INTERPRETATION OF CBC A complete blood count (CBC) gives important information about the kinds and numbers of cellsin the blood, especially red blood cells, white blood cells, and platelets. A CBC helps your doctor check any symptoms, such as weakness,fatigue, or bruising, you may have. A CBC also helps him or her diagnose conditions, such as anemia, infection, and many other disorders. A CBC test usually includes: White blood cell (WBC, leukocyte) count. White blood cells protect the body against infection. If an infection develops, white blood cells attack and destroy the bacteria, virus, or other organism causing it. White blood cells are bigger than red blood cells but fewer in number. When a person has a bacterial infection, the number of white cells rises very quickly. The number of white blood cells is sometimes used to find an infection or to see how the body is dealing withcancer treatment. White blood cell types (WBC differential). The major types of white blood cells are neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Immature neutrophils, called band neutrophils, are also part of this test. Each type of cell plays a different role in protecting the body. The numbers of each one of these types of white blood cells give important information about the immune system. Too many or too few of the different types of white blood cells can help find an infection, an allergic or toxic reaction to medicines or chemicals, and many conditions, such as leukemia. Red blood cell (RBC) count. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. If the RBC count is low (anemia), the body may not be getting the oxygen it needs. If the count is too high (a condition called polycythemia), there is a chance that the red blood cells will clump together and block tiny blood vessels (capillaries). This also makes it hard for your red blood cells to carry oxygen. Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood's volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present. Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's ability to carry oxygen throughout the body. Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes. Platelet (thrombocyte) count. Platelets (thrombocytes) are the smallest type of blood cell. They are important in blood clotting. When bleeding occurs, the platelets swell, clump together, and form a sticky plug that helps stop the bleeding. If there are too few platelets, uncontrolled bleeding may be a problem. If there are too many platelets, there is a chance of a blood clot forming in a blood vessel. Also, platelets may be involved in hardening of the arteries (atherosclerosis). Mean platelet volume (MPV). Mean platelet volume measures the average amount (volume) of platelets. Mean platelet volume is used along with platelet count to diagnose some diseases. If the platelet count is normal, the mean platelet volume can still be too high or too low. Your doctor may order a blood smear test to be done at the same time as a CBC but it is not part of the regular CBC test. In this test, a drop of blood is spread (smeared) on a slide and stained with a special dye. leukocyte) Conditions that can lower WBC values include chemotherapy and reactions to other medicines. lupus. AIDS. tuberculosis (TB). inflammatory bowel disease. long-term lung disease. some tumors. inflammation. . or surgery). some cancers. white blood cells. thyroid gland problems. Low values Red blood cell (RBC) Anemia lowers RBC values. underactive adrenal glands. kidney failure. Anemia can be caused by heavy menstrual bleeding. alcoholism. Conditions that affect the body's water content can also cause high RBC values. exposure to carbon monoxide. diarrhea or vomiting. injury. such as pernicious anemia. or Cushing's syndrome. and shape of red blood cells. lead poisoning. leukocyte) Conditions that cause high WBC values include infection. malaria. rheumatoid arthritis. which is a problem with absorbing vitamin B12. Platelets High platelet values may be seen with bleeding. damage to body tissues (such as a heart attack). liver disease. The RBC indices value and a blood smear may help find the cause of anemia. A large spleen can lower the WBC count. severe physical or emotional stress (such as a fever. The number. or a rare disorder of hemoglobin that binds oxygen tightly. kidney disease.lupus. sickle cell disease. a rare disorder of the bone marrow (polycythemia vera). size. burns. malaria.Addison's disease. excessive sweating. and platelets are recorded. severe burns. such as leukemia. malnutrition. some diseases like cancer. thalassemia. or reactions to some chemicals and medicines. iron deficiency. A lack of folic acid or vitamin B12 can also cause anemia. this is sometimes called spurious polycythemia. A low RBC value may also be seen if thespleen has been taken out. White blood cell (WBC. viral infections. and diseases such as cancer. These conditions include dehydration. alcoholism.stomach ulcers. Blood cells with different shapes or sizes can help diagnose many blood diseases. leukemia. White blood cell (WBC. A large spleen can lower the platelet count. High values Red blood cell (RBC) Conditions that cause high RBC values include smoking. or removal of the spleen can also cause high WBC values. certain forms of heart disease. or sickle cell disease. colon cancer. The slide is looked at under a microscope. and the use of diuretics. The use of corticosteroids. aplastic anemia. Platelets Low platelet values can occur in pregnancy or idiopathic thrombocytopenic purpura (ITP) and other conditions that affect how platelets are made or that destroy platelets. The lack of fluid in the body makes the RBC volume look high. certain medicines. or problems with the bone marrow. At some stage during the course of renal disease. Altered Laboratory Tests in Renal Disease The kidneys excrete metabolic waste products and regulate the serum concentration of a variety of substances.Interpretation of LFT Interpretation of RFT The kidneys The kidneys regulate the amount of water and salts that we have in our bodies. The kidneys also pass out certain waste products from the body. Urine is made up of the excess water. They do this by filtering the blood through millions of structures called nephrons. salts and waste products passed out by the kidneys down to the bladder. the following routinely . Creatinine is formed spontaneously at a constant rate from creatine. In renal disease with the nephritic syndrome. though not specific. Hyperphosphatemia.measured substances often become abnormal and the extent of the abnormality generally depends on the severity of the disease. Protein in serum can generally be maintained at concentrations above the lower limit of normal by increased hepatic protein synthesis so long as protein loss is less than about 3 g/day. however. hyperuricemia and acidosis (metabolic with an anion gap) do not develop until there is 70-80% loss of functional capacity (i. Urea formation is influenced by a number of factors such as liver function. the urinary protein excretion rate is usually about 1 .. However. Calcium deficiency. The extent of proteinuria also provides useful information. Determination of creatinine clearance. uric acid or bicarbonate.e. measurement of serum phosphate and uric acid is useful for monitoring the effect of therapy during chronic renal disease and/or the effects of attempts to minimize increased serum concentrations by restricting dietary intake of phosphate and nucleotides. unless impairment is rapid (as in acute renal failure) or is sufficiently severe to cause oliguria. does not usually result in frank hypocalcemia because secondary hyperparathyroidism develops as a compensatory response to maintain serum calcium concentrations within the normal range. and is therefore a very sensitive. Excretion rates of creatinine or urea (quantity in urine/day) do not change in renal disease. and so do not provide information about the status of renal function. do not provide a very sensitive indication of the possibility of renal disease. and blood concentrations depend almost solely upon GFR. in the renal failure stage) so that measurements of serum phosphate. urine protein is generally less than 1 g/day. Urea excretion also depends upon hydration status and the extent of water reabsorption as well as upon GFR. from measurement of creatinine concentration in both a 24 hour urine collection and a serum specimen. Bone calcium.4 g/day). Protein in urine is noticeably increased in renal disease of any etiology. Calcium deficiency and consequent osteomalacia is treated with . The greatest degree of proteinuria is found in the nephrotic syndrome ( > 3 . except obstruction. Only in the nephrotic syndrome is the urine protein loss sufficiently great to result in hypoproteinemia. In tubulo-interstitial disease. Acidosis is generally mild and without pathophysiologic consequences until the uremic stage. Serum creatinine and urea concentrations change inversely with changes in GFR and are therefore useful in gauging the degree of renal dysfunction. which occurs during the renal failure stage of chronic renal disease because of deficient renal activation of vitamin D. general screening test for renal disease. provides a clinically useful estimate of GFR. is lost in the process causing renal osteodystrophy which is typically a mild form of osteomalacia and is only rarely the more severe osteitis deformans (Van Ricklenhausen's disease) classically associated with primary hyperparathyroidism. Changes in serum creatinine concentration more reliably reflect changes in GFR than do changes in serum urea concentrations.2 g/day. protein intake and rate of protein catabolism. however. not useful for detecting or assessing the progression of renal disease. so long as intake is not extremely variable. unless renal dysfunction is sufficiently severe to cause oliguria. without hypoxic damage to renal tubule cells despite decreased renal blood flow. However. aldosterone elevation is ineffective in stimulating sodium reabsorption because of tubular damage so that urine sodium concentration is generally at least 25 mEq/L and often greater than 50 mEq/L. aldosterone effectively stimulates sodium reabsorption and urine sodium concentration is generally less than 30 mEq/L.activated vitamin D. serum calcium determinations are not useful for detecting or assessing the severity of renal disease. The fraction of filtered sodium excreted ( FENa) is a more discriminating parameter for evaluating tubular function and is determined by measurement of both serum and urine concentrations of sodium and creatinine: FENa = ( Nau/Nas) / ( Cru/Crs) . Evaluation of renal sodium reabsorption is. Electrolyte determinations are. Sodium and potassium homeostasis is maintained. therefore. but are useful for monitoring the effectiveness of vitamin D therapy and assuring that hypocalcemia is prevented. valuable for assessing tubule function and is useful for distinguishing whether rapidly developing azotemia is due to acute renal failure or to prerenal azotemia from a compensatory decrease in renal blood flow due to hypovolemia. there is considerable overlap in urine sodium concentrations between cases of prerenal azotemia and acute renal failure. In cases of prerenal azotemia. Although calcium metabolism is abnormal. In acute renal failure. Disposable pipets 4.5 mm in internal diameter. Various factors affect the ESR. . The straight tube is 30 cm long.5 ml sodium chloride in puncture ready vials 5. Label the puncture ready vial with the patient’s name. This numeric value is determined (in millimeters) by measuring the distance from the bottom of the surface meniscus to the top of erythrocyte sedimentation in a vertical column containing diluted whole blood that has remained perpendicular to its base for 60 minutes. such as RBC size and shape. and globulin levels. AND EQUIPMENT 1. Westergren rack 3. Westergren tubes 2. In abnormal conditions when RBCs can form rouleaux. SPECIMEN Fresh anticoagulated blood collected in EDTA. In normal whole blood. Remove cap from the puncture ready vial and add well mixed blood up to the line (see illustration). the RBC mass is small and therefore the ESR is decreased (cells settle out slowly). 0. the RBC mass is greater. Timer QUALITY CONTROL Commercial controls are available for this procedure. Hemolyzed specimens cannot be used. PROCEDURE 1. 3. plasma fibrinogen.ERYTHROCYTE SEDIMENTATION RATE PRINCIPLE The erythrocyte sedimentation rate (ESR). SUPPLIES. The Westergren method is preferred by NCCLS standards because of its simplicity and greater distance of sedimentation measured in the longer Westergren tube. The method it replaces is called the Wintrobe method. Approximately 1 mL of blood is required. 2. measures the settling of erythrocytes in diluted human plasma over a specified time period. as well as mechanical and technical factors. The ESR is directly proportional to the RBC mass and inversely proportional to plasma viscosity. REAGENTS. the test must be set up within 6 hours. thus increasing the ESR (cells settle out faster). Leveling plate for holding the Westergren rack 6. and calibrated in millimeters from 0-200. Collect whole blood anticoagulated with EDTA. They will not be used for this exercise. If anticoagulated blood is refrigerated. 2. also called the sed rate. RBCs do not form rouleaux. Blood should be at room temperature and should be no more than 2 hours old. Vibration such as from a nearby centrifuge will cause a false ESR. MLAB 1315 Hematology Replace cap and invert 8 times making sure the blood and saline mix well. less than 6 hours refrigerated. Carefully insert the Westergren tube into plungeable vial cap of blood/diluent mixture twisting as you push the tube down. it is elevated. 6. Set timer for 1 hour. The ESR is elevated in established myocardial infarction but normal in angina pectoris. an angle of even 3 degrees from vertical can accelerate sedimentation by as much as 30%) 7. but not in osteoarthritis. 2.) REPORTING RESULTS Normal values Adult male 0-15 mm/hr Adult female 0-20 mm/hr PROCEDURE NOTES Sources of error 1. Incorrect ratio of blood to diluent 5. Bubbles in the Westergren tube 6. and pyogenic arthritis.must be less than 2 hours at room temperature. rheumatoid arthritis. the ESR is not elevated. Place the tube in the Westergren rack to a vertical position and leave undisturbed for exactly 1 hour. Do not include the buffy coat in this measurement. 7. It is elevated in rheumatic fever. but may be noticeable in cases of leukocytosis or thrombocytosis. the ESR is usually normal. 5. It is usually negligible. After 1 hour has passed. but it may rise later with a superimposed bacterial infection. early in the course of an uncomplicated viral infection.must be between 20-25 C and blood must be at room temperature. 8. read the distance in millimeters from the bottom of the plasma meniscus to the top of the sedimented erythrocytes. temperatuare will cause a false ESR. For example. The ESR can be an index to . Tilting of the Westergren tube (accelerates the fall of the erythrocytes. Within the first 24 hours of acute appendicitis. 3.EXERCISE 1: Erythrocyte Sedimentation Rate 4. 4. Temperature . Age of specimen . (The buffy coat is the layer of white cells and platelets at the interface of red cells and plasma. It can be used to differentiate among diseases with similar symptoms or to monitor the course of an existing disease. but in the early stage of acute pelvic inflammatory disease or ruptured ectopic pregnancy. Usefulness of the ESR The ESR is not a specific test therefore it is used for screening for certain disease conditions. 2. Factors affecting the ESR Increase Rouleaux formation Elevated fibrinogen Excess immunoglobulin Decrease Microcytes Sickle cells Spherocytes . It can therefore be expected that disease states that are characterized by hyperfibrinogenemia or elevated immunoglobulin levels will result in an increased ESR. This is observed with sickle cells and spherocytes. Biological factors affecting the ESR 1. The ESR is of little diagnostic value in severe anemia or in hematologic states evidenced by poikilocytosis.disease severity. Plasma factors Increased plasma concentration of fibrinogen. will result in rouleaux formation and an increased ESR. a decreased or low ESR is expected. RBC factors When rouleaux formation cannot occur. along with immunoglobulin. owing to the shape or size of the RBC.


Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study.Crit Care. 2010; 14(3):R118.CC
Stroke volume variation (SVV) is a good and easily obtainable predictor of fluid responsiveness, which can be used to guide fluid therapy in mechanically ventilated patients. During major abdominal surgery, inappropriate fluid management may result in occult organ hypoperfusion or fluid overload in patients with compromised cardiovascular reserves and thus increase postoperative morbidity. The aim of our study was to evaluate the influence of SVV guided fluid optimization on organ functions and postoperative morbidity in high risk patients undergoing major abdominal surgery.
Patients undergoing elective intraabdominal surgery were randomly assigned to a Control group (n = 60) with routine intraoperative care and a Vigileo group (n = 60), where fluid management was guided by SVV (Vigileo/FloTrac system). The aim was to maintain the SVV below 10% using colloid boluses of 3 ml/kg. The laboratory parameters of organ hypoperfusion in perioperative period, the number of infectious and organ complications on day 30 after the operation, and the hospital and ICU length of stay and mortality were evaluated. The local ethics committee approved the study.
The patients in the Vigileo group received more colloid (1425 ml [1000-1500] vs. 1000 ml [540-1250]; P = 0.0028) intraoperatively and a lower number of hypotensive events were observed (2[1-2] Vigileo vs. 3.5[2-6] in Control; P = 0.0001). Lactate levels at the end of surgery were lower in Vigileo (1.78 +/- 0.83 mmol/l vs. 2.25 +/- 1.12 mmol/l; P = 0.0252). Fewer Vigileo patients developed complications (18 (30%) vs. 35 (58.3%) patients; P = 0.0033) and the overall number of complications was also reduced (34 vs. 77 complications in Vigileo and Control respectively; P = 0.0066). A difference in hospital length of stay was found only in per protocol analysis of patients receiving optimization (9 [8-12] vs. 10 [8-19] days; P = 0.0421). No difference in mortality (1 (1.7%) vs. 2 (3.3%); P = 1.0) and ICU length of stay (3 [2-5] vs. 3 [0.5-5]; P = 0.789) was found.
In this study, fluid optimization guided by SVV during major abdominal surgery is associated with better intraoperative hemodynamic stability, decrease in serum lactate at the end of surgery and lower incidence of postoperative organ complications.
Current Controlled Trials ISRCTN95085011.


