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Nathan Goodyear

High-Dose NAC Improves Small Airway Function in COPD - Natural Medicine Journal: The Of... - 0 views

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    NAC reduced COPD exacerbation and hospitalization versus placebo.  The dosing and the duration of this study was low and short respectively. 
Nathan Goodyear

Preventive Cardiology - Natural Medicine Journal: The Official Journal of the American ... - 0 views

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    Preventive Cardiology.  Assessing plaque burden using calcium scoring and carotid intima media thickness.
Nathan Goodyear

Hyperkalemia - American Family Physician - 0 views

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    Good review of hyperkalemia, causes and treatment.
wheelchairindia9

Wheelchair 4 Wheel Drive - 0 views

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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
wheelchairindia9

Cp Child Wheelchair - 0 views

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    young children have a different set of needs than adults. Aesthetically, devices designed for kids are often sleek and colorful, and functionally, they are typically lightweight and adjustable. As any parent knows, young people don't stay the same size for long and since a wheelchair is a major purchase -- don't want a simple growth spurt to render it useless. Wheelchair category offers models that feature seat width and depth adjustability, elevating legrests, and other versatile features. As a weight-bearing activity is critical to proper physical and mental function-which is why children with cerebral palsy, who may sit for stretches in a wheelchair and typically are unable to stand on their own, can benefit greatly from pediatric standers as part of a comprehensive pediatric rehabilitation program. Pediatric standers are offered in passive, active and mobile formats: Passive standers stay in one place and feature a support surface, active standers allow reciprocal movement of the extremities while in a standing position, and mobile standers enable users to self-propel. Cerebral Palsy Wheelchair: Cerebral Palsy Wheelchair Description: The model designed for cerebral palsy child only. Ultra light weight aluminium alloy frame. Seat Width 38 cms (15"). Net Weight: 18.5 kgs. Epoxy powder coated frame. Detachable arm rest & foot rest provided. Elevated and swinging foot rest. Elevated foot rest provided to elevate leg angle. Height adjustable and detachable head rest. Hydraulic reclining high back for a comfortable posture. Hydraulic adjustable seat angle. Detachable back and seat pad. Extra cushion upholstery provided to under arm, head & calg Foldable. Lever and paddle brakes provided. Safety belt provided. Maintenance free rear solid wheels. Cloth look like water proof upholstery. Anti wheels for better safety and stability. Extra cushion upholstery provided to under arm, head & leg. Folding action. Lever and paddle brakes provide
wheelchairindia9

Chair For Cerebral Palsy Child - 0 views

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    Cerebral palsy (CP) is a group of conditions caused by medical abnormalities in the development of a fetus or the early life of a child. These lead to damage or delayed development in the brain. The disorder is permanent and, though it does not worsen with age, the level of functionality of a person with cerebral palsy varies widely: in some cases, effects may be very minor, while in others, movement is impaired to the extent that a wheelchair is required. Common complications associated with CP vary by the type of CP disorder but can include vision problems, seizures, learning disabilities, and issues speaking, writing, and performing other tasks. Cerebral palsy causes problems with muscle tone, movement, balance and/or coordination. Symptoms and effects range from mild to severe. In some infants, problems are evident soon after birth. In others, diagnosis comes in later infancy or toddlerhood. Cerebral Palsy Wheelchair Description: The model designed for cerebral palsy child only. Ultra light weight aluminium alloy frame. Seat Width 38 cms (15"). Net Weight: 18.5 kgs. Epoxy powder coated frame. Detachable arm rest & foot rest provided. Elevated and swinging foot rest. Elevated foot rest provided to elevate leg angle. Height adjustable and detachable head rest. Hydraulic reclining high back for a comfortable posture. Hydraulic adjustable seat angle. Detachable back and seat pad. Extra cushion upholstery provided to under arm, head & calg Foldable. Lever and paddle brakes provided. Safety belt provided. Maintenance free rear solid wheels. Cloth look like water proof upholstery. Anti wheels for better safety and stability. Extra cushion upholstery provided to under arm, head & leg Folding action. Lever and paddle brakes provided. Safety belt provided. Maintenance free rear solid wheels. Cerebral Palsy Wheelchair Recline system: Recline system provides kids with the most comfortable resting environment. It also allows stretching abdomin
Nathan Goodyear

Elderly men over 65 years of age with late-onset hypogonadism benefit as much from test... - 0 views

