Fitness and Health For Women and Children

How to Manage Obesity Effectively?

2011-06-09T02:13:00.000-07:00

We spend millions of pesos every year on diets and weight control paraphernalia, yet the results are dismal. For many, permanent,successful weight control is more difficult to achieve than victory over drugs, tobacco or alcohol. Being fat isn't healthful. Excess weight impairs health and shortens life. As little as 10 to 15 pounds of extra weight produces measurable changes that can lay the foundation for disease. And for every 10 pounds of overweight, a lifespan can be shortened by as much as a year.

People who are overweight need major revisions in thinking and attitudes. Weight control programs usually fail because they are short-term fixes for long term problems. It's time to face the reality that obesity can be serious and life threatening condition.

Managing obesity is much more than a dietary problem. Like diabetes, hypertension, alcoholism or smoking, obesity requires a comprehensive approach to lifestyle changes.

First, you have to have a long term commitment, a lifelong commitment that does not change when binges or other serious lapses occur. With this kind of commitment, you can get up when you fall, start again, and persevere.

Second, you need to identify and change habits that cause obesity. This may be as simple as eliminating soft drinks or cutting back on fats and oils. Or it may require you to completely restructure your eating patterns and lifestyle.

Third, attitudes often need radical surgery. Willingness to change is critically important. Read books, attend seminars, join fitness groups, and make friends with health minded people. Weight control is not a vanity trip. Keep the focus on improved health, and the weight will take care of itself.

Finally, look for a weight control plan that's consistent with a lifetime of good health. This will include regular exercise, a low fat, high fiber diet, and a physical, mental, and psychological outlook that meets your needs in every area of life . Weight control should be only part of a full and fulfilling life not its main preoccupation. Put your heart into it and keep it there.

How to lose weight if your overweight?

2011-06-03T01:06:00.000-07:00

Obesity is usually measured by the upper arm skin fold measurement and is described as excessive body fatness. Those over the 85th percentile are categorized as obese, while the group over the 95th percentile are super-obese. Super-obesity has increased tremendously over the past year . Being a couch potato does affect weight. Science shows this to be true, but many youth and adults are not fitness per se. Oh yes, we may have friends who work out on a daily basis, but many youth are spending more time in front of the television than even before

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Obesity definitely does have its downside as far as health is concerned. There is a strong association between childhood and adolescent obesity and cardiovascular disease, especially hypertension and its complications. Coughs and colds are more frequent, and respiratory diseases may impact obese children and youth through sleep apnea syndrome and later, the effects of chronic low oxygenation of the blood and other breathing problems and respiratory infections.

Many people are dieting today. It is encouraging to know that the majority of those trying to lose weight know how to diet, and reducing snacks and general food intake. Unhealthy dieting behaviors, such as fasting, taking diet pills, or vomiting can be dangerous themselves.

What can be done if your overweight?
1. Acknowledge that there is a problem with your weight and read about healthy food preparation and eating practices. Become informed. Do not follow fad diets, and do not limit the variety of foods eaten.

2. Buy healthy foods. Do not be tempted to fill your cupboards with convenience foods high in fats and sugars. Provide balanced meals, and serve portions that suit the needs of each family member. Provide alternative low calorie foods,if necessary , for snacking.

3. Involve in more activites. Take things gently at first. Make some fundamental rules regarding the time to be spent watching television, and involve the family in physical activities that you will enjoy. Keep record of your weight and encourage the venture. Reward yourself to a SPA or malling for even small steps of success.

4. Drink more fluids and eat more fruits and vegetables.

5. Don't live a sedentary lifestyle.

6. Exercise can be a great activity, especially when you do it for fun with your friends. One good way is to organize an aerobics club. Plan to meet at a different friend's home each week for lively music and exercise. If you don't like aerobics, get together with your friends, and play volleyball,basketball,tennis, swimming, or other sports. If you aren't the athletic type, walking maybe your answer. Go for a briskwalk three or four times a week around the neighborhood with a friend. Or check some local trails and wooded areas and go hiking or mountain climbing.

The effects of Tobacco and Cigarrete smoking

2011-05-24T09:14:00.000-07:00

Tobacco is Addictive

Tobacco is one of the most addictive of all substances used by humans.

Nicotine is six to eight times more addictive than alcohol. And when compared to other drugs, it is as addictive as cocaine creck.

Of all the people who use nicotine 95-100%are addictive.

According to the Surgeon General,tobacco usage is an addiction and should be treated (JAMA 252:2874)

Tobacco is Toxic (poisonous)

Tobacco contains over 4,000 Identified chemicals. Thirty or more are known to be highly toxic carcinogens.

Do you know what some of these chemicals are used for?

- Ammonia is used in cleaning products
- Arsenic is used as ant poison
- Butane is used as lighter fluid
- Cadmium is in rechargeable batteries
- Carbon monoxide is in car exhaust
- Cyanide is used in rat poison
- Formaldehyde preserves corpses
- Methanol is used in jet fuel
(U.S. Surgeon general's report, 1989,pp 79-84)

Harmful effects of Cigarette Smoke

Cancers -Lungs, Liver , Pancreas, Mouth(oral cavity) , Bladder, Throat(Pharynx), Kidney, Voice box (larynx), Cervix, Trachea (wind pipe), Leukemia, Esophagus, Colon, Stomach, Skin , Penis

Heart Problems - Atherosclerosis, Ischemic heart Disease, stroke, COPD, heart attach

Risk for pregnant women and fetus - miscarriages, SIDS, premature/stillbirths

Male reproduction - Infertility, Impotence, deformed and less motile sperm.

Female reproduction - cervical cancer, Infertility, dysmenorrhea

Common trigger for Asthma exacerbation

Circulatory Problems - narrowing of blood vessels, and reduced blood flow to organs and body parts.

Have a Smoke Free Life

Hair - Free of Smells

Eyes- Clear and bright

Breath and Teeth - Clean and Healthy

Complexion - Looking Good

Lungs - Plenty of Breath

Heart - Strong and Fit

Fertility - A baby when you want

Pregnancy - A healthy mum , a healthy baby

Finger and Nail - No stains

Savings - More money for other things

Effects of Smoking Cessation

Within one week : Teeth and smell dramatically improve. All of the 5 senses return to normal. More physical withdrawal symptoms disappear. Fetus is free of Nicotine. Teeth are whiter and mouth is fresher.

Within one month :

Circulation Improves - More blood platelets are activated. Respiratory problems decrease. Energy and stamina increase. Pulse rate and blood pressure lower.

- Stroke risks reduced to that of a non-smoker 5 to 15 years after quitting.
- cancers of the mouth , throat, and esophagus reduced to half the risks in 5 years
- Coronary Heart Disease risks cut in half within one year after cessation and return to that of a non smoker in 5 years
- Chronic Obstructive Disease risks of death reduced after long term quitting
- Lung cancer reduced as much as half in 5 years after cessation
- Pancreatic cancer reduced to that of a non smoker in 10 years
- Ulcer reduced compared to a non-smoker within few weeks
- Bladder and cervical cancer reduced to that of a non-smoker within a few years
- Low birth weight baby risk reduced to that of non-smoking women who quits before pregnancy or during first trimester.

Mortality of Smokers

At least 25 percent of all smokers die prematurely from smoking-induced illness.

Those individuals lose an average of 21 years of life.

An individual who starts smoking as a teenager and continues through middle age will cut an average of 24 years off their life.

Tobacco use: A Public Health Disease

Tobacco Kills :

every 10 seconds = 1
every minute         = 6
every hour            = 360
every day             = 8,640
every month         = 259,200
every year            = 3,153,600
year 2,000 WHO = 4,000,000
by 2030 WHO    = 10 million

20,000 Filipinos die every year due to tobacco related diseases , 2 or 3 every hour

The Benefits of Stopping smoking

Step 1 - Pick your Favorite Benefit - To stay successfully off cigarettes you must want to stop smoking for your own well-being. Which of the following benefits do you desire?
Health benefits - less risk of cancer , heart disease, emphysema, stroke and accidents.
Economic Benefits - More money to spend or save, less sickness and medical expense and damage to possessions ; more job opportunities.
Social Benefits- improved appearance of skin , teeth and fingers
Fresher smelling person and possessions. More self-confidence and influence with others.

Step 2 - Set a Time That's Definite
Unless you are under unusual stress, plan to make the break sometime soon gradually within the next week. Although there is no wrong time to stop smoking. there is no time now. The difference between a goal and a dream is action.

Step 3 - Prepare Physically
Like an athlete in training for olympics, your success in breaking free from smoking on proper preparation.
Begin to: Get eight hours of sleep each night. Drink eight glasses of water and eat a balanced breakfast. Walk briskly at every opportunity. Many who get regular exercise lose their desire to smoke. Make your teeth cleaned immediately following your break free date.

Step 4 - Prepare Mentally
Visualized yourself enjoying all the benefits of living tobacco free. Visualized this joy by repeating frequently, " I love being free from smoking" . Believe that you are becoming free of tobacco and you will be free. Ask a non smoking friend for moral support.

Step 5 - Plan rewards that motivate
Write down the rewards you'll give yourself when you accomplish each of the following present Goals breaking free : One week of freedom ; Three months of freedom ; six months of freedom.

Step 6- Observe nonsmokers to Imitate - Observe nonsmokers to learn how they react to situations that would prompt you to smoke. Note how they handle stress, occupy their hands . Imitate their better methods for meeting these needs.

What kind of Car are you ?

2011-04-20T12:36:00.000-07:00

According to surveys Men are major car buyers in United States and UK. They dreams about owning high powered automobile and they are like kids when it comes to cars . So if your into buying or purchasing a car there is certainly a lot of information you need to understand. Research the difference between buying a used car or brand new car from a dealer , private seller or auction . Then you need to decide on what to purchased. If you want to buy a used car here is some tips you need to remember .

Before buying a used car it is important to check the car's condition and consider taking a qualified vehicle examiner with you. Always know the market value of any car so you can negotiate better. And make sure you get the detailed vehicle history report. So be careful some dishonest dealers pose as private sellers to offload unsafe and clocked cars so it is necessary for you to know where to purchased your used car.

Research dealership and sellers in your area . And if you are in Italy you can start with auto usate milano , vendita auto usate , compro auto usate wherein they sell and buy car since 1978 and provide customer quality service and assistance with efficiency and competence.It also offers affordable and competitive rates for buyers and sellers compared to other car dealers .

Car shoppers today are turning to previously owned cars as alternative because new vehicles lose so much of their value as soon as they're purchased.

Important things you need to know about Mesothelioma

2011-04-12T00:18:00.000-07:00

Many people are still clueless about Mesothelioma so here is some of the things you need know about this disease .Mesothelioma is actually a rare disease which affects the mesothelium which covers many of the internal organ of the person. Environmental and Occupational Asbestos exposure is usually the main cause of this disease.

Signs and Symptoms of Mesothelioma

Symptoms often resemble those of common everyday ailment .

Patient with Pleural Mesothelioma - Shortness of breath, chest pain, lower backpain , weight loss, persistent cough, difficulty swallowing , fever and nausea.

Patient with Peritoneal Mesothelioma- Nausea, weight loss, abdominal pain, abdominal swelling, swelling of the feet

Treatment

Treatment of malignant mesothelioma at earlier stages has a better prognosis but cure is very rare.

The most common Surgery is that the Lining of the chest is removed ( Pleurectomy). Less common surgery is removal of lung, lining of the inside of the chest , the hemi diaphragm and pericardium are removed whuch is called (extrapleural pneumonectomy(EPP).

Other Treatment for Mesothelioma includes Radiation , Chemotheraphy , Immunotheraphy , Multimodality Theraphy

So if you have been exposed to Asbestos during work you can take legal action against an employer . It is advisable to consult a New York Mesothelioma Lawyers or Mesothelioma Lawyers San Diego for compensation claims if you are near this area .

Why Medical Scrubs is needed?

2011-01-17T17:31:00.001-08:00

Nursing scrubs is a stylish and lightweight clothing for nurses and medical practitioners. It comes in various prints and sizes. However, because of its comfortable and fashionable design, this supposed to be a , becomes a fashion statement. More and more people are now into wearing scrub uniform even if they are not a nurse of a doctor. People who find nursing scrubs one of the comfortable clothing for daily use are growing in numbers. You can find them wearing it even when shopping with friends or simply walking on the park. On the other hand, even caregivers and nannies are now wearing green scrubs as well.

Genital warts causes

2010-12-23T16:54:00.001-08:00

Genital warts are a contagious disease that can be sexually transmitted. Genital wart is caused by the human papillomavirus or HPV, a sexually transmitted disease affects both men and women. A person who had sexual contact with someone who has genital warts will most likely to develop the disease within three month. This is also indirectly related to the use of birth control pills because pills may urge people to have sex with no barrier, to have multiple sex partners and to have sex at an early age. However, one can easily get rid of genital warts with the numerous genital warts treatment available over the counter and some home treatment like the preventing the transmission to a sexual partners and the like.

Electronic Cigarettes- More Attractive and Sophisticated

2010-11-30T15:05:00.001-08:00

Do you like to participate in the task of making the world green and habitable for the next generation teens? You should know that the global warming and environment pollution have reached an alarming level due to the release of the dark lethal smoke in the air massively. The environment is under the threat of air, water and sound pollution. Every year, numerous innocent guys stoop to the pre-matured death due to the attack of the lethal diseases and incurable physical deformity.

The contaminated heated air will enter into your body and it will infect the lungs, heart and respiratory system. The kidney and other internal parts will be damaged soon owing to the aftermath effect of the air pollution. In this connection, the invention of the electronic cigarettes is certainly a great achievement for the scientists and researchers who have done a magnificent job by launching the electronic cigarettes at the comfortable price range. There are a number of the functionalities of this e cigarette. It will release the zero percentage smoke and fume. It will not put you in trouble. It will not make your life hell after several years.

If you do a comparative study to test the efficiency and effectiveness of this electronic device, you will come to conclusion that this is the new branded electronic smoking device which will minimize the rate of the air pollution to a great extent. The fact is that generally you will have to put your life at stake while smoking the ordinary tobacco punched cigars. The body will be damaged severely in the case of smoking the common cigars or cigarettes. According to the experienced healthcare consultants and the doctors, though they can’t support the usage of e cig as it will nurture the addiction and bad habit of human beings, they are ready to accept that this electronic cigarette will not produce the destructive elements in the open air. It will keep your body intact from the environment pollution.

Walking unexpensive form of exercise

2010-11-23T15:19:00.000-08:00

Walking as a form of exercise is simple, easy, and inexpensive. You don't need any costly special equipment to engage in it . In fact all you need is any worn out working clothes which you're about to convert into an exercise suit, a pair of old rubber shoes or sneakers which fit you comfortably , a cap to shield your eyes if you so desire ,plus two feet which are willing to step where you want them to and presto , your in business for exhilarating adventure of walking.

