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Jazzy Select Elite - 0 views

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    Jazzy Select Elite The Jazzy Select Elite delivers a potent blend of power, performance and style. In-line, front-wheel drive technology gives the Elite excellent stability and maneuverability for solid performance indoors and out. Jazzy Select Elite Features Jazzy includes shroud and controller guards to protect against daily wear and tear. Red or blue color-through shroud. Black high-back seat with removable, replaceable back and seat covers. Dual-layer powder coated frame for increased durability. Larger foot platform. 40 amp, PG GC 3 controller. Built with ease of service in mind. Jazzy Select Elite Specifications Weight Capacity: 300 lbs. Turning Radius: 24.75" Width: 22.75" Length: 34.75" Maximum Speed Up to 4 mph Ground Clearance: 1.5" Front Wheels: 3" solid anti-tips Drive Wheels: 9" solid Rear Wheels: 6" solid casters Drivetrain: Two-motor, in-line, front-wheel drive Braking System Regenerative and electro-mechanical Suspension Type Limited High-Back Seating: 20"W x 20"D (max. dimensions) High-Back Seat-to-Floor Range: 21.5" - 23.5" Specialty Seating: 20"W x 20"D (max. dimensions) Specialty Seat-to-Floor Range: 16.5" - 18.5" Synergy Seating 20"W x 20"D (max. dimensions) Synergy Seat-to-Floor Range 17.25" - 19.25" Standard Electronics: 40A, PG GC3 Battery Size: 12 volt, U-1 (2 required) Standard Battery Charger: 3A, off-board Per-Charge Range Up to 15 miles Battery Weight: 24.5 lbs. each Base Weight: 68.5 lbs. Standard Seat Weight: 43 lbs. (comfort, high-back) Standard Seat Size: 18" x 18"-20"
wheelchairindia9

Pristine Flex Ostrich Mobility Wheelchair - 0 views

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    Pristine Flex Ostrich Mobility Wheelchair Pristine is the most stylish powered wheelchair with revolutionary Split Frame Chassis (SFC). This indoor outdoor mobility equipment gives great comfort, stability and safety even in the toughest outdoor conditions. The body panels and the shopping basket make this equipment best suited for your kind of lifestyle. Pristine Flex Ostrich Mobility Wheelchair Features Split Frame Chassis (SFC). Call alarm, fault alarm, reverse alarm (on request). Low voltage alarm. Key pad locking. Mobility cut-off while charging. Auto shut-off after 3 minutes. Five speed selector. Length adjustable joystick control unit (can be changed from left to right and vice versa). Foldable, height adjustable and angle adjustable foot rest. Wide arm rest with height and width adjustment. Bucket seat with headrest and lap belt. Seat can be folded for transportation. Seat reclines 25 degrees in 6 steps. Removable and width adjustable calf support. Reflectors as per standards. Head lamp. Tail lamp. Pristine Flex Ostrich Mobility Wheelchair Specifications Load capacity: 110 Kg Speed: 9.5 Kmph max Speed selection: 5 speeds, Speed 1- 1.5Kmph, Speed 2-2.5 Kmph, speed 3- 4.8 Kmph, Speed 4- 7.2 Kmph, Speed 5- 9.5 Kmph Power: 320W Motor speed: 5300 rpm Gear ratio: 32:1 Brake: Electromagnetic Permissible Gradeability: 12 Degrees Drive range: 32-35 Km Ground clearance:2.5 inches Turn circle radius: 620mm Tire: Puncture free foam filled rubber tires Front- Tire diameter: 220X55 mm, Rear- Tire diameter: 320X72mm, Anti tippers-1 inch solid Battery: 24 Volt 48 Ah Sealed Maintenance Free VRLA Charger Input-230/240 Volts AC Single phase, Output-24 Volts-4 Amps DC Overall length with footrest (at 90 degree):1180mm, Overall width:640mm, Overall height: 1250mm, Overall height after folding the seat: 690mm, Overall weight: 102 Kg Seat depth: 500mm, Seat width:480mm, Backrest height: 540mm (without head rest), Backrest width: 440mm, Se
Nathan Goodyear

Membrane 5alpha-pregnane-3,20-dio... [J Steroid Biochem Mol Biol. 2005] - PubMed - NCBI - 0 views

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    Progesterone metabolites are present on the membrane of ER/PR + as well as ER/PR - breast cancer cell lines.  The balance of 5 alpha pregnane:3 alpha pregnane regulates tumor genesis.  Estradiol increased 5 alpha pregnane receptors as well as 5 alpha pregnane unregulated itself via autocrine activity.  The 3 alpha pregnenes, 3 alpha hydroxyprogesterone and 20 alpha-dihydroprogesterone, decrease the 5 alpha pregnane receptors via paracrine activity.
wheelchairindia9

