However, this study provides further evidence that once tobacco smoke initiates and causes progression as far as GOLD stage IIb COPD-E, discontinuing smoking may slow but not necessarily halt the persistent inflammation and progression of this severity of COPD-E. These studies underscore the need to identify novel therapies to prevent the progression of moderate to severe COPD-E even in ex-smokers.

Author contributions: Dr Miller: contributed to processing and analyzing sputum samples, performing statistical analysis of results, and editing the manuscript.

Dr Cho: contributed to processing and analyzing sputum samples, performing statistical analysis of results, and editing the manuscript.

Ms Pham: contributed to processing and analyzing sputum samples, performing statistical analysis of results, and editing the manuscript.

Dr Friedman: contributed to interpreting and scoring of chest CT scans, analyzing the results, and editing the manuscript.

Dr Ramsdell: contributed to clinical characterization of study subjects, analyzing the results, and editing the manuscript.

Dr Broide: contributed to study design, supervising the measurements made, analysis of results, and writing the manuscript. Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Friedman interprets chest CT scans for COPDGene, a National Institutes of Health-supported research project, and consults for Broncus Technologies on CT scans in emphysema. Drs Miller, Cho, Ramsdell, and Broide, and Ms Pham have reported that no potential conflict of interest exist with any companies/organizations whose products or services may be discussed in this article.

Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or in the preparation of the manuscript.

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The main function of AAT is to protect the lung tissue against proteolytic stress

Thursday, October 16th, 2014 | Permalink

Background: Severe -antitrypsin deficiency is a known genetic risk factor for COPD. Heterozygous (protease inhibitor [PI] MZ) individuals have moderately reduced serum levels of -antitrypsin, but whether they have an increased risk of COPD is uncertain.

Methods: We compared PI MZ and PI MM individuals in two large populations: a case-control study from Norway (n = 1,669) and a multicenter family-based study from Europe and North America (n = 2,707). We sought to determine whether PI MZ was associated with the specific COPD-related phenotypes of lung function and quantitative CT scan measurements of emphysema and airway disease Kamagra shop, go now.

Results: PI MZ was associated with a 3.5% lower FEV/FVC ratio in the case-control study (P = .035) and 3.9% lower FEV1/vital capacity (VC) ratio in the family study (P = .009). In the case-control study, PI MZ also was associated with 3.7% more emphysema on quantitative analysis of chest CT scans (P = .003). The emphysema result was not replicated in the family study. PI MZ was not associated with airway wall thickness or COPD status in either population. Among subjects with low smoking exposure (< 20 pack-years), PI MZ individuals had more severe emphysema on chest CT scan than PI MM individuals in both studies.

Conclusions: Compared with PI MM individuals, PI MZ heterozygotes had lower FEV/(F)VC ratio in two independent studies. Our results suggest that PI MZ individuals may be slightly more susceptible to the development of airflow obstruction than PI MM individuals.

Abbreviations: AAT = cq-antitrypsin; BD = bronchodilator; FEV1/(F)VC = FEV/FVC or FEV/vital capacity ratios; HU = Hounsfield units; ICGN = International COPD Genetics Network; %LAA950 = percent low attenuation areas <-950 Hounsfield units; PI = protease inhibitor; SRWA-Pi10 = square root of wall area at internal perimeter of 10 mm; VC = vital capacity.

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Severe a antitrypsin (AAT) deficiency is a known genetic risk factor for COPD,  but severe deficiency only accounts for about 1% to 2% of all COPD cases. AAT is a protease inhibitor (PI) encoded by the SERPINA1 locus on chromosome 14q32.1. The main function of AAT is to protect the lung tissue against proteolytic stress, primarily by inactivation of the enzyme neutrophil elastase. More than 100 alleles at the PI locus have been described, most of them quite rare.

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Treatment by Food

Monday, October 6th, 2014 | Permalink

One is obliged to fast at least one day during the month, to give a rest to his stomach.

One, who fasts, shall not go for a walk. This is one of the rules. A student, who comes on a trip, shall carry bread, drink water and thank Cod. Everyone will be satisfied on a trip.

Leave a patient to hunger in order to wake up in him a desire for life. In this way he will recover sooner than if he eats.