Aside from the badly needed exercise which you'll get especially if you've adopted a sedentary lifestyle , walking will reward you with a lot of bonuses over and above the conditioning which it'll give your sagging muscles. Consider , for instance , the following extra dividends which you'll enjoy when you go walking

Visit your gym regularly and be healthy and sexy

2010-11-05T17:31:00.001-07:00

We all know that getting sexy the healthy way to have a balanced diet, healthy lifestyle and regular exercise or visit to your favorite gym. If you are in Finland particularly in Helsinki or Espoo, you can have a fun exercising experience at various Forever kuntosali branches in the area. Like many of the gyms you can see anywhere in the world, Forever also features different gym facilities that you surely find helpful in your exercising adventure. You can opt to do weights with the assistance of their personal trainers, gymnastics, and more. You can even have a great spa for wellness if you like.

Tips in improving appetite and prevent weight loss

2010-11-02T07:02:00.000-07:00

Here are some suggestions that may hep improve your appetite and prevent weight loss:

- Try eating smaller, more frequent meals

- Take advantage of times when you feel good and are hungry. For example, you may find you have your appetite in the morning when you're rested.

- Boost calories in recipe by using whole milk or cream in soups, eggs or cheese in casseroles, and butter or sauces on vegetables.

- Keep snacks readily available for when you feel like eating something. Cheese, ice cream , canned fruit or peanut butter with crackers are examples of high calorie , nutritious snacks that require little or no preparation.

- Since fluids create a feeling of fullness, drink beverages towards the end of your meals, rather than before or at the beginning of meals. Drink beverages, such as milk or juice, that contain calories and other nutrients.

- Create a pleasant mealtime atmosphere with an attractive table, quiet music and conversation.

- Try to organize cooking exchanges or potluck meals with neighbors or friends. Eating with others usually makes for more enjoyable eating.

Look good all over with the right hair products and body wraps

2010-05-27T16:14:00.001-07:00

Looking good requires a lot of regimens and beauty products to achieve. Excellent hair products are just a few of the products that you need in order to look good. Shiny, healthy, and bouncy hair generally affects to one’s look and beauty.

Another beauty regimen that one needs to do in order to look good is to do body wrapping. You can buy body wraps in kit if you wish to do it, just make sure that you buy the genuine and the right one. You can also opt to head to your favorite beauty shop if you want an expert to do it for you.

5 Alternative Remedies for Colds That Actually Work

2010-04-20T17:42:00.001-07:00

Many people are turning their attention to alternative remedies for colds and other ailments. The beauty is that these are very natural and yet very powerful in their approach and application.

Garlic: There’s a reason that you hear so much about this particular herb, because it happens to have some really potent powers. Garlic is a good herb to take on a daily basis to work towards prevention and general health. When a cold strikes however, garlic can get to work fast and help to relieve the symptoms that you may be suffering form. Garlic has antiviral and antibacterial properties which not only help to alleviate the symptoms, but also help to fight off the cold virus altogether.

Echinacea: Though many of us know of Echinacea as a preventative herb, it can be helpful beyond that. One of the main purposes of this herb is to naturally boost the immune system, and it does a great job of that. If you take Echinacea at the first signs of symptoms, it can be quite powerful in moving things out quickly and easily. If however you find yourself with a full fledged cold, then Echinacea can prove to be powerful with its antibacterial properties as well. At the very least, taking Echinacea can lessen the duration that you have to suffer with a cold for.

Vitamin C: You probably heard about taking Vitamin C as a child, as it has turned into a well known remedy for colds and other illnesses. That’s because Vitamin C is the best at helping the body fight infections. This is why you are told to bump up your intake of this during a cold, and it will provide some excellent results. If you learn to embrace the powers of Vitamin C, you will find that you suffer with far less symptoms and will deal with a much shorter duration for the cold in the first place. Though you can get Vitamin C from foods such as citrus fruits and sweet potatoes, it’s always a good idea to take a supplement as it will help the body to fight things off faster.

Ginger: Many people know of ginger as a helpful herb for stomach problems, but its aid doesn’t stop there. Ginger actually contains dozens of antiviral compounds. Not only does it help to fight off the cold, but it can eliminate any pain or symptoms that you are coping with. Ginger works as an antiseptic, an antioxidant, and a natural pain reliever. So if you want to get rid of the cold and all of the related symptoms a whole lot faster, turning to ginger may offer some excellent help.

Hot Liquids: Along with other home remedies, you’ve probably heard that taking in hot liquids can be of great help when you are suffering from a cold. There’s a reason that hot chicken soup has become one of the most well known and effective home remedies one can find for a cold. Chicken soup is a great one to consider, but in all actuality any hot liquids can help to do the trick and get the body back to a healthy and normal state.

If you want to get better fast, then turning to these home remedies can work quite well. For those that want to try something else or want to take a more natural path, these can work wonders.

M. Frederick writes about how to obtain a nurse practitioner degree.

Are you fit?

2010-04-20T17:40:00.000-07:00

Can you run upstairs without panting for breath? Take the family dog for along walk and arrive home without feeling totally exhausted? If you can't , it looks as if you, along with many other people, are slightly unfit.Feeling fit and being fit are essentially two different things. We can't all afford the luxury of employing a personal trainer like some of the top stars to attain a wonderful figure, but then again with a little time and effort on your part you can look just as good, if not better, even if it does entail having to forego that daily bar of chocolate or can of fizzy drink. But surely, at the end of the day , looking and feeling so much healthier is worth the initial input.

A unique gift idea for men and women

2010-04-19T16:59:00.000-07:00

If you are having a hard time looking for the right gift for your adult friend and wants to be unique amongst others, then giving away some unique sex toys like the vibrators can be your best bet. Shopping for adult sex toys are not hard at all. They come in different design, color, and features wherein you can surely find want that will works best for your friend or partner. These vibrators may come discreet, waterproof, remote controlled, multi-function and more. The best part of giving away this type of gift, most of them comes handy, which is perfect to those who actually enjoyed using it.

Cleansing the colon is made easy with various products we have today

2010-04-01T08:39:00.001-07:00

Cleansing the colon is one of the most important thing to do in order to maintain a healthy colon. With the numerous products available today, cleansing our colon is as easy as a snap. Products include the following:

Bowtrol – hailed as the best colon cleanse product of 2009

Dual Action Cleanse – has dual functions including the removal of toxins and the improvement of the liver function.

Colonix by Dr Natura – this product has the kit that contains Colonix, Paranil, and Toxinout, natural systems that are designed especially to reduce constipation, eliminates waste material buildup, flush out toxins and helps improve overall health.

Rediscover the long lost health and wellness with Chiropractic

2010-03-02T19:30:00.001-08:00

Illness should not hinder us in doing our daily tasks and enjoying life to the fullest. With this regard, a great way to prevent illness is now available and it is called Chiropractic, a health care discipline that focuses on the diagnosis, treatment and prevention of mechanical disorders. One can enjoy this one of a kind wellness program with the help of the charlotte chiropractors that has the heart to serve and educate others that health and wellness come from within if one is living close to Charlotte. Denver residents need not to worry, for denver chiropractor are just around the corners to serve.

Does Your Body Need A Recharge? Try MonaVie EMV!

2010-02-16T16:44:00.001-08:00

MonaVie EMV is full of natural energy ingredients. The natural energy source in MonaVie is known as Palantinos. This is a carbohydrate-based energy. There are seven different fruits used to make up 80% of the juice within MonaVie EMV.

With MonaVie you will have no energy crash or jitters. There is a very sustained energy level to help you get through the day feeling better and more alert. There are no side affects. You will get a very natural energy boost from very healthy ingredients.

You with MonaVie EMV you will feel very refreshed. Your sense of well-being and overall health will improve. As health begins to improve, you will notice a higher level of stamina. This will lead to improved endurance and a higher level of alertness. There will be none of the complications that come along with other so called energy drinks. Your body is only being fueled with nutrients that your body needs. There are no stimulants involved.

MonaVie EMV is an all-natural way to increase health and energy. It is completely safe to use on a daily basis. You do not have to worry about any long-term health issues. You are putting nothing but the highest quality, most natural ingredients into your body. You are actually doing something good for your body using and MonaVie product on a daily basis. It is a very healthy decision.

MonaVie EMV has the same great taste that you can expect from MonaVie products. It is also lightly carbonated. This will help you replace those unhealthy soft drinks. In time, you will probably prefer MonaVie over any other carbonated beverage.

You can depend on all-natural ingredients. There are no artificial colors, sweeteners, flavors, or preservatives. You are putting nothing but the best into your body with MonaVie EMV. You will be healthier, have a higher sense of well-being, and just feel better all around.

It does not matter if you are an athlete or someone who just needs a pick me up through the day. MonaVie EMV will help you do just that. Many people have joined MonaVie in order to do something good fort heir body. The body often is run down because it needs nutrients. MonaVie EMV gives you both protein and carbohydrates. Your body will benefit greatly from the pure nutrients the MonaVie EMV can provide. This is true of all MonaVie products.

If you would like to compare MonaVie EMV with other popular energy drinks, visit the EMV website.

Lose weight and Feel Good

2009-12-07T18:57:00.001-08:00

Losing weight will not only make you look good but feel good as well. Many of us have attempted to lose weight with some successfully did it well and some who are not lucky enough to lose some weight. How those successful one did the great job, well, simply because aside from the good exercise and diet, most of them are also taking the right weight loss supplements. Know the top weight loss supplements and the best one for you by simply visiting Weight Loss Supplements. They have reviewed the best ones and are on the helping hand to help you find the right one for you weight loss needs.

Types of Diet

2009-12-07T18:55:00.000-08:00

Regular Full Diet

- most frequently used of all hospital diets
- it follows the principle of good meal planning and permist the use of all foods.
- The diet outlined meets the minimum requirements of most adult diets for ambulatory or bed patients whose conditions do not necessitate a modified diet.

Soft Diet
- follows the regular diet pattern but modified in consistency
- foods allowed are those which are easy to digest , such as fruits and vegetables with low cellulose content and meat with little or no tough connective tissue
- cooking, cutting, mashing, pureeing and removal of skin and seeds from fruits and vegetables and gristle and elastin from meat may increase the digestibility of these foods.
- pray be nutritionally adequate but prophylactic supplementation of diet with vitamins

Mechanical Soft Diet
- Dental soft or Geriatric Soft Diet
- Consists of foods that require minimum chewing
- It follows the food pattern of the regular diet
-Hard and large pieces of food are chopped ,ground, pureed, sieved, or reduced to small pieces by other mechanical means

Tube Feeding
-consists of natural foods that are liquid or are liquified by means of a mechanical blender and administered bu nasogastric tube for patients unable to take food by mouth
-a 24 hour formula feeding prepared and put in labeled sterile bottles and refrigerated
- Each feeding should be warmed over hot water to lukewarm temp or sufficient amount of how water may be added to a serving of an undiluted formula.

Erase Wrinkle with the best Wrinkle Cream

2009-11-24T19:13:00.000-08:00

Stop the signs of aging by using the right product that will make your skin looks soft and smooth with the use of the right wrinkle cream. If you are not certain as to which product is right for you and your skin, you can have a view some of the honest LifeCell Review by various customer that has successfully use the said product.

On the other hand, if you have not convinced with the reviews for LifeCell Wrinkle Cream, or have find out from the reviews that the product does not fit in with your skin type, you can also have a glance to some of the Dermajuv Review, which are also done by real customers.

Choosing For the Right Eye Cream that’s best for you

2009-11-24T19:11:00.000-08:00

Dark circles under our eyes are disturbing and is a known sign of aging and stress. Eye Creams are now widely used to erase dark circles. However, it is hard to determine if we are using the right and effective product for our eyes. With the help of the customer’s Eye Cream Review from Wrinkle Erased, knowing the right eye cream has never been easy.

From the honest reviews of actual users, you can definitely decide the Best Eye Cream that will help you cure and eventually remove dark circles under your eyes. In this way, you can already conceal the signs of aging and can finally look young and good looking in an effective way.

Get in-shape with the right Ab exercise

2009-11-20T22:55:00.000-08:00

Having a six-pack abs is everyone’s dream, but not all have achieved of having one. If you ware one of those who have been dreaming of having a sexy six-pack abs, then aside from the right balanced diet, you must also know the right Ab exercise that is best for you.

All that you will get and learn from Six Pack Ab exercises are a great tool in helping you achieve a Ripped Abs in a fast and easy way. SixPackAbExercises.com has the best ab exercise available for everybody. In addition, you will also learn the diet secret for six-pack abs.

Erase Stretch Mark with Purity Stretch Marks Cream

2009-11-06T01:47:00.000-08:00

After giving birth or after undergoing weight loss, stretch marks are a normal thing. At World of hair, they do not only have wonderful and effective products for hair care but powerful and tested products for skin care as well.

Worry no more on your stretch marks as you can now purchase the purity stretch marks cream at world of hair. Using five of the most powerful ingredients including helichrysum, emu oil, trentinoin, rose hip oil, healing butters combines, and pure aloe that can help you erase your stretch marks, this stretch mark lotion is considered as the most powerful available in the market today.

The importance of Nutrition

2009-10-24T02:15:00.001-07:00

It is important to consider nutrition in menu planning. The provision of an adequate diet is so vital because the ability of the body to function well is dependent on the constituents found in a variety of foods. One food may contain one or two nutrients but no one food alone contains all the nutrients in amounts necessary for good nutrition . Therefore, to ensure adequate intake of all the nutrients, it is necessary to include a variety of foods.

Along with water , there are six essential components for good health , which if consumed in the correct proportions, will provide the body with both sustained energy and the correct balance nutrients required.

Food Allergy

2009-10-20T05:27:00.000-07:00

A food allergy involves an immune system reaction that is triggered when a specific food or food additive is eaten. The reaction may be started by ingestion of only a small amount of food. It may also occur very suddenly after eating the food and can be serious, even life-threatening. This severe reaction is called anaphylactic shock or anaphylaxis.

Often a child need to eat food more than once before a parent knows the child is allergic. For example, the first time the child is exposed to nuts, there will probably be no reaction. But if the child develops an allergy to nuts, subsequent exposures could be serious, perhaps even fatal. The initial allergic reaction act likes a warning signal for later reactions. This holds true for nuts and many other highly allergenic substances.

A child with food allergy may be developed wheezing, hives, vomiting or diarrhea. The diagnosis of food allergies is difficult to make and requires a physician.

Any foodd can trigger an allergenic reaction . Common trigger foods are Cow's milk , Nuts, Eggs, Peanut butter, Fish or shellfish.

Common Dietary Problems

2009-10-20T04:36:00.001-07:00

Common Dietary Problems

1. Obesity/overweight
2. Anemia
3. Scurvy
4. Vitamin D Deficiency
5. Malnutrition

Obesity - body weight of at least 20% in excess of normal body weight for his height, age, sex and build. This can be serious health hazard because the patient is highly susceptible to diseases.

