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Willow O'Donnell

Refurbished Abbott Hospira Plum A+ 3 Triple Channel Infusion IV Pump - 0 views

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    Refurbished Abbott Hospira Plum A+ 3 Infusion Pump. The A+3 is a triple channel pump that allows each channel to be programmed and ran individually. Delivery rates in include primary, secondary and concurrent. The A+3 allows for a variety of delivery units including: mL/hr, mcg/kg/min, mcg/min, mcg/kg/hr, cg/hr, mg/min, mg/kg/hr, mg/hr, ng/kg/min, g/hr, mEq/hr, Million units/hr, units/min, units/hr, units/kg/hr, units/kg/min, mmol/min, mmol/hr. *Refurbished *1-Year Warranty
Willow O'Donnell

Refurbished Abbott Hospira Plum A+ 3 Triple Channel Infusion IV Pump - 0 views

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    Refurbished Abbott Hospira Plum A+ 3 Infusion Pump. The A+3 is a triple channel pump that allows each channel to be programmed and ran individually. Delivery rates in include primary, secondary and concurrent. The A+3 allows for a variety of delivery units including: mL/hr, mcg/kg/min, mcg/min, mcg/kg/hr, cg/hr, mg/min, mg/kg/hr, mg/hr, ng/kg/min, g/hr, mEq/hr, Million units/hr, units/min, units/hr, units/kg/hr, units/kg/min, mmol/min, mmol/hr. *Refurbished *1-Year Warranty
Willow O'Donnell

Refurbished Abbott Hospira Plum A+ 3 Triple Channel Infusion - nextechclassifieds - 0 views

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    Refurbished Abbott Hospira Plum A+ 3 Infusion Pump. The A+3 is a triple channel pump that allows each channel to be programmed and ran individually. Delivery rates in include primary, secondary and concurrent. The A+3 allows for a variety of delivery units including: mL/hr, mcg/kg/min, mcg/min, mcg/kg/hr, cg/hr, mg/min, mg/kg/hr, mg/hr, ng/kg/min, g/hr, mEq/hr, Million units/hr, units/min, units/hr, units/kg/hr, units/kg/min, mmol/min, mmol/hr. *Refurbished *1-Year Warranty
Nathan Goodyear

Testosterone level in men with type 2 diabetes mellitus and related metabolic... - 0 views

  • defined by consistent symptoms and signs of androgen deficiency, and an unequivocally low serum testosterone level
  • the threshold serum testosterone level below which adverse clinical outcomes occur in the general population is not known
  • most population-based studies use the serum testosterone level corresponding to the lower limit, quoted from 8.7 to 12.7 nmol/L, of the normal range for young Caucasian men as the threshold
    • Nathan Goodyear
       
      this equals 251 to 366 in serum Total Testosterone
  • ...57 more annotations...
  • Researchers tried to examine whether serum total or free testosterone would be a better/more reliable choice when studying the effect of testosterone. The results were mixed. Some reported significant associations of both serum total and free testosterone level with clinical parameters25, whereas others reported that only serum free testosterone26 or only serum total testosterone6 showed significant associations.
  • −0.124 nmol/L/year in serum total testosterone
    • Nathan Goodyear
       