J6 Power Wheelchair - 0 views

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    J6 Power Wheelchair The compact J6 is the ultimate choice for users who demand the superb stability of Mid-Wheel 6 design and tight-quarter maneuverability. Highly adaptable, the J6 accepts a wide range of seating and electronics options while its powerful drive train delivers high-performance torque. J6 Power Wheelchair Features: Mid-Wheel 6 allows six wheels on the ground for maximum stability. Compatible with TRU-Balance Tilt. OMNI-Casters (nylon, spherical-shaped casters) on front and rear prevent wheel hang-ups. Side-mounted, easily accessible freewheel levers. ATX Suspension (Active-Trac with extra stability) incorporates front OMNI-Casters for enhanced. Performance over more varied terrain. Easy front access to batteries. J6 Power Wheelchair Specifications: Drive Wheels: 10" Solid Optional: 10" Pneumatic Caster Wheels Front: 5" Solid Rear: 6" Solid Anti-Tip Wheels N/A Maximum Speed^4/^: Up to 4 mph Ground Clearance: 2.5" (frame) Turning Radius^5/^: 22" Overall Length: 34.74" without foot riggings Base Width: 23.19" Seating Sizes: TRU-Balance® 2 Synergy/Static: W: 10-20" D: 10-20" Power Tilt: W: 14-20" D: 14-20" Lift & Tilt: N/A Seat-to-Floor Heights: TRU-Balance® 2 Synergy/Static8: 16.5" - 17.5" Power Tilt8: 16.875" Lift & Tilt8: N/A Manual Tilt/Recline^10/^: Yes Battery Size^6/^: U-1 Battery Weight^14/^: 23.4 lbs. Available Electronics^12/^: 70A Q-Logic 2 NE 70A Q-Logic 2 NE+ 70A Q-Logic 2 EX Battery Charger 5A Off-board Motor Packages 2-Pole 4 mph Weight Capacity^7/^: 300 lbs.9 Base Weight: 100.2 lbs
pharmacybiz

10.5 M LFD Test Kits : UKSHA Plans To Distribute It Per Week - 0 views

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    As an unprecedented demand for Lateral Flow Device (LFD) test kits continues through the Pharmacy Collect service, the UK Health Security Agency (UKHSA) is planning to distribute 10.5 million tests per week via Alliance Healthcare this month. By the end of this week (January 8), the UKHSA aims to distribute more than 8 million tests to Alliance Healthcare - sole distributor to pharmacies. The announcement comes after many in the pharmacy sector voiced concerns over shortage of test kits. Earlier this week, it emerged that Alliance Healthcare closed for four days shortly after receiving around 2.5 million tests on Christmas Eve. Meanwhile, the UKHSA indicated that Alliance Healthcare has been delivering 86 per cent of its orders within 24 hours of the pharmacy order, nearly half of that on the same day. Besides, a plan to switch on a Parcel Force delivery contingency is being finalised by UKHSA, which would enable supply of a further 3.5 million test kits.
Nathan Goodyear

JISSN | Full text | International Society of Sports Nutrition position stand: creatine ... - 0 views

  • the energy supplied to rephosphorylate adenosine diphosphate (ADP) to adenosine triphosphate (ATP) during and following intense exercise is largely dependent on the amount of phosphocreatine (PCr) stored in the muscle
  • Creatine is chemically known as a non-protein nitrogen
  • It is synthesized in the liver and pancreas from the amino acids arginine, glycine, and methionine
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  • Approximately 95% of the body's creatine is stored in skeletal muscle
  • About two thirds of the creatine found in skeletal muscle is stored as phosphocreatine (PCr) while the remaining amount of creatine is stored as free creatine
  • The body breaks down about 1 – 2% of the creatine pool per day (about 1–2 grams/day) into creatinine in the skeletal muscle
  • The magnitude of the increase in skeletal muscle creatine content is important because studies have reported performance changes to be correlated to this increase
  • "loading" protocol. This protocol is characterized by ingesting approximately 0.3 grams/kg/day of CM for 5 – 7 days (e.g., ≃5 grams taken four times per day) and 3–5 grams/day thereafter [18,22]. Research has shown a 10–40% increase in muscle creatine and PCr stores using this protocol
  • Additional research has reported that the loading protocol may only need to be 2–3 days in length to be beneficial, particularly if the ingestion coincides with protein and/or carbohydrate
  • A few studies have reported protocols with no loading period to be sufficient for increasing muscle creatine (3 g/d for 28 days)
  • Cycling protocols involve the consumption of "loading" doses for 3–5 days every 3 to 4 weeks
  • Most of these forms of creatine have been reported to be no better than traditional CM in terms of increasing strength or performance
  • Recent studies do suggest, however, that adding β-alanine to CM may produce greater effects than CM alone
  • These investigations indicate that the combination may have greater effects on strength, lean mass, and body fat percentage; in addition to delaying neuromuscular fatigue
  • creatine phosphate has been reported to be as effective as CM at improving LBM and strength
  • Green et al. [24] reported that adding 93 g of carbohydrate to 5 g of CM increased total muscle creatine by 60%
  • Steenge et al. [23] reported that adding 47 g of carbohydrate and 50 g of protein to CM was as effective at promoting muscle retention of creatine as adding 96 g of carbohydrate.
  • It appears that combining CM with carbohydrate or carbohydrate and protein produces optimal results
  • Studies suggest that increasing skeletal muscle creatine uptake may enhance the benefits of training
  • Nearly 70% of these studies have reported a significant improvement in exercise capacity,
  • Long-term CM supplementation appears to enhance the overall quality of training, leading to 5 to 15% greater gains in strength and performance
  • Nearly all studies indicate that "proper" CM supplementation increases body mass by about 1 to 2 kg in the first week of loading
  • short-term adaptations reported from CM supplementation include increased cycling power, total work performed on the bench press and jump squat, as well as improved sport performance in sprinting, swimming, and soccer
  • Long-term adaptations when combining CM supplementation with training include increased muscle creatine and PCr content, lean body mass, strength, sprint performance, power, rate of force development, and muscle diameter
  • subjects taking CM typically gain about twice as much body mass and/or fat free mass (i.e., an extra 2 to 4 pounds of muscle mass during 4 to 12 weeks of training) than subjects taking a placebo
  • The gains in muscle mass appear to be a result of an improved ability to perform high-intensity exercise via increased PCr availability and enhanced ATP synthesis, thereby enabling an athlete to train harder
  • there is no evidence to support the notion that normal creatine intakes (< 25 g/d) in healthy adults cause renal dysfunction
  • no long-term side effects have been observed in athletes (up to 5 years),
  • One cohort of patients taking 1.5 – 3 grams/day of CM has been monitored since 1981 with no significant side effects
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    Nice review of the data, up to the publication date, on creatine.
Nathan Goodyear