Shalev Wins Lifetime Achievement Award
December 1, 2007
Each year at its Annual Meeting, ISTSS presents awards in recognition of achievements made in the field of traumatic stress studies. The 2007 awards ceremony was held Thursday evening, November 15, in the Grand Ballroom of the Baltimore Marriott Waterfront Hotel. Details of individual award recipients will be featured in this publication throughout the year, beginning with the Lifetime Achievement Award in this issue. Award winners were announced in the October issue of StressPoints.
Arieh Shalev, MD, is the 2007 recipient of the Lifetime Achievement Award, the highest honor given by ISTSS. It is awarded to the individual who has made great lifetime contributions to the field of traumatic stress. A prominent psychiatrist and researcher, Shalev has stood as a leading figure in the field for more than 30 years.
Among many other accomplishments, Dr. Shalev is professor of psychiatry and chair of the Department of Psychiatry at Hadassah University Hospital in Jerusalem, and is the founding director of the Centre for Traumatic Stress at the same hospital.
He is the editor and co-founder of Sihot (Dialogue), the Israel Journal of Psychotherapy. In addition, he has published two books, “Traumatic Stress and its Consequences: A Primer for Helping Professionals,” and “International Handbook of Human Response to Trauma,” along with countless articles in peer-reviewed journals.
Arieh Shalev accepts the Lifetime Achievement Award from then-ISTSS President Elana Newman
Dr. Shalev's research has focused on the etiology, course and treatment of PTSD in adults. According to Rivka Tuval Mashiach, PhD, of the Department of Psychology, Bar Ilan University, Israel, “Dr. Shalev is studying stress and the sequel of responses to trauma using longitudinal approaches. Using a prospective design, he became one of the experts on early responses to trauma, and on evaluation and treatment in the acute phase following traumatic events. His studies include the course of early symptoms, the psychophysiology of evolving PTSD, responses to the trauma of terrorism, evidence–based treatments for PTSD, and genetic markers of persistent PTSD symptoms.”
His research has been tremendously influential on the traumatic stress community in Israel and internationally. A well-respected pioneer in his field, he has received numerous grants, including several from NIH/NIMH.
Dr. Shalev earned his MD at the Faculté de Medecine in Montpellier, France. He has taught at the Tel Aviv School of Medicine, New York Medical College, and the Uniformed Services University of the Health Sciences in Bethesda, Md.
ISTSS previously granted Dr. Shalev the Robert S. Laufer Memorial Award for Outstanding Scientific Achievement in the Field of PTSD in 1995. He has also received the Meritorious Service Award from the Uniformed Service University of the Health Sciences, and the Weiler Award from the Israel Ministry of Justice.
His commitment to understanding the nature of trauma and its effects makes him a truly deserving winner of ISTSS's top honor.


This system of human development functions as an organized measure to promote and provide treatment in which individuals reach. And other basic wellness services to all the members of the community it.
Use the 19 social categories in the journal of transcultural nursing (vol.
Health care system in the philippines essay. Regardless of the assessment criteria, the healthcare system in the philippines is steadily improving. Its end is to supply first assistance. The universal health care (uhc) was implemented to address the inequities in the health system.
Also, many insurance companies, agents, lawyers, and doctors, pharmaceutical companies, medical suppliers and even hospitals all compete for money in a cutthroat fashion. The philippine health care system. The universal healthcare act will add preventive health care services to existing philhealth benefits, such as free consultation fees, laboratory tests, and other diagnostic procedures.
As a partial result of deficiencies in the healthcare delivery system, the average life expectancy for the philippines in 2014 was 68.2, which is significantly below the world average and other east asian countries. The department of health (doh) lists 1,071 licensed private hospitals, and 721. Health care in the philippines essay.
Another reason why people would dream of coming to united states would be the health care received. Examining the filipino culture's health disparities, health related practices, and health care outcomes. Cover dental costs thesis statement:
Providing uniform and universal healthcare for all, regardless of race or stature, can only improve our country. These are viewed as “essential for the enjoyment by all the people of the blessings of democracy.”. The philippine health system 3.1 health facilities, personnel and the distribution of medicines 3.2 regional dissimilarities and the devolution 3.3 health care utilization 3.4 the main sector priorities for health.
Public healthcare in the philippines is administered by philhealth, a government owned corporation. A health care system is a framework of interrelated, interacting, and interdependent descriptions of human development in a given country, region, or community. In a 2018 review of the philippine health care system, manuel m.
Hospitals are classified based on ownership as public or private hospitals. I have family members who came and hope to come to the united states from the philippines to get great medical care. Health facilities health facilities in the philippines include government hospitals, private hospitals and primary health care facilities.
Maternal and child wellness attention. However, our health care system is not quiet. A typology of common issues, challenges, and priorities are generated for the diverse mix of health systems of southeast asia at different stages of socioeconomic development (see webappendix.
The health care system in the philippines has undergone dramatic changes in the last 20 years as the government has instituted various reforms and policies to provide easy access to health benefits for every filipino. The network of health facilities and personnel which carries out the task of rendering health care to the people. Is a complex set of organizations interacting to provide an array of health services (dizon, 1977).
Enrolling with philhealth is mandatory for expats who are employed in the philippines. Describe and assess the culture of. Philippines verses united states health care system everyone wants to go to the united states for freedom.
As pharmacists, we are part of this cadre, and we should feel privileged to be able to contribute to the health of others in such a special way. 1892 words | 8 pages. Dental care costs should be covered under the umbrella of canada’s publicly funded health care system because o**l health is linked to our overall health, the current insurance scheme widens the gap between the rich and poor, and the dire need for universal dental coverage is rather a major social and health care issue that has to be acted upon by the.
The health of a health care system. Its mandate is to ensure that every filipino receives affordable and quality health care that is accessible, efficient, adequately funded, fairly financed, and appropriately used. Healthcare, education, welfare and other aspects of the society are the primary concern of the state.
Department of health (doh) secretary francisco duque iii said that the law will change the country’s present health care system from being “used to taking care of the sick to one that is used to keeping people healthy.” The quality of many health care professionals is what makes our health care system outstanding. As such, all filipino citizens are entitled to free medical care through the philippine health insurance corporation, known as philhealth.
Above all, this is thanks to government reforms that are moving the country closer to a universal system. 21) to assist in defining the social status. Men and residents of impoverished regions of the.
Comprising 50% of the health system but regulatory functions of the government have yet to be fully maximized. Health financing in the philippines 4.1 financing resources and agents 4.1.1 public spending 4.1.2 private spending 4.1.3.


AchieveTMS is the leading provider of TMS depression treatments. With over 500 patients treated and countless success stories, we’ve brought hope back to those who have been suffering in silence.
Reduced depression severity on average by 49% (PHQ-9 Score)
The Patient Health Questionnaire (PHQ-9) is a is a self-administered tool for common mental disorders. The PHQ-9 is the depression module, which scores each of the nine DSM-IV criteria and has been validated for use in primary care.
It is used to monitor the severity of depression and response to treatment.
In a survey of 209 respondents…
…with an average depression severity of Moderately Severe (17.39), the dTMS treatments reduced overall severity by an average of 49% resulting in depression severity of Mild (8.83) by end of the treatments.
PHQ-9 Depression Screening
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Achieve TMS offers an online version of the commonly used Depression Screening tool called the PHQ-9. The nine items of the PHQ-9 are based directly on the nine diagnostic criteria for major depressive disorder in the DSM-IV.
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0 to 4 Points: No depression 5 to 9 Points: Mild depression 10 to 14 Points: Moderate depression 15 to 19 Points: Moderately severe depression 20 to 27 Points: Severe depression
If you scored over 10 on the PHQ-9 please contact us right away for a free consultation:
Question 1 of 9
Little interest or pleasure in doing things?
Question 2 of 9
Feeling down, depressed, or hopeless?
Question 3 of 9
Trouble falling or staying asleep, or sleeping too much?
Question 4 of 9
Feeling tired or having little energy?
Question 5 of 9
Poor appetite or overeating?
Question 6 of 9
Feeling bad about yourself – or that you are a failure or have let yourself or your family down?
Question 7 of 9
Trouble concentrating on things, such as reading the newspaper or watching television?
Question 8 of 9
Moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you have been moving around a lot more than usual?
Question 9 of 9
Thoughts that you would be better off dead, or of hurting yourself in some way?