      this equates to a 4 ng/dl decline annually in total Testosterone.
  • In experimental studies, androgen receptor knockout mice developed significant insulin resistance rapidly
  • In mouse models, testosterone promoted differentiation of pluripotent stem cells to the myogenic lineage
  • testosterone decreased insulin resistance by enhancing catecholamine induced lipolysis in vitro, and reducing lipoprotein lipase activity and triglyceride uptake in human abdominal tissue in vivo
  • by promoting lipolysis and myogenesis, testosterone might lead to improved insulin resistance
  • testosterone regulated skeletal muscle genes involved in glucose metabolism that led to decreased systemic insulin resistance
  • In the liver, hepatic androgen receptor signaling inhibited development of insulin resistance in mice
  • independent and inverse association of testosterone with hepatic steatosis shown in a cross-sectional study carried out in humans
  • In short, androgen improves insulin resistance by changing body composition and reducing body fat.
  • Although a low serum testosterone level could contribute to the development of obesity and type 2 diabetes through changes in body composition, obesity might also alter the metabolism of testosterone
  • In obese men, the peripheral conversion from testosterone to estrogen could attenuate the amplitude of luteinizing hormone pulses and centrally inhibit testosterone production
  • leptin, an adipokine, has been shown to be inversely correlated with serum testosterone level in men
  • Leydig cells expressed leptin receptors and leptin has been shown to inhibit testosterone secretion, suggesting a role of obesity and leptin in the pathogenesis of low testosterone
    • Nathan Goodyear
       
      So what is "unequivocal"?
  • Baltimore Longitudinal Study of Aging (BLSA) cohort made up of 3,565 middle-class, mostly Caucasian men from the USA, the incidence of low serum total testosterone increased from approximately 20% of men aged over 60 years, 30% over 70 years, to 50% over 80 years-of-age
  • 30–44% sex hormone binding globulin (SHBG)-bound testosterone and 54–68% albumin-bound testosterone
  • As the binding of testosterone to albumin is non-specific and therefore not tight, the sum of free and albumin-bound testosterone is named bioavailable testosterone, which reflects the hormone available at the cellular level
  • Serum total testosterone is composed of 0.5–3.0% of free testosterone unbound to plasma proteins
  • alterations in SHBG concentration might affect total serum testosterone level without altering free or bioavailable testosterone
  • listed in Table​T
  • A significant, independent and longitudinal effect of age on testosterone has been observed with an average change of −0.124 nmol/L/year in serum total testosterone28. The same trend has been shown in Europe and Australia
  • Asian men residing in HK and Japan, but not those living in the USA, had 20% higher serum total testosterone than in Caucasians living in the USA, as shown in a large multinational observational prospective cohort of the Osteoporotic Fractures in Men Study
  • subjects with chronic diseases consistently had a 10–15% lower level compared with age-matched healthy subjects
  • In Caucasians, the mean serum total testosterone level for men in large epidemiological studies has been reported to range from 15.1 to 16.6 nmol/L
  • Asians, higher values, ranging from 18.1 to 19.1 nmol/L, were seen in Korea and Japan
  • Chinese middle-aged men reported a similar mean serum testosterone level of 17.1 nmol/L in 179 men who had a family history of type 2 diabetes and 17.8 nmol/L in 128 men who had no family history of type 2 diabetes
  • The reduction of total testosterone was 0.4% per year in both groups
  • HK involving a cohort of 1,489 community-dwelling men with a mean age of 72 years, a mean serum total testosterone of 19.0 nmol/L was reported
  • pro-inflammatory factors, such as tumor necrosis factor-α in the testes, could locally inhibit testosterone biosynthesis in Leydig cells47, and testosterone treatment in men was shown to reduce the level of tumor necrosis factor-α
  • In Asians, a genetic deletion polymorphism of uridine diphosphate-glucuronosyltransferase UGT2B17 was associated with reduced androgen glucuronidation. This resulted in higher level of active androgen in Asians as compared to Caucasians, as Caucasians' androgen would be glucuronidated into inactive forms faster.