Formula: BMI=wt In lbs x 03 =
Ht. In inches2
= kg/m2

BMI < 20 - underweightBMI 20-24 - normal BMI 25-29 - overweight BMI> = 30 -obese

Causes
1. Overeating (comfort eating, boredom)
2. Sedentary lifestyle
3. Low basal metabolism (endocrine problem)
4. Heredity
5. Drugs
6. Cultural Factors

Being Overweight
|
|
|
Makes exercise Difficult
|
|
|
Leads to weight gain

Complications

1. Diabetes mellitus
2. Heart disease
3. high blood pressure – may lead to MI or stroke
4. High blood cholesterol
5. Osteoarthritis

Commercial vs. Homemade Foods

2009-10-17T17:12:00.000-07:00

Homemade and commercial foods both provide the necessary nutrients. A wider variety maybe available in commercial products which are often more convenient . No salt or additives are added to commercial infant foods. Some fruit products and desserts contain sugar to lower the activity.

Homemade foods may be less costly if the ingredients are in season and if they can be prepared without added salt/sugar or spices and precisely to the infant preferences for texture. However as a rule it may be safer for child care facilities to use only commercially prepared foods as it is readily available and it much more convenient to prepare.

Steroids in Olympics?

2009-10-16T01:39:00.000-07:00

Imagine after winning the most coveted medal in sports arena, you will end up with nothing after long time of hard work and practice. To some it may sound a tragic ending to a very touching story. However, if you will dig up the real facts you will find out that sometimes it is not always the case. It is no longer new for people to hear about Olympics medalists being stripped of their medals for using steroids. The scandal continues to destroy the career of athletes, like Tyler Hamilton, who received an eight year ban from cycling after admitting the use of herbal product knowing it includes steroid, to fight depression. One of the common steroids being used by athletes is the Clentuberol or otherwise known as clen. This is used to let the body stay active and in order to lose fat. However, one of the major drawbacks is that it will affect the performance of pulmonary, cardiac, and central nervous system. Thus, the doctors will always say that if you want to stroids you have to consider its potential side effects. Better safe than sorry. Lastly, it may not be the end of steroids looming the sporting events, but if the laws will be effectively imposed, I know it will somehow lessen the use of these drugs to have an unfair advantage.

Health Tips for Men

2009-09-30T20:07:00.000-07:00

Are you fond of reading mens health articles, or you are a man who wants to learn more about beauty tips and healthy informations. Or you are a woman who wants to learn more about your men? Well good news, you will discover great informations about health and beauty articles. One of which is how to cut the risk of heart disease when medication is no longer working, other related topics include cutting heart attack risk and even reverse heart disease in men and women. So what are you waiting for? Visit the site now and learn to appreciate your life more.

At this site, you can find great tips and free articles regarding automotive, arts and entertainment, beauty, education, computer, career, business, law related topics, marketing related information, and a lot more. In fact you can also read interesting topics like how to get help on debt consolidation, mortgage tips, how to fix bad credit, you can also fix your bad credit, patients loan poor credit, bad credit lenders, bad credit car loans, and many more. So if you happen to have bad records and you want to learn how to make a good comeback, then this site will help you a lot.

How to take care of your eyes?

2009-09-30T05:55:00.000-07:00

There are lots of products which aim to treat dark circles under the eyes, eye wrinkles, skin discoloration, eye puffiness, and under eye bags. But it is first important to know and fully understand the condition of your eyes before applying anything. If you want to learn more about Night Eye Creams. You do want to regain those beautiful eyes don’t you? Well this website offers a lot of information about the latest news about eye creams, new product releases, or ingredients making waves. For indeed the eyes are the windows to your soul. So you better take care of your eyes.

At the latest Eye Cream Reviews. They are always up to date and they know about the latest in eye cream products. Like the Elite Serum which has taken the anti-aging sectors by storm. Are you familiar with Kinerase under eye rescue, the purpose of which is to increase the elasticity of the skin and reducing the appearance of sagging, in as little as two to four weeks after beginning the course of treatment. This will help you regain that youthful beauty and refreshing look again. You will be a head turner again just like in the old days.

Lose stomach fat in healthy way

2009-09-30T03:31:00.000-07:00

Do you want to lose that stomach fat in an instant? Well here’s what you have been looking for! Just by following the proper steps in using this new amazing product, it is a guarantee that you will surely achieve that “to die for” body you have dreaming for the rest of your life. Yes, with recumbent bikes it will not only help you lose weight, this product is a perfect combination of advanced console electronics and quality construction. With the help of easy to use built in equipments, it will help you lessen the burden in your exercise.

In fact, recumbent bikes have already been in the market for quite sometime, however they do not get that much attention. But now, it will definitely change. With recumbent bikes, you can ride bikes differently, you can even steer it differently, starting and stopping is different as well, and climbing hills requires a different approach. I can’t wait to try this now. I will give reasons why you should try this also, it is comfortable, it will reduce stress injuries, and it is an equipment that lends a tremendous advantage does not reflect the merits of the athlete. Just visit the site Recumbent Bikes to learn more.

Stay Fit and Earn

2009-09-30T03:17:00.000-07:00

Are you planning to put up a business, and you cannot decide which one will suit you. Or you are a health conscious person who wants to own your healthy food menu. Well you can always go to the internet for some help on which business to decide. In fact maybe you should try Website for Restaurant, this website will help you put up your own restaurant within a few minutes. Who knows, you will be very successful in putting of your business in food. This website is an 18 minute website and it will help you on how to put up your own business. Don’t worry if your new at the business for it will surely be a big shoulder to count on. So just Click To Go To 18minutewebsite.com, where your dreams will surely become a reality. Remember this site, Click To Go To.

Get Free from Dark Circles and Wrinkles and feel healthy and beautiful

2009-09-25T05:51:00.000-07:00

The dark circles around eyes are very disturbing and will make us look tired and stressed. These unwanted marks in our face will be eliminated already with the presence of the wonder product called the Purity Dark Circle Eye Cream. This haloxyl based cream treatment will eliminate dark circle around and under your eyes without any proven side effects. While putting on this cream, this will not only reduce bags and puffiness on your eye but will also reduce wrinkles as it also has an anti wrinkle feature. However, if you want something more, a face wrinkle cream is also available.

Stress Management

2009-09-21T20:01:00.000-07:00

There are many methods in handling stress. Some are positive and healthy others are harmful or destructive. Americans consume more than 20 tons of aspirin per day , and doctors prescribe muscle relaxers, tranquilizers and change or eliminate stressors.

- Change partners to avoid a negative or hostile personality
- hostile personality
- Change work hours
- Cut back on overtime
- Change your attitude about stressor
- Stop wasting your energy complaining or worrying about things that you cannot change such as Skid row alcoholics, Abused children, Nursing home transfers, Cleaning contaminated EMS units

The term stress management refers to the tactics that have been shown to alleviate or eliminate stress reactions. these may involve changing a few habits, changing your attitude, and perseverance.

Stress and Nutrition

2009-09-21T19:50:00.000-07:00

Anyone can respond to a sudden physical stress for a short time. If stress is prolonged ,especially if physical action is not permitted response, the body can quickly be drained of its reserves. This can leave it depleted of key nutrients, weakened , and more susceptible to illness.

Your body's three sources of fuel carbohydrates and protein-are consumed in increased quantities during stress, particularly it physical activity is involved. The quickest source of energy is glucose, taken from stored glycogen in the liver. However, this supply will last less than a day Protein, drawn primarily from muscle, is a long-term source of glucose. Tissues can use fat for energy . The body also conserves water during periods of stress. To do so, it retains sodium by exchanging and losing potassium from the kidneys. Other nutrients, that are susceptible to depletion are the vitamins and minerals that are not stored by the body in substantial quantities. These include such as water-soluble B and C vitamins and most minerals.

Keep Your Joints Healthy

2009-09-17T03:06:00.000-07:00

When it comes to health, everyone is concern especially as we grow older joint pains are very common. To keep us free from these disgusting joint pains, Nature’s Best comes to a supplement that works effectively for our joints, and this is the glucosamine. This health supplement helps replenish the cartilage in our knees and eventually keeps our joints healthy. Available in two kinds, the glucosamine sulphate and Glucosamine hydrochloride, Nature’s Best recommends the more compact one, which is the sulphate. Tested with a very few side effects if there is any, the world’s one of the popular supplement Glucosamine is obviously safe for daily intake.

Being the best quality producer in the market for Glucosamine Sulphate, Nature’s Best is proud to be UK made. In addition, the brand boasts off being one of the few to have really made it to the pharmaceutical standards, and thus taking their products is guaranteed safe and effective. With the numerous Glucosamine product Nature’s Best has, they highly recommend that you will first determine the right supplement for you. Included in the family is the Glucosamine and Chondroitin, Glucosamine gold, Glucosamine with Cider Vinegar and all are effective as long as the one you have chosen to your supplement is the one that works with your health.

Way In Keeping You Safe At All Times

2009-09-17T02:39:00.000-07:00

When it comes to out laptops, we always wanted to be at their best look and performance that why we do everything we can to protect them from dust and dirt and keep them safe at all times. Generally, people who tend to purchase a laptop are those who are working remote or those who frequently travels. However, this time, even students and those working at homes purchase laptops already as many of them are affordable this time. Generally, laptop owners also purchase some

laptop accessories to enhance the look and performance of their laptops.

On the other hand, it is an instant gesture to purchase a laptop bag in order to protect the gadget and keep them intact during travel. However, this time around, we can already see people using laptop bags due to the presence of many of the colorful, fancy, and hip laptop cases. Works like the laptop bag, a laptop case generally conceal the identity of a laptop, thus it does not only protects your laptop from dust and dirt but also to those laptop-prying eyes around you. For your laptop accessories needs, Gearzap offers the most stylish and affordable accessories, bags, and cases you might need.

Know London Well Through Qype

2009-09-03T03:55:00.000-07:00

If you are new to London or someone that is not outgoing but wanted to have some fun to relax and unwind, the Qype London is the place to be. You can see in this page numerous reviews from locals that will surely guide you on your adventure. If you want to have a healthy and good-looking you, the site has the health and beauty section that contains lots of reviews ranging from gym, to yoga, to fitness centers, to beauty salon and more. One great example of it is the Nordic Balance that has services from pre and post-natal exercises, yoga, pilates, reflexology, reiki, sports conditioning, and even nutritional advice.

If you are looking for the best Restaurants to dine in London, you will never be wrong in turning to Qype. You will see some Thai restaurants, Japanese restaurants, Italian restaurants and more having honest to goodness straight from the customer reviews. Hanging out in London is not hard at all with the numerous Restaurants London has to offer. The Shaftesbury Bar, Franco Manca, Ten Ten Tei, and Churchill Arms are just a few. If you prefer to hang out in a pub rather than in a resto or bar, then the Pubs London has includes but not limited to The Wheatsheaf, Churchill Arms, The Princess Louise and more. Read on the reviews and have an idea on which bar, resto, or pub is best for you.

The Vegetarian Child

2009-08-31T07:14:00.000-07:00

When children are on vegetarian diets, caregivers may wish to consult a dietician and should ensure that the child's diet contains the necessary nutrients and the extra bulk of alternative foods are not too great for the child to eat. Children in vegetarian families should receive plant proteins, such as legumes, mild milk cheese (if acceptable to their parents), tofu and meat like products made from vegetables protein. Since nuts are highly allergenic, the introduction of nut butters should be delayed until the end of the second year of life. After 9 months of age, infants on a Lacto-Ovo Vegetarian diet can probably have eggs. The texture of foods needs to be modified for young toddlers by cooking foods well, pureeing, or putting them through a sieve, blender or grinder. For infants, the pureed food may have to be thinned in order to attain the right consistency.

Children's Food Attitudes and Preferences

2009-08-20T18:03:00.000-07:00

Children's food attitudes and preferences are developed at a very early age and are strongly influenced by the attitudes and preferences of the adults who care for them/as well as by the child's cultural and family heritage.

It is important for caregivers to assess their own attitudes and food preferences, because their example will have a strong influence on children's attitudes. Caregivers should try to understand and accommodate cultural food patters.

The child's age also influence food preferences. For the infant, food may represent security and love; for toddler, food may also be a source of interest and experimentation, or it may be used to express frustration. This behavior is not unusual and if occasional/should be seen as part of the child's normal development. Food should not be used by adults as reward, a way to control or coerce the child, or as a focus to work out conflicts..

Precor Elliptical Trainer

2009-08-16T16:02:00.000-07:00

Precor elliptical trainer is a well-reputable type of fitness equipment. Precor is a popular USA manufacturer of fitness equipment including elliptical trainers, treadmills, stationary bikes, and climbers. Of course this list is not full because their product range is rather wide. Though ellipticals are among the most popular trainers for using at home gyms.

By the way the variety of ellipticals is also rather wide. There are cordless versions and those equipped with heart rate monitor. The latter is very important for constant cardiovascular work outs control. There are also cross trainer ellipticals which you can buy for very attractive prices at online store with minimal shipping costs. By the way elliptical trainers are one of the most effective for rapid calorie-burning process.

Consequently they are rather helpful for weight loss purposes. They also help avoid getting overweight provided having regular exercises. This is very convenient for people who can afford eating what they like and don’t be afraid of becoming overweight because their elliptical trainer is right here to help.

When choosing an elliptical or any other fitness machine it’s really important to pay attention to the manufacturer and its reputation. Of course the price is also important. That is why it’s so great to get a high-quality trainer with a huge discount offered when buying online.

TV and Children's Health

2009-08-13T18:00:00.000-07:00

Because children tend to imitate what they see, parent, consumer, medical and halth groups have long critized the types of foods featured or advertised on children's programs (such as sugar coated cereals, pop, candy, deserts, snacks and fast foods). They have noted the poor health haboits of many prime time TV heroes and heroines -everything from driving without seatbelts to drinking, eating junk foods or indulging in high risk behavior. Pressure from these groups has paid off to certain extent; high risk behavior like smoking or driving without seatbelts have either disappeared from the small screen, or diminished in recent years.

TV and Obesity

At least one research study(Diets and Gortmaker, 1985) has found a relationship between heavy TV viewing and obesity in some children and adolescents. The reasons that were suggested include:

-The fact that watching TV requires very little energy compared to other activities.
-The viewing replaces activities that use up more energy;
-The habit of snacking often accompanies TV viewing;
-High-calorie food is advertised or otherwise features on TV
-Favorite TV stars, who may eat a lot without ever seeming to gain weight , are imitated

TV and Health
In another study, this time teenage boys (Tucker;1987), heavy viewers showed poorer physical and emotional fitness, and practiced unhealthier lifestyles (including substance abuse), than did their light or moderate TV viewing peers. While there was no suggestion that this was a case of cause and effect (there were other possible reasons for the test results), heavy viewing is guilty by association.

Care For Your Skin and Look A Few Years Younger

2009-08-12T19:25:00.000-07:00

Skin care products are popping up like mushroom nowadays. You can see them everywhere, in a department store, skin care clinic, drug store, and more. Part of the skin problems that every woman is battling are the wrinkles that going visible as time goes. To get rid of this, most women use wrinkle creams. However, before choosing the right wrinkle cream for you, it is best to check first some Wrinkle Cream Reviews to have a better idea of the product. You can easily avail great reviews from Skin Care Options. They collect reviews from independent product users, so you can assure of an honest review. The latest review that they got currently is for an Eye Serum product that will help you get rid of those dark circles under your eyes.

