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Nathan Goodyear

Substantial contribution of extrinsic risk factors to cancer development - 0 views

  • Here we provide evidence that intrinsic risk factors contribute only modestly (<10~30%) to cancer development
  • we conclude that cancer risk is heavily influenced by extrinsic factors. These results carry immense consequences for strategizing cancer prevention
  • cancers are proposed to originate from the malignant transformation of normal tissue progenitor and stem cells
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  • “Intrinsic processes” include those that result in mutations due to random errors in DNA replication whereas “extrinsic factors” are environmental factors that affect mutagenesis rates (such as UV radiation, ionizing radiation, and carcinogens
  • intrinsic factors do not play a major causal role.
  • intrinsic cancer risk should be determined by the cancer incidence for those cancers with the least risk in the entire group controlling for total stem cell divisions
  • if one or more cancers would feature a much higher cancer incidence, for example, lung cancer among smokers vs. non-smokers, then this most likely reflects additional (and probably extrinsic) risk factors (smoking in this case)
  • Particularly, for breast and prostate cancers, it has long been observed that large international geographical variations exist in their incidences (5-fold for breast cancer, 25-fold for prostate cancer)14, and immigrants moving from countries with lower cancer incidence to countries with higher cancer rates soon acquire the higher risk of their new country
  • Colorectal cancer is another high-incidence cancer that is widely considered to be an environmental disease17, with an estimated 75% or more colorectal cancer risk attributable to diet
  • melanoma, its risk ascribed to sun exposure is around 65–86%
  • non-melanoma basal and squamous skin cancers, ~90% is attributable to UV
  • 75% of esophageal cancer, or head and neck cancer are caused by tobacco and alcohol
  • HPV may cause ~90% cases in cervical cancer23, ~90% cases in anal cancer24, and ~70% in oropharyngeal cancer
  • HBV and HCV may account for ~80% cases of hepatocellular carcinoma
  • H pylori may be responsible for 65–80% of gastric cancer
  • While a few cancers have relatively large proportions of intrinsic mutations (>50%), the majority of cancers have large proportions of extrinsic mutations, for example, ~100% for Myeloma, Lung and Thyroid cancers and ~80–90% for Bladder, Colorectal and Uterine cancers, indicating substantial contributions of carcinogen exposures in the development of most cancers
  • onsistent estimate of contribution of extrinsic factors of >70–90% in most common cancer types. This concordance lends significant credibility to the overall conclusion on the role of extrinsic factors in cancer development
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    Really great read.  Cancer is a majority lifestyle disease.
Nathan Goodyear

Normal Fasting Plasma Glucose Levels and Type 2 Diabetes in Young Men - NEJM - 0 views

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    Fasting glucose levels >90 require treatment.  Don't wait until they increase above 100, damage is actively occurring in the kidneys at levels above 90.  institute dietary/lifestyle changes at any point above 84.
Nathan Goodyear

PLOS ONE: Increased Risk of Non-Fatal Myocardial Infarction Following Testosterone Ther... - 0 views

  • For all TT prescription subjects combined, the post/pre prescription rate ratio for MI (RR)was 1.36
  • In men aged 65 years and older the RR was 2.19 (1.27, 3.77), while in men under age 65 years the RR was 1.17
  • increasing RR with increasing age.
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  • The RRs were 0.95 (0.54, 1.67) under 55 years
  • 1.35 (0.77, 2.38) at 55–59
  • 1.29 (0.71, 2.35) at 60–64,
  • 1.35 (0.44, 4.18) at 65–69, 1.62
  • 3.43 (1.54, 7.66) at 75 years and older
  • The adjusted post/pre RR for PDE5I across all ages was 1.08
  • For TT prescription, in men under age 65 years, the RR was 2.90 (1.49, 5.62) for those with a history of heart disease and 0.90 (0.61, 1.34) for those without
  • In men aged 65 year and older, the RR was 2.16 (0.92, 5.10) for those with a history of heart disease and 2.21 (1.09, 4.45) for those without.
  • Among men aged 65 years and older, we observed a two-fold increase in the risk of MI in the 90 days after filling an initial TT prescription
  • Among younger men with a history of heart disease, we observed a two to three-fold increased risk of MI in the 90 days following an initial TT prescription and no excess risk in younger men without such a history
  • Among older men, the two-fold increased risk was associated with TT prescription regardless of cardiovascular disease history
  • our own findings appear consistent with a higher frequency of thrombotic events following TT prescription among men with more extensive coronary vascular disease.
  • Our findings are consistent with a recent meta-analysis of placebo-controlled randomized trials of testosterone therapy lasting 12 or more weeks among mainly older men, which reported that testosterone therapy increased the risk of adverse cardiovascular-related events (OR = 1.54, 95%CI:1.09, 2.18), as well as serious adverse cardiovascular-related events (OR = 1.61, 95%CI:1.01, 2.56) which included myocardial infarction along with other conditions
  • This association appeared unrelated to average baseline testosterone level (p = 0.70) but varied by source of funding (p = 0.03), with a stronger summary effect in a meta-analysis of studies not funded by the pharmaceutical industry (OR = 2.06, 95%CI:1.34, 3.17) compared with studies funded by the pharmaceutical industry
    • Nathan Goodyear
       