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British Prime Minister Boris Johnson received his first dose of the AstraZeneca Covid-19 vaccine on Friday and urged the public to do the same, saying “he did not feel a thing.”
Johnson, 56, received his vaccine at the same hospital where almost a year ago he was put in an intensive care unit and given oxygen via a tube in his nose after he contracted the virus and fell seriously ill. He later said he was so sick that plans were drawn up on how to announce his death.
“I literally did not feel a thing. It was very good, very quick,” Johnson said after receiving the injection at St Thomas’ Hospital in London. “I cannot recommend it too highly, everybody when you do get your notification to go for a jab, please go and get it, it is the best thing for you, best thing for your family and for everyone else.”
Pictures showed the prime minister wearing a black mask, a shirt and tie with his sleeve rolled up while a nurse gives him the vaccine.
Britain broke its record for the most coronavirus shots given out in one day on Friday and almost half of all adults have received one dose, making it one of the fastest countries in the world to roll out a vaccine program.
This success has helped the ruling Conservatives regain the lead over the main opposition Labour Party in opinion polls after the prime minister last year was accused of acting too slowly to stop the spread of the virus.
Johnson received his vaccine as European countries on Friday resumed using the AstraZeneca shot after regulators said its benefits outweighed any risks following recent reports of blood clots.
Countries including Germany and France reversed their decision to temporarily pause its use after reports of about 30 cases of rare brain blood clots sent scientists and governments scrambling to determine any link.
The AstraZeneca vaccine, developed by scientists at the University of Oxford, has also been at the centre of tensions between Britain and the European Union, after Brussels expressed anger over the lack of deliveries of the shot coming from Britain.
Scientists are exploring several possibilities that might explain at least 18 reports of extremely rare blood clots in the brain that occurred in individuals in the days and weeks after receiving the AstraZeneca Covid-19 vaccine.


Can The Edmonton Obesity Staging System Provide A Path For New Anti-Obesity Drugs?Monday, August 22, 2011
As readers of these pages are well aware, there is currently only one prescription drug (orlistat) for the long-term management of obesity and recent applications for new anti-obesity drugs have run into considerable obstacles with licensing agencies, not least the US Food and Drug Administration.
Thus, despite meeting criteria for efficacy, recent applications for new anti-obesity drugs were rejected due to safety concerns, the argument being that the expected widespread use of these drugs warrants higher standards of safety than for drugs in other therapeutic areas.
This may well be true, if anti-obesity drugs are indeed to be made freely available (even on prescription) and are to be used without careful consideration of the risk/benefit ratio.
As discussed previously in the context of bariatric surgery, the risk side of this equation is not limited to the ‘risk’ associated with treatment but must also include the ‘risk’ associated with not treating the condition.
As our recent papers on the Edmonton Obesity Staging System (EOSS) clearly show, the ‘risk’ associated with obesity varies considerably – from virtually no risk for patients with EOSS 0 to very significant and immediate risk for patients with EOSS 3.
So, while even the smallest treatment-related risk may be unacceptable for treating obesity in a patient with EOSS 0, a higher level of risk would be certainly be acceptable with higher EOSS stages – or in other words – the greater the risk of not treating, the greater the acceptable risk for a potentially beneficially treatment (which, for e.g., is why cancer warrants the considerable treatment risks of chemotherapy).
Of course, this would mean that rather than having to prove the safety and efficacy of anti-obesity drugs in anyone with a BMI over 30, it may be enough to show that these drugs are effective and safe enough to warrant their use in people with higher EOSS stages (2/3) – the greater the risk of the target population, the greater the acceptable risk of treatment.
This should not be difficult. We know that many of the conditions that patients with EOSS 2/3 present with can be ameliorated even with rather modest weight loss. For these patients, the 5-10% sustainable reductions in body weight that can be achieved with anti-obesity drugs, can have very significant health benefits, which would easily outweigh and justify a reasonable risk of adverse effects – a risk that may be unacceptable in patients presenting with EOSS 0/1 obesity.
This, of course means rewriting some of the approval criteria and guidelines for anti-obesity drugs, but also requires redesigning pharmacological trials to focus on the high-risk EOSS 2/3 patients rather than on the low-risk EOSS 0/1 patients.
I certainly look forward to following how this discussion evolves and wether or not we can indeed find a way out of the current impasse of anti-obesity drug development and approval.
Padwal RS, Pajewski NM, Allison DB, & Sharma AM (2011). Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne PMID: 21844111
Kuk JL, Ardern CI, Church TS, Sharma AM, Padwal R, Sui X, & Blair SN (2011). Edmonton Obesity Staging System: association with weight history and mortality risk. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme PMID: 21838602


Maria Inês Almeida is a Project Leader at Instituto de Investigação e Inovação em Saúde (i3S) and an Assistant Investigator at Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), University of Porto. Her research interests are centered on molecular engineering, particularly on the use of non-coding RNAs (microRNAs and long non-coding RNAs) as diagnostic and therapeutic tools. Her scientific career has been devoted to the study of biological processes and molecular pathways associated with non-coding RNAs. In 2006, Maria Ines Almeida completed her University Degree in Biology from the University of Minho, Portugal. After an internship at Leiden University Medical Center, Netherlands, she joined Life and Health Sciences Research Institute (ICVS) where she worked in microbiology and cancer research. In 2009, she enrolled on a PhD program in Health Sciences and moved to MDAnderson Cancer Center, The University of Texas, USA, aiming to investigate the role of non-coding RNAs in colorectal cancer. While working on her PhD, she was involved in several projects in different tumor types. She studied microRNAs and long-non-coding RNAs in order to find new tumor targets and novel therapeutic strategies for cancer. She completed her PhD in 2012. She then joined Instituto de Engenharia Biomédica (INEB) to search how non-coding RNAs could promote tissue regeneration and repair, and modulate inflammation. She is also interested in using extracellular vesicles/exosomes-mediated microRNA and RNA molecules for regenerative medicine. Her current ambition is to develop alternative treatments using non-coding RNA as tools to improve recovery time and quality of life for patients who suffer bone fractures, or have been diagnosed with osteoarticular conditions, including bone diseases.
Main research topics: Molecular Biology, Bioengineering, Regenerative Medicine and Cancer.


PURPOSE: We aimed to compare the complication rate between port catheters (PC) and peripherally inserted central catheters (PICC) for the administration of postoperative chemotherapy for breast cancer.
METHODS: All patients treated from January 2010 to August 2012 at the Centre Henri Becquerel for early breast cancer requiring postoperative chemotherapy were retrospectively screened. The primary endpoint was the occurrence of a major complication related to the central venous catheter. Major complications were defined as any grade 3 event according to CTCAE 4.0, delay in chemotherapy >7 days, change of the device, life-threatening event, event requiring a hospitalization, or a prolongation of hospitalization.
RESULTS: A total of 448 patients were included; 290 had a PC and 158 a PICC. Overall, 31 major complications related to the central venous catheter were observed: 13 for patients with a PC (4.5 %) and 18 for patients with a PICC (11.4 %). In univariate analysis, having a PICC was the only factor significantly associated with a higher risk of major complications (HR = 2.83, p = 0.0027). We observed a trend for a higher risk of major complications for patients older than 60 years or with BMI >25 (p = 0.06). In multivariate analysis, having a PICC was the only predictive factor of major complications (HR = 2.89, p = 0.004).
CONCLUSIONS: In univariate and multivariate analysis, having a PICC instead of a PC was the only predictive factor of device-related major complication. If confirmed prospectively by the NCT02095743 ongoing trial, this result might modify the management of adjuvant chemotherapy administration.
Lefebvre, L., Noyon, E., Georgescu, D., Proust, V., Alexandru, C., Leheurteur, M., Thery, J.C., Savary, L., Rigal, O., Di Fiore, F., Veyret, C. and Clatot, F. (2015) Port catheter versus peripherally inserted central catheter for postoperative chemotherapy in early breast cancer: a retrospective analysis of 448 patients. Supportive Care in Cancer. September 5th. .
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Ask the Expert (Research Focus): Deep Brain Stimulation - Australian advances and research
Online Session via Zoom (map)
Wed 29th Jun 2022, 5:30pm to 6:30pm (1 hour)
In this Ask the Expert session, we will hear the latest news on Australian-based research on Deep Brain Stimulation (DBS) and how this is further advancing this important treatment option.
Fight Parkinson's is pleased to present the new online webinar series, Ask The Expert.
Each session will feature a respected leader in their field discussing a topic of interest related to living with Parkinson’s.
Hear the latest news on Australian-based research into Deep Brain Stimulation (DBS) in Parkinson’s from Dr Wes Thevathasan at our Ask the Expert session on Wednesday 29 June.
Pre-submit your questions during registration.
Any questions? Please email firstname.lastname@example.org or call us on 03 8809 0400