  • The benefits of restoring serum testosterone in men with LOH were not significantly different between men older than 65 years of age and younger men. There were no indications that side effects were more severe in elderly men. The effects on prostate and urinary function and hematocrit were within safe margins.
  • obesity, but also impaired general health, are the more common causes of low testosterone in aging men
  • Severe LOH is associated with substantially higher risks of all-cause and cardiovascular mortality,
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  • advanced age, obesity, a diagnosis of metabolic syndrome, and poor general health status were predictors of LOH
  • Diabetes mellitus was correlated with hypogonadism in most studies
  • coronary heart disease, hypertension, stroke, and peripheral arterial disease did not predict hypogonadism, they did correlate with the incidence of low testosterone
  • LOH can be defined by the presence of at least three sexual symptoms associated with a total testosterone level of less than 11 nmol/L (3.2 ng/mL) and a free testosterone level of less than 220 pmol/L (64 pg/mL)
    • Nathan Goodyear
       
      the European Male Aging study defined low T as total < 320 ng/dl and free < 64 pg/ml.  
  • Mean weight decreased
  • Waist circumference decreased
  • Total cholesterol decreased
  • Low-density lipoprotein decreased
  • Triglycerides decreased
  • High-density lipoprotein (HDL) increased
  • ratio of total cholesterol to HDL improved
  • Prostate volume increased
  • PSA increased
  • The benefits for men older than 65 years of age were compared with those of younger men, and the improvements in body weight, metabolic factors, psychological functioning, and sexual functioning were of the same magnitude in both age groups
  • weight loss was progressive over the 6-year period, effects of testosterone on lipids and on psychological and sexual functioning reached a plateau after approximately 3 years and these effects were sustained
  • Effects of testosterone on hematopoiesis, on the prostate, and on bladder function were not more severe in older men than in younger men
  • observe a mild increase in prostate volume and serum PSA over time, which is a normal finding in aging men. Maybe somewhat surprising, postvoiding residue and the IPSS did not deteriorate with aging but showed a degree of improvement
  • the severity of the metabolic syndrome is associated with the severity of lower urinary tract symptoms
  • The symptoms of the metabolic syndrome improve upon testosterone treatment and testosterone may thus have a favorable effect on lower urinary tract symptoms
  • it seems reasonable to conclude that the risks of testosterone administration to elderly men are not disproportionately higher in elderly men than in younger men.
  • Despite evidence to the contrary, physicians still harbor a wrongful association between testosterone and the development of prostate pathology (prostate cancer and benign prostate hyperplasia)
  • Not surprisingly, the incidence of prostate cancer was higher in older men; however, it was lower than expected in both groups
  • These observations suggest that the incidence of prostate cancer in patients receiving testosterone therapy, both in the younger and in the older group, was not greater than in the general population not receiving testosterone treatment
  • The historical fear that raising testosterone levels will result in more prostate cancer has been dispelled, particularly by the work of Abraham Morgentaler
  • Higher serum testosterone levels fail to show an increased risk of prostate cancer, and supraphysiological testosterone does not increase prostate volume or PSA in healthy men
  • This apparent paradox is explained by the "saturation model,"
  • Recent studies indicate no increased risk of prostate cancer among men with serum testosterone in the therapeutic range
  • In the present observational study, no cases of major adverse cardiovascular events occurred.
  • the benefits of testosterone therapy are fully achieved only by long-term treatment
  • To achieve maximal benefits, good patient adherence is a prerequisite
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    Study finds new difference in Testosterone benefits and/or side effects between men < 65 with low T and men > 65 with low T.
Nathan Goodyear

Subclinical hypothyroidism: deciding when to treat. [Am Fam Physician. 1998] - PubMed r... - 0 views

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    Subclinical hypothyroidism: deciding when to treat.
Nathan Goodyear

Coenzyme Q10 and statins: biochemical and clinical... [Mitochondrion. 2007] - PubMed re... - 0 views

  • physicians should be aware of this drug-nutrient interaction and be vigilant to the possibility that statin drugs may, in some cases, impair skeletal muscle and myocardial bioenergetics.
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    Statins not good for those who have CoQ10 dysfunction
Nathan Goodyear

NMJ Original Research: Reproducibility and Reliability of Two Food Allergy Testing Meth... - 0 views

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    ALCAT shown to be reproducible and reliable
Nathan Goodyear

Alternative Therapies: Part I. Depression, Diabetes, Obesity - September 1, 2000 - Amer... - 0 views

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    alpha lipoic acid provides great support in diabetic neuropathy treatment
Nathan Goodyear

Occupational Lead Poisoning - February 15, 1998 - American Family Physician - 0 views

  • The freely diffusible plasma fraction is distributed extensively throughout tissues, reaching highest concentrations in bone, teeth, liver, lungs, kidneys, brain and spleen
  • Inorganic lead does not undergo any metabolic transformation or digestion in the intestines, or detoxification in the liver.5
  • With chronic exposure over a long period of time, most absorbed lead ends up in bone
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  • The total bodily content of lead is called the body burden; in a steady state, about 90 percent of the body burden is bound to bone.2
  • n general, lead is excreted quite slowly from the body (with the biologic half-life estimated at 10 years). Since excretion is slow, accumulation in the body occurs easily.2
  • hronic toxicity is an insidious illness with protean manifestations.3,6 Symptoms may include arthralgias, headache, weakness, depression, loss of libido, impotence and vague gastrointestinal difficulties.
  • Late effects may include chronic renal failure, hypertension, gout and chronic encephalopathy.6
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    occupational lead poisoning
Nathan Goodyear

http://press.endocrine.org/doi/pdf/10.1210/jc.2014-2934 - 0 views

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    Again, what is the evidence on androgens in women.  The majority of data is points to negative metabolic effects.  This study looked at men and women and found inverse relationships between Testosterone and DHEA in the sexes.  In women, higher bioavailable Testosterone and DHEA was associated with visceral and subcutaneous fat in women, where as the opposite is true in men.  In both men and women, higher SHBG was associated with lower fat.
Nathan Goodyear