      This supports prior analysis that studies done by pharmaceutical corps will be more favorable to their product(s) than those independently funded.  This is called bias.
  • the evidence supports an association between testosterone therapy and risk of serious, adverse cardiovascular-related events–including non-fatal myocardial infarction–in men
  • there is some evidence that low endogenous testosterone levels may also be positively associated with cardiovascular events
  • effects of endogenous and exogenous testosterone may differ. Exogenous testosterone (TT) is associated with physiologic changes that predispose to clotting and thrombotic disorders including increased blood pressure [18], polycythemia [19], reductions in HDL cholesterol [18], [20], and hyperviscosity of the blood and platelet aggregation. [20]–[23]; TT also increases circulating estrogens [24], [25] which may play a role in the observed excess of adverse cardiovascular-related events, given that estrogen therapy has been associated with this excess in both men and women
  • did not include information on the serologic or diagnostic indications for treatment.
  • no association between PDE5I prescriptions and the risk of MI
  • Recently TT has been increasing extraordinarily rapidly, including among younger men and among those without hormone measurement
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    New cohort study finds increased risk of Testosterone in men > 65 and those : these are based in marketing-based medicine not evidence based medicine.
Nathan Goodyear

Measurement of salivary cortisol in 2012 - laboratory techniques and clinical indications - 0 views

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    Review of data analyzing salivary cortisol finds saliva is a great medium, with sensitivity and specificity exceeding 90%, for evaluating the stress response.  So, where is the Louisiana State Board of Medicine, BCBS, and other insurance companies on this.  They are in favor of inferior testing and treatments ie.  hysterectomies for pelvic pain (50% success rate).   The great item here is this is not one study but an analysis of multiple studies. This is contrast to "opinions" that often govern the above mentioned organizations/businesses.
Nathan Goodyear

ScienceDirect.com - Food and Chemical Toxicology - Long term toxicity of a Roundup herb... - 0 views

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    First long-term study on GMO effects on rats. The majority of studies on GMO have been on animals with the end point at < 90 days.  This study followed the rats for 2 years.  Increased mammary tumors were found.  Is this definitive?  Of course not, but this is the first study to look at long term effects.
Nathan Goodyear

Utility of Salivary Cortisol Measurements in Cushing's Syndrome and Adrenal Insufficiency - 1 views

  • It is expected that the use of the measurement of salivary cortisol will become routine in the evaluation of patients with disorders of the HPA axis.
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    Salivary cortisol testing shown to have sensitivity and specificity that exceeds 90%.  Final Quote: "salivary cortisol will become routine in the evaluation of patients with disorders of the HPA axis
Nathan Goodyear

Glucose Targets in Pregnant Women With Diabetes: A Systematic Review and Meta-Analysis - 0 views

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    Target range for glucose in pregnancy should be < 90.
wheelchairindia9