Dietary Strategy to Repair Plasma Membrane After Brain Trauma - 0 views

  • strategies directed to preserve phospholipids in the plasma membrane such as the use of dietary docosahexaenoic acid (C22:6n-3; DHA)5 can have beneficial effects for post-TBI recovery
  • DHA is the most abundant polyunsaturated fatty acid (PUFA) in the brain
  • The combination of curcumin and DHA had a trend of greater effects in BDNF (117% of CTL; Figure 1C) compared with DHA or curcumin alone.
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  • Our previous study indicated that n-3 fatty acids supplemented in the diet counteracted learning disability after TBI
  • There was a significant group effect on BDNF (F 4,25 = 5.229, P < .01 by ANOVA), and FPI reduced BDNF levels (50% of CTL, P < .01; Figure 1C), which was counteracted by DHA supplementation (90% of CTL, P < .05; Figure 1C). Curcumin also counteracted this reduction of BDNF
  • Curcumin provided in the diet before TBI can reduce oxidative damage and counteract TBI-related cognitive dysfunction.
  • curcumin contributed to enhance the action of DHA, protecting against cognitive impairment, and these effects were associated with elevations in the BDNF receptor signaling
  • Our current results show that curcumin contributes to enhance the effects of DHA on TBI by promoting phosphorylation of the BDNF receptor TrkB in the hippocampus.
  • previous evidence indicates that curcumin10 and DHA5 counteract TBI-related learning disability by involving BDNF
  • The effects of the DHA diet and curcumin on cognitive enhancement were consistent with enhanced elevations in BDNF receptor signaling
  • effects of DHA and curcumin up to 2 weeks after TBI because this is the most critical period for the course of injury recovery because the brain is metabolically dysfunctional during this time
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    study that finds curcumin + DHA increased cognitive improvement after TBI within 2 weeks.  Good discussion of the proposed mechanism--increased BDNF.
Nathan Goodyear

Healthcare | Free Full-Text | The Effects of Resistance Training on Physical Function a... - 0 views

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    Breast cancer survivors (BCS) exhibit decreased physical function and quality of life (QOL) following cancer treatments. Resistance training (RT) may elicit positive changes in physical and mental well-being. This study assessed 27 BCS, pre-and post-intervention (six months) on the following variables: muscular strength (via one repetition maximum (1RM) of chest press and leg extension), physical function (via the Continuous Scale-Physical Functional Performance test) and QOL (via the Short Form-36 survey). RT consisted of two days/week of ten exercises including two sets of 8-12 repetitions at 52%-69% of their 1RM. A repeated measures analysis of variance revealed BCS significantly (p < 0.05) increased upper (71 ± 22 to 89 ± 22 kg) and lower body (74 ± 18 to 93 ± 24 kg) strength, total physical function (65.5 ± 12.1 to 73.6 ± 12.2 units) and the subcomponents of physical function: upper body strength (63.5 ± 16.3 to 71.2 ± 16.8 units), lower body strength (58.5 ± 14.9 to 68.6 ± 16.3 units), balance and coordination (66.5 ± 12.2 to 74.6 ± 11.6 units), and endurance (67.2 ± 12.0 to 75.0 ± 11.6 units). No changes were observed over time for subjective measures of physical function and QOL. Results showed RT could be an effective means to improve objective physical function in BCS. Further research is needed to clarify the effects of RT on subjective physical function and QOL.
Nathan Goodyear