  • Compared with Caucasians, the frequency of this deletion polymorphism of UGT2B17 was 22-fold higher in Asian subjects
  • Other researchers have suggested that environmental, but not genetic, factors influenced serum total testosterone
  • The basal and ligand-induced activity of the AR is inversely associated with the length of the CAG repeat chain
  • In the European Male Aging Study, increased estrogen/androgen ratio in association with longer AR CAG repeat was observed
  • a smaller number of AR CAG repeat had been shown to be associated with benign prostate hypertrophy and faster prostate growth during testosterone treatment
  • In India, men with CAG ≤19 had increased risk of prostate cancer
  • the odds of having a short CAG repeat (≤17) were substantially higher in patients with lymph node-positive prostate cancer than in those with lymph node-negative disease or in the general population
  • assessing the polymorphism at the AR level could be a potential tool towards individualized assessment and treatment of hypogonadism.
  • In elderly men, there was reduced testicular response to gonadotropins with suppressed and altered pulsatility of the hypothalamic pulse generator
  • a significant, independent and longitudinal effect of age on serum total testosterone level had been observed
  • A significant graded inverse association between serum testosterone level and insulin levels independent of age has also been reported in Caucasian men
  • Low testosterone is commonly associated with a high prevalence of MES
  • most studies showed that changes in serum testosterone level led to changes in body composition, insulin resistance and the presence of MES, the reverse might also be possible
  • MES predicted a 2.6-fold increased risk of development of low serum testosterone level independent of age, smoking and other potential confounders
  • Other prospective studies have shown that development of MES accelerated the age-related decline in serum testosterone level
  • In men with type 2 diabetes, changes in serum testosterone level over time correlated inversely with changes in insulin resistance
  • weight loss by either diet control or bariatric surgery led to a substantial increase in total testosterone, especially in morbidly obese men, and the rise in serum testosterone level was proportional to the amount of weight lost
  • To date, published clinical trials are small, of short duration and often used pharmacological, not physiological, doses of testosterone
  • In the population-based Osteoporotic Fractures in Men Study cohort from Sweden, men in the highest quartile of serum testosterone level had the lowest risk of cardiovascular events compared with men in the other three quartiles (hazard ratio [HR] 0.70
  • low serum total testosterone was associated with a significant fourfold higher risk of cardiovascular events when comparing men from the lowest testosterone tertile with those in the highest tertile
  • Shores et al. were the first to report that low serum testosterone level, including both serum total and free testosterone, was associated with increased mortality
  • low serum total testosterone predicted increased risk of cardiovascular mortality with a HR of 1.38
  • low serum total testosterone increased all-cause (HR 1.35, 95% CI 1.13–1.62, P < 0.001) and cardiovascular mortality (HR 1.25
  • European Association for the Study of Diabetes 2013 suggested there was an inverse relationship between serum testosterone level and acute myocardial infarction
  • Diabetic men in the highest quartile of serum total testosterone had a significantly reduced risk of acute MI when compared with those in the lower quartiles
  • serum total testosterone level in the middle two quartiles at baseline predicted reduced incidence of death compared with having the highest and lowest levels
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    Nice review of Testosterone levels and some of the evidence linking Diabetes with low T.  However, the conclusion by the authors regarding what is causing the low T in men with Diabetes is baffling.  The literature does not point to one cause, it is clearly multifactorial--obesity, inflammation, high aromatase activity...I would suggest the authors continue their readings in the manner.
Nathan Goodyear