Vegetarian Diets

2009-08-10T23:46:00.000-07:00

Vegetarian Diets , if properly manage are safe, have long cultural traditions and may reduce the risk of certain conditions such as obesity. Adults who provide a vegetarian diet for their families are often very knowledgeable about nutrition and serve well-balanced meals .

Types of Vegetarian Diets
1. The "Vegan" diets, consisting only of non-animal foods
2. The"Ovo-Vegetarian' diet, consisting of non animal food plus eggs and
3. The "Lacto-Ovo-Vegetarian" diets, consisting of non animal food plus eggs and dairy products

The growth the infants and children on a very restricted vegetarian diet(Vegan) may be compromised. Children may have difficulty obtaining enough energy ,protein, iron, calcium,vitamin D, vitamin B12 and riboflavin. Malnutrition can result if a child's parents are not familiar with children's minimal nutritional requirements, or if adequate care is not taken in meal planning and preparation.

Children eating an OVO-vegetarian or Lacto-Ovo-Vegetarian diet will have less difficulty meeting their nutritional needs, therefore , the less restrictive Lacto-Ovo diet should be promoted.

Are you protected from BV?

2009-08-09T09:10:00.000-07:00

Bacterial Vaginosis (BV) causes vaginal infection. It can be with our without symptoms and may occur to women of childbearing age. Symptoms of BV include excessive vaginal discharge that has fishy smell especially after sex. It can also be itchy at times, and can be recurring. To avoid from getting infected with BV, get yourself educated and well-informed about it and read 3 Days To Permanent Bacterial Vaginosis Relief, san eBook that will help you determine the solution and relief for the said disorder. Available for purchase at an affordable price, this eBook will help you treat BV fast and prevent it from recurring.

Meat and Alternatives

2009-07-27T10:00:00.000-07:00

These foods are generally started last and are good source of protein and iron. Single pureed meat should be started first. After the infant develops some teeth/coarser-textured meats may be offered.

Single egg white is known allergen/egg yolks should not be started until the infant is 6 to 12 months of age and egg white after 12 months of age. Raw eggs should not be offered to children.

Commercial combination dinners are mixtures of meat, vegetables, eggs, cereal, and pasta and or milk products. They offer advantage over the separate foods, and should not be used in early feeding in case of allergies.

Live the Healthy Life By Eating The Right Food

2009-07-14T20:05:00.000-07:00

It is known that the secret of living the healthy life is to eat the right food at the right amount or what we commonly known as the balanced diet. However, how would you know that you are eating the right food at the right amount? You can be properly guided at eat-healthy-live-healthy.com with their list of foods to intake and avoid. In addition, they also have included in their site the best steps in keeping your body healthy. Give their site a visit now, browse over their informative articles and good luck on your aim of living healthy by eating healthy.

How to give food safely

2009-07-14T19:54:00.000-07:00

How to help with feeding...

1. Have an assessment

2. Environment:quite and relaxed
* avoid eating when tired or upset
* ensure adequate lighting
* avoid talking while eating

3. Duration- allow enough time (20-25 minutes)

4. Make food appealing

5. Do mouth care before/after meals

6. Posture- sit upright
swallow with head slightly down

7. Use appropriate utensils
* cup with sprout
* straw
* 2 handled drinking cups
* wide-handled drinking cups
* plates with rims
* cloth under dish

8. Provide sips of water between bites

9. Provide small bites

Criteria for Not Starting CPR

2009-07-07T03:25:00.000-07:00

All patient in cardiac arrest received resuscitation unless

*The patient has a valid Do Not Attempt Resuscitation (DNAR)order
* The patient has a signs of irreversible death: rigor mortis, decapitation, or dependent lividity .

When to STOP CPR

S - spontaneous signs of Circulation
T - turn over to professional provider
O - operator is exhausted
P - Physician assumes responsibility

CPR for Healthcare Providers

2009-07-07T03:10:00.000-07:00

Step 1 : Survey the scene
If scene is safe

Step 2: Check for responsiveness "Hey Maam are you ok?"
If no response

Step 3: Call Emergency Medical Service or Transfer Facility

Step 4: Check for Signs of Breathing or Life
(opening the airway, look, listen and feel for movement and breathing) No more than 10 seconds

Step 5: Give two Initial breahts - If no sings of life /victim id breathless if chest does not rise proceed to unconscious choking algorithm.

Step 6 : Check for circulation (no more than 10 seconds)

Step 7 START
RB- If patient has no breathing , but has pulse.
Give 24 cycles RB?adult; 40 cycles
RB-child/infant for 2 minutes

CPR- If patient has no breathing and has no pulse.
(Give 5 cycles of 30 compression and 2 ventilations for 2 minutes )

Step 8: Re-Check for circulation after 2 minutes of RB/CPR
If has pulse and breathing - place the patient on a recovery position

If still no pulse and breathing repeat STEP 7

Note: If at any time obvious sing of life is found, stop CPR , place in recovery position and monitor breathing.

Body Wraps: the easiest way to lose fats

2009-06-02T04:37:00.001-07:00

You can forget those tedious daily fat burning works outs and diets just to lose an inch or two. The body wraps is already here to make your fat eliminating experience as simple and fast as possible. Using the Ultra body wrap, you will have the chance to lose five to fifteen inches in just one wrap. This formula is suppose to be for spa use but is now already available for home use. Works effectively for your belly, chin, thighs, and arms, the Ultimate Body Wrap will definitely keep you in shape without bothering to visit your fitness gym or skipping those mouth-watering meals.

MD Strength: the perfect skin whitening

2009-06-02T04:35:00.000-07:00

If you are tired of your dark skin and was getting bullied because of it, you can go and give a try MD Strength. By just applying this skin whitening product seven times, you will already have the fair white skin that you dreamed for a long long time, and not just that. To completely keep your skin clear and free from blemishes, they also have the scar treatment product that dissolves dead skin and scar build up. It is 100 percent proven effective and is priced lower than those you can see on retail stores. Remove your scars now and enjoy a clear and young looking skin.

bodybuilding diet

2008-11-26T05:31:00.000-08:00

Losing weight is not easy. I have to admit, gaining the weight in the first place was a lot more fun. Now I've been looking at different alternatives to weight loss, as well as some free weight loss plans. I haven't decided exactly what to do yet, but I think I have a basic idea. When I was young I would follow a diet , which was very high in protein. I think I'll do that again while trying to add lean muscle mass and lower my body fat.

I plan on trying CLA for weight loss his time around. I'm not sure how effective it is, but many of the reports seem to hold promise. If that can help me cut my bodyfat percentage a bit, it will be worth the effort.

I definitely plan on using protein bars to lose weight this time. I'll use a protein bar as a meal replacement so I get more protein but fewer calories. In addition to a fat burner, and some serious time at the gym, I'm sure I'll lose some weight quickly.

Seeing fireworks might help people who are depressed

2008-09-19T02:52:00.000-07:00

When seeing a Fireworks display, everybody would think of a celebration right away. It is now already became a tradition to incorporate fireworks display in celebration our years of success, may it be with our family, business or any professional career.

Our celebration with fireworks display would be livelier if we include some Rockets from Ghengis Fireworks in it. It has the ability to provide loud sounds that adds the festiveness of every celebration. In addition, it will attract more people to watch the display.

While everybody is enjoying watching the display, one is not with everyone else while enjoying the happiness and that is the operator, that is why the Single Ignition Fireworks is created.

Correct your vision disorder

2008-09-10T03:57:00.000-07:00

Pinhole Glasses– a great way to save for your traditional prescription eyeglasses

Prescription eyeglasses have been once became the known solution for people with eyesight problems. They used prescription eyeglasses to make their vision clearer. However, prescription eyeglasses costs a lot that not all visually impaired can afford. However, less financially visually impaired person will now not to worry anymore because the natural alternative to prescription eyeglasses called the Pinhole is now here to make see even clearer. For those who are new with the Pinhole, it is an effective and cheap alternative for prescription eyeglasses. It consist of precision-manufactures lightweight perforated plastics lenses, inset into a standard metal or plastic frames. The Pinhole is perfect for those who are suffering from refractive eye disorders, the elderly, and today’s computer power users. Clients who are able to purchase and eventually use the Pinhole claimed to have clearer eyesight the moment they wear the Pinhole. If you think you still have a perfect vision of 20/20 and does not need the Pinhole, then you must think twice, because the Pinhole will let you see more clearly.

If you are still skeptical in using the Pinhole, take into consideration the following advantages of using the Pinhole.

• First, the Pinhole-Glasses is very cheap with its starting price of just $14.99 a pair, and for sure, it will let you save millions for the rest of your life.
• Next is it improves vision clarity and resolution, and it is guaranteed.
• Another advantage is that, it increases object brightness, which is perfect and recommended to those who are struggling to see in low light situation.
• It also provide good vision at all distances, which means, whether you are far sighted or near sighted, you can use the Pinhole without any special apparatus to install.
• One more advantage of the Pinhole is that, one pair suits all situations. There is no need for you to buy one pair for a specific purpose, which is another savings and convenient feature the Pinhole has.

Those are just few of the advantages the Pinhole-Glasses have. If you are not yet familiar with the Pinhole-Glasses, you can visit their website and read more about the product.

Hair off the Square Products

2008-09-03T04:52:00.000-07:00

Looking for the right product for our hair and body is not easy and it takes sometime to decide if a certain product is the right product for our hair and body. However, hair off the square is here to help you keep your hair look shiny with their nioxin hair shampoo products, which is a complete set of hair care that includes shampoo, conditioner, and treatment that will nourish, replenish and treat. After using it and you get the good looking hair that you desire, you can now share it with your family and friends because hair off the square is offering a bath and body basket gift baskets filled with a unique high quality bath and body products. For sure, your friends will also get the kind of hair as what you have, and they will thank you for it.

Keep your skin and scalp healthy with Ens-Bio

2008-09-03T04:51:00.000-07:00

Keeping our skin healthy is not easy and a time consuming thing to do. We ladies normally spent almost all of our time keeping our skin healthy, younger looking and free from any skin defects like scars, spider veins, stretch marks, acne, skin rashes and irritations, scalp problems and much more. However, today, all our worries about our skin is gone with the presence of the Ens-Bio. You want treatment for spider veins? Ens-Bio has it for you at a very affordable price. Ens-Bio’s product the spider veins cream will penetrate deep with concentrate vitamin k and will keep your skin free from spider veins. In addition, Ens Bio also has various products for your scalp treatment to keep your scalp healthy and free from flakes. These products will purify and regain balance to your scalp skin keeping it healthy all the time. Their award-winning product will let you forget about using the traditional shampoo.

Herpes Simplex I (cold sores)

2008-08-30T20:19:00.000-07:00

There are two types of herpes simplex virus type 1 and type 2 . Infections with type 1 usually involve the mouth and are from person to person by direct contact with infected droplets of saliva or by contact with the lesions.Infections with type 2 usually involve the genital tract and are spread by sexual contact.

The first time children are infected with Herpes Simplex type 1 , they often have no illness. However some children will get an acute illness with high fever and painful ulcers throughout the mouth. The illness usually lasts for a week or more. The ulcers may be so painful that the child is unable to eat or drink and has to be hospitalized.

Herpes virus produces a lifelong infection. The herpes virus can survive in body cells and become active again. Some people get recurrent attacks in the form of vesicles or blisters on the lips, called fever blisters or cold sores. The number of attacks of cold sores and the pain felt with the sores varies greatly from person to person.

MOT:
direct contact with infected saliva

Symptoms:
fever
ulcers in the mouth
drooling
irritability

Treatment
Supportive
analgesic for fever
analgesic for pain

Management
avoid hot foods
oral hygiene
proper handwashing

Head Lice

2008-08-30T18:24:00.000-07:00

Headlice is very common condition in children and is not caused by lack of cleanliness. Head lice are tiny insects that live on the scalp. They lay eggs called nits that stick to the shaft of the hair very near the scalp. The eggs or nits appears as whitish gray or tan specks, about the size of the grain of sand. They are firmly attached to the hair shaft very close to the scalp. Many children with head lice have no symptoms. Some children may have itching of the scalp. In order to find head lice ,caregivers must do a careful check of the hair and scalp. There are effective treatments for head lice. The special shampoos or cream rinses all contain an insecticide, which kills the insect. It maybe necessary to treat all members of the household at the same time.

Transmission
Head lice spread from person to person by direct contact between children, or through items such as hats, combs, or hairbrushes. Head lice cannot jump or fly.

Things to do when a child has head lice
1. Notify the parents of the child with head lice, and ask them to contact their physician or local public health agency for advice about treatment. All family members may have to be treated with a special shampoo or cream rinse. Advise parents to carefully follow the directions of the bottle.
2. Check other children and staff in the same group for the presence of nits. If nits are found, notify the child's parents to pick their child up.
3.Ensure all infested children and caregivers are treated.
4. Vacuum carpets, rugs, and upholstered furniture thoroughly
5. Dry-clean or simply store clothing in closed(sealed)plastic bags for ten days. All the lice will die in the sealed bag.
6. Put pillows and non washable furry toys in clothes dryer at the hottest setting for 20 minutes
7. Soak all combs and hairbrushes for ten minutes in the head lice treatment solution

Pinworm

2008-08-30T18:17:00.000-07:00

Pinworm are small,white,threadlike worms that live in the cecum.

Cause: parasite(enterobius)

MOT: Fecal Oral
Direct Contact
Indirect Contact

Treatment: anti parasite(Mebendazole)

Management:

1. Handwashing
2. Cut nails short(avoid nail biting)
3. Watch out for other children for anal, itchiness
4. Prepare food properly.

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2008-08-30T18:11:00.000-07:00

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2008-08-30T18:07:00.000-07:00

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Appendicitis

2008-08-27T07:40:00.000-07:00

Appendicitis - inflammation of the appendix
- most common cause of surgery

Cause: Fecalith Complications : peritonitis

Signs and Symptoms:
1. Anorexia
2. Nausea
3. Vomiting
4. Mc. Burney's point

Treatment:
1. Surgery(appendectomy)

Caregiver's Management:
1. Assess the child's pain
2. Do not give anything by mouth(Non per orem)
3. Assist child with finding a position of comfort
4. Avoid palpating(touching) the abdomen
5. Do not apply heat to the abdomen

Equipment Used in Taking Blood Pressure

2008-08-27T07:32:00.000-07:00

1. Aneroid Manometer- is an air pressure gauge that registers the BP by a pointer on a dial. The dial generally attaches to the cuff by hooks that fit into small pocket.
2. Mercury Manometer- the mercury rises in a calibrated glass tubes as the cuff is inflated with air, then falls as the air is released. Rubbing tubing connects the mercury reservoir with the cuff.

Floor Model - can be moved from one place to another
Portable Model - comes in a box, can be seen mostly in clinics

3. Stethoscope - an instrument used for listening to body sounds

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2008-08-01T16:15:00.000-07:00

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2008-08-01T16:13:00.000-07:00

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2008-07-22T03:32:00.000-07:00

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2008-07-22T03:20:00.000-07:00

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Depression

2008-06-30T05:48:00.000-07:00

Depression - Presence of five symptoms lasting for two weeks or more.