Interaction of 5-methyltetrahydrofolate and tetrah... [Am J Physiol Heart Circ Physiol.... - 0 views

  • We demonstrate that 5-methyltetrahydrofolate binds the active site of nitric oxide synthase and mimics the orientation of tetrahydrobiopterin
  • 5-methyltetrahydrofolate attenuates superoxide production (induced by inhibition of tetrahydrobiopterin synthesis) and improves endothelial function
  • e suggest that 5-methyltetrahydrofolate directly interacts with nitric oxide synthase to promote nitric oxide (vs. superoxide) production and improve endothelial function
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  • 5-Methyltetrahydrofolate may represent an important strategy for intervention aimed at improving tetrahydrobiopterin bioavailability.
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    5-methyltetrahydrofolate promotes NO synthase and improves endothelial vascular function;  proposed as way to increase tetrahydropbiopterin
wheelchairindia9

Pride Go Chair - 0 views

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    Pride Go Chair The Go-Chair is the first travel chair that combines super portability, maneuverability and style at a low cost. Pride Go Chair Features Easy to remove battery pack and compact, lightweight frame. Twin motors for traction and precision handling. Conveniently disassembles into four manageable pieces. Fits in most vehicle trunks. Top speed of 3.5 mph and enough power to get you where you want to go. Pride Go Chair Specifications Weight Capacity 250 lbs. Turning Radius 26.87" with foot platform Width: 19" Length 27" without foot platform Maximum Speed up to 3.5 mph Ground Clearance: 1.37" Front Wheels 3x5" solid casters Drive Wheels 3x8" solid Rear Wheels 3" solid anti-tips Drivetrain One-motor, rear-wheel drive Braking System Regenerative Suspension Type Limited Standard Electronics: 40A, PG GC3 Battery Size: 12 volt, 12 amp (2 required) Standard Battery Charger: 2A, off-board Per-Charge Range Up to 8 miles Battery Weight 20 lbs. Base Weight 57 LBS. (rear section 34.5 lbs.; front section 22.5 lbs.) Standard Seat Weight 25 lbs. (foldable, compact, lightweight)
wheelchairindia9

Tynor Frog Splint - 0 views

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    Tynor Frog Splint Frog-Splint Provides perfect alignment of the inter-phalangeal joints by maintaining them in optimal functional position. Malleable arms fold to hold the finger in the finger in the desired position. No tapes required. Light weight Softened arms for good grip Comfortable cushioning Hypo allergenic Tynor Frog Splint Features Coated aluminum body Extra malleable arms, can be shaped for good grip Strong, provides rigid immobilization Aesthetically pleasing Light weight Anatomic design Immobilizes both interphalangeal joints in neutral functional position Ensures easy wearing during injury Well ventilated and comfortable Does not restrict the movement of other fingers. Sleek, simple and light in weight Ethafoam lining High cushioning Enhanced comfort Easy to clean and maintain. Hypoallergenic, odorless Tynor Frog Splint Measurements Length of Fingers Size Chart- Size Inches CM Small Below 2 Below 5 Medium 2-3 5-7.5 Large 3-4 7.5-10
wheelchairindia9

Tynor Finger Cot - 0 views

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    Tynor Finger Cot Finger cot Supports, protects and immobilizes the phalanges in case of fractures, injuries or post operative care. Hook and loop bands ensure a snug fit and eliminates the need for taping. Light weight Pleasing aesthetics Comfortable cushioning Hypo allergenic Inbuilt tightening Tynor Finger Cot Features Coated aluminum body Malleable can be bent and customized Strong, provides rigid immobilization Aesthetically pleasing Light weight Ergonomic design U design ensures full protection in injuries and burns. Ensures easy wearing during injury Well ventilated and comfortable Better compliance. Ethafoam lining High cushioning Enhanced comfort Easy to clean and maintain. Inbuilt Hook loop fasteners Close fitting and excellent grip Easy application and removal. Tynor Finger Cot Measurements Length of Fingers Size Chart - Size Inches CM Small Below 2 Below 5 Medium 2-3 5-7.5 Large 3-4 7.5-10
Nathan Goodyear

Testosterone Deficiency, Cardiac Health, and Older Men - 0 views

  • Studies have shown pharmacological doses of testosterone to relax coronary arteries when injected intraluminally [39] and to produce modest but consistent improvement in exercise-induced angina and reverse associated ECG changes [40]. The mechanism of action is via blockade of calcium channels with effect of similar magnitude to nifedipine
    • Nathan Goodyear
       
      This directly refutes the recent studies (3) that Testosterone therapy increases cardiovascular events.
    • Nathan Goodyear
       
      Testosterone acts as a calcium channel blocker inducing vasodilation.
  • men with chronic stable angina pectoris, the ischaemic threshold increased after 4 weeks of TRT and a recent study demonstrates improvement continuing beyond 12 months [
  • Exercise capacity in men with chronic heart failure increased after 12 weeks
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  • Studies have shown an inverse relationship between serum testosterone and fasting blood glucose and insulin levels
  • Medications such as chronic analgesics, anticonvulsants, 5ARIs, and androgen ablation therapy are associated with increased risk of testosterone deficiency and insulin resistance
  • Women with T2D or metabolic syndrome characteristically have low SHBG and high free testosterone
    • Nathan Goodyear
       
