Treatment of exercise-associated hyponatremia with hypertonic IV infusion to correct plasma sodium levels is also a standard and accepted use of IV fluid infusions
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Shower Wheelchair - 0 views
www.wheelchairindia.com/...COMMODE-WHEELCHAIR
Shower Wheelchair Can Dramatically Improve Lives pleasant and comfortable bathing lightweight and portable for travel comfortable toilet seat armrests can be folded up extra height and stability require minimum storage space
shared by wheelchairindia9 on 20 Apr 15
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Commode chairs are portable toilets, designed to be placed at the bedside of a disabled individual whose activity is very limited. It is typically consist of a frame and a waste receptacle that can be easily removed and emptied. Having such a device close at hand is especially helpful for those too debilitated to make the trip to the bathroom. So, if someone close to needs the support and convenience that commodes can offer, the right place. Adapted and assisted toileting systems help provide independence while being designed to be practical, versatile and comfortable, as well as, easy to clean. These adjustable toilets and commodes can be used as a freestanding commode chair, over the toilet, on the toilet, or as a shower chair. Commode Wheelchair Rainbow 6 Features: Frame Material : M.S.Chrome Plated. Single Seat with center cut commode. Both Option Available In Single Seat. Plastic Commode Seat With Pot. Cushioned Top Cover. Square Pan Commode Pan . Removable Pan. Commode Wheelchair Rainbow 6 Measurements: Frame Style : Foldable Open Position Wheel To Wheel Width In : 26" (Inches) Seat Width : 18" (Inches) Total Width in Closing Position : 11" (Inches) Rear Wheel Size : 24" (Inches) Front Wheel Size : 8" (Inches) Seat to Floor Height : 19" (Inches) Seat Depth : 18" (Inches) Total Height : 34" (Inches) Max User Weight Capacity : 110 (kgs) Net Weight : 19.5 (kgs) Armrest : Fixed Footrest : Fixed Wheel Quality : Rear Tyre Solid Tube Less Rear Wheel Lock : Yes Hand Brakes : No Drop Back Handle : No Providing a wide range of commode wheelchairs which are specially designed for aged and physically challenged people. These wheelchairs can be used for indoor toilet purposes. Fabricated using quality raw material, these wheelchairs are suitable for western as well as Indian toilets. This advanced technology involved wheelchair has a comfortable seat and made of a strong steel frame. This chair is very durable
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Km 2500 Wheelchair - 0 views
wheelchairsindia.net/...KM-2500-Small-Wheel-Wheelchair
Km 2500 Wheelchair Improve Patients Independence light and compact transit wheelchair Km 2500 Wheelchair Karma Km 2500 Wheelchair Karma Km 2500 Backrest fordable double cross brace provide
shared by wheelchairindia9 on 12 Oct 15
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Km 2500 Wheelchair is amazingly light and compact transit wheelchair which is ideal for outings and travelers. It folds down to take up virtually no space in the boot of a car and weighs just over 9kg making it easy for anyone to lift into a vehicle. It is built with an ultra-lightweight aircraft-grade aluminum alloy frame with a standard seat width of: 16"" and 18"", it has a foldable frame with dual brake system and 20"" flat-free rear wheels. Ultra-lightweight aircraft-grade aluminum alloy frame Standard seat width: 16"" and 18"" Foldable frame with dual brake system 20"" flat-free rear wheels Attendant cable brake Detachable and washable cushion. KARMA KM 2500 SMALL WHEEL WHEELCHAIR: Karma KM 2500 Small Wheel Wheelchair Specifications: Width 18" Front/Rear Wheels 6" to 14" Seat Width 47cm Seat Depth 40cm Overall Width 66cm Overall Collapsed Width 36cm Armrest Height 21cm Overall Length 90cm Seat Height 47cm Backrest Height 38cm Overall Height 86cm Weight 9.2 k.g. Karma KM 2500 Small Wheel Wheelchair Seat and Back AEGIS Microbe Shield Approved by the FDA, EPA, EU, etc., bonded anti-microbial barrier upholstery protects from odor, staining and deterioration from bacteria, fungus and other microorganisms. It is a shield for your health. Karma KM 2500 Small Wheel Wheelchair Extended Armrest: By simulating the natural position of arms, the extended armrest design is ergonomic and creates bigger seating space. An Ultra lightweight wheelchair (9.2 kg) with a compact design for either attendant assisted or self propelling users. The use of aircraft-grade aluminium alloy and double cross brace provide this model with outstanding strength and durability. Karma Healthcare KM-2500 Premium Wheelchair is amazingly light and compact transit wheelchair which is ideal for outings and travelers. It folds down to take up virtually no space in the boot of a car and weighs just over 9.2 kg making it easy for anyone to lift into a v
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Short-term testosterone therapy failed to increase CV risk in women | Endocrinology - 0 views
www.healio.com/...d-to-increase-cv-risk-in-women
testosterone therapy women female hormone hormones cardiovascular disease
shared by Nathan Goodyear on 23 May 14
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24 week study of 71 women post-hysterectomy finds no increase in cardiovascular biomarkers. Several problems with this study. First, there was a large drop out--24%. Second and most important, the women were pretreated with estrogen prior to Testosterone therapies were initiated. Other studies have proposed that this protects cardiovascular risk in women on Testosterone. Previous studies show increasing endogenous Testosterone is associated with increasing cardiovascular disease in women. This study would be much better if no estradiol was prescribed. That would give an unbiased view of Testosterone in post-hysterectomy women. Not much can be taken from this study. If you doctor doesn't know this, find another doctor. Inherent bias in this study as ties to the manufacturer of the Testosterone was disclosed. This study point to the inherent flaws in so much of the medical literature today. Most would read the headlines and read no further, but the "further" dispels the headline as flawed.