Criteria of Depression:

1. depressed mood
2. worthlessness-hopelessness
3. loss of interest/pleasure in daily activities
4. weight loss/weight gain
5.Excessive guilt
8.insomnia/hypersomnia
9. thoughts of suicide/suicidal attempts of suicide.

Types of depression

Unipolar- symptoms lasting for more than two weeks.

Bipolar depression that includes cycles of mania

Dysthymia- long term, chronic depression

Atypical depression- chronic depression with other symptoms such as excessive fatigue, oversleeping and overeating

Seasonal depression -Onset is associated with a certain time of the year or insufficient sunlight.

Psychotic depression- severe depression accompanied by delusions or hallucinations, requiring immediate psychiatric care.

Hormonal depressions - premenstrual dysphoric disorder

Post Traumatic Stress Disorder- depression that can occur after exposure to traumatic life-threatening experience.

Depression Signs and Symptoms

Feelings of helplessness and hopelessness
A bleak outlook—nothing will ever get better and there's nothing you can do to improve your situation.

Loss of interest in dailly activities
No interest in or ability to enjoy former hobbies, pastimes, social activities, or sex.

Appetite or weight changes
Significant weight loss or weight gain—a change of more than 5% of body weight in a month.

Sleep changes
Either insomnia or oversleeping (also known as hypersomnia).

Psychomotor agitation or retardation
Either feeling "keyed up" and restless or sluggish and physically slowed down.

Loss of energy
Feeling fatigued and physically drained. Even small tasks are exhausting or take longer.

Self-loathing
Strong feelings of worthlessness or guilt. Harsh criticism of perceived faults and mistakes.

Concentration problems
Trouble focusing, making decisions, or remembering things.

Irritability
Easily annoyed or frustrated. Lashing out in anger or snapping at others.

Aches and pains
New or worse physical symptoms, including headaches, backaches, diarrhea or constipation, abdominal pain, and aching joints.

Treatment:

Psychotherapy - studies shows that psychotherapy is very useful in preventing relapse or recurrence of major depression in women who have been successfully treated with anti-depressant.

Antidepressant Medications- they work by helping the brain do what it was designed to do or more efficiently. They help in increasing neurotransmitters in the brain which becomes depleted when depressed.

What you can do to help overcome depression?

a. Acknowledge your struggle with depression
b. Be honest and open with God in prayer
c. Share your struggles with someone who will be supportive and empathetic.
d. Set small goals and take small steps. Don't try to do it all.
e. Remember , growing and changing happens one day at a time.

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2008-06-20T02:13:00.000-07:00

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2008-06-14T06:58:00.000-07:00

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2008-06-14T06:54:00.000-07:00

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2008-05-21T03:12:00.000-07:00

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Case Presentation on Syncope

2008-05-07T01:00:00.000-07:00

Case Summmary:
This is a case of a 24-year-old man brought to the emergency department (ED) after several episodes of nearly blacking out. He also experienced palpitations with associated light-headedness. An electrocardiogram (ECG) is obtained, and a diagnosis of Syncope was considered. Proper Interventions were then given to prevent complications of the disease condition.

Chief Complaint:
Episodes of nearly blacking out, light-headedness, and palpitations.

History of Illness:
A 24-year-old man presents to the emergency department (ED) after several episodes of nearly blacking out that have occurred 3-4 times over the past 3 days. The patient states that he also felt his “heart beating really fast” and associated light-headedness. He smokes 2-4 packs of cigarettes per day and has done so for 5-6 years. No history of significant cardiac disease or sudden cardiac death in his family is noted.

II.Case Discussion

What is syncope?
Syncope (SIN'ko-pe) is temporary loss of consciousness and posture, described as "fainting" or "passing out." It's usually related to temporary insufficient blood flow to the brain.
It most often occurs when the blood pressure is too low (hypotension) and the heart doesn't pump a normal supply of oxygen to the brain.

Pathophysiology
Syncope occurs when cerebral perfusion globally decreases. Brain parenchyma depends on adequate blood flow to provide a constant supply of glucose, the primary metabolic substrate. Brain tissue cannot store energy in the form of high-energy phosphates found elsewhere in the body; therefore, a cessation of cerebral perfusion lasting only 3-5 seconds results in syncope. Cerebral perfusion is maintained relatively constant by an intricate and complex feedback system involving cardiac output, systemic vascular resistance, arterial pressure, cerebrovascular resistance with intrinsic autoregulation, and metabolic regulation. A clinically significant defect in any one of these or subclinical defects in several of these systems may cause syncope.
Any of the following may manifest as syncope. Cardiac output can be diminished secondary to mechanical outflow obstruction, pump failure, hemodynamically significant arrhythmias, or conduction defects. Systemic vascular resistance can drop secondary to vasomotor instability, autonomic failure, or vasodepressor/vasovagal response. Arterial pressure decreases with all causes of hypovolemia. A central nervous system (CNS) event, such as a hemorrhage or a seizure, can also present as syncope. Syncope can occur without reduction in cerebral blood flow in patients who have severe metabolic derangements (eg, hypoglycemia, hyponatremia, hypoxemia).

What causes syncope?
It may be caused by emotional stress, pain, pooling of blood in the legs due to sudden changes in body position, overheating, dehydration, heavy sweating or exhaustion. Syncope may occur during violent coughing spells (especially in men) because of rapid changes in blood pressure. It also may result from several heart, neurologic, psychiatric, metabolic and lung disorders. And it may be a side effect of some medicines.
Some forms of syncope suggest a serious disorder:
• those occurring with exercise
• those associated with palpitations or irregularities of the heart
• those associated with family history of recurrent syncope or sudden death

Management of Syncope
The majority of children and young adults with syncope have no structural heart disease or significant arrhythmia (abnormal heart rhythm). So, extensive medical work-up is rarely needed. A careful physical examination by a physician, including blood pressure and heart rate measured lying and standing, is generally the only evaluation required.
In other cases an electrocardiogram (EKG or ECG) is used to test for abnormal heart rhythms such as long Q-T syndrome. This is a genetic heart condition that can cause sudden cardiac death. Other tests, such as exercise stress test, Holter monitor, echocardiogram, etc. may be needed to rule out other cardiac causes of syncope.
If EKG and cardiac tests are normal, the person will undergo a tilt test. The blood pressure and heart rate will be measured while lying down on a board and after the board is tilted up. Someone who has NMS will usually faint during the tilt, due to the rapid drop in blood pressure and heart rate. As soon as the person is placed on his or her back again, blood flow and consciousness are restored.
To help prevent syncope, people with NMS should be on a high-salt diet and drink plenty of fluids to avoid dehydration and maintain blood volume. They should watch for the warning signs of fainting — dizziness, nausea and sweaty palms — and sit or lie down if they feel the warning signs. Some people also may need medication.
Prehospital Care
Prehospital management of syncope covers a wide spectrum of acute care and includes rapid assessment of airway, breathing, circulation, and neurologic status.
• Treatment may require the following:
• Intravenous access
• Oxygen administration
• Advanced airway techniques
• Glucose administration
• Pharmacologic circulatory support
• Pharmacologic or mechanical restraints
• Defibrillation or temporary pacing
• Advanced triage decisions, such as direct transport to multispecialty tertiary care centers, may be required in select cases.
Emergency Department Care
In patients brought to the ED with a presumptive diagnosis of syncope, appropriate initial interventions include intravenous access, oxygen administration, and cardiac monitoring. ECG and rapid blood glucose evaluation should be performed promptly. Syncope may be the manifestation of an acute life-threatening process but is generally not emergent. Clinically ruling out certain processes is important. The treatment choice for syncope is dependent upon the cause or precipitant of the syncope. Patients in whom a cause cannot be ascertained in the ED, especially if they have experienced significant trauma, warrant supportive care and monitoring.
• Situational syncope treatment focuses on educating patients about the condition. For example, in carotid sinus syncope, patients should be instructed not to wear tight collars, to use a razor rather than electric shaver, and to maintain good hydration status; they should also be informed of the possibility of pacemaker placement in the future.
• Orthostatic syncope treatment also focuses on educating the patient. Inform patients about avoiding postprandial dips in BP, teach them to elevate the head of their bed to prevent rapid BP fluctuations on arising from bed, and emphasize the importance of assuming an upright posture slowly. Additional therapy may include thromboembolic disease (TED) stockings, mineralocorticoids (eg, fludrocortisone for volume expansion), and other drugs such as midodrine (an alpha1-agonist with vasopressor activity). Patients' medications must be reviewed carefully to eliminate drugs associated with hypotension. Intentional oral fluid consumption is useful in decreasing frequency and severity of symptoms in these patients.
• Cardiac arrhythmic syncope is treated with antiarrhythmic drugs or pacemaker placement. Consider cardiologist evaluation or inpatient management since this is more commonly associated with poor outcomes. Trials assessing beta blockade to prevent syncope have conflicting results, but no clear effect has been demonstrated.
• Cardiac mechanical syncope may be treated with beta-blockade to decrease outflow obstruction and myocardial workload. Valvular disease may require surgical correction. This, too, is associated with increased future morbidity and mortality.
• Neurologic syncope may be treated in the same fashion as orthostatic syncope, or it may be treated with antiplatelet medications. Patients are recommended to have neurologic follow-up care to determine whether they need further neurovascular imaging.

Medications
Drug Category: Anticholinergics
These agents improve conduction through the AV node by reducing vagal tone via muscarinic receptor blockade. For patients with infranodal block, this therapy is ineffective.
Drug Category: Nutrient supplements
Parenterally injected dextrose is used in patients unable to sustain adequate oral intake. Its direct oral absorption results in a rapid increase in blood glucose concentrations.
Drug Category: Benzodiazepines
CNS agents of the 1,4-benzodiazepine class exert their effects by binding at stereo-specific receptors in the CNS. Their exact mechanism of action has not been clearly elucidated. Benzodiazepines cause a dose-related CNS depression, which varies from mild sedation to hypnosis.
Drug Category: Vasopressor
Midodrine forms an active metabolite, desglymidodrine, that is an alpha1-agonist acting upon receptors of the arteriolar and venous vasculature.

Deterrence/Prevention• Education may have a substantial impact on the prevention of recurrence, especially in situational and orthostatic syncope. Patients may be trained to avoid situations that prompt syncope in situational cases. In orthostatic syncope, patients should drink 500 mL of fluid each morning in addition to their usual routine and should avoid standing up too quickly.

III. Conclusion
The thorough history of the patient with syncope should begin with the observations of onlookers.
The history also should include the identification of aggravating and alleviating factors, especially the additions of new medications. Antiarrhythmic and antihypertensive medications raise the possibility of proarrhythmia or orthostasis. Phenothiazines and tricyclic medications predispose older patients to orthostasis. Over-the-counter medications and supplements also can contribute to syncope.
The physical examination of a patient with syncope should include measurements of blood pressure and pulse rate in the upper and lower extremities while the patient is in the supine and upright positions to identify orthostatic hypotension, autonomic dysfunction, or possible organic heart disease. Checking for carotid bruits can find impaired cerebral blood flow or underlying coronary artery disease. On examination, the physician also may find signs of pulmonary hypertension, left ventricular dysfunction, valvular heart disease, or other forms of organic heart disease. Neurologic disorder is suggested by abnormal cognition, speech, visual field, motor strength, sensation, tremor, or gait disturbance.
Syncope is not associated with increased mortality when no underlying heart disease is present. When the initial evaluation is normal, it is often challenging to discern the origin of syncope. Although many of the most serious possible causes of syncope can be excluded by a normal evaluation, the possibilities of neurocardiogenic syncope, carotid sinus hypersensitivity, paroxysmal bradyarrhythmia, supraventricular tachycardia, ventricular tachycardia, and many noncardiac causes still exist.
We, as future nurses should embody the knowledge, skills, and attitude in our everyday nursing practice to ensure patient’s safety and improvement of well-being.

Journal Article

Causes and Outcomes in Patients with Syncope
Syncope is a relatively common problem with a favorable prognosis in most patients. In one subgroup of patients, however, syncope denotes increased risk for serious cardiac or neurologic disease. Soteriades and coworkers used data from the Framingham Heart Study to provide some specific population-based numbers on the causes of syncope and its long-term outcomes.
The authors scanned records for 7,814 Framingham participants and found 822 subjects with reported syncope; follow-up data were available for 727 of these patients. Based on chart reviews, a physician committee excluded 120 other reported syncope cases as equivocal. To minimize recall bias, they also excluded 101 cases in which patients had not had a clinical examination in the previous four years. Other exclusions included 47 cases of syncope associated with head trauma and seven cases with incomplete records.
Four diagnostic groups were established for describing the cause of syncope: cardiac cause (e.g., ischemia, arrhythmias); neurologic cause (e.g., transient ischemic attack, stroke, seizure); unknown cause; and vasovagal or other cause (e.g., vasovagal syncope, orthostatic syncope, medication-induced syncope, syncope from cough or micturition, situational syncope).
The average age of the 822 study subjects reporting syncope was 65.8 years. The overall incidence of syncope was 6.2 cases per 1,000 person-years; the incidence increased with age and nearly doubled in the cohort of patients older than 70 years. The authors found that the most common diagnostic group was the group with vasovagal or other cause of syncope (44.9 percent), followed by the groups with unknown cause (36.6 percent), cardiac cause (9.5 percent), and neurologic cause (9.0 percent).
The average duration of follow-up available for review after a first report of syncope was 8.6 years (n = 2,181). After adjustments for age, sex, smoking, hypertension, diabetes, cardiovascular disease, use of cardiac medications, and several other relevant clinical variables, the overall risk of death from any cause was found to be 31 percent higher in the patients with syncope than in those without the diagnosis (i.e., hazard ratio of 1.31). Patients with a cardiac etiology of syncope had double the risk of death from any cause compared with patients who did not have syncope. The overall risk of death in patients with a neurologic or unknown cause of syncope was elevated to a lesser degree (hazard ratios of 1.54 and 1.32, respectively). Risk of death, myocardial infarction, or stroke was not found to be significantly elevated in the patients with vasovagal or other cause of syncope.
The authors noted that their findings supported a benign prognosis for syncope with a vasovagal cause. Their findings suggested that the small group of patients with cardiac causes of syncope should be closely monitored because of their high risk of morbidity and mortality. In addition, patients with syncope from an unknown cause may require further testing.
BILL ZEPF, M.D.

Source:
Soteriades ES, et al. Incidence and prognosis of syncope. N Engl J Med September 19, 2002;347:878-85, and Maisel WH, Stevenson WG. Syncope--getting to the heart of the matter [Editorial]. N Engl J Med September 19, 2002;347:931-3.

A case study about Schizophrenia

2008-05-07T00:48:00.000-07:00

Case Summary
This is a case of A.O., 30 years old, female, from Amamaros, Pototan, Iloilo, who was admitted at Pototan Mental Health Unit last February 10, 2008, with a chief complaint of behavioral changes and a working diagnosis of Schizophrenia. She’s under the supervision of Dr. Ali Robles.