      This stands in polar opposite of that with men.
  • Hypogonadism is a common feature of the metabolic syndrome
  • The precise interaction between insulin resistance, visceral adiposity, and hypogonadism is, as yet, unclear but the important mechanisms are through increased aromatase production, raised leptin levels, and increase in inflammatory kinins
  • levels of testosterone are reduced in proportion to degree of obesity
  • Men should be encouraged to combine aerobic exercise with strength training. As muscle increases, glucose will be burned more efficiently and insulin levels will fall. A minimum of 30 minutes exercise three times weekly should be advised
  • Testosterone increases levels of fast-twitch muscle fibres
  • By increasing testosterone, levels of type 2 fibres increase and glucose burning improves
  • Weight loss will increase levels of testosterone
  • studies now clearly show that low testosterone leads to visceral obesity and metabolic syndrome and is also a consequence of obesity
  • In the case of MMAS [43], a baseline total testosterone of less than 10.4 nmol/L was associated with a greater than 4-fold incidence of type 2 diabetes over the next 9 years
  • There is high level evidence that TRT improves insulin resistance
  • Low testosterone predicts increased mortality and testosterone therapy improves survival in 587 men with type 2 diabetes
  • A similar retrospective US study involved 1031 men with 372 on TRT. The cumulative mortality was 21% in the untreated group versus 10% ( ) in the treated group with the greatest effect in younger men and those with type 2 diabetes
  • the presence of ED has been shown to be an independent risk factor, particularly in hypogonadal men, increasing the risk of cardiac events by over 50%
  • A recent online publication on ischaemic heart disease mortality in men concluded optimal androgen levels are a biomarker for survival
  • inverse associations between low TT or FT (Table 2) and the severity of CAD
  • A recent 10 year study from Western Australia involving 3690 men followed up from 2001–2010 concluded that TT and FT levels in the normal range were associated with decreased all-cause and cardiovascular mortality, for the first time suggesting that both low and DHT are associated with all-cause mortality and higher levels of DHT reduced cardiovascular risk
  • TDS is associated with increased cardiovascular and all-cause mortality
  • The effect of treatment with TRT reduced the mortality rate of treated cohort (8.4%) to that of the eugonadal group whereas the mortality for the untreated remained high at 19.2%
  • hypogonadal men had slightly increased triglycerides and HDL
  • Men with angiographically proven CAD (coronary artery disease) have significantly lower testosterone levels [29] compared to controls ( ) and there was a significant inverse relationship between the degree of CAD and TT (total testosterone) levels
  • TRT has also been shown to reduce fibrinogen to levels similar to fibrates
  • men treated with long acting testosterone showed highly significant reductions in TC, LDL, and triglycerides with increase in HDL, associated with significant reduction in weight, BMI, and visceral fat
  • Low androgen levels are associated with an increase in inflammatory markers
  • In the Moscow study, C-reactive protein was reduced by TRT at 30 weeks versus placebo
  • In some studies, a decline in diastolic blood pressure has been observed, after 3–9 months [24, 26] and in systolic blood pressure
  • A decline was noted in IL6 and TNF-alpha
  • No studies to date show an increase in LUTS/BPH symptoms with higher serum testosterone levels
  • TRT has been shown to upregulate PDE5 [65] and enhance the effect of PDE5Is (now an accepted therapy for both ED and LUTS), it no longer seems logical to advice avoidance of TRT in men with mild to moderate BPH.
    • Nathan Goodyear
       
      What about just starting with normalization of Testosterone levels first.
  • Several meta-analyses have failed to show a link between TRT and development of prostate cancer [66] but some studies have shown a tendency for more aggressive prostate cancer in men with low testosterone
    • Nathan Goodyear
       
      And if one would have looked at their estrogen levels, I guarantee they would have been found to be elevated.
  • low bioavailable testosterone and high SHBG were associated with a 4.9- and 3.2-fold risk of positive biopsy
  • Current EAU, ISSAM, and BSSM guidance [1, 2] is that there is “no evidence TRT is associated with increased risk of prostate cancer or activation of subclinical cancer.”
  • Men with prostate cancer, treated with androgen deprivation, develop an increase of fat mass with an altered lipid profile
  • Erectile dysfunction is an established marker for future cardiovascular risk and the major presenting symptom leading to a diagnosis of low testosterone
Nathan Goodyear

The Contribution of Cytotoxic Chemotherapy to 5-year Survival in Adult Malignancies | C... - 0 views