BioPsychoSocial Medicine | Full text | Effects of antidepressant treatment on heart rat... - 0 views

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    antidepressants shown to reduce heart rate variability (HRV) and an increased heart rate (HR), both of which increase cardiovascular disease (CVD).
Nathan Goodyear

Low serum albumin levels and liver metastasis are powerful prognostic markers for survi... - 0 views

  • poor PS,8-10 the presence of liver metastases,7, 9, 10 and elevated LDH levels10 were independent prognostic factors
  • lymphopenia (HR of, 1.89; P = .04) and hypoalbuminemia (HR of 2.7; P < .0001) were independent prognostic factors for overall survival
  • lymphopenia in cancer patients remain unclear and may reflect in part poor nutrition
  • ...2 more annotations...
  • may result in part from the destruction of lymphocytes by the tumor and/or an impaired differentiation of lymphocytes progenitors
  • presence of liver metastasis (HR of, 2.27; P = .0003) and hypoalbuminemia were the 2 most powerful adverse prognostic factors
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    study finds that lympohopenia and low albumin was associated with the worse prognosis in 317 patients with liver mets with unknown primary cancer. 
wheelchairindia9

Golden Motor Electric Wheelchair - 0 views

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    Powerchairs are generally four-wheeled or six-wheeled and non-folding, however some folding designs exist and other designs may have some ability to partially dismantle for transit. Four general styles of powerchair drive systems exist: front, centre or rear wheel drive and all-wheel drive. Powered wheels are typically somewhat larger than the trailing/castoring wheels, while castoring wheels are typically larger than the castors on a manual chair. Centre wheel drive powerchairs have castors at both front and rear for a six-wheel layout. Angel Wheelchair Electric standing wheelchair Standing up, driving function by power. Head and signal light (controlled by joystick). Adjustable headrest. Adjustable footplate. Detachable backrest Rigid steel framework W/liquid coating Flip-backward armrest Max speed: 9.15KM/H Front castor: 2.80/2.50-4 pneumatic castor (9") Rear wheels: 3.00-8 pneumatic tire (14") Available seat width: A (46 cm), D (42 cm) Max loading: A size: 135 kg Net weight w/o battery: 62.7 kg A powerchairs is a wheelchair that is propelled by means of an electric motor rather than manual power. Power wheelchairs are useful for those unable to propel a manual wheelchair or who may need to use a wheelchair for distances or over terrain which would be fatiguing in a manual wheelchair. They may also be used not just by people with 'traditional' mobility impairments, but also by people with cardiovascular and fatigue based condition. An powerwheelchair powers more than just chair. It gives the power to safely travel long distances on own. It empowers to navigate through home, backyard, school, workplace or local park. It gives power to do the things,want to do. It gives power. When accidents occur that leave permanent leg injuries, or as age sets in and joint pain becomes unbearable, the power chair acts as a gateway to continue living life to the fullest. The powerwheelchairs in our lineup are all battery powered, yet each device fills
wheelchairindia9

Golden Motor Wheelchair - 0 views

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    GM LITE POWER WHEELCHAIR GM Lite Brushless Power Wheelchair with Batteries is a revolutionary light weight power wheelchair using brushless motor. It is the most economic power wheelchair without sacrificing safety & durability. The wheelchair promotes pressure redistribution, reduces downward sliding and helps maintain good posture. Specifications: 10 times longer life Lightest - 23 kg 5 year long life, safe LiFePO4 battery (10ah) High efficiency brushless hub motor 5 seconds folding and unfolding Easy to carry Load : 120 kg Speed : 8km/hr Range: 15 km Slope : 12% 24V180W brushless 8-inch gear hub motor
Nathan Goodyear

Normalization of testosterone level is associated with reduced incidence of myocardial ... - 0 views

  • Normalized-TRT group had significantly fewer deaths than no-TRT
  • Mortality was also significantly lower in the non-normalized-TRT group compared with those in no-TRT group
  • the normalized-TRT group was associated with significantly increased all-cause mortality-free survival (log-rank, P < 0.05) compared with the non-normalized-TRT or no-TRT groups
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  • normalized-TRT group showed lower risk of MI than non-normalized-TRT (HR: 0.82, CI 0.71–0.95, P = 0.008) and no-TRT
  • normalized-TRT group had significantly lower stroke events compared with non-normalized-TRT (HR: 0.70, CI 0.51–0.96, P = 0.028) and no-TRT
  • study of men with low TT levels and without prior MI or stroke, normalization of TT levels using TRT is associated with lower all-cause mortality, fewer MIs, and ischaemic strokes
  • retrospective study
  • the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalize the TT levels
  • Patients who failed to achieve the therapeutic range after TRT did not see a reduction in MI or stroke and had significantly less benefit on mortality
  • selected patients without any previous history of MI or stroke prior to initiation of TRT to reduce bias related to CV outcomes
  • currently only half of the men on TRT had been diagnosed with hypogonadism.
  • 25% of users did not have their T concentrations tested prior to initiating therapy, and 21% of those prescribed TRT did not have their levels tested at any time during treatment.
  • men without a history of previous MI or stroke who have low TT levels, TRT might be associated with decreased risks of MI, ischaemic stroke, and all-cause mortality in long-term follow-up
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    Testosterone therapy in men with low T found to reduce all cause mortality, stroke and MI.
Nathan Goodyear