Best Heart Valve Expert in Jaipur | Rajasthan | India – The menace of Heart problems has now increased to a whole new level. Today, its tough to find the Best Heart Valve Expert not only in Rajasthan, but all over India. Almost in all of the Bigger hospitals, you can see their scarcity. Moreover, heart disease is the fastest growing disease in India which holds the major death ratio in India. as per the study in major cases patients unable to understands the cause of the heart attack.
The reason vary a lot, from unconventional eating habits, impure food consumption, and degraded environment to the carelessness towards exercises. This has lead to the increase in the heart patients year after year.
This is one of the biggest reasons being the ever increasing demand for Best Heart Valve Expert in India everywhere. Now, more and more specialists need to be employed.
Best Heart Valve Expert in Jaipur | Rajasthan | India, makes the patient aware by the symptoms of a heart attack. Not only that, they can teach you some of the elementary precautions you should know for situations like this.
Here are the symptoms of a heart attack –
- squeezing pain in the center of the chest
- uncomfortable pressure experience
- pain or discomfort pain spreading beyond the chest to shoulder, neck, back, jaw both arms and teeth
- nausea and lightheaded,
So, these are some symptoms explained by the best heart valve expert in Rajasthan | India.
Best Heart Valve Expert in Jaipur | Rajasthan | India
The matters of the heart and its surgeries are very delicate and can be intense at times. To deal with such intricate matters, we need very qualified and experienced experts. You can get the help of most sought-after consultant, Dr. Ravinder Singh Rao, who is the best heart valve expert in Jaipur | Rajasthan | India.
His specialties in the domain of interventional cardiology make him the best heart expert in Jaipur | Rajasthan | India. He is head of the Complex Angioplasty and TAVI program, also a chief interventional cardiologist. He is considered as one of the best doctors in this field. Medical industry in India is flourishing because of such incredible medical professionals. His capabilities as a heart valve expert are unparalleled in Jaipur, Rajasthan. Not only that, he’s a great human being to meet in person too.
His knowledge of the latest technology and recent trends in medical science enhances his capabilities to be the best Heart Expert in Jaipur and his name is popular at the national level and right up their among the few highest ranked cardiologists in India. for more details and checkup please visit www.drravindersinghrao.com
Angioplasty Process By Best Cardiologist in India- Dr. Ravinder Singh Rao
Angioplasty is a process of unblocking of blood vessels. before entering into the angioplasty process we first have to know the reasons for angioplasty. Best heart valve expert in India explains it in simple language, angioplasty is needed when a person gets a cardiac arrest or in case of blocking of blood vessels especially a coronary artery. when blood vessels coronary artery get blocked due to blood clot, fat, calcium any reason the blood flow gets affected and heart will not able to pump the proper blood flow which causes an improper supply of oxygen to the heart. The heart treatment patients will undergo the angioplasty for the long run life of a heart.
Heart Valve Expert in Rajasthan follows the different protocols to perform the angioplasty. The procedure used under angioplasty the process explained by the best heart valve expert in India tiny balloon is guided by the catheter to blockage area after that balloon is for a short time period inflated to push the plaque and opens the arty to boost blood flow to the heart. doctors also use the balloon to place the stent in the artery to keep it open. In the latest procedure, some angioplasty expert removes the blood clots with a small vacuum device.
So, now you know who is to consult when you need Best Heart Valve Expert in Jaipur | Rajasthan | India. Hence, Dr. Rao is an expert of his field, and when in times like these when the hearts are unhealthy, you need people like him. Also, you keep yourself healthy, or get ready to meet Dr. Rao because you can count on him.


Is tai chi beneficial for those with fibromyalgia?
Science: Yes, after 12 weeks those doing tai chi had reduced their FIQ score by 18.4 points more than those in the control group.
Conclusion: Tai chi appears to reduce the symptoms of fibromyalgia for most participants.
Non-pharmacologic treatments are needed
Fibromyalgia is a common and poorly understood pain disorder that afflicts an estimated 200 million or more people worldwide. Pharmacological treatments for fibromyalgia are not available to the vast majority of these individuals.
Even when available, prescription treatments for fibromyalgia are often marginally effective or entirely ineffective. Standard drug treatments are also associated with frequent and often severe side effects.
Therefore non-pharmaceutical treatments that provide meaningful relief could be of great benefit to all, but especially to those without access to prescription drugs.
Tai chi, also called tai chi chuan, is a form of Chinese martial art which is largely practiced for its perceived health benefits and to ensure longevity.
There are numerous ‘forms’ of tai chi, but each involves a series of postures or movements performed in a slow, deliberative manner with continuous flowing motion. The effect is low impact exercise and gentle muscle stretching.
The clinical trial summarized below utilized the classic Yang style of tai chi. The results after 12 weeks were impressive. In fact it has been observed that no intervention to date has shown a better outcome.
For that reason, it’s good to be somewhat cautious in interpreting the results. In fact the study authors admit a number of limitations, including the difficulty of constructing a ‘placebo’ appropriate to a non-pharmaceutical intervention.
But that’s always going to be the case for ‘non-pill’ treatments. So if we’re to identify treatments other than ‘pills’ that may be effective in fibromyalgia, we’ll just have to put up with a little uncertainty regarding the ‘placebo’. What’s certain is that the authors made a genuine attempt to include a control, and that they’ve brought to light what might be for many people a very effective treatment.
A randomized trial of tai chi for fibromyalgia.
Summary of the Abstract
Tai chi may offer therapeutic benefit for patients with fibromyalgia. Therefore a trials was conducted in which tai chi was compared with wellness education and stretching, which served as the ‘control’ in this trial.
Two 60 minute sessions were conducted each week for 12 weeks. The primary end point was a change in the Fibromyalgia Impact Questionnaire (FIQ) score at the end of 12 weeks, with subsequent determination at 24 weeks.
A total of 66 patients were studied, half of which participated in the tai chi class and half in the ‘control’ activities. After 12 weeks, FIQ scores for the tai chi group were decreased by 18.4 points more than the decrease observed for the ‘control’ group. (Actual measured decrease was 27.8 for the tai chi group and 9.4 for the control group.)
The difference between tai chi and control groups remained stable at 24 weeks with a difference between treatment and control of 18.3 points.
Tai chi may therefore be useful in the treatment of fibromyalgia.


North Shore Physical Wellness is the destination for health and physical wellness on the North Shore of Chicago, IL. We offer physical wellness solutions such as chiropractic care, physical therapy, custom molded orthotics, massage therapy and acupuncture to patients of all ages and for a wide array of conditions. We pride ourselves on finding the cause of the problem and not simply treating the symptoms.
At North Shore Physical Wellness we strive to have a customer service mentality to healthcare, keeping you informed every step of the way, catering to your wants and needs, as well as keeping all appointment wait times to a minimum. We also work with an established referral network of medical doctors, neurologists, and orthopedists should your condition require a “team approach”.
• Highland Park


I haven t been able to exercise because of my lethargy and constant exhaustion.Unless a gal is getting paid to walk a runway or posing for Vogue.
I will be looking into your question and guiding you through the process.Rivaroxaban (Xarelto) is a...Xarelto Weight Gain - Talk to an experienced Xarelto Lawyer today to file a Xarelto Injury Lawsuit - (844) 549-0883.Find a comprehensive guide to possible side effects including common and rare side effects when taking Xarelto (Rivaroxaban Film-Coated Oral Tablets) for healthcare.Includes 46 patient rankings on scale of 1-5, comments, side effects, dosage, sex, age, time taken.Find information about common, infrequent and rare side effects of Xarelto Oral.
Commonly Used Brand Name(s) Xarelto. confusion, dizziness, nausea, rapid weight gain, swelling of the face, ankles, or hands,.Please get yourself evaluated for the weight loss if you feel its significant enough.Are you (or someone you care for) currently taking this drug.The link between lisinopril and weight gain is a matter of debate.
I can put the weight on, but I lose I seem to lose it, plus some, almost immediately.Ketoconazole should only be used to treat fungal infections. loss of appetite, weight loss.Find patient medical information for Xarelto Oral on WebMD including its uses, side effects and safety, interactions, pictures, warnings and user ratings.Rivaroxaban: learn about side effects, dosage, special precautions, and more on MedlinePlus.
The information reflected here is dependent upon the correct functioning of our algorithm.Daily I am doing hand practice and but aftr tht I take heavy diet aftr eating thn again I think to do hand practice that s y I think I am going day by day silm and my face is also going week tell me what I should do.Uses: Xarelto is taken to prevent Blood Clots and is mostly mentioned together with this indication.
Usage of the website does not substitute professional medical advice.Do I need to bridge patients with heparin or low-molecular-weight heparin (LMWH) to XARELTO.Treato does not review third-party posts for accuracy of any kind, including for medical diagnosis or treatments, or events in general.
Complete analysis from patient reviews and trusted online health resources, including first-hand experiences.But my food intake was only minimally reduced, if at all, during those 15 months and I have no other known health issues.I fell like I am pregnant.I eat less and the weight just keeps coming.The makers of Pradaxa and Xarelto say it takes time for doctors to get up to speed on new types of treatments and how to best administer them outside.I barely make it through a day. is there anything I can do to help with the weight.Sign in Sign in with facebook Or sign in with facebook First time here.I m afraid I ll just waste away.what else could cause this and what should I.The drug may also cause uncontrolled bleeding that can lead to hospitalization and.
Save 1 2 3 Next 58 posts mention Xarelto and Weight Loss - did you have this too.