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Intravenous Fluid Use in Athletes - 0 views
www.ncbi.nlm.nih.gov/...PMC3435915
IV intravenous fluid nutrition athletes athlete sports medicine sports exercise
shared by Nathan Goodyear on 13 Jan 15
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athletes who present for medical care with hypernatremia who cannot tolerate oral fluids can benefit from IV fluids
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Vaporization of sweat accounts for 80% of heat loss in hot, dry atmospheric conditions. This mechanism of water loss is the major contributor for exercise-associated dehydration
- ...30 more annotations...
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Pre- and postexercise body weight measurements are the most common means to estimate overall water loss but are condition specific
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In highly trained endurance athletes, plasma volume and sodium serum concentration were preserved despite a 5% body weight loss
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In Ironman triathletes, dehydration to 5% body weight loss did not correlate with occurrence of medical complications
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hydration should begin hours prior to exercise, especially if known deficits are present, and fluids should be consumed at a slow, steady rate, with 5 to 7 mL/kg taken 4 hours prior to exercise
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Sodium concentration did not produce significant changes in the rate of absorption but was primarily dependent on carbohydrate concentration
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IV treatment of severe dehydration (>7% body weight loss), exertional heat illness, nausea, emesis, or diarrhea, and in those who cannot ingest oral fluids for other reasons, is clinically indicated
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A recent survey of the National Football League teams revealed that 75% (24 of 32) of the teams utilized IV infusion of fluids for prehydration in at least some otherwise healthy individuals
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In the National Football League, an average of 1.5 L of normal saline was administered approximately 2.5 hours prior to competition
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after 2 hours of exercise, the rectal temperature was 0.6° higher in the group not receiving IV infusion. Also, stroke volume and cardiac output were 11% to 16% lower in the control group versus the IV infusion group.
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Recent evidence suggests the etiology of EAMC is related to muscle fatigue and neuronal excitability
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there may be a subset of muscle cramping that is associated with a loss of both body fluid and sodium
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elevation of plasma volume by 200 to 300 mL via dextran infusion resulted in 15% increase in stroke volume, 4% increase in VO2 max, and an increase in the exercise time to fatigue
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Neither the tonicity nor mode of hydration resulted in improved speed of rehydration, greater fluid retention, or improved performance
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There are beneficial anecdotal reports of EAMC treatment in elite and professional-level athletes with IV hydration during the course of an event
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Plasma volume was better restored during rehydration with IV fluids at preexercise and 5 minutes of exercise. At 15 minutes, there was no difference between IV and oral rehydration
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More rapid restoration of plasma volume was accomplished in the IV treatment group with no advantages over oral rehydration in physiological strain, heat tolerance, ratings of perceived effort, or thermal sensations
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No difference was found in exercise time to exhaustion. IV and oral rehydration methods were equally effective. Heart rates were statistically higher in the oral rehydration group through 75 minutes of exercise, and there were higher increases in norepinephrine plasma concentrations
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No significant differences between the groups were found for time to recovery, number of days with pain, number of days with stiffness, sleep disturbance, fatigue, rectal temperature, and loss of appetite
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There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route
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Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase
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this should be reserved for high-level athletes with strong histories of symptoms in well-monitored settings.