  • In this group, the 5-year survivalrateduesolelytocytotoxicchemotherapywas14%
  • There is also no convincing evidence that usingregimens with newer and more expensive drugs are anymore beneficial than the regimens used in the 1970s
  • two systematic reviews of chemotherapy inrecurrent or metastatic breast cancer have not been able toshow any survival benefit
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  • The five most common adult malignancies (colorectal, breast, prostate, melanoma and lung cancer)
  • n breast cancer, the optimal regimen(s) for cytotoxicchemotherapy in recurrent/metastatic disease are still notdefined, despite over 30 years of ‘research’ and a plethora of RCTs since the original Cooper regimen was published in1969
  • The five most ‘chemo-sensitive’ cancers,namely testis, Hodgkin’s disease and non-Hodgkin’s lym- phoma, cervix and ovary
  • only 13 out of the 22 malignancies evaluated showed any improvement in 5-year survival, and theimprovement was greater than 10% in only three of those13 malignancies
  • the contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults is 2.3% in Australia and 2.1% in the USA
  • a benefit of less than 2.5% is likely to be applicable in other developed countries
  •   Overview The Contribution o
  • the benefit of cytotoxic chemotherapy may have been overestimated for cancers of oesophagus, stomach,rectum and brain.
  • this reflects the presentation of results as a ‘reduction in risk’ rather than asan absolute survival benefit[89,90]and by exaggerating theresponse rates by including ‘stable disease’
  • recent studies have documented impaired cognitive function inwomen receiving adjuvant treatment for breast cancer
  • the 5-year survival rate due solely to cytotoxicchemotherapy was 1.6%
  • the value of palliative chemotherapy has beenquestioned
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    Incredibly low impact of cytotoxic chemotherapy despite its wide spread utilization.  This article referenced cost yet did not evaluate the cost of cytotoxic side effect.  The question to answer: is Cytotoxic chemotherapy a valid treatment, at all, for the majority of cancers.
spineneuro

List of India's Best 5 Hospitals for Gamma Knife Delivers Precision Treatment for Brain... - 0 views

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    India's best 5 hospitals for Gamma Knife demonstrated tumor control rates near to 100 % for brain tumors less than a centimeter in diameter that was targeted early. "As the proof maintains to mount and show the gamma knife's efficacy, more oncologists are surveilling patients and finding brain tumors earlier-permitting us to be more proactive and to avoid neurological symptoms," says neurologist of India's best 5 hospitals for gamma knife.
Nathan Goodyear

Potent Inhibition of Human Phosphodiesterase-5 by Icariin Derivatives - Journal of Natu... - 0 views

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    A natural phosphodiesterase 5 inhibitor would be nice.  This study looked at a lot of traditional herbal remedies to block phosphodiesterase 5 activity.  Only Epimedii herb with the active ingredient icariin worked.  Other preparations were shown to work, but via different mechanisms.  This is a review of studies looking at these herbal preparations.
wheelchairindia9

Tynor Restrainer - 0 views

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    Tynor Restrainer Applications To manage combative or disoriented patient. Manage post anesthesia delirium. Patients with head injuries or recovering from seizures. Schizophrenia, mental illness, dementia, or side effects from their treatment. To limit the body movement. Maintain a particular position. Tynor Restrainer Features Cushiony & comfortable. Easy to tie and open. Strong and durable. Fits left, right, wrist & ankle. Tynor Restrainer Measurements Size Chart - Size Inches CM Universal 5-9.5 12.5-23.8
Nathan Goodyear

Plasma membrane receptors for the... [Biochem Biophys Res Commun. 2000] - PubMed - NCBI - 0 views

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    The receptors for 5 alpha progesterone and 3 alpha hydroxyprogesterone are distinct from other hormone receptors.  These receptors are plasma membrane bound.  Through these receptors, these progesterone metabolites initiate autocrine and paracrine activity.  E2 increased 5 alpha progesterone receptors.  This is very important in ER-/PR- breast cancer, but does still have significance in ER+/PR+ cancer as well.
Nathan Goodyear

Testosterone and the Cardiovascular System: A Comprehensive Review of the Clinical Lite... - 0 views