If you want to get advice and support with your nutrition, you are welcome here to MKCareSweden where you will meet me Sofie who is a educated lic. nutrition adviser. I help you with weight loss, nutrition schedules, healthy weight gain or if you just want to get advice regarding your nutrition, for example related to diabetes m.m. Before the first visit, you must have filled in a food diary that you can send to your email, so that I can get an overview of what the normal nutrition intake looks like.
Then during the visit we talk through your goals of changing your nutriton, as well as doing a health examination (BIA measurement/body composition, blood pressure, heart rate and any blood tests if you wish it as an additional service), and we will set up a plan on how you want to proceed further.
My goal is to get a healthy view of food without direct bans, and that it will become a sustainable lifestyle. Also has a special focus when it comes to recovery from eating disorders.
For more information or for booking, please contact firstname.lastname@example.org


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Inderal is used for high blood pressure treatment, stenocardia prevention (chest pain), heart condition control, caused by hypertrophic stenosis, quick heart rhythm prevention, life improvement after heart attack at some patients, tremor treatment, migraine prevention and adrenals edema symptoms prevention.
Use Inderal in accordance with your doctor indications.
- take this drug every day at the same time before or after meal;
- do not take antacids containing aluminium within 2 hours after Inderal intake;
- continue using Inderal even if you feel better within several days. Do not miss any dose.
Mechanism of action
Inderal is beta-adrenergic blocker. It works by slowing the heart works and decreasing blood pressure by thus helping to decrease heart load.
Take Inderal as soon as you remember about it. If it happened during next dosage intake time take missed dose and then follow intake schedule. The intake of two pills in one day is prohibited.
Store Inderal at the temperature of 68 -77 F degrees (20 -25 С degrees). Short term storage at the temperature of 59 -86 F degrees (15 ° -30 ° С) is not allowed. Keep away from the sources of heat, humidity and light. Do not store at bathroom. Keep Inderal away from children and pets.
Do not use Inderal if:
- you are allergic to any of its component;
- you have slow heart beat, you had heart attack, you have low blood pressure or heart insufficiency;
- you have asthma or Reino disease;
- you are a child, you suffer from diabetes or heart insufficiency;
- you take mibefradil.
Contact your doctor at once if any of the following relates to you.
- do not drive if you take Inderal for the first time.
- consult with your doctor about alcohol usage during Inderal intake.
- patients taking the drugs used for high blood pressure treatment feel tired often. You are to keep taking this drug even if you do not feel really good. Inform your doctor if you noticed any new symptom.
- Inderal can mask the signs of hypertheriosis (thyroid gland increased activity). If you have thyroid gland increased activity this drug intake can cause hypertherosis (increased heart beat) .
- patients having heavy allergic reactions can become more sensitive to allergens when taking Inderal. These patients might not react to adrenaline usual doses (adrenaline).
- Diabetes. Inderal can hide the signs of sugar low level in blood and the heart beat might increase. Mind following other signs of sugar low level in blood. Sugar low level in blood can cause agitation, perspiration, giddiness, sleepiness or fainting. It can decrease vision, cause headache, shivering or the feeling of hunger. Check sugar blood level. Consult with your doctor before changing the dose.
- inform your dentist or doctor about Inderal intake before getting any medical or dental assistance, urgent medical assistance or surgery.
- Inderal can influence the results of some tests such as glaucoma screening test. Inform your doctor about Inderal intake before making glaucoma screening test.
- During Inderal intake you can make such laboratory tests such blood pressure tests and heart function tests. These tests can be used for your condition monitoring and side effects revealing. Mind keeping all doctor prescriptions and laboratory analysis.
- pregnancy and breast feeding: Inderal can possibly harm foeutus. Do not take Inderal if you are pregnant. Contact your doctor if you suspect of being pregnant. You will need to discuss the advantages and risks of Inderal usage during pregnancy. Inderal is present at mother milk. Do not do breast feeding during this drug intake.
Consult with your doctor if any of the most widespread effects persist or irritate:
- constipation; depression, diarrhea, giddiness, sleepiness, tiredness, hallucinations, vomiting, insomnia, stomach spasms, tiredness, vision problems, bright dreams, nausea and weakness.
Contact your doctor immediately if any of the following serious side effects arise:
- heavy allergic reactions (rash, nettle rash, itch, breathing difficulties, chest constraint, mouth, lips, face or tongue edema),
Inderal should be used on doctor’s prescription only. Consult with your doctor in case you have any questions about Inderal intake.


© 2016 Lecube et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: Helicobacter pylory (HP) infection has been associated to an increased rate of type 2 diabetes (T2D) and liver disease through its effect on insulin resistance and systemic inflammation. However, results are inconstant and no studies exist in morbidly obese patients, in which both insulin resistance and inflammation coexist. Material and Methods: Cross-sectional study to evaluate the relationship between HP infection and alterations in carbohydrate metabolism, lipid profile, inflammation markers, and liver disease in patients awaiting for bariatric surgery. HP infection was histologically assessed in gastric antrum biopsy from 416 subjects. Liver biopsy was also available in 93 subjects. Results: Both impaired fasting glucose and T2D were similar when comparing subjects with and without HP infection (24.2% vs. 22%, p = 0.290 and 29.4% vs. 29.1%, p = 0.916, respectively), with no differences between groups in the HOMA-IR, lipid profile neither inflammatory parameters. However, HP infection was higher among subjects with a BMI ≥ 40.0 kg/m2 in comparison with lower degrees of obesity (71.7% vs. 60.0%, p = 0.041). In addition, subjects without HP infection showed higher degrees of steatosis (44.1±26.4% vs. 32.0±20.7%, p = 0.038), as well as a lower prevalence of non-alcoholic steatohepatitis (9.3% vs. 30.7%, p = 0.023). Conclusions: In patients with morbid obesity, HP infection does not seem to be associated with abnormal carbohydrate metabolism. In addition, less advanced degrees of non-alcoholic fatty disease were observed. We suggest that low-grade inflammation that accompanies obesity mitigates the diabetogenic effect of HP, so the presence of obesity should be considered in studies that evaluate the HP metabolic effects.


In Esbjerg Municipality looking after your health is considered one of the most important maintenance jobs.
You can read much more about the services offered to citizens in Esbjerg Municipality on matters such as diet, smoking, alcohol, exercise, weight, blood pressure and ethnic minority health on the Your Health section of the municipality's website (in Danish).
The site provides a wealth of general information on health and provides plenty of ideas on maintaining a healthy lifestyle.
You are free to choose any public hospital in Denmark for examination and treatment. If the waiting time is more than one month, you can alternatively choose to be examined and treated at a private hospital. If you have a life-threatening illness, waiting times are even shorter.
You can read more about hospitals in Denmark at lifeindenmark.dk.
If you are in need of after hours care or emergency contact information, find important numbers and more information in the Emergency Numbers section.