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La Terapia con Células Madre es un Tratamiento Alternativo la Diálisis para l... - 0 views
www.hospitalrenal.com/...1343.html
función renaltratamientola diálisisla terapia con células madrelos efectos secundarios
shared by star yu on 27 Mar 16
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Los pacientes con CKD no quieren tomar la diálisis, eso es un problema constante. Los pacientes nesecitan saber un asunto que la terapia con células madre es un tratamiento alternativo la diálisis ahora. No se preocupan de esta terapia es eficaz o no. En esta artículo, le daremos una respuesta acerca de esta terapia.
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Los pacientes con CKD no quieren tomar la diálisis, eso es un problema constante. Los pacientes nesecitan saber un asunto que la terapia con células madre es un tratamiento alternativo la diálisis ahora. No se preocupan de esta terapia es eficaz o no. En esta artículo, le daremos una respuesta acerca de esta terapia.
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No pay, no expenses, no laws for Venezuela opposition lawmakers - Locality News - 0 views
www.localitynews.com/enezuelas-opposition-lawmakers
POWER CUTS VENEZUELA OPPOSITION LAWMAKER WORLD NEWS
shared by arunaraayala on 15 Oct 16
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Pharmacologic ascorbic acid concentrations selectively kill cancer cells: Action as a p... - 0 views
www.pnas.org/...13604.full
IV vitamin C cancer ascorbic acid vitamin C H2O2 GPX glutathione Perioxidase
shared by Nathan Goodyear on 09 Feb 11
- Cached
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Taken together, these data indicate that ascorbate at concentrations achieved only by i.v. administration may be a pro-drug for formation of H2O2, and that blood can be a delivery system of the pro-drug to tissues.
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These findings give plausibility to i.v. ascorbic acid in cancer treatment, and have unexpected implications for treatment of infections where H2O2 may be beneficial
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pharmacologic concentrations of ascorbate killed cancer but not normal cells, that cell death was dependent only on extracellular but not intracellular ascorbate, and that killing was dependent on extracellular hydrogen peroxide (H2O2) formation with ascorbate radical as an intermediate
- ...48 more annotations...
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Our data show that ascorbic acid selectively killed cancer but not normal cells, using concentrations that could only be achieved by i.v. administration
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Ascorbate-mediated cell death was due to protein-dependent extracellular H2O2 generation, via ascorbate radical formation from ascorbate as the electron donor. Like glucose, when ascorbate is infused i.v., the resulting pharmacologic concentrations should distribute rapidly in the extracellular water space (42). We showed that such pharmacologic ascorbate concentrations in media, as a surrogate for extracellular fluid, generated ascorbate radical and H2O2. In contrast, the same pharmacologic ascorbate concentrations in whole blood generated little detectable ascorbate radical and no detectable H2O2. These findings can be accounted for by efficient and redundant H2O2 catabolic pathways in whole blood (e.g., catalase and glutathione peroxidase) relative to those in media or extracellular fluid
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ascorbic acid administered i.v. in pharmacologic concentrations may serve as a pro-drug for H2O2 delivery to the extracellular milieu
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H2O2 generated in blood is normally removed by catalase and glutathione peroxidase within red blood cells, with internal glutathione providing reducing equivalents
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The electron source for glutathione is NADPH from the pentose shunt, via glucose-6-phosphate dehydrogenase. If activity of this enzyme is diminished, the predicted outcome is impaired H2O2 removal causing intravascular hemolysis, the observed clinical finding.
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Only recently has it been understood that the discordant clinical findings can be explained by previously unrecognized fundamental pharmacokinetics properties of ascorbate
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Intracellular transport of ascorbate is tightly controlled in relation to extracellular concentration
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Intravenous ascorbate infusion is expected to drastically change extracellular but not intracellular concentrations
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For i.v. ascorbate to be clinically useful in killing cancer cells, pharmacologic but not physiologic extracellular concentrations should be effective, independent of intracellular ascorbate concentrations.
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There was no correlation with ascorbate-induced cell death and glutathione, catalase activity, or glutathione peroxidase activity.
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H2O2, as the product of pharmacologic ascorbate concentrations, has potential therapeutic uses in addition to cancer treatment, especially in infections
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Use of ascorbate as an H2O2-delivery system against sensitive pathogens, viral or bacterial, has substantial clinical implications that deserve rapid exploration.