Testosterone deficiency and cardiovascular mortality Morgentaler A, - Asian J Androl - 0 views

  • overall mortality and CV mortality were inversely associated with serum T concentrations.
  • men with low serum T, defined as < 8.7 nmol l−1 (250 ng dl−1 ), demonstrated significantly greater all-cause mortality than men with higher serum T (hazard ratio [HR]: 2.24; 95% CI: 1.41-3.57), as well as greater CV mortality
  • lower T levels were significantly associated with the presence of any CV disease
  • ...19 more annotations...
  • more than 30 years of studies suggesting that low levels of T represent an increased risk for CV and overall mortality,
  • lower serum T concentrations also are associated with CV disease, including incident coronary artery disease [17],[18],[19] and atherosclerosis,
  • the actual rate of adverse events was only half as great in the T group (123 events in 1223 men at risk = 10.1%) as in the untreated group (1587 events in 7486 men = 21.2%)
  • The study by Vigen et al. [7] has already undergone two published corrections,
  • 29 medical societies have called for retraction of the article, asserting "gross data mismanagement and contamination," that rendered the study "no longer credible
  • Mortality in T-treated men was reduced by approximately half in treated men compared with untreated men, at 10.3% versus 20.7%, respectively
  • The mortality rate for men who received TTh was 3.4 deaths per 100 person-years, and 5.7 deaths per 100 person-years in untreated men
  • HR of 0.61 (95%CI: 0.42-0.88; P = 0.008), indicating a significant reduction in mortality with TTh
  • men in the highest prognostic MI risk quartile, treatment with TTh was associated with reduced risk
  • tripling in T prescriptions in the US over the last decade
  • a majority of observational studies have found that low endogenous serum T levels are associated with increased mortality.
  • Men who received TTh were able to exercise significantly longer without ischemia compared with men who received placebo
  • In men with congestive heart failure, those who received T demonstrated greater walking distance and other functional endpoints compared with those who received placebo
  • TTh has been shown uniformly and repeatedly to improve several known CV risk factors, including reduced fat mass, body fat percent, and waist circumference, and increased lean mass
  • improved glycemic control
  • reductions in insulin resistance.
  • the evidence strongly points to improved CV status with normal serum T or treatment with TTh in men with TD
  • analysis of health insurance claims data that reported a 36% increased rate of nonfatal MI in the 90d following receipt of a T prescription compared with the 12 prior months.
  • Comparison with men who received a prescription for a phosphodiesterase type 5 inhibitor (PDE5i) revealed no increased rate of MI following the prescription
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    Great review by Morgentaler of Testosterone and CVD.  He highlights the significant flaws in the JAMA and the NEJM articles of Testosterone therapy risks.  Morgentaler highlights the significant evidence that points to low T and increased risk of CVD. On contention I have, is Morgantaler seems to flip aside the massive uptick of Testosterone use in the US as compared to other countries.  The evidence definitely points to Testosterone therapy as being safe in those with low T, but there is definitely a problem of significant Testosterone doping that is taking place as well.
Nathan Goodyear

https://www.cayugamed.org/docs/Nutrition_Update_for_the_Ultraendurance_Athlete%208.pdf - 0 views

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    Nutrition for ultra endurance.  To be read.
wheelchairindia9