Imagine waking up in the middle of the night to a sudden, intense, pulsating pain from the lower right side of your mouth. You make an attempt to bite down but you barely have any movement because your body is too focused on the pain. You quickly realize that toothache that has been coming and going is finally establishing a permanent presence. It's exactly 1:34am- dental clinics are closed; the only place available for help is the local hospital's emergency room. It's only a toothache right? The pain is too intense to go back to sleep so you decide to go to the ER. Once there, after waiting for a few hours you finally consult with a doctor and the diagnosis is that you have a decayed tooth; Treatment Plan- Tooth Extraction. You become anxious about the idea of now having an unappealing smile but agree quickly to the extraction because you want the pain and swelling to just go away. Four and half-hours later the tooth is now gone but you are still in pain, and also stuck having to pay $2500 in hospital fees.
Sounds familiar? Unfortunately this has been an increasing trend in the past decade across the nation. As the economy has been declining so has our emphasis on the importance of dental care. An increase in patients that have not been seeking regular dental care until a serious emergency occurs has been noted in hospital emergency rooms across the country. Living in the world of consumerism we tend to categorize items/services by wants and needs. It's surprising, however, to learn that especially in recent years, more and more patients are grouping dental care as a "want" rather then an important "need".
A significant number of patients are now waiting until the problem is so advanced that their only option is tooth removal. According to a Newsday article it states that in New York, emergency room visits and surgery center treatment for tooth decay related problems cost more that $31 million; a percent increase from 2004. Meanwhile, the state of Florida spent more than $88 million in emergency dental care services. These facts show that more and more individuals are simply putting off basic dental care services and relying on emergency care when most of the problems could be treated or avoided entirely with just routine care and maintenance at the dental office. An analyst stated "...It's the wrong service, in the wrong setting, at the wrong time."
One of the main reasons this trend is on the rise is that many people either don't have the dental coverage they once had, making the cost of dental care an increased burden, or they simply must use the money previously set aside for dental care for other necessary bills. Taking all of this into account, we at Great Neck & Mid-Island Dental Associates have attempted to make it easier to afford dental care. We offer many payment programs so patients can seek the proper dental care that is needed without unduly staining their budget. The last place anyone wants to end up with a toothache is a hospital emergency room so before that happens please take the time to have a checkup and find out if there are any conditions or problem that require immediate treatment. Prompt identification is the simplest and most affordable way to ultimately have the best treatment possible.


“What is psoriasis?” might seem like a pretty straightforward question—it’s a skin condition that causes raised bumpy patches, right? Not quite, actually. Psoriasis is a chronic autoimmune condition that causes issues with the skin. And it’s so much more than the physical symptoms you probably associate with it. For one, there are several different types of psoriasis and each person’s experience with the condition is unique. Moreover, psoriasis’s impact is more than skin-deep, with the potential to cause everything from painful psoriatic arthritis to serious self-image issues.
Before we dive in, let’s cover the basics: Psoriasis causes the skin to regenerate more quickly than normal. Typically, your skin cells go through a cycle known as cell turnover, starting deep in your skin and slowly rising to the surface. Usually, this takes about a month, but according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, it can take only a few days when you have psoriasis, causing the skin cells to rise too fast and pile up on the surface of your skin. Because of this, people who have psoriasis—about 7.5 million people in the U.S., per the American Academy of Dermatology (AAD)—can have flare-ups that cause the characteristic itchy, scaly skin patches to show up on their skin.


Dispirin synonyms, Dispirin antonyms - FreeThesaurus.com
acetylsalicylic acid (redirected from Dispirin)
Also found in: Dictionary
Synonyms for acetylsalicylic acid
the acetylated derivative of salicylic acid
References in periodicals archive
He also advised to take 300 mg dispirin
in emergency before going to the doctor or hospital.
Avoid frequent use of medicines like aspirin and dispirin
From rubbing Vicks on my chest to downing multi-packs of dispirin
to eating raw chilly powder - nothing seems to work.
At first I thought I was coming down with the flu mixed with a bit of a hangover so I took some Dispirin
and went to bed.
And it all produced so many tense, nervous headaches in the stands that you'd have thought the game had been sponsored by Dispirin


Housing Authority receives health, wellness incentive grant
Published 11:56 am Friday, December 8, 2017
The LaGrange Housing Authority has been selected by the Association County Commissioners of Georgia (ACCG) to receive one of the Employee Health & Wellbeing Incentive Grants awarded statewide to promote worksite programs designed to enhance the health and wellbeing of employees and family members.
Awards are made to members of the ACCG Group Health Benefits Program (GHBP), underwritten by Blue Cross Blue Shield of Georgia, based on a county’s commitment to employee health and demonstrated collaboration with other community groups and organizations engaged in health promotion.
As part of the grant process, the LaGrange Housing Authority appointed Chad Cooper as the designated Health Promotion Champion to develop a workplace health promotion action plan and to attend Local Government Risk Management Services’ (LGRMS) High Impact Health Promotion Champion training session.
Workplace wellbeing programs have a demonstrated track record of improving employee health and quality of life while reducing medical claims and improving workplace morale. The ACCG offers wellbeing services to all member counties through LGRMS, a not-for-profit agency operated jointly with the Georgia Municipal Association.
Employees will be offered a confidential health assessment program using a Health Risk Appraisal, with blood pressure screening and health improvement feedback.
Chad Cooper, Director of Development of the housing authority said, “We are pleased that the ACCG recognizes our interest in employee health and in managing health care costs. This grant will help us provide new programs to our staff and their families.”
The ACCG – GHBP is available to all Association County Commissioners of Georgia members. Currently, several counties and authorities participate in the health plan. All counties and authorities participating in the ACCG – GHBP are eligible to apply for the Health & Wellbeing Incentive Grants on an annual basis. The ACCG is pleased to support the LaGrange Housing Authority in this important endeavor.
To keep up with the latest news involving the City of LaGrange, go to www.lagrangega.org or follow us on Facebook, Twitter and Instagram.


Growth hormone (GH), also called somatotropin or human growth hormone (HGH), is a substance in the body that helps children grow and develop. In biochemical terms, GH stimulates protein synthesis and increases fat breakdown to provide the energy necessary for tissue growth. It is produced by the pituitary gland present in the brain, responsible for producing many hormones.
It also helps keep your tissues and organs healthy throughout life. At the age of 40 to 60, the pituitary gland gradually reduces the production of growth hormones. This hormone can help to speed up healing after an injury and repair muscle tissue after exercise. This helps to build muscle mass, boost metabolism, and burn fat.
Types of GH
- Somatotropin is the other name for growth hormone 1, which is produced naturally in animals.
- Somatropin is the synthetic form of growth hormone that is synthesized using recombinant DNA technologies. It is also referred to under the brand name Humatrope.
Deficiency of GH (Growth Hormone)
There are two types of growth hormone deficiency:
First, congenital in which the child suffers from this problem along with birth. Even though they are born with the condition, some babies look like they are generally growing until they are about 6 to 12 months old. They may also have problems with other hormones.
Second, growth hormone deficiency occurs when the body stops making enough growth hormone to grow normally. It can start at any time in childhood.
Symptoms of GH Deficiency
Adults with growth hormone deficiency may have symptoms including:
- poor bone density (which can lead to osteoporosis if untreated)
- reduced muscle mass
- poor memory
- increased body fat around the waist.
Children with growth hormone deficiency may have symptoms including:
- Short height,
- Delayed puberty,
- Late teething,
- Delayed nail growth,
- Muscle weakness,
- Loss of energy,
- Small penis at birth in boys,
- Low blood sugar
In some cases, GH deficiency is the result of GHRH deficiency, in which case GH secretion may be stimulated by infusion of GHRH.
Side effects of growth hormone use
people who use synthetic growth hormone may have these side effects:
- fluid retention (which leads to swelling in the arms and legs)
- joint and muscle pain
- carpal tunnel syndrome
- high blood sugar levels
- high cholesterol levels.
Growth hormone injection treatment is prescribed for children who have been diagnosed with growth hormone (GH) deficiency and other conditions causing short stature.
In children, GH is used to treat:
- Growth hormone deficiency
- Conditions that cause short stature, such as chronic kidney disease, Turner syndrome, and Prader-Willi syndrome
In adults, GH is used to treat:
- Growth hormone deficiency
- Muscle wasting from HIV
- Short bowel syndrome