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Recent pharmacokinetics studies in men and women show that 10 g of ascorbate given i.v. is expected to produce plasma concentrations of nearly 6 mM, which are >25-fold higher than those concentrations from the same oral dose
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As much as a 70-fold difference in plasma concentrations is expected between oral and i.v. administration,
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Complementary and alternative medicine practitioners worldwide currently use ascorbate i.v. in some patients, in part because there is no apparent harm
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We first investigated whether ascorbate in pharmacologic concentrations selectively affected the survival of cancer cells by studying nine cancer cell lines
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Clinical pharmacokinetics analyses show that pharmacologic concentrations of plasma ascorbate, from 0.3 to 15 mM, are achievable only from i.v. administration
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plasma ascorbate concentrations from maximum possible oral doses cannot exceed 0.22 mM because of limited intestinal absorption
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For five of the nine cancer cell lines, ascorbate concentrations causing a 50% decrease in cell survival (EC50 values) were less than 5 mM, a concentration easily achievable from i.v. infusion
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All tested normal cells were insensitive to 20 mM ascorbate.
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As ascorbate concentration increased, the pattern of death changed from apoptosis to pyknosis/necrosis, a pattern suggestive of H2O2-mediated cell death
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Apoptosis occurred by 6 h after exposure, and cell death by pyknosis was ≈90% at 14 h after exposure
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In contrast to lymphoma cells, there was little or no killing of normal lymphocytes and monocytes by ascorbate
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Ascorbate is transported into cells as such by sodium-dependent transporters, whereas dehydroascorbic acid is transported into cells by glucose transporters and then immediately reduced internally to ascorbate
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Whether or not intracellular ascorbate was preloaded, extracellular ascorbate induced the same amount and type of death.
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extracellular ascorbate in pharmacologic concentrations mediates death of lymphoma cells by apoptosis and pyknosis/necrosis, independently of intracellular ascorbate.
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Because these data implicated H2O2 in cell killing, we added H2O2 to lymphoma cells and studied death patterns using nuclear staining (19, 28). The death patterns found with exogenous H2O2 exposure were similar to those found with ascorbate
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For both ascorbate and H2O2, death changed from apoptosis to pyknosis/necrosis as concentrations increased
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Sensitivity to direct exposure to H2O2 was greater in lymphoma cells compared with normal lymphocytes and normal monocytes
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There was no association between the EC50 for ascorbate-mediated cell death and intracellular glutathione concentrations, catalase activity, or glutathione peroxidase activity
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H2O2 generation was dependent on time, ascorbate concentration, and the presence of trace amounts of serum in media
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whatever H2O2 is generated should be removed by glutathione peroxidase and catalase within red blood cells, because H2O2 is membrane permeable
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The data are consistent with the hypothesis that ascorbate in pharmacologic concentrations is a pro-drug for H2O2 generation in the extracellular milieu but not in blood.
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In patients with glucose-6-phosphate dehydrogenase deficiency, i.v. ascorbate is contraindicated because it causes intravascular hemolysis
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ascorbate, an electron-donor in such reactions, ironically initiates pro-oxidant chemistry and H2O2 formation
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data here showed that ascorbate initiated H2O2 formation extracellularly, but H2O2 targets could be either intracellular or extracellular, because H2O2 is membrane permeant
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More than 100 patients have been described, presumably without glucose-6-phosphate dehydrogenase deficiency, who received 10 g or more of i.v. ascorbate with no reported adverse effects other than tumor lysis
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Vitamin C inhibits NO-induced stabilization of HIF-1alpha in HUVECs | Request PDF - 0 views
www.researchgate.net/...zation_of_HIF-1alpha_in_HUVECs
Hypoxia-inducible Factor 1 HIF-1alpha vitamin C nitric oxide HIF-1 NO
shared by Nathan Goodyear on 01 Apr 21
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30More
JISSN | Full text | International Society of Sports Nutrition position stand: creatine ... - 0 views
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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
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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
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The body breaks down about 1 – 2% of the creatine pool per day (about 1–2 grams/day) into creatinine in the skeletal muscle
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The magnitude of the increase in skeletal muscle creatine content is important because studies have reported performance changes to be correlated to this increase
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"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
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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
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A few studies have reported protocols with no loading period to be sufficient for increasing muscle creatine (3 g/d for 28 days)
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Most of these forms of creatine have been reported to be no better than traditional CM in terms of increasing strength or performance
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Recent studies do suggest, however, that adding β-alanine to CM may produce greater effects than CM alone
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These investigations indicate that the combination may have greater effects on strength, lean mass, and body fat percentage; in addition to delaying neuromuscular fatigue
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Green et al. [24] reported that adding 93 g of carbohydrate to 5 g of CM increased total muscle creatine by 60%
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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.