Folding Power Wheelchair - 0 views

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    GM LITE POWER WHEELCHAIR GM Lite Brushless Power Wheelchair with Batteries is a revolutionary light weight power wheelchair using brushless motor. It is the most economic power wheelchair without sacrificing safety & durability. The wheelchair promotes pressure redistribution, reduces downward sliding and helps maintain good posture. Specifications: 10 times longer life Lightest - 23 kg 5 year long life, safe LiFePO4 battery (10ah) High efficiency brushless hub motor 5 seconds folding and unfolding Easy to carry Load : 120 kg Speed : 8km/hr Range: 15 km Slope : 12% 24V180W brushless 8-inch gear hub motor
wheelchairindia9

Heavy Duty Wheelchair - 0 views

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    Bariatric wheelchairs (often referred to as extra wide wheelchairs or heavy duty wheelchairs) are strong enough to accommodate almost any user. Just like lighter manual chairs, bariatric wheelchairs are all foldable and feature armrests and swing-away footrests - but they differ quite a bit in their construction. While lightweight wheelchairs often employ materials like aluminum or titanium alloy, a bariatric wheelchair is usually fashioned from steel. Karma 8020 X Heavy Duty Wheelchair: It comes with detachable swing away footrests. The wheel chair has flip-back armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 K.G. Heavy duty wheelchairs (often referred to as extra wide wheelchairs or bariatric wheelchairs) are sturdy enough to accommodate almost any user. Just their lighter cousins, manual chairs, heavy duty models all fold and feature arm rests and swing-away footrests - but they differ quite a bit in their construction. Heavy duty wheelchairs require more strength to push by the caregiver and by the user, if the chair is self-propelled. In some cases, it may be wise for the caregiver to ask for assistance from another person in order to push the wheelchair safely. Karma 8520 Heavy Duty Wheelchair: It comes with detachable swing away footrests. The wheel chair has flip-back armrests. It comes with centre of gravity adjustment. The wheel chair has wide profile casters. Seat Size 20'' inch & 22'' inch Total Weight 17 K.G. Features: Dual, reinforced steel cross braces. Supports individuals maximum weight. Reinforced steel frame provides added support. Heavy duty, nylon reinforced upholstery with a back carry pouch. Removable, reversible desk length arms. Adjustable leg support.
wheelchairindia9

Electronic Wheel chair - 0 views

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    Golden Technologies takes all the worry out of purchasing a power wheelchair. Designers blend the most technologically advanced components with superior designs to provide with the almost in quality, comfort and style. Motorized wheelchairs to enter bike lanes if a sidewalk isn't available or passable by wheelchair. Wheelchair users would be required to yield the right-of-way to bikers. The proposal also adds motorized wheelchairs to current law affecting vehicles and bicycles on the road, including the required three foot law between bikers and drivers. Supporters bill would help wheelchair users get around quickly and that areas without sidewalks are often difficult to navigate. It's the standard chair, with the main frame attaches to the front. This isn't a futuristic design as such, but a very good way of maintaining or building strength in those who are bound to a wheelchair, and may hope to walk again in their future. Personally, this bike is pretty cool. It's got a front frame similar to a chopper, with the added comfort of a chair appose to a saddle. A new module is set to transform electric powered wheelchairs into communication hubs. An powerchair is more compact and has a better turning radius than an electric scooter; making it is easier to navigate narrow doorways and tight turns. Another advantage of the powerwheelchair is that its armchair joystick does not require an upright posture like an electric scooter's handlebars. Most power wheelchairs can also be taken apart and stowed, while scooters usually can't. Powerwheelchairs are also usually less expensive than scooters. For many disabled people, the only way to move around is by using a wheelchair. Those who cannot powered wheelchairs propel themselves with their arms, which often leads to fatigue, pain, and even permanent damage to arms and shoulders. BENEFITS: Activates circulation system and improves cardio-pulmonary function. Helps prevent decubitus sores. Improves bowel regu
Nathan Goodyear