Can I Collect Social Security for Failed Back Surgery Syndrome?
Our experienced Social Security attorneys have represented thousands of men and women with back problems. And we understand that almost nothing is as painful as a back or spinal injury or condition.
Unfortunately, because of the extremely high volume of back pain related Social Security claims that are submitted every year, Social Security Disability decision-makers are very strict when approving back pain applications. And, sadly, many deserving individuals are denied Social Security for their back pain.
Additionally, many back pain claims are denied because SSA examiners simply expect individuals to be able to work through a certain degree of pain. And because pan is “subjective” – and doesn’t show up in a blood test or MRI – many examiners discount the devastating effect it can have on a person’s ability to work or function.
What is Failed Back Surgery Syndrome (FSB or FSSB)?
One of the most common types of medical conditions affecting the back is “Failed Back Surgery Syndrome”. This is a condition where persistent pain follows back or spinal surgery or surgeries. Failed Back Syndrome (FBS) can result in either chronic back pain, chronic leg pain, or both.
Typically, a patient will receive a diagnosis of Failed Back Surgery Syndrome (FSB or FSSB) from a spinal surgeon and/or neurologist whose medical specialty allows then to conclude that the patient has an irreversible condition which cannot be improved through any further surgical means.
“Failed Back Surgery Syndrome” most often occurs after a “laminectomy” (removal of the lamina bone to take pressure off of a protruding disc). If FBS occurs after a laminectomy, it may also be referred to as “Post-Laminectomy Syndrome”.
But Failed Back Syndrome can also occur after many other types of back or spinal surgeries as well.
Getting Social Security for Failed Back Syndrome
In order to receive Social Security Disability or SSA approval for Failed Back Surgery Syndrome there are specific criteria that an individual must meet.
First – as with any Social Security Case – in order to be considered “disabled” by Social Security, you must be able to prove that you have a disease or health problem that is severe enough to keep you from working for at least 12 months. If you can prove that FBS prevents you from being able to work – and that the disability will last for at least 12 months – you may be entitled to Social Security Disability benefits.
Some spine disorders are included under the Social Security Administration’s “Blue Book List” of qualifying health problems. These diagnoses include degenerative disc disease, spinal stenosis, herniated nucleus pulpous, spinal arachnoiditis, osteoarthritis, facet arthritis and vertebral fracture.
However, a being diagnosed with one of these spine disorders will not, in and of itself, qualify you for Social Security Disability benefits – unless you can also prove that the back condition makes it not possible for you to continue working in any occupation for which you may be qualified.
Typically Social Security Claimants will be approved for SSD if their back pain is ongoing, severe, and unresponsive to treatments – and is expected to last for more than 12 months.
Additionally, when seeking Social Security for Failed Back Surgery Syndrome (FSB), the claimant must be able to demonstrate a medically determinable basis for back pain. This means that, along with a doctor’s diagnosis, the individual should present MRIs, x-rays, or another medical documentation that indicates the cause of the pain.
It can be very challenging for a Social Security Disability applicant – especially one in severe back pain – to know what medical evidence is needed and how to best present that medical evidence to the SSA. But an experienced and Social Security Disability attorney will be able to help you create the strongest case possible, by thoroughly demonstrating that you meet the requirements for approval.
Our Attorneys Can Help Get Social Security for Failed Back Surgery Syndrome (FSB)
Our experienced Long Beach Social Security attorneys are here to help you with all aspects of your Social Security Disability Case arising from your Failed Back Surgery Syndrome (FSB). Our experienced lawyers would be happy to discuss your unique situation with you, to ensure that you receive the maximum Social security Disability benefits for which you may qualify.


Earlier this week, Professor Colleen Cartwright, did a webinar for ISQua titled “Health Care Costs, Futile Treatment and Patient’s Rights.”
The presentation did not break a lot of new ground but provided a nice general overview of issues relating to end-of-life decision making. What I especially liked was her use of “futile treatment” to encompass both treatment that is (1) unwarranted from a medical perspective and (2) unwanted from the patient’s perspective.
“Futile” is typically reserved for judgments framed as clinical and physiological. But treatment can be inappropriate not only for those reasons but also because it is unwanted by the patient. I tried to summarize this in this graphic.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.


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Taming the Teenage Tempest: A Guide to Managing Hormonal Excitement
Dr. Deepak Sharma
BHMS, MD, Ph.D. (Scholar)
Homeopathic Physician and Educator
Founder – Orbit Clinics (World Class Homeopathic Clinics Worldwide)
The teenage years are a whirlwind of change and growth, fueled by a surge of hormones that can leave adolescents feeling like they’re on an emotional roller coaster. Hormonal excitement during adolescence is a normal part of human development, but it can be a challenging experience for both teenagers and their parents. With emotions running high and hormones in overdrive, it’s essential to equip teenagers with the tools they need to navigate this critical period in their lives. In this article, we will delve into the science behind hormonal excitement in teenagers and provide practical tips for managing these powerful emotions.
Understanding Hormonal Excitement in Teenagers:
During adolescence, the body undergoes significant hormonal changes as it transitions from childhood to adulthood. Two primary hormones responsible for these changes are testosterone in boys and estrogen in girls. These hormones regulate mood, energy levels, and sexual maturation, often leading to unpredictable and intense emotions. As teenagers learn to navigate their newfound feelings, they may experience moments of excitement, confusion, and even frustration.
Strategies for Managing Hormonal Excitement:
- Awareness and Education:
Knowledge is power, and understanding the science behind hormonal excitement can help teenagers feel more in control of their emotions. Parents and educators should provide age-appropriate information about the hormonal changes taking place during adolescence, and teenagers should be encouraged to ask questions and engage in open conversations about their experiences.
- Emotional Regulation:
It’s crucial for teenagers to develop healthy emotional regulation skills, which can help them manage their hormonal excitement. Techniques such as mindfulness, deep breathing, and progressive muscle relaxation can be beneficial in achieving emotional balance.
- Physical Activity:
Regular exercise is known to have a positive impact on emotional well-being. Engaging in physical activities can help release endorphins, which are natural mood stabilizers. Encourage teenagers to participate in sports, dance, or any form of exercise they enjoy to help manage their emotions.
- Healthy Sleep Habits:
Sleep is vital for overall health and emotional regulation. Teenagers should aim for 8-10 hours of sleep per night and maintain a consistent sleep schedule. Practicing good sleep hygiene can help improve the quality of sleep and, in turn, help manage hormonal excitement.
- Balanced Diet:
Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help regulate hormone levels and support emotional well-being. Encourage teenagers to avoid excessive caffeine and sugar consumption, as these can exacerbate mood swings.
- Social Support:
Having a strong support system is essential for navigating the challenges of adolescence. Encourage teenagers to maintain close relationships with family, friends, and mentors who can provide guidance and understanding during this turbulent time.
- Professional Help:
If hormonal excitement is significantly impacting a teenager’s daily life, seeking professional help from a therapist or counselor can be beneficial. Mental health professionals can provide valuable tools and coping strategies for managing intense emotions.
Managing hormonal excitement during adolescence can be a challenging but rewarding journey. By fostering open communication, promoting healthy lifestyle choices, and providing emotional support, parents and educators can help teenagers navigate this critical period with confidence and resilience. Armed with the right tools and strategies, teenagers can learn to harness their hormonal excitement and use it as a driving force for personal growth and self-discovery.


Columbia Basin Hospital
Columbia Basin Hospital is a Critical Access Hospital providing quality health care services to rural citizens of Ephrata, Washington. This Government hospital has a total of 58 beds and 37 beds for assisted living and 131 facility personnel. Community outreach programs such as health fairs and health screenings are conducted.
Columbia Basin Hospital accepts both Medicare and Medicaid patients.Address: 200 Southeast Boulevard , Ephrata
Number of Beds: 0
Total Staff : 0
Click here to see the complete state rankings.


The integration of behavioral epigenetics' principles (eg, DNA methylation) into the study of human infants' development has mainly focused on the effects of early adverse exposures, paying less attention to protective caregiving experiences. The present review focused on DNA methylation linked to variations in maternal behavior in human infants and children. Literature search occurred on three databases (PubMed, Scopus and Web of Science) and 11 records were selected. Key variables were abstracted from each article including: sample size and characteristics, time and type of maternal caregiving behavior exposure, time and locus of methylation biomarker, presence/absence, time and type of adverse exposure. Six out of eleven records documented the predictive effect of maternal caregiving on DNA methylation, whereas the remaining five reported on the role of maternal behavior as an influencing factor of the adversity-to-methylation link. Consistent with evidence from the animal model, the quality of maternal caregiving in humans (a) might be associated with variations in DNA methylation status of specific genes involved in socio-emotional development and (b) might partially buffer the association between early adversities and epigenetic variations in infants and children. Current evidence suggests that the quality of maternal caregiving can contribute to behavioral development trajectories of human infants and children at least partially through epigenetic regulation. Open questions and methodological aspects are discussed to guide future human developmental research in behavioral epigenetics.
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