Modern humans satisfy hunger through physical food. They can also eat air, but in a special way. How will they take in the air? Through the pores. However, the pores of modern people are clogged, due to which they cannot use the air as food. When their pores are open, the air enters through them and feeds the body. Then, by little food, they gain great power.

Fasting is used for renovation of the organism, for rejuvenating. After the fast, as longer as possible, consume unvaried foods and food, which requires little efforts for digestion, in order your appetite not to be stirred, in order lungs to be able to develop and take more food from the air and water, to take out more juices from food than now. The important Viagra pharmacy Canada thing is, through fasting, to achieve power, health, and not to show off and compete who can fast for more days. One, who has been fasting for 10 days, can do many things; one, who has been fasting for 20 days, will get rid of many delusions.

Fasting is a way of renovation of the human organism. The main idea of fasting is to awaken the hidden energy in cells and renovate the organism. But it shall be worked more rationally. Fasting shall be done step by step. There are certain laws that must be followed. If you make yourself fast, not knowing why, it is not useful. Time shall also be observed. Days, during which you will fast, shall be observed. If you start your fasting on Monday, you will have one result. If you start on Tuesday, you will have another result. If it is on Wednesday, Thursday, Friday, Saturday, Sunday – different results. Moreover, if you start fasting from the morning, from lunch time or from the evening, you again will have different results.

If you are not fulfilling God’s will, nothing will be of benefit to you even if you fast for twenty days. But if you fast for ten days and each day you bring your meal, set for that day, to poor people, this fast can help you. Or, if you fast to eliminate one weakness of yours or gain good disposition of your soul, to purify your thoughts and feelings, I understand such a fasting.

With a 24-hours conscious fasting, one can renovate the cells of his organism.

If you decide to fast, you can begin the fasting when you are in an ascending degree of your spirit.

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By fasting and a prayer you shall heal the diseases and weaknesses. However, if you are well-disposed, you shall fast longer, but if you feel exhausted, you shall stop fasting.

The stomach zone is related to the sympathetic nervous system. It shall not be loaded by excess alien substances. If this happens, you shall impose to yourselves fasting to restore the normal condition. Fasting should be moderate, reasonable until you remove the excess fats and sludge. Fasting means to abstain from bad thoughts and feelings – that fasting hides in itself magical power.

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The quality of penile erectile function was categorized

Friday, October 3rd, 2014 | Permalink

Subjective Sexual Function

The subjects provided sexual histories to a trained interviewer regarding the following: (1) frequency of sexual intercourse, (2) level of interest in sexual activity, (3) observation of spontaneous morning erections, and (4) quality of penile erections (duration and firmness). Changes in these parameters were recorded as percentage of the level of function at the time of the study vs the level of function just prior to the onset of severe exertional dyspnea (premoibid level). The observation of morning erections was recorded as same, decreased, or absent. The quality of penile erectile function was categorized as follows:

0. No change in firmness or duration of erection from die premorbid state.

1. Slight or moderate decrease in firmness or duration but no difficulty completing coitus.

2. Firm to semifirm erections capable of intromission but with as much as 75 percent reduction in duration. Subject is usually able to complete coitus.

3. Firm to semifirm erection that detumesces after intromission, frequently before climax.

4. Semifirm erection, much shortened in duration, usually not able to achieve intromission, occasional short-duration, firm erections.

5. Usually flaccid penis with occasional short-duration, semifirm erections or no erections at all.

Objective Erectile Function

Mercury-filled Silastic strain gauges placed at the tip and base of the penis and connected to a tumescence monitor (Event Systems) were used during three nights of polygraphic monitoring to evaluate erectile function objectively. Sleep stages were recorded by EEC and scored according to criteria of Rechtschaffen and Kales. Tumescence studies were scored according to criteria of Karacan et al and Fisher et al. Full erections required a circumferential change exceeding 16 mm or 80 percent of a maximal erection measured at the tip. The duration of full erections was reported as the time from initial deflection to the time of return to baseline (Fig 1). If the subject had no full nocturnal erections or an average of less than one full erection lasting at least five minutes per night of monitoring he was considered to have organogenic impotence.

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