Analysis of the Case

History of Past Illness

Two weeks PTA (prior to admission), A.O. together with her sister arrived at Iloilo. They came from Antipolo and they will stay at their Aunt’s house at Amamaros, Pototan.
Two days PTA, patient A.O. complained that she cannot sleep well and that she had sleep disturbances. The Aunt had also noticed that A.O. was exhibiting strange and peculiar behaviors in the past few days. She barely talks and was found to be staring blankly at the ceiling. Sometimes, she talked to herself, with words her Aunt can’t understand. One moment, she walked aimlessly inside their house.

There were also moments when she prefers to stay at one corner of her room.
1 day PTA, as the Aunt was about to go to sleep, she was startled when she heard A.O. yelling. She went to her room and found A.O. going wild. She was throwing her things and was yelling incoherent words. She was uncontrolled. Then Aunt forced her to take medication and after a few hours, she was calm.
Few hours PTA, the Aunt brought A.O. at Pototan Mental Health Unit for consultation. She was alarmed with the patient’s behaviors last night. Thus, she was admitted with a chief complaint of behavioral changes.

Review of Systems-Mental Status Examination
I. General Appearance and Behavior
o Physical Appearance
Patient A.O. is about 4’9’’ tall, wears appropriate dress; always attend to her hygiene; hair is short, black, wavy, on neck length, kempt; appearance is appropriate to situation and weather
o Facial Expressions
Most of the time has flat affect; sometimes stares blankly into space or at the student nurses; has poor eye contact. Odd mannerisms are crossing her hands, placing hands on face (as if wiping it), stretching hands, or legs and make some cracking sounds of bones. A.O. answers questions in a soft, sometimes barely audible voice.
o Manner of Client During Nurse-Patient Interaction
A.O. is passive; only talk if you student nurses talk first or when being asked. She never initiates to open a topic; changes the subject of discussion whenever the topic is about her family or the reason why she was admitted. A.O. is sometimes very unpredictable. One moment she is normal, the suddenly she would talk about weird things and would speak incoherent words. Sometimes she would answer in a monosyllabic speech even when asked with open-ended questions.

II. Characteristics of Speech Quantitative Speech
A.O. barely take the initiative to talk; answers open-ended questions with monosyllabic speech; sometimes would answer questions in a barley audible voice; the longest answer in about 4-5 words only.
 Qualitative Speech
A.O. would sometimes answer questions inappropriately or completely irrelevant to the questions asked; neologisms was also noted; and talks about bizarre things like “barang” or “ninakaw ang kaluluwa”.

III. Mood and Affect
Most of the times A.O. does not exhibit any significant mood and has flat affect. Sometimes there are also sudden changes of mood. However, there are also times when A.O’s mood and affect is appropriate to the thought content.

IV. Thought Content
No significant themes were noted. Patient most of the times answer in a monosyllabic speech. Delusions were noted:
SN: “Sino po si Cesar manang?”
Pt.: “Cesar Montano…asawa ko…”
Patient has delusion of grandeur. She’s claiming that Cesar Montano is her husband.

V. Perception
Hallucination was also noted when she kept on insisting and pointing that there was something itchy under the table, though there was none.

VI. Sensorium Functions Patient is oriented to person, place and time.

Memory
1. Rote Memory- Patient rote memory is impaired
2. Recent Memory- Patient recent memory is intact. When she was asked what she did this morning, her answer coincides with the answer of the folk.
3. Remote Memory- Patient remote memory is intact as evidenced when asked when her birthday is and she answered Sept. 27, 1977. Her birthday is indeed September 27, 1977.
4. Immediate Memory- Patients’ immediate memory is impaired.

Attention and Concentration Patient’s attention and concentration is questionable. Student nurses cannot tell whether the attention is really impaired or the patient is just having difficulty to think.

Insight and Judgment
Insight:
 Patient is aware of her condition. Though, she does not know that her condition is a serious matter and not merely “nerbiyos”.
Judgment:
 Patient exhibits good judgment. Her decisions were appropriate to the situation given.

Past Health History-Contributory Factors to Condition:
A. History of Psychological Problems
A.O’s uncle in the father side has been thought to have a psychological disturbance because his wife left him. A.O’s aunt in the paternal side and her cousin’s father in the maternal side were diagnosed to have nervous breakdown. Her cousin on the maternal side also has a psychological problem, which is believe a cause of high level of intelligence.

B. Childhood Upbringing
A.O’s primary caregiver is not her mother but her yaya (an Aunt from the mother side). Though, her mother is the one who gives her milk. She’s cuddled and breastfed by her mother per demad. The mother cannot attend to all her necessities since she’s also busy doing household chores and taking care of her other children.
When A.O. entered high school, she was left in the care of her Aunts in the maternal side at Negros Occidental, whom supported her secondary education.
When she entered college, she stayed in a boarding house under the supervision of a family friend named Father A.

C. Frequent Relocations of the Family
Their original residence is at Amamaros, Pototan, Iloilo, where she stayed until she was 12 years old. She left Iloilo and went to Negros Occidental to study high school to the care of her Aunts in the maternal side. She moved back to Iloilo again when she was about to enter college and stayed in a boarding house.
Then, the family migrated to Antipolo, Manila last 2005. That is when she consulted a specialist to treat her psychological problems.
Two weeks PTC, she went back again to Pototan, to the care of her Aunt to continue her consultation at PMHU.
The family members would notice that every time they move into a new place, A.O. would have a hard time adjusting to the new environment.
D. Loses
She lost her father when she was just 7 years old. It was hard for her since she was closer to her father than her mother was. Until now, she would still mention her father.

E. Unachieved Desires or Frustrations
She really wanted to study since she excels in academics since she was in elementary. However, she was told to stop schooling due to the recurrence of the signs and symptoms and the relapse of her condition.

F. Altered Self-esteem
Among the five of them (patient has 4 siblings), she is the “not-so-pretty”. Her classmates in high school would tease her “law-ay”. She is very sensitive when it comes to that matter. Sometimes, the family members would find her crying in one corner.

G. Traumatic Experience
18 years PTC, A.O. had experienced a traumatic event. She was with her mother and an aunt. They came to Iloilo (from Negros) for a vacation. They were riding a public jeepney when a track loaded with bamboo poles crashed them. She witnessed the scene when a bamboo pole struck her Aunt right to her chest and declared dead upon arrival in the hospital. She was in state of shock for several weeks.

Types of Bandages

2008-05-07T00:41:00.001-07:00

Types of bandage
• Gauze bandage
The most common type of bandage is the gauze bandage, a simple woven strip of material which can come in any number of widths and lengths. A gauze bandage can be used for almost any bandage application, including holding a dressing in place.
• Compression bandage
The term 'compression bandage' describes a wide variety of bandages with many different applications.
• Short stretch compression bandages
are applied to a limb (usually for treatment of lymphedema or venous ulcers). This type of bandage that is capable of shortening around the limb after application and is therefore not exerting ever-increasing pressure during inactivity. This dynamic is called resting pressure and is considered safe and comfortable for long-term treatment. Conversely, the stability of the bandage creates a very high resistance to stretch when pressure is applied through internal muscle contraction and joint movement. This force is called working pressure.
• Long stretch compression bandages
have long stretch properties, meaning their high compressive power can be easily adjusted. However, they also have a very high resting pressure and must be removed at night or if the patient is in a resting position.
• Triangular bandage
A triangular bandage is a piece of cloth cut into a right-angled triangle. This is felt by many trainers to be the most versatile of the bandages available, as it can be used fully unrolled as a sling, folded as a normal bandage, or for specialist bandages such as on the head. has various sizes.
• Tube bandage
A tube bandage is applied using an applicator, and is woven in a continuous circle. It is used to hold dressings or splints on to limbs, or to provide support to sprains and strains.and it stops the bleed.

Beta-2-symphatomimetic Clenbuterol

2008-05-06T06:49:00.000-07:00

Clenbuterol hydrochloride or otherwise known as clen is not a steroid hormone but a beta-2-symphatomimetic. Its effects however can by all means be compared to those of steroids. It is a lipolytic drug intended as a fat burner. Athletes often use it and bodybuilders who will help them lose fat by allowing your body to release and burn more stored fat. It has been used for decades in veterinary world to increase the lean yield of livestock. This kind of drug is used specifically for fat loss however it may also be used as repartitioning agent it means that it will increase your ratio of Fat Free Mass to Fat Mass. As a result, your body temperature will increase and your appetite will be slightly repressed. One of the major drawbacks of using clen is that it seems to stop working after couple of weeks it is at the same time not good to the heart for it will cause the enlargement of the ventricles. It is an asthma medication but studies show that it can reduce cardiovascular performance.

Necessary things for you to know in buying steroids

2008-05-06T06:44:00.000-07:00

You can buy steroids at reasonable prices. You can select from Decca 250, Tren Fina 75, Winstroll, Clenbuterall, D-bolic, and Anvar 10. The Decca 250 is very effective in increasing receptor activation; the Tren Fina is effective in developing rock hard pumps; the Winstroll is the clear cut choice of bodybuilders; the D-bolic has been designed as a mass and strength building compound; and the Anvar is the favorite steroid for bodybuilders as well. These drugs are extremely strong anabolic steroids, thus they extreme caution is required in cycling them. They offer 100% legal, affordable, and effective anabolic compounds to give you the best result. No prescription is required in purchasing the products the shipping is discreet as well as billing and ordering. However, if you are below 18 years of age, you cannot buy the product. The information provided in the site is not intended to be substitute for doctor’s prescription. You should consult with your healthcare professional before planning to start a diet or medication.

Steroids

2008-05-06T06:06:00.000-07:00

The history of steroids will date back on the year testosterone were discovered. Then in 19th century, scientists discovered that the removal of testicles from birds caused a disappearance of the male sexual properties. This discovery helped them to figure out how testosterone worked. Thus, it led scientists to the synthesizing of the testosterone as the first anabolic steroid. It was first tested on dogs, until it has been used by athletes. In fact the American weightlifting team in began using them in 1954 to enhance their strength. The used of steroids were banned by the Olympics committee and many sports council follow suit. The scandal is what has given steroids a bad name. However, the medical community found the medical use of anabolic steroids it has made good impact in the treatment of certain illness and ailment. Today, steroids are still being widely used in the United States.

Why people got hooked with anabolic steroids?

2008-05-06T06:03:00.000-07:00

Anabolic steroids or otherwise known as anabolic androgenic steroids were developed in the 1930s to promote growth of skeletal muscle and to develop male sexual characteristics. “Anabolic” refers to muscle building, and “androgenic” refers to increased masculine characteristics. They are used to promote cell growth, which helps the growth of tissues. Anabolic steroid is a term, which describes the process of muscle building including the bone and other tissues. However, there are side effects attached to using this kind of steroids, such as the increasing of cholesterol level, kidney and liver problems, and elevated blood pressure. Although at the same time, it has favorable effects to the user, it includes the bone marrow stimulation, growth stimulation, treatment for chronic wasting, induction of puberty, and hormone replacement therapy. It is sad to note that anabolic steroids are always on the news because of the abusive use by athletes including teens who are into sports. Most users are bodybuilders or regular gym goers who want to change their physical appearance.

Bald no more

2008-05-06T00:46:00.000-07:00

Hippocrates noted that castration saved the eunuchs in the Persian army from baldness — but stopped short of recommending it as a treatment. The belief that a hairless scalp is a sign of manliness has persisted. Doctors have spent decades searching for a way to reverse hair loss. Why haven't we found the ultimate remedy? Jeremy Laurance reports. But now you can say goodbye to baldness. Dr. Shapiro hair institute offers the leading edge in hair transplant. If you are interested you may call them and they will offer 100 free grafts. Over 10,000 cases performed with 17 years experience in hair transplant surgery. Dr. Shapiro exclusively specializes in micro mini grafts and he is the first doctor to do a strip incision. He has a highly trained medical staff and they also specialize in assisting hair replacement surgery. Hair restoration surgery relies on the genetics of hair growth. If you have already had hairline loss, hair transplants are the only solution for restoring natural hairlines. The "donor hair" is already genetically resistant to the male/female-pattern balding it can be used for the restoration of natural hairlines, which are also genetically resistant to balding. You can try their hair transplant Florida located at Ft. Lauderdale, Delray Beach, Pompano Beach, Hollywood, West Palm Beach, FL
and surrounding South East Florida locations. The Hollywood Hair Restoration Surgery Clinic, located at 3475 Sheridan St., #201 Hollywood, Florida 33021 and the Delray Beach Hair Restoration Surgery Clinic, located at 5050 W. Atlantic Avenue, Delray Beach, Florida 33445.

2008-05-05T07:33:00.000-07:00

Self-suggestion and alternative medicine

If you are really interested in what alternative medicine is about you should definitely take a look at or even taste miracle water that has a lot of benefits and actually is the only treatment from such troubles like bad luck or different illnesses. It is called an esoteric product that can be a good alternative to artificial supplements and traditional pills prescribed by doctors. Moreover, many physicians do recommend to turn to quality supplements that can be bought at vitamin shop and alternative medicine products when there is practically no chance to be healed by traditional ways. Anyway, even if it doesn't bring any improvements at least it won't do any harm to your health! This is just pure water energized with ions!

Outpatient radiology center in Pennsylvania claims that some hopeless patients diagnosed with incurable diseases and those who have lost hope tasted alternative medicine products - not just energized water but herbals and natural nutrition supplements and their condition improved! The results of the survey show that more than 60% of all patients became more tranquil, their blood pressure normalized and skin color has improved! This or that way, self-suggestion plays here not the last role as well.

Why The World Should Ask 'Am I Number 12?

2008-05-01T07:26:00.000-07:00

The word hepatitis (pronounced: heh-puh-tie-tus) means an inflammation of the liver, and it can be caused by one of many things - including a bacterial infection, liver injury caused by a toxin (poison), and even an attack on the liver by the body's own immune system. Hepatitis, an infectious liver disease, is more contagious than HIV, and just like HIV, there is no cure. Hepatitis infection can be serious, but knowing what puts you at risk can help protect you. There are around 500 million people worldwide are currently infected with hepatitis B or C and to educate people to the shocking fact statistic they have launch “Why The World Should Ask 'Am I Number 12

Helping you become a picture of Health

2008-05-01T07:11:00.000-07:00

High blood pressure usually has no symptoms. The only way you can find out that your blood pressure is too high is to check it with a pressure monitor. The higher your blood pressure is, the more often you need to check it. In Healthscape, you can buy products that will help you become a picture of health. There are blood pressure monitors with such device it becomes easy for you to keep track of your blood pressure thus preventing heart attack and other stroke. Nebulization is gaining popularity as a treatment alternative. For those with history of Asthma acquiring a Nebulisers is a indeed needed as they are simple, compact, and battery-operated, meaning that they are silent and portable and can be used by ambulatory patients. Several devices are available to create the drug aerosol particles. These include jet nebulizers, ultrasonic nebulizers, metered-dose inhalers, and dry powder inhalers through which particles can reach the upper and lower respiratory tracts and be quickly absorbed into the bloodstream., When you are trying to stay at a healthy weight, a Body Fat Monitors can be a helpful tool, ecg machines, fertility and pregnancy, pain relief, digital thermometers, and stethoscope. For blood pressure monitors, they have the microlife 3ag1 blood pressure monitor, which is an economical upper-arm blood pressure monitor with BHS A/A grade accuracy, or you, may try or their microlife as easy as 123 blood pressure monitor. The website is a demo store which is a fully functional store that allows you to try X-shopping cart software. You can browse their products or put them in your cart and check their features. As of today, their most popular products are the fertility score male fertility test, microlife as easy as 123 blood pressure monitor, and microlife 3ag1 blood pressure monitor. You can sign in and register to make it easier to order for their new products. You are required to fill out their forms, such as your personal information, billing address, contact information, your username and password which will be confidential and kept. They also have a help zone wherein you can email them if you have questions or clarifications with regard to their products. You can visit Healthscape as well to learn more bout health issues, beauties, diet and nutrition, exercise and fitness, healthy living, medical, supplements, and other features stories.