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Studies suggest that increasing skeletal muscle creatine uptake may enhance the benefits of training
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Long-term CM supplementation appears to enhance the overall quality of training, leading to 5 to 15% greater gains in strength and performance
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Nearly all studies indicate that "proper" CM supplementation increases body mass by about 1 to 2 kg in the first week of loading
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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
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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
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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
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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
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there is no evidence to support the notion that normal creatine intakes (< 25 g/d) in healthy adults cause renal dysfunction
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One cohort of patients taking 1.5 – 3 grams/day of CM has been monitored since 1981 with no significant side effects
1More
Equine Estrogens Impair Nitric Oxide Production and Endothelial Nitric Oxide ... - 0 views
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This is the perfect study to compare synthetic, unnatural hormones with bioidentical hormones. Premarin was compared with bioidentical estradiol. Premarin reduced the endothelial NO synthase transcription and activity by 30-50% compared to Estradiol. Thus, premarin results in a lower NO production and thus greater endothelial dysfunction compared to Estradiol.
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Lead acetate may cause erectile dysfunctio... [Cell Biol Toxicol. 2013] - PubMed - NCBI - 0 views
1More
Cyclooxygenase inhibition reduces blood p... [Clin Exp Hypertens. 2000] - PubMed - NCBI - 0 views
www.ncbi.nlm.nih.gov/...10744360
cyclooxygenase NO Hg mercury heart health COX cardiovascular disease hypertension
shared by Nathan Goodyear on 16 Sep 14
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1More
The Benefits and Harms of Systemic Dehydroepiandrosterone (DHEA) in Postmenopausal Wome... - 0 views
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Review of the data points to poor quality of evidence dealing with DHEA in post-menopausal women with normal adrenal function. Yet if DHEA is low, which is >95% produced by adrenals in women, then how can the adrenal function be "normal". The meta-analysis found no improvement in libido and/or sexual function, and no improvement in lipids, glucose, weight... was noted. Essentially not positive or negative effects were noted. Abstract only available here, so dosage is a question.
1More
Effect of Testosterone Treatment on Constitutional and Sexual Symptoms in Men With Type... - 0 views
press.endocrine.org/...jc.2014-1872
low T Testosterone aging obese diabetes men male hormone hormones
shared by Nathan Goodyear on 07 Oct 14
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Study finds no improvement in sexual desire and/or ED in older, obese men with Type II diabetes by Testosterone therapy over 40 weeks. There is so much wrong with this study. The authors, by design, assume that Testosterone is all there is. No assessment of Testosterone metabolism and or its effects on inflammation was designed into this study. These men are known to have increased inflammatory cytokine production and likely are aromatase dominant. Given these men Testosterone may just be throwing fuel on the biochemical fire.
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Endothelial dysfunction of rat coronary arteries after exposure to low concentrations o... - 0 views
www.ncbi.nlm.nih.gov/...PMC3081124
Hg mercury NO cardiovascular disease heart health ROS reactive oxygen species oxidative stress
shared by Nathan Goodyear on 16 Sep 14
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low dose, chronic exposure induces ROS and decreased NO availability. This decrease in NO will result in increase vasoconstriction. This will have localized effects and will result in increased central pressure as a result of the increased peripheral pressure. In addition, inhibition of COMT will result in increase in catecholeamines.