  • Low endogenous bioavailable testosterone levels have been shown to be associated with higher rates of all‐cause and cardiovascular‐related mortality.39,41,46–47 Patients suffering from CAD,13–18 CHF,137 T2DM,25–26 and obesity27–28
  • have all been shown to have lower levels of endogenous testosterone compared with those in healthy controls. In addition, the severity of CAD15,17,29–30 and CHF137 correlates with the degree of testosterone deficiency
  • In patients with CHF, testosterone replacement therapy has been shown to significantly improve exercise tolerance while having no effect on LVEF
  • ...66 more annotations...
  • testosterone therapy causes a shift in the skeletal muscle of CHF patients toward a higher concentration of type I muscle fibers
  • Testosterone replacement therapy has also been shown to improve the homeostatic model of insulin resistance and hemoglobin A1c in diabetics26,68–69 and to lower the BMI in obese patients.
  • Lower levels of endogenous testosterone have been associated with longer duration of the QTc interval
  • testosterone replacement has been shown to shorten the QTc interval
  • negative correlation has been demonstrated between endogenous testosterone levels and IMT of the carotid arteries, abdominal aorta, and thoracic aorta
  • These findings suggest that men with lower levels of endogenous testosterone may be at a higher risk of developing atherosclerosis.
  • Current guidelines from the Endocrine Society make no recommendations on whether patients with heart disease should be screened for hypogonadism and do not recommend supplementing patients with heart disease to improve survival.
  • The Massachusetts Male Aging Study also projects ≈481 000 new cases of hypogonadism annually in US men within the same age group
  • since 1993 prescriptions for testosterone, regardless of the formulation, have increased nearly 500%
  • Testosterone levels are lower in patients with chronic illnesses such as end‐stage renal disease, human immunodeficiency virus, chronic obstructive pulmonary disease, type 2 diabetes mellitus (T2DM), obesity, and several genetic conditions such as Klinefelter syndrome
  • A growing body of evidence suggests that men with lower levels of endogenous testosterone are more prone to develop CAD during their lifetimes
  • There are 2 major potential confounding factors that the older studies generally failed to account for. These factors are the subfraction of testosterone used to perform the analysis and the method used to account for subclinical CAD.
  • The biologically inactive form of testosterone is tightly bound to SHBG and is therefore unable to bind to androgen receptors
  • The biologically inactive fraction of testosterone comprises nearly 68% of the total testosterone in human serum
  • The biologically active subfraction of testosterone, also referred to as bioavailable testosterone, is either loosely bound to albumin or circulates freely in the blood, the latter referred to as free testosterone
  • It is estimated that ≈30% of total serum testosterone is bound to albumin, whereas the remaining 1% to 3% circulates as free testosterone
  • it can be argued that using the biologically active form of testosterone to evaluate the association with CAD will produce the most reliable results
  • English et al14 found statistically significant lower levels of bioavailable testosterone, free testosterone, and free androgen index in patients with catheterization‐proven CAD compared with controls with normal coronary arteries
  • patients with catheterization‐proven CAD had statistically significant lower levels of bioavailable testosterone
  • In conclusion, existing evidence suggests that men with CAD have lower levels of endogenous testosterone,13–18 and more specifically lower levels of bioavailable testosterone
  • low testosterone levels are associated with risk factors for CAD such as T2DM25–26 and obesity
  • In a meta‐analysis of these 7 population‐based studies, Araujo et al41 showed a trend toward increased cardiovascular mortality associated with lower levels of total testosterone, but statistical significance was not achieved (RR, 1.25
  • the authors showed that a decrease of 2.1 standard deviations in levels of total testosterone was associated with a 25% increase in the risk of cardiovascular mortality
  • the relative risk of all‐cause mortality in men with lower levels of total testosterone was calculated to be 1.35
  • higher risk of cardiovascular mortality is associated with lower levels of bioavailable testosterone
  • Existing evidence seems to suggest that lower levels of endogenous testosterone are associated with higher rates of all‐cause mortality and cardiovascular mortality
  • studies have shown that lower levels of endogenous bioavailable testosterone are associated with higher rates of all‐cause and cardiovascular mortality
  • It may be possible that using bioavailable testosterone to perform mortality analysis will yield more accurate results because it prevents the biologically inactive subfraction of testosterone from playing a potential confounding role in the analysis
  • The earliest published material on this matter dates to the late 1930s
  • the concept that testosterone replacement therapy improves angina has yet to be proven wrong
  • In more recent studies, 3 randomized, placebo‐controlled trials demonstrated that administration of testosterone improves myocardial ischemia in men with CAD
  • The improvement in myocardial ischemia was shown to occur in response to both acute and chronic testosterone therapy and seemed to be independent of whether an intravenous or transdermal formulation of testosterone was used.
  • testosterone had no effect on endothelial nitric oxide activity
  • There is growing evidence from in vivo animal models and in vitro models that testosterone induces coronary vasodilation by modulating the activity of ion channels, such as potassium and calcium channels, on the surface of vascular smooth muscle cells
  • Experimental studies suggest that the most likely mechanism of action for testosterone on vascular smooth muscle cells is via modulation of action of non‐ATP‐sensitive potassium ion channels, calcium‐activated potassium ion channels, voltage‐sensitive potassium ion channels, and finally L‐type calcium ion channels
  • Corona et al confirmed those results by demonstrating that not only total testosterone levels are lower among diabetics, but also the levels of free testosterone and SHBG are lower in diabetic patients
  • Laaksonen et al65 followed 702 Finnish men for 11 years and demonstrated that men in the lowest quartile of total testosterone, free testosterone, and SHBG were more likely to develop T2DM and metabolic syndrome.