Reclining Commode Wheelchair - 0 views

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    wheelchair category (standard, transport, power, etc.) could be classified as a reclining wheelchairs, since the product class is built around one key feature: the capability to adjust the backrest and/or footrest into a reclined position. This feature is especially important to users who find it difficult or impossible to sit in a fully upright position, and users who sleep in their chairs frequently. For those that are looking for a more portable chair, however, products from this category may not be a great fit. When compared with a similar, non-reclining chair, a reclining wheelchair tends to weigh more and - unlike other manual models - manual wheelchairs that recline typically aren't foldable. Some people use special wheelchairs to distribute pressure and thus reduce the risk of skin sores. These chairs also increase comfort and sitting tolerance. One type of chair, called "tilt in space," changes a person's orientation while maintaining fixed hip, knee, and ankle angles. The whole seat, in effect, tilts. The other chair option is called a recline system, which basically changes the seat-to-back angle, flattening out the back of the chair and in some cases raising the legs to form a flat surface. Different Types Of Reclining Wheelchairs: Reclining Wheelchair 902 GC Reclining Wheelchair 609 GC Karma Aurora 4 Reclining Wheelchair Karma Reclining Wheelchair KM 5000 Karma VIP 515 Wheelchair Reclining Wheelchair 902 GC: Reclining Wheelchair 902 GC is one of the basic models of a Reclining Wheelchair which helps transfer to bed to wheelchair easily and comes with head and neck support and Calf support for added comfort. Reclining Wheelchair 902 GC Features: The chair boast of movable armrest and elevating footrest. A well padded thigh support helps the user thigh's during reclining. The front and the rear wheels are designed and placed in such a way so as to support the users weight during reclining. The Pneumatic rear wheels help the movement
wheelchairindia9

Karma Vip 515 Wheelchair - 0 views

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    Wheelchair category (standard, transport, power, etc.) could be classified as a reclining wheelchairs, since the product class is built around one key feature: the capability to adjust the backrest and/or footrest into a reclined position. This feature is especially important to users who find it difficult or impossible to sit in a fully upright position, and users who sleep in their chairs frequently. For those that are looking for a more portable chair, however, products from this category may not be a great fit. When compared with a similar, non-reclining chair, a reclining wheelchair tends to weigh more and - unlike other manual models - manual wheelchairs that recline typically aren't foldable. Karma Reclining Wheelchair KM 5000: The karma reclining wheelchair km-5000 Transport Wheelchair is an ultra lightweight folding aluminum reclining wheelchair. With full length padded armrests, an adjustable height head pillow, and more this wheelchair has added comfort for any user. This chair also features swing-away elevating footrests and adjustable length leg supports and footplates. With a weight of 33 Lbs this chair can be transported with ease. Karma Reclining Wheelchair KM 5000 Features: Folding 6061 T-6 Aircraft-grade aluminum frame in black powder coat finish Backrest Reclines 90°~163° and includes anti-tippers Full length padded detachable armrests with side panels Swing-away detachable elevating footrests Adjustable length leg supports & footplates Adjustable-height head pillow 14" Mag wheels with flat free polyurethane tires 7" x 1" Flat free front polyurethane casters Adjustable toggle wheel locks High-grade flame retardant, breathable nylon upholstery Limited lifetime warranty on frames and cross-braces, one year on parts One of only two lightweight recliners available in the USA Also Available in Large Manual Rear Wheel option, (KM- 5000F), please call for more info Frame Color: Silver Karma Reclining Wheelchair KM 5000 Me
wheelchairindia9