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Wheelchair 4 Wheel Drive - 0 views
www.wheelchairindia.com/...Wheelchair-With-4-Small-Wheels
Wheelchair Wheels Are Detachable And Foldable electric propulsion by motors safe operation Wheelchairs weigh maximum fixed or detachable armrests rear wheels by hand strong and durable frame low resistant Nylon
shared by wheelchairindia9 on 22 May 15
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A wheelchair is a wheeled mobility device in which the user sits. The device is propelled either manually (by turning the wheels by the hand) or via various automated systems. Wheelchairs are used by people for whom walking is difficult or impossible due to illness (physiological or physical), injury, or disability. The chair seat size (width and depth), seat-to-floor height, footrests/leg rests, front caster outriggers, adjustable backrests, controls, and many other features can be customized on, or added to, many basic models, while some users, often those with specialised needs, may have wheelchairs custom-built. The usual size of the rear wheel ranges from twenty to twenty-six inches in diameter. A larger wheel increases the height of the seat off the ground and decreases the rolling resistance, thus easing the effort of pushing. The rear wheels can be solid or pneumatic. Solid wheels have a low rolling resistance and are very easy to maintain. They are ideal for use in institutional settings or for indoor use in noncarpeted areas. Pneumatic wheels have better grip on carpeted surfaces and are better if there is going to be significant outdoor use, but they run the risk of flats and require higher maintenance. The flat tire problem can be circumvented by the use of a foam insert that can prevent leaks. Wire spokes are lighter in weight but higher in maintenance. Most older persons will select large plastic spokes referred to as mag wheels. The wheels can be offset posteriorly to decrease the risk of tipping backwards. Wheelchair With 4 Small Wheels: Wheelchair With 4 Small Wheels foldable frame wheelchair made of chrome with 18" inches seat width, 8" Inches Front and Rear wheel, total weight 14 kg helps physical challenged person to move around indoor. Wheelchair With 4 Small Wheels Measurements: Seat Width : 16 inch., 18 inch. Frame Style : Foldable Frame Material : M.S. Chrome open position wheel to wheel width in : 22" (inches) Seat Width : 1
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Normalization of testosterone level is associated with reduced incidence of myocardial ... - 0 views
eurheartj.oxfordjournals.org/...eurheartj.ehv346
low T low Testosterone men Testosterone mortality stroke MI CVD cardiovascular disease hormones male
shared by Nathan Goodyear on 11 Aug 15
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Mortality was also significantly lower in the non-normalized-TRT group compared with those in no-TRT group
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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
- ...10 more annotations...
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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
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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
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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
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the first study to demonstrate that significant benefit is observed only if the dose is adequate to normalize the TT levels
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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
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selected patients without any previous history of MI or stroke prior to initiation of TRT to reduce bias related to CV outcomes
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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.
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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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Hypothalamic-Pituitary-Testicular Axis Disruptions in Older Men Are Differentially Link... - 0 views
press.endocrine.org/...jc.2007-1972
low T low Testosterone low T Testosterone aging LH hormone hormones men male SHBG
shared by Nathan Goodyear on 03 Sep 14
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The core hormonal pattern with increasing age is suggestive of incipient primary testicular dysfunction with maintained total T and progressively blunted free T associated with higher LH.
- ...16 more annotations...
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Obesity was associated with progressively lower total and free T independent of the simultaneous decrease in SHBG.
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our data highlight the fact that LH was unchanged or even lower in older men in the face of lower T in obesity, suggesting that there may be a failure at the hypothalamic-pituitary level.
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This pattern supports the hypothesis that different underlying mechanisms influence the functions of the HPT axis: age predominantly affects testicular function, whereas obesity impairs hypothalamic/pituitary function.
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the effects of aging on testicular function can be moderated by increased LH compensation for many decades
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obesity impairs hypothalamic/pituitary function independent of age, arguably an adaptive response for which there should be no compensatory mechanism.
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Obesity is associated with insulin resistance (28), and the increased circulating insulin inhibits hepatic SHBG synthesis
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the SHBG increase with age may be related to relative IGF-I deficiency (27), although this has not been directly proven.
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Obesity is associated with peripheral and central insulin resistance (30) and proinflammatory cytokine production (TNFα and IL-6) from adipocytes (31) and central nervous system endocannibinoid release (32), all of which are potential candidates for abrogating hypothalamic endocrine and downstream reproductive axis functions.
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The relationship between obesity and T can be bidirectional: low T may be the cause rather than consequence of obesity
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chronic alcohol abuse is known to suppress LH (40), our data showed no significant association among the three hormones or SHBG and alcohol intake.
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increase in total T in smokers occurs through a primary increase in SHBG with a compensatory rise in LH
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the effects of obesity (BMI or waist circumference) was by far the most important determinant of variance in total T, whereas age per se was important for SHBG, LH, and free T with comorbidity and smoking being comparatively minor contributors
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It is noteworthy that these predisposing lifestyle and health factors are modifiable. This implies that the apparent age-related decline in T may constitute a barometer of health and thus be potentially preventable and/or reversible.
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Age induced decline in Testosterone is more associated with a decline in leydig cell function and thus elevated LH will be associated. In contrast, obesity is more of a HPA axis disruption and thus LH may be normal to low. The pulse amplitude is decrease. No change in pulse frequency is noted. With obesity, a decline in TT and fT was independent of SHBG. Aging is associated with a greater decrease in fT versus TT.