Current Concepts in Concussion: Evaluation and Management - American Family Physician - 0 views

  • Shear forces disrupt neural membranes, allowing potassium efflux into extracellular space. Resultant increases of calcium and excitatory amino acids are followed by further potassium efflux, leading to suppression of neuron activity.8–10,12,20 As sodium-potassium pumps restore balance, there is increased energy requirement, yet a paradoxical decrease in cerebral blood flow.
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    review of the current dogma on concussion management.
Nathan Goodyear

Panax ginseng - American Family Physician - 0 views

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    panax ginseng is a great "hot" adaptogenic herb.
Nathan Goodyear

Management of Hyponatremia - American Family Physician - 0 views

  • SIADH is a diagnosis of exclusion
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    hyponatremia
Nathan Goodyear

Transfusion of Blood and Blood Products: Indications and Complications - - American Fam... - 0 views

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    Good review of transfusion indications and complications
Nathan Goodyear

Long-term stabilization of stage 4 colon cancer using sodium dichloroacetate therapy - 1 views

  • inhibition of mitochondrial pyruvate dehydrogenase kinase
  • inhibition of aerobic glycolysis (the Warburg effect) and activation of mitochondrial potassium ion channels
  • angiogenesis blockade
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  • changes in expression of HIF1-α
  • alteration of pH regulators V-ATPase and MCT1, and other cell survival regulators such as PUMA, GLUT1, Bcl2 and p53
  • DCA as a cancer stabilizing agent
  • A protocol of natural medications was developed to address the dose-limiting neurologic toxicity, in collaboration with a naturopathic physician (Andrews). The oral DCA regimen that was developed included three natural medications acetyl L-carnitine[29-31], R-alpha lipoic acid[32-34] and benfotiamine[35-37], for the primary purpose of neuropathy prevention
  • measurable benefits from DCA therapy in 60%-70% of cases
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    Good review of dichloracetate or DCA in antitumor activity.  DCA has been shown to have numerous anticancer properties.
Nathan Goodyear

Statin use and risk of diabetes mellitus - 0 views

  • An increase in new onset diabetes, i.e., 3% in statin arm and 2.4% in placebo arm was reported. This was accompanied by increase in median value of glycated haemoglobin and was one of the earlier studies to report the increase in new onset diabetes in patients on statins
  • Even after adjustment for potential confounders, statin therapy was associated with an increased risk of new-onset diabetes mellitus
  • Authors suggest that statin-induced diabetes mellitus is a medication class effect
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  • Another study also reported that as compared to placebo, statin group showed a higher risk of physician reported incident diabetes and it was also observed that risk was higher in women as compared to men
  • Meta-analysis of randomized controlled trials by Sattar et al[25] involving 91140 non-diabetic patients showed that statin therapy was associated with 9% increased risk of incident diabetes
  • A number of studies showed dose dependent association between statin administration and incident diabetes
  • intensive dose of statins was associated with high incidence of new - onset diabetes
  • Treatment with atorvastatin and simvastatin may be associated with an increased risk of new onset diabetes as compared to pravastatin
  • Increased incidence of diabetes was seen with atorvastatin in the Anglo-Scandinavian Cardiac Outcomes Trial
  • Increased insulin resistance secondary to statins was demonstrated in a prospective non randomised study in patients with coronary bypass surgery
  • downregulation of GLUT4
  • Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial
  • Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial
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    Great review article of the increased risk of worsening insulin resistance, glycated hemoglobin, and diabetes risk.  Atorvastatin appears to be the worst culprit.  Mechanism partially through a decrease in GLUT4.
Nathan Goodyear

Transaminase Levels and Vigorous Exercise - 0 views

  • We accept 1–2 times the upper limit of normal to be attributable to exercise
  • Some physicians, whether they are gastroenterol-ogists or internists, forget that exercise can cause this abnormality
  • it is good for patients with liver disease to exercise, particularly those with fatty liver disease
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  • we see a trend toward improved ALT and AST levels in patients performing moderate exercise, regardless of the etiology of their liver disease
  • We therefore discourage very heavy exercise in these patients, but a moderate amount does not cause a problem
  • once enzymes are abnormal, they remain abnormal for up to 1 week. Were subjects to exercise vigorously again during that week, transaminase levels could increase further
  • there is a ratio that in healthy individuals is considered normal. AST levels normally measure at approximately 0.8 of ALT levels. A dysregularity of this ratio can also signal hepatic illness but usually inflammation of any kind affects both measures
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    Vigorous exercise yields abnormal liver enzymes.  How one defines vigorous exericse is going to vary from person to person.
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