Agents for Herpes and Cytomegalovirus

2008-05-01T01:50:00.001-07:00

Herpes viruses account for a broad range of conditions, including cold sores, encephalitis, shingles and genital infections. Cytomegalovirus (CMV) although slightly different from the herpes virus can affect the eye, respiratory tract and liver and reacts to many of the same drugs.

1. Acyclovir (Zovirax) – is specific for herpes virus infections. Is excreted unchanged in the urine and therefore must be used cautiously in the presence of renal impairment. It crosses into breast milk and exposes the neonate to high levels of the drug.
2. Cidofovir (Vistide) – is used to treat CMV retinitis in patients with AIDS only. It is associated with severe renal toxicity and granulocytopenia. It is excreted unchanged in the urine and must be given with probenecid to increase renal clearance of the drug. Use in children with AIDS should be very cautious because of potential.
3. Famiciclovir (Famvir) – is most effective in treating herpes infections. It is well absorbed in the GI tract, reaching peak levels in 2 to 3 hours. It is metabolized in the liver and excreted in the urine and feces.
4. Foscarnet (Foscavir) – is available in intravenous (IV) form only. It can be highly toxic to the kidneys and is reserved for treatment of CMV retinitis in immunocompromised patients and for mucocutanneous acyclovir-resistant herpes simplex infections.
5. Ganciclovir (Cytovene) – which is available in IV and oral forms and is used for long term treatment and prevention of CMV infections. Primarily excreted unchanged in the feces with some urinary excretion. It is carcinogenic and should be used only with extreme caution in children.
6. Valacyclovir (Valtrex) – is an oral agent used for the treatment of herpes zoster and recurrent genital herpes. Rapidly absorbed from the GI tract and metabolized in the liver to acyclovir. Excretion occurs through the urine so caution should be used in patients with renal impairment.
7. Valganiclovir (Valcyte) – which is the oral prodrug of ganciclovir, is used for the treatment of CMV retinitis in AIDS patients. Primarily excreted unchanged in the feces with some urinary excretion.

Therapeutic Actions and Indications
Drugs that combat herpes and CMV inhibit viral DNA replication by competing with viral substrates to form shorter, noneffective DNA chains. This action prevents replication of the virus, but it has little effect on the host cells of human because their DNA uses different substrate. These antiviral agents indicated for treatment of the DNA viruses herpes simplex, herpes zoster and CMV.

Contraindications and Cautions
Drugs indicated for the treatment of herpes and CMV should not used during pregnancy or lactation or I patients with known allergies to antiviral agents, renal disease which could interfere with excretion of the drug or severe CNS disorders.

Adverse Effects
The adverse effects most commonly associated with these antivirals include nausea and vomiting, headache and depression and rash and hair loss. Rash and inflammation and burning often occur at sites of IV injection and topical application.

Clinically Important Drug-Drug Interactions
The risk of nephrotoxicity increases when agents indicated for the treatment of herpes and CMV are used in combination with other nephrotoxic drugs. The risk of drowsiness also rises when these antiviral agents are taken with zidovudine and anti retroviral agent.

Nursing Diagnoses
The patient receiving a DNA-active antiviral agent may have the following nursing diagnoses related to drug therapy:
· Acute pain related to GI, CNS, local effects of drug
· Disturbed Sensory Perception related to CNS
· Deficient knowledge regarding drug therapy

Implementation
· Ensure good hydration to decrease the toxic effects on the kidneys.
· Administer the drug as soon as possible after the diagnosis has been made to improve effectiveness of the antiviral activity.
· Ensure that the patient takes the complete course of the drug regimen to improve effectiveness and decrease the risk of the emergence of resistant viruses.
· Wear protective gloves when applying the drug topically to decrease risk of exposure to the drug and inadvertent absorption.
· Provide safety precautions if CNS effects occur (e.g., use side rails, appropriate lighting, orientation, assistance) to protect the patient from injury.
· Warn the patient that GI upset, nausea, and vomiting can occur, to prevent undue anxiety and increase awareness of the importance of nutrition.
· Monitor renal function tests periodically during treatment to detect and respond to renal toxicity as soon as possible.
· Provide the patient with instructions about the drug therapy and to promote compliance.

The patient should:
· Avoid sexual intercourse if genital herpes is being treated, because these drugs do not cure the disease.
· Wear protective gloves when applying topical agents.
· Avoid the driving and hazardous tasks dizziness and drowsiness occurs.

Evaluation
· Monitor patient response to the drug
· Monitor for adverse effects
· Evaluate effectiveness of the teaching plan
· Monitor for the effectiveness of comfort and safety measures and compliance with regimen

Agents for HIV and AIDS

2008-05-01T01:48:00.000-07:00

The human immunodeficiency virus (HIV) attacks the helper T cells within the immune system. This virus enters the helper T cells and multiplies within the cell. When the cell ruptures many new viruses are released to attack other helper TY cells. The end result is that the immune system loses an important monitor that propels the immune reaction into full force when the body is invaded.

Reverse Transcriptase Inhibitors
The reverse transcriptase inhibitors bind directly to HIV reverse transcriptase, blocking both RNA- and DNA-dependent DNA polymerase activities. They prevent the transfer of information that would allow the virus to replicate and survive.

1. Delavirdine (Rescriptor) – must be used in combination therapy regimens, because resistant strains develop rapidly when it is used alone. It is rapidly absorbed from the GI tract, with peak levels occurring within 1 hour.
2. Efavirenz (Sustiva) – is used in adults and in children in combination with other anti retrovural agents. It is absorbed rapidly from the GI tract, reaching peak levels in 3 to 5 hours. It is metabolized in the liver by the cytochrome P450 system and is excreted in the urine and feces with a half-life of 52 yo 76 hours.
3. Nevirapine (Viramune) – is recommended for use in adults and children. After rapid GI absorption, nevbirapine is metabolized by the cytochrome P450 system in the liver.

Protease Inhibitors
The protease inhibitors block protease activity within the HIV virus. Protease is essential for the maturation of infectious virus, without it an HIV particle is immature and non effective.

1. Amprenavir (Agenerase) – was approved in 1999 for the treatment of adults and children with HIV in combination with other antiretroviral agents. It is rapidly absorbed from the GI tract, reaching peak levels in 1 to 2 hours.
2. Indinavir (Crixivan) – is available for treatments of adults with HIV rapidly absorbed from the GI tract reaching peak levels in 0.8 hours.
3. Lopinavir (Kaletra) – is a fixed combination drug that combines lopinavir and ritonavir. This drug is approved for used in adults and children in combination with other antiretroviral agents for the treatment of HIV infection.
4. Nelfinavir (Viracept) – must be given in combination with other drugs and can be used in the treatment of children with HIV.
5. Ritonavir (Norvir) – can be used alone and is available for use in adults and children.
6. Saquinavir (Fortovase, Invirase) – is used in combination regimens for adults.

Nucleosides
Nucleosides interfere with HIV replication by inhibiting cell protein synthesis, leading to viral death.
1. Abacavir (Ziagen) – is used in combination therapy in adults and children.
2. Didanosine (Videx) – is used to treat advanced infections in adults and in children.
3. Lamnivudine (Epivir) – is recommended specifically for use with other antiretroviral agents as an oral solution.
4. Stavudine (Zerit) – is recommended specifically for used with other retroviral agents.
5. Tenafovir (Viread) – is a new drug that affects the virus at a slightly different point of replication- a nucleotide that becomes a nucleoside.
6. Zalcitabine (Hivid) – is used to treat advanced cases of HIV/AIDS in adults.
7. Zidovudune (Retrovir) – was one of the first drugs found to be effective in the treatment of AIDS.

Therapeutic Actions and Indications
The antiviral agents used to treat HIV and AIDS operate at various point in the life cycle of the virus and results in its death or inactivation. Use of these drugs in combination can affect more viral particles and reduce the number of mutant viruses that are formed and spread to non infected cells.

Contraindications and Cautions
Because these drugs are used in the treatment of a potentially fatal with no known cure, there are no true contraindications to their use. Zidovudine is the drug of choice during pregnancy to block maternal transmission of the virus. Cautions should be used with known allergies to any of these drugs, with hepatic or renal dysfunction which could lead to increased drug levels and toxicity and with pregnancy or lactation because of potential adverse effects on the neonate.

Adverse Effects
The adverse effects reported with the used of these drugs often are not distinguishable from the effects of ongoing disease process. Adverse effects are often reported include the CNS effects of headache, dizziness and myalpatic toxicity related to direct drug effects on the liver, fever and flu-like symptoms, rash and bone marrow depression including a granulocytosis and anemia.

Nursing Diagnoses
The patient receiving a DNA-active antiviral agent may have the following nursing diagnoses related to drug therapy:
· Acute pain related to GI, CNS, local effects of drugs
· Disturbed sensory perception related to CNS
· Deficient knowledge regarding drug therapy

Implementation
· Monitor renal and hepatic function before and periodically during therapy to detect renal or hepatic function changes.
· Ensure that the patient takes the complete course of the drug regimen and takes all drugs included in a particular combination.
· Administer the drug around the clock, if indicated, to provide the critical concentration needed for the drug to be effective.
· Monitor nutritional status if GI effects are severe, and take appropriate action to maintain nutrition.
· Stop drug if severe rush occurs, especially if accompanied by blisters, fever, and so on, to advert potentially serious reactions.
· Provide safety precautions (e.g., the use of side rails, appropriate lighting, orientation, assistance) if CNS effects occur, to protect patient from injury.
· Teach the patient about the drugs prescribed, to enhance patient knowledge about drug therapy and to promote compliance. Include as a teaching point the fact that these drugs do not cure the disease and therefore appropriate precautions should still be taken to prevent transmission.

The patient should:
Have regular medical care.
Have periodic blood tests, which are necessary to monitor the effectiveness and toxicity of the drug.
Realize that GI upset, nausea, and vomiting may occur but the efforts must be taken to maintain adequate nutrition.
Avoid driving and hazardous tasks if dizziness or drowsiness occurs.
Report extreme fatigue, severe headache, difficulty breathing, or severe rash ot a heath care provider.
Evaluation
· Monitor patient response to the drug.
· Monitor for adverse effects.
· Evaluate the effectiveness of the teaching plan.
· Monitor the effectiveness of comfort and safety measures.

Locally Active Antiviral Agents

1. Idoxuridine (Herplex) – which is applied directly to the eye and is used to treat herpes simplex keratitis.
2. Imiquimod (Aldara) – which is appli9ed locally for the treatment of genital and perinatal warts.
3. Formivirsen (Vitravene) – which is injected into the eye to treat CMV retinitis to patients with AIDS.
4. Ganciclovir (Vitrasert) – which is implanted into the eye every 5 to 8 months for treatment of patients with CMV retinitis.
5. Penciclovir (Denavir) – which is applied locally for the treatment of herpes labialis (cold sores) on the face and lips.
6. Trifluridine (Vitroptic) – which is applied locally to treat herpes simplex infections in the eye.
7. Vidarabine (Vira-A) – which is used locally to treat herpes simplex infections of the eye that are not responsive to idoxuridine.

Therapeutic Actions and Indications
These antiviral agents act on viruses by interfering with normal viral replication and metabolic processes. They are indicated for specific local viral infections.

Contraindications
Locally active antiviral drugs are not absorbed systematically but caution should be used in patients with known allergies reactions to any topical drugs.

Adverse Effects
Because these drugs are not absorbed systematically, the adverse effects of most commonly reported are local burning, stinging, and discomfort. These effects usually occur at the time of administration and pass with time.

Nursing Diagnoses
The patient receiving a topical antiviral drug may have the following nursing diagnoses related to drug therapy:

· Acute Pain related to GI, CNS, local effects of drug
· Deficient Knowledge regarding drug therapy

Implementation

· Ensure proper administration of the drug to improve effectiveness and decrease risk of adverse effects.
· Stop the drug if severe local reaction occurs or if open lesions occur near the site of administration, to prevent systemic absorption.

Evaluation

· Monitor patient response to the drug.
· Monitor adverse effects.
· Evaluate effectiveness of the teaching plan.

ANTIVIRAL AGENTS

2008-05-01T01:44:00.000-07:00

ANTIVIRAL AGENTS

Viruses cause a variety of conditions, ranging from warts, to the common cold and “flu”, to diseases such as chicken pox and measles. A single virus particle is composed of a piece of DNA or RNA inside a protein coat. To carry on any metabolic processes, including replication, a virus must enter a cell. Once a virus has injected his DNA or RNA into its host cell, that cell is altered and it is programmed to control the metabolic processes that the virus need to survive. The virus including the protein coat, replicates in the host cell. When the host cell can no longer carry out its metabolic functions because of the viral invader, the host cell dies and releases the new viruses into the body to invade other cells.

Agents for Influenza A and Respiratory Viruses
Influenza A and other respiratory viruses including Influenza B and respiratory syncytial viruses (RSV) invade the respiratory tract and cause the signs and symptoms of respiratory “flu”.

1. Amantadine (Symmetrel) – was first used to treat Parkinson’s disease. It is now used for both treatment and prevention of respiratory viral infections. It is slowly absorbed from the gastrointestinal tract reaching in peak levels of 4 hours.
2. Oseltamivir (Tamiflu) – effective in the treatment of uncomplicated influenza infections that have been symptomatic for less than 2 days. It is readily absorbed from the GI tract, extensively metabolized in the urine and excreted in the urine with a half-life of 6 to 10 hours.
3. Ribavirin (Virazole) – is effective against influenza A, RSV, and herpes virus. This agent has been used in the treatment of children with RSV and has been tested for used in several other viral conditions. Absorbed well in the respiratory tract and has a half-life of 9.5 hours.
4. Rimantadine (Flumandine) – a synthetic agent used for the prevention and treatment of Influenza A infections. It is absorbed in the GI tract with peak levels of 6 hours. Extensively metabolized and excreted in the urine. It is embryo toxic in animals. It should not be used by nursing mothers because it crosses into the breast milk and can cause toxic reactions to neonate.
5. Zanamivir (Relenza) – was approved in 1999 to treat uncomplicated influenza infections in adults and in children older than 12 years of age who have had symptoms for less than 2 days. It is absorbed through the respiratory tract and excreted unchanged in the urine with a half-life of 2.5 to 5.1 hours.