  • Vikan et al followed 1454 Swedish men for 11 years and discovered that men in the highest quartile of total testosterone were significantly less likely to develop T2DM
  • authors demonstrated a statistically significant increase in the incidence of T2DM in subjects receiving gonadotropin‐releasing hormone antagonist therapy. In addition, a significant increase in the rate of myocardial infarction, stroke, sudden cardiac death, and development of cardiovascular disease was noted in patients receiving antiandrogen therapy.67
  • Several authors have demonstrated that the administration of testosterone in diabetic men improves the homeostatic model of insulin resistance, hemoglobin A1c, and fasting plasma glucose
  • Existing evidence strongly suggests that the levels of total and free testosterone are lower among diabetic patients compared with those in nondiabetics
  • insulin seems to be acting as a stimulant for the hypothalamus to secret gonadotropin‐releasing hormone, which consequently results in increased testosterone production. It can be argued that decreased stimulation of the hypothalamus in diabetics secondary to insulin deficiency could result in hypogonadotropic hypogonadism
  • BMI has been shown to be inversely associated with testosterone levels
  • This interaction may be a result of the promotion of lipolysis in abdominal adipose tissue by testosterone, which may in turn cause reduced abdominal adiposity. On the other hand, given that adipose tissue has a higher concentration of the enzyme aromatase, it could be that increased adipose tissue results in more testosterone being converted to estrogen, thereby causing hypogonadism. Third, increased abdominal obesity may cause reduced testosterone secretion by negatively affecting the hypothalamus‐pituitary‐testicular axis. Finally, testosterone may be the key factor in activating the enzyme 11‐hydroxysteroid dehydrogenase in adipose tissue, which transforms glucocorticoids into their inactive form.
  • increasing age may alter the association between testosterone and CRP. Another possible explanation for the association between testosterone level and CRP is central obesity and waist circumference
  • Bai et al have provided convincing evidence that testosterone might be able to shorten the QTc interval by augmenting the activity of slowly activating delayed rectifier potassium channels while simultaneously slowing the activity of L‐type calcium channels
  • consistent evidence that supplemental testosterone shortens the QTc interval.
  • Intima‐media thickness (IMT) of the carotid artery is considered a marker for preclinical atherosclerosis
  • Studies have shown that levels of endogenous testosterone are inversely associated with IMT of the carotid artery,126–128,32,129–130 as well as both the thoracic134 and the abdominal aorta
  • 1 study has demonstrated that lower levels of free testosterone are associated with accelerated progression of carotid artery IMT
  • another study has reported that decreased levels of total and bioavailable testosterone are associated with progression of atherosclerosis in the abdominal aorta
  • These findings suggest that normal physiologic testosterone levels may help to protect men from the development of atherosclerosis
  • Czesla et al successfully demonstrated that the muscle specimens that were exposed to metenolone had a significant shift in their composition toward type I muscle fibers
  • Type I muscle fibers, also known as slow‐twitch or oxidative fibers, are associated with enhanced strength and physical capability
  • It has been shown that those with advanced CHF have a higher percentage of type II muscle fibers, based on muscle biopsy
  • Studies have shown that men with CHF suffer from reduced levels of total and free testosterone.137 It has also been shown that reduced testosterone levels in men with CHF portends a poor prognosis and is associated with increased CHF mortality.138 Reduced testosterone has also been shown to correlate negatively with exercise capacity in CHF patients.
  • Testosterone replacement therapy has been shown to significantly improve exercise capacity, without affecting LVEF
  • the results of the 3 meta‐analyses seem to indicate that testosterone replacement therapy does not cause an increase in the rate of adverse cardiovascular events
  • Data from 3 meta‐analyses seem to contradict the commonly held belief that testosterone administration may increase the risk of developing prostate cancer
  • One meta‐analysis reported an increase in all prostate‐related adverse events with testosterone administration.146 However, when each prostate‐related event, including prostate cancer and a rise in PSA, was analyzed separately, no differences were observed between the testosterone group and the placebo group
  • the existing data from the 3 meta‐analyses seem to indicate that testosterone replacement therapy does not increase the risk of adverse cardiovascular events
  • the authors correctly point out the weaknesses of their study which include retrospective study design and lack of randomization, small sample size at extremes of follow‐up, lack of outcome validation by chart review and poor generalizability of the results given that only male veterans with CAD were included in this study
    • Nathan Goodyear
       
      The authors here present Total Testosterone as a "confounding" value
    • Nathan Goodyear
       
      This would be HSD-II
  • the studies that failed to find an association between testosterone and CRP used an older population group
  • low testosterone may influence the severity of CAD by adversely affecting the mediators of the inflammatory response such as high‐sensitivity C‐reactive protein, interleukin‐6, and tumor necrosis factor–α
  •  
    Good review of Testosterone and CHD.  Low T is associated with increased all cause mortality and cardiovascular mortality, CAD, CHF, type II diabetes, obesity, increased IMT,  increased severity of CAD and CHF.  Testosterone replacement in men with low T has been shown to improve exercise tolerance in CHF, improve insulin resistance, improve HgbA1c and lower BMI in the obese.
Nathan Goodyear

Dietary supplement adverse events: Report of a one-year poison center surveillance project - 0 views

  •  
    Context, context, context.   In the year 2006, there were 1.5 million adverse events reported directly related to prescription drugs at a cost of 3.5$ billion.  One often hears of the dangers of supplements.  This analysis from 2008 found 275 adverse events reported.  Contrast 1.5 million versus 275 and it really puts into context where the dangers lie.
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