Karma Vip 515 - 0 views

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    Wheelchair with comfortble reclining back headrest. This wheelchair allows the user to obtain a more comfortable position, equally for those who are unable to sit at 90 degrees, but need to lie back. Options include elevating legrests and cushioning. This type of Wheelchair is a superb light weight aluminium total care chair with all the actions one would wish. All fully adjustable, tilt in space, reclining back, multi positional headrest,elevating legrests and full pressure cushioning. The reclining deluxe manual wheelchair. This wheelchair has all the features one would need in a wheelchair, fully adjustable arms, legrests, reclining back and pop off wheels. To remove the wheels simply press the button in the centre of the wheel and slide them off. Ideal for those who need to recline in the wheelchair as the back rest on this wheelchair can be adjusted to any position. With cushions, elevating legrests and other options, this wheelchair can be configured to meet most needs. This chair does not have tilt in space mechanism or pressure care cushioning, for this must look to the tilt in space chair. Comfort and positioning tilt-in-space wheelchair which is durable, modern looking and comfortable. It offers adjustable seat height and depth, back height, length adjustable armpads and infinite recline and tilt. The multifunction tilt in space wheelchair focuses heavily on the need of each individual user which is why it has many adjustments in one frame to make sure it can alter to cater individual requirements. One of the main features of this chair is its tilt in space feature, which allows a step less adjustment of the backrest and the seat angle. This is easily operated from the push handle and can be quickly adjusted when needed. The design of the backrest and seating on the wheelchair helps ensure comfort and support for the user. Wheelchair comes with elevating leg rests fitted as standard which again are step less and easily adjusted. There is also the o
Nathan Goodyear

Testosterone Deficiency Increases Hospital Readmission and Mortality Rates in Male Pati... - 0 views

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    Men with CHF and low Testosterone have higher readmission rates within 90 days compared to those men with CHF and normal Testosterone.
Nathan Goodyear

Subclinical Thyroid Dysfunction: A Joint Statement on Management from the American Asso... - 0 views

  • the potential benefits of early detection and treatment of subclinical thyroid dysfunction significantly outweigh the potential side-effects that could result from early diagnosis and therapy
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    Joint statement on early treatment of thyroid disease and subclinical thyroid dysfunction from The american association of clinical endocrinologists, the American Thyroid Association, and the Endocrine Society
Nathan Goodyear

Short-Term Aromatase-Enzyme Blockade Unmasks Impaired Feedback Adaptations in Luteinizi... - 0 views

  • administration of a potent and selective aromatase antagonist reduces estradiol and elevates mean LH concentrations equivalently in young and older men. The low estrogen-feedback state in elderly men unmasks diminished incremental LH pulse amplitude and area; absence of further acceleration of LH pulse frequency; impaired regulation of the orderliness of LH release; and reduced testosterone to SHBG ratios
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    estrogen decreases testosterone production
Nathan Goodyear

Small Differences in Thyroid Function May Be Important for Body Mass Index and the Occu... - 0 views

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    TSH doesn't have to be above normal for your weight to be negatively affected
Nathan Goodyear

Thyroid Hormone Concentrations, Disease, Physical Function, and Mortality in Elderly Me... - 0 views

  • High serum rT3 may result from a decreased peripheral metabolism of thyroid hormones due to the aging process itself and/or disease and may reflect a catabolic state.
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    elevated serum rT3 indicates tissue hypothyroidism; very different than rT3 in the pituitary, where high concentrations accumulate
Nathan Goodyear

ingentaconnect Immune Status, Latent Viral Reactivation, and Stress During Long-... - 0 views

  • stress hormone levels
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    salivary cortisol testing used to evaluate stress of 90 degree bed rest in astronauts
Nathan Goodyear

http://onlinelibrary.wiley.com/store/10.1002/hep.23588/asset/23588_ftp.pdf;jsessionid=C... - 0 views

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    More than 90% of drug induced autoimmune hepatitis is due to minocycline and nitrofurantoin.  No cirrhosis occurred in f/u.
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
wheelchairindia9

PF Night Splint Derotation - 0 views

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    PF Night Splint (Derotation) Applications Prevention and correction of foot drop. Night splint for early healing. Ambulatory, can be used as a day splint. Perfect post-operative immobilisation and derotation. Peroneal / Peritibial nerve or muscle damage. Ankle or Plantar flexion contracture and functional alignment. Can be used to protect the diabetic/ injured ankle & foot. PF Night Splint (Derotation) Features Removable de-rotation bar. Moulded foot casing, aesthetically pleasing and durable. Effective Liner, improved comfort. Highly functional Design, customized degree of dorsiflexion. Double strapping mechanism, better grip.
Nathan Goodyear

SAGE Journals: Your gateway to world-class journal research - 0 views

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    Quercetin found to inhibit HSP 70 which also delayed HSP 90 transcription. HSPs are increased in response to thermal stress. This results in an anti-apoptosis effect and increased cell survival
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