Docosahexaenoic Acid but Not Eicosapentaenoic Acid Lowers Ambulatory Blood Pressure and... - 0 views

  • The results of this study suggest that DHA is the principal 3 fatty acid in fish and fish oils that is responsible for their BP- and HR-lowering effects in humans.
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    Omega-3, DHA lowers pressure and heart rate
Nathan Goodyear

Comparisons of normal saline and lactated Ringer's resuscitation on hemodynamics, metab... - 0 views

  • NS contains 154 mM Na+ and Cl-, with an average pH of 5.0 and osmolarity of 308 mOsm/L.
  • LR solution has an average pH of 6.5, is hypo-osmolar (272 mOsm/L), and has similar electrolytes (130 mM Na+, 109 mM Cl-, 28 mM lactate, etc.) to plasma
  • hyperchloremic acidosis
  • ...26 more annotations...
  • LR’s acid base balance is superior to that of NS’s
  • There were no significant differences between LR and NS groups in fibrinogen concentrations or platelet count
  • Total protein dropped
  • no significant differences in Hct (Table  1) or total protein between LR and NS groups
  • Bicarbonate HCO3- levels were decreased by hemorrhage but returned to pre-hemorrhage values by 3 h after LR resuscitation, whereas no return was observed with NS resuscitation
  • Na+ was increased after NS resuscitation
  • No changes in Na+ or K+ were observed
  • K+ did not change initially after NS resuscitation but was elevated at 6 h afterwards
  • Ca++ was similarly decreased
  • Cl- was elevated for 6 h after NS resuscitation, with no changes shown after LR resuscitation
  • PT was similarly prolonged by resuscitation with LR (from 11.2 ± 0.2 sec at baseline to 12.1 ± 0.2 sec at 6 h) and NS
  • Plasma aPTT was also similarly prolonged by resuscitation with LR (from 17.1 ± 0.5 sec baseline to 20.1 ± 1.2 sec at 6 h) or NS
  • NS resuscitation resulted in better oxygen delivery and oxygen delivery-to-oxygen demand ratio as an index of oxygen debt
  • NS had better tissue perfusion and oxygen metabolism than LR
  • LR resuscitation returned BE and bicarbonate to pre-hemorrhage levels within 3 h, but no return of BE or bicarbonate was observed for 6 hr with NS resuscitation
  • current blood bank guidelines state that LR should not be mixed with blood to prevent the risk of clot formation from calcium included in LR
  • LR resuscitation should not be given with blood through the same iv-line and crystalloids should be avoided in patients with blood transfusion
  • PT and aPTT were prolonged for 6 h after hemorrhage and resuscitation, suggesting a hypocoagulable states
  • potential thrombotic risk from LR resuscitation is unlikely.
  • we suspected that the blood pressure after NS resuscitation would be lower than that of LR due to its vasodilator effects
  • NS required a larger resuscitation volume and was associated with poor acid base status and elevated serum potassium in this model
  • NS required 50% more volume and was associated with a higher cardiac output and lower peripheral resistance, as compared to LR resuscitation
  • These differences are possibly due to the vasodilator effects from NS
  • an elevation of K+ was observed at 6 h post NS resuscitation, while no change of K+ was observed after LR resuscitation
  • The mechanism for the increase of K+ from NS is not fully known
  • NS is associated with vasodilator effects and the risks of metabolic acidosis and hyperkalemia
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    LR vs NS crystalloid.
FMS Dental Hospital

Best Cosmetic Dental Clinic in India - 0 views

FMS DENTAL is one of the top dental clinics in Hyderabad, India and 5th best dental center in the world (GCR Rating), with multi-specialty practice, in-patient facility and 24 hr. emergency dental ...

Best Cosmetic Dental Clinic in India Dentist

started by FMS Dental Hospital on 27 Mar 18 no follow-up yet
Nathan Goodyear

The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for ... - 0 views

  • The ‘Glucose Ketone Index’ (GKI) was created to track the zone of metabolic management for brain tumor management
  • The GKI is a biomarker that refers to the molar ratio of circulating glucose over β-OHB, which is the major circulating ketone body.
  • We present evidence showing that the GKI can predict success for brain cancer management in humans and mice using metabolic therapies that lower blood glucose and elevate blood ketone levels
  • ...14 more annotations...
  • The GKI can be useful in determining the success of dietary therapies that shift glucose- and lactate-based metabolism to ketone-based metabolism
  • Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, chronic inflammatory disease, and epilepsy
  • The zone of metabolic management is likely entered with GKI values between 1 and 2 for humans
  • Optimal management is predicted for values approaching 1.0, and blood glucose and ketone values should be measured 2–3 hours postprandial, twice a day if possible
    • Nathan Goodyear
       
      check GKI 2-3 hr postprandial twice daily
  • Preclinical studies have demonstrated a clear linkage between GKI and therapeutic efficacy
  • the Warburg effect (aerobic fermentation of glucose) is a common metabolic malady expressed in nearly all neoplastic cells of these and other malignant tumors
  • Aerobic fermentation (Warburg effect) is necessary to compensate for the insufficiency of mitochondrial oxidative phosphorylation in the cells of most tumors
  • Normal brain cells gradually transition from the metabolism of glucose to the metabolism of ketone bodies (primarily β-hydroxybutyrate and acetoacetate) for energy when circulating glucose levels become limiting
  • Ketone bodies bypass the glycolytic pathway in the cytoplasm and are metabolized directly to acetyl CoA in the mitochondria
  • Tumor cells are less capable than normal cells in metabolizing ketone bodies for energy due to their mitochondrial defects
  • daily activities and emotional stress can cause blood glucose levels to vary making it difficult for some people to enter the predicted zone of metabolic management
  • a clear association of the GKI to the therapeutic action of calorie restriction against distal invasion, proliferation, and angiogenesis in the VM-M3 model of glioblastoma
  • The results suggest that GKI levels that approach 1.0 are therapeutic for managing brain tumor growth
  • Therapeutic efficacy of the KD or calorie restriction is greater with lower GKI values than with higher values
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    The glucose ketone index shown to predict dietary metabolic success. In humans with brain cancer-- the target is 1.  The glucose and ketone (betahydroxybutyrate) should be measured 2-3 hours postprandial twice daily.
Nathan Goodyear

Acute Exercise Remodels Promoter Methylation in Human Skeletal Muscle: Cell Metabolism - 0 views

  • our results provide evidence to suggest that acute exercise induces gene-specific DNA hypomethylation in human skeletal muscle
  • Our results suggest that DNA methylation is a component of the exercise-induced effect on expression of these genes.
  • Caffeine exposure decreased promoter methylation of Pgc-1α, Tfam, Mef2a, Cs, and Pdk4
  • ...4 more annotations...
  • the effect of exercise on DNA methylation in human skeletal muscle and provide evidence that acute exercise alters promoter methylation of exercise-responsive genes in a dose-dependent manner
  • DNA methylation was unaltered 48 hr after a 3-week exercise training program, whereas RNA expression of PGC-1α and TFAM promoters was elevated (data not shown), further suggesting that DNA hypomethylation is a transient mechanism involved in mRNA synthesis
  • Our findings that ionomycin, AICAR, or ROS production increased mRNA expression without altering promoter methylation may support the notion that DNA methylation does not exclusively control exercise-induced gene expression
  • acute exercise leads to transient changes in DNA methylation in adult skeletal muscle
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    Small study finds acute exercise is associated with epigenetic alteration of muscle through methylation.  This study found a hypomethylation of the genes PGC-1alpha, PDK4, and PPAR-delta with a respondent increase in expression.  The methylation activity was in the promoter region of these genes.
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