Therapeutic Actions and Indications
These viral agents prevent shedding of the viral protein coat and entry of the virus into the cell. This action prevents viral replications causing viral death. These antiviral drugs are indicated for prevention of Influenza A infection.

Contraindications and Cautions
Caution should be used when giving these antiviral agents to patients with a known allergy; to pregnant or lactating women or to patients with renal or liver disease which could alter metabolism and excretion of the drug.

Adverse Effects
Use of these antiviral agents is frequently associated with various adverse effects that may be related to possible effects on dopamine levels in the brain. These include light headedness, dizziness and insomnia, nausea, orthostatic hypotension and urinary retention.

Clinically Important Drug-Drug Interactions
Patients who received amantadine or rimantadine may experience increased atropine-like effects if either of these drugs is given with an anticholinergic drug.

Nursing Diagnoses
The patient receiving a respiratory antiviral drug may have the following nursing diagnoses related to drug therapy.
· Acute pain related to GI, CNS, GU effects of drug
· Disturbed sensory perception related to CNS effects of drug
· Deficient knowledge regarding drug therapy

Implementation
· Start drug regimen as soon after exposure to the virus as possible to achieve best effectiveness and decrease the risk of complications of viral infection.
· Administer Influenza A vaccine before the flu season begins if at all possible, to prevent the disease and decrease the risk of complications.
· Administer the full course of the drug to obtain the full beneficial effects.
· Provide safety provisions if CNS effects occur, to protect the patient from injury.
· Instruct the patient about the appropriate dosage scheduling regimen; safety precautions, including changing position slowly and avoiding driving and hazardous tasks, to take if CNS effects occur; and the need to report any difficulty walking or talking to enhance patient knowledge about drug therapy and to promote compliance.

Evaluation
· Monitoring patient response to the drug
· Monitor for adverse effects
· Evaluate the effectiveness of the teaching plan
· Monitor for the effectiveness of comfort and safety measures and compliance with regimen

Color Contacts to Match Your Personality

2008-04-30T20:33:00.000-07:00

While it's always been popular to express your personality with your clothes, accessories, hairstyle and makeup, now you can match your eye color to your character as well. Simply by using colored contact lenses, you can enhance or even completely change your natural eye color to suit your mood and your personality. From enhancement tints to opaque lenses, color contacts offer many different style options in a complete rainbow of different colors. Whether you want your eyes to express vibrancy or warmth, to be bright green or soft amethyst, the wide array of available colored contact lenses will provide you with a multitude of outstanding choices so you can find the perfect match for your individual personality.

As a leading retailer of discount contact lenses, Coastal Contacts offers an excellent variety of colored contact lenses so you can achieve exactly the look you've been wanting. With color contacts from Coastal Contacts, you can enhance your natural eye color or give yourself a new and completely different eye color. Coastal Contacts also offers lenses that will define your eyes with a limbal ring or add an extra shimmer to your eyes to complement your sparkling personality. Whether you're looking to make your eyes emerald green, bright blue, violet or sparkly gold, Coastal Contacts has the variety and quality you're looking for in color contacts.

With brands including Freshlook, Acuvue and Focus, Coastal Contacts is an excellent source for top-quality colored contact lenses at highly affordable prices. With a reputation for outstanding customer service, Coastal Contacts makes the experience of purchasing contact lenses simple, straightforward and convenient. No matter what character traits you want the world to notice, there are color contacts available to make your best attributes shine through. So if your eyes simply aren't conveying what's on the inside, try using color contacts to express and match your unique personality.

The Deadliest Cancer

2008-03-28T17:33:00.000-07:00

Ovarian cancer is one of the deadliest cancer because it often goes undetected for years. Compared to other female reproductive organ disease, ovarian cancer claims more women lives for more than 16,000 annually. The reason why it is so deadly is that most of the victims of this disease present signs at stage three or four (terminal stage of the disease). Ovarian cancer often has no symptoms until it is advanced making it difficult to diagnose and treat effectively. Symptoms can include abdominal pain or bloating, increasing abdominal girth, loss of appetite, vaginal bleeding, constipation, frequent urination or shortness of breath, Pain or swelling in the abdomen, pain in the pelvis, and gastrointestinal problems, such as gas, bloating, or constipation.

Signs and Symptoms
Possible signs of ovarian cancer include pain or swelling in the abdomen. Early ovarian cancer may not cause any symptoms. When symptoms do appear, ovarian cancer is often advanced. If the symptoms get worse or do not go away on their own, a doctor should be consulted so that any problem can be diagnosed and treated as early as possible. When found in its early stages, ovarian epithelial cancer can often be cured. Women with any stage of ovarian cancer should think about taking part in a clinical trial. Once it is diagnosed aggressive treatment is necessary.

Treatment

Treatment should include removal of the tumors or affected tissue, surgery, intravenous chemotherapy, cancer drugs, anti-cancer medicines, and other therapies. But still the best treatment is to increase the awareness of the disease to fight against it. Screening programs should be conducted to target presence of ovarian cancer.

Analysis

Ovarian cancer can sometimes be associated with known risk factors for the disease. Many risk factors are modifiable though not all can be avoided. Avoiding risk factors when possible and increasing protective factors may help prevent ovarian cancer. Genetic Factors: Women who have inherited certain altered genes have a much higher risk of developing ovarian cancer. These mutations may be found in BRCA1 , BRCA2 , or hereditary nonpolyposis colon cancer (HNPCC) genes. Age: The risk of developing ovarian cancer increases as a woman gets older. Obesity: Having excess body fat as measured by body mass index, including during the teen years, increases the risk of ovarian cancer. Diet and nutrition during the teen years may play a role in prevention. Oral Contraceptives: Studies show that the use of oral contraceptives reduces the risk of developing ovarian cancer. The longer you use oral contraceptives, the lower your risk might be. The decrease in risk may last up to 25 years after the use of oral contraceptives has ended. This lower risk is seen both in women who have given birth and in women who have not. Oral contraceptives may also protect against ovarian cancer in women who are at higher risk because they have inherited an altered version of BRCA1 and BRCA2 genes. Harms from taking oral contraceptives include a higher risk of blood clots that can block blood vessels, especially in smokers and a slightly higher short-term risk of breast cancer that decreases over time when use is stopped.

Brief Essay of Important Theme

Ovarian epithelial cancer is a disease in which malignant (cancer) cells form in the tissue covering the ovary. The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ where a fetus grows). Each ovary is about the size and shape of an almond. The ovaries produce eggs and female hormones (chemicals that control the way certain cells or organs function). Ovarian epithelial cancer is one type of cancer that affects the ovary.
Women who have a family history of ovarian cancer are at an increased risk of developing ovarian cancer. Anything that increases your risk of getting a disease is called a risk factor. Women who have one first-degree relative (mother, daughter, or sister) with ovarian cancer are at an increased risk of developing ovarian cancer. This risk is higher in women who have one first-degree relative and one second-degree relative (grandmother or aunt) with ovarian cancer. This risk is even higher in women who have two or more first-degree relatives with ovarian cancer.

Reference:
Medical-Surgical Nursing Vol.2, by Lipincott, 3rd edition, pp. 1324.
http://www.cancer.gov/cancertopics/pdq/prevention/ovarian/Patient/page2
www.fccc.edu/pdq/English/Patients/OvarianEpithelialCancer.html

Resources for Mind , Body and Spirit

2008-03-26T23:12:00.000-07:00

In healthjourneys.com, you can have good resources for your mind, body, and spirit. The site provides articles on weekly events, such as groundbreaking research which identifies genetic predisposition to PTSD; inspiring stories about three women with fertility struggle; and a lot more. Most frequently asked topics on insomnia, depression, pain, cancer, weight loss, fertility, heart health, and stress are useful guidelines in order to find solutions to such problems. The site offers outstanding practitioners such as Andrew Well, Jon Kabat-Zinn, Roxanne Daleo, Cyndi Lee, Emmett Miller, Susan Winter Ward, Carol Dickman, and Steven Mark Kohn and depression therapy as well as meditation cds. Recently, the website tackles issues on depression which provides that depression isn’t just sadness; it’s a lack of physical, emotional and psychic energies. There’s some cognitive distortion with depression too – people most of the time had wrong impression on themselves as having fewer choices, and being more narrowly restricted than they really are. Depression is very common, and it’s even estimated that over 50% of the patients suffer depression.

How can you prevent Choking?

2008-03-15T08:52:00.001-07:00

According to University of Oklahoma police department;

Adults:
-Cut food into small pieces.
-Chew food slowly and thoroughly, especially if wearing dentures.
-Avoid laughing and talking during chewing and swallowing.
-Avoid excessive intake of alcohol before and during meals.

Infants and Children:
-Keep marbles, beads, thumbtacks, and other small objects out of their reach and prevent them from walking, running, or playing with food or toys in their mouths.

Choking Prevention In Young Children

Young children can choke on virtually any object. Tragically, children have died from choking on things such as small balls, tiny toys, balloons and plants. For this reason, it is important to be aware of how to prevent choking:
· Hot dogs, nuts, peanuts, peanut butter, popcorn, carrots and grapes should not be given to children less than 4 years of age. In older children hot dogs should be sliced lengthwise first.
· Children should eat or drink only when sitting upright, and not while lying down. Also children should not be forced to feed, especially when they are sleepy.
· Children should never be allowed to eat or drink while playing or running around.
· Young children should always be supervised by an adult during meals or snacks, and even playtime.
· Toys your child plays with should be labeled appropriate for his or her age, and keep older children's toys away from any young child.
· If you have had visitors for a party or a dinner, remember to always immediately remove all foods, beverages or other objects potentially dangerous to a young child.
· It is important that your child's play and sleep areas are free of small objects.
· Latex balloons are pretty and often tempting to give as a gift or use as a decoration; But they pose a great choking hazard. Young children should not be given nor be in contact with balloons at all.
· Jewelry can easily be swallowed or inhaled. For this reason children should not wear any earrings, rings nor any other jewelry items before the age of 5.
· Keep coins and other small objects such as buttons, toothpicks, paper clips. plants etc(and any other household or office item that can be a potential choking threat) away from young children at all times.
· When visiting a friend’s or neighbor’s house or on vacation, make sure your child is not exposed to any choking hazards.
· It is a good idea to learn to give first aid to a choking child just in case...but prevention in the first place is best.
Choking Prevention
In addition to food, there are household items that can become choking hazards. You can help ensure a safe environment by keeping these items away from infants and young children:
· Latex balloons
· Coins
· Marbles
· Toys with small parts
· Toys that can be compressed to fit entirely into a child's mouth
· Small balls
· Pen or marker caps
· Small button-type batteries
· Medicine syringes
Choking can be prevented. Before your child begins to crawl, get down on his level and look for dangerous items. If you have older children, pay extra attention to their toys and be sure your younger child can't get into them. In addition to thoroughly childproofing your home, keep this list of choking prevention tips in mind:
· Learn cardiopulmonary resuscitation (CPR) (basic life support).
· Be aware that balloons pose a choking risk to children of any age.
· Keep the following foods from children until 4 years of age:
o Hot dogs
o Nuts and seeds
o Chunks of meat or cheese
o Whole grapes
o Hard, gooey, or sticky candy
o Popcorn
o Chunks of peanut butter
o Raw vegetables
o Raisins
o Chewing gum
· Insist that children eat at the table, or at least while sitting down. They should never run, walk, play or lie down with food in their mouths.
· Cut food for infants and young children into pieces no larger than one-half inch and teach them to chew their food well.
· Supervise mealtime for infants and young children.
· Be aware of older children's actions. Many choking incidents occur when older brothers or sisters give dangerous foods, toys or small objects to a younger child.
· Avoid toys with small parts and keep other small household items out of reach of infants and young children.
· Follow the age recommendations on toy packages. Age guidelines reflect the safety of a toy based on any possible choking hazard as well as the child's physical and mental abilities at various ages.
· Check under furniture and between cushions for small items that children could find and put in their mouths.
· Do not let infants and young children play with coins
Choking prevention! Choking -- what are the risks?
What types of food can cause choking?
Dangerous foods can be grouped in four categories:

Crisp, crunchy foods
These include peanuts and other nuts, raw carrots and celery, popcorn kernels, sunflower seeds, fruits with pits, dried peas and beans. These foods can cause a severe coughing fit and end up in the bronchi (breathing tubes for the lungs), causing wheezing and eventually pneumonia.

Don’t introduce these foods to children until they are at least three years old and can chew and swallow crusty bread and raw apple and pear without coughing. Never give unpopped popcorn kernels to a toddler.

Round and rubbery foods

These include hot dogs, whole grapes and gel candies (such as “Fruit Poppers”), which are the most deadly foods. They can become stuck between the vocal cords and completely block breathing.

Cut hot dogs and grapes lengthwise and into small pieces until children are at least four years old and can chew and swallow steak without coughing. Avoid gel candies, which are banned but still available in certain stores in Canada.

Gum and hard candies
These can be inhaled and get stuck between the vocal cords.

Don’t give children gum or hard candies until they are at least five years of age and can understand the danger.

Fish bones (and other small bones)
Small and fine bones can become stuck higher in the throat and cause severe pain.
Carefully pick out bones before serving fish and poultry.
How can I keep my child safe at mealtimes?
Children are less likely to choke if they chew food thoroughly before swallowing. Teach children to sit quietly during meals and always supervise them while they eat. These activities will put your child at high risk for a choking episode:
· Talking, laughing or walking, running, jumping with food in the mouth
· Unsupervised snacking
· Incomplete chewing
· Tipping chairs backwards
Which non-food items cause choking?
It’s not only foods that pose a choking hazard. Common non-food risks include:

Small hard objects
Examples of these include plastic toy parts, metal hardware and fishing tackle. They can cause coughing fits and end up in the bronchi.

Teach children not to put non-food objects in their mouths and not to hold them between their lips or teeth. Keep these objects out of reach of young children.

Coins

These are the most common foreign bodies. Coins can become stuck in the esophagus (swallowing tube) and can cause pain and often drooling and retching.

Teach children to keep coins out of their mouths. Never store coins in open bowls or containers that are within reach of toddlers.

Disc batteries
Like coins, disc batteries are tempting to young children. However, they are much more dangerous because they cause severe internal burns and even death.

Keep toys and electronics with removable disc batteries away from young children. Store unused or discarded batteries where children cannot find them.

Balloons
Deflated balloons can become stuck between the vocal cords and completely stop a child’s breathing. Keep deflated balloons away from all young children.

Dishwasher powder and caustic liquids
Most household cleaners and hair straightners or relaxers can cause severe burns of the swallowing and breathing passages. Not all are marked with warning labels. Keep all caustic substances out of reach of children.
How can I prevent choking?
Remember choking deaths in children are mainly caused by foods and small objects such as gel candies, hot dogs, grapes, balloons, disc batteries and handfuls of nuts. Follow these simple steps to prevent choking:
· Keep a careful eye on the child during meals and snacks
· Introduce new food textures slowly and carefully
· Check for small items of any type that a child may choke on
· Choose toys that are labeled appropriate for the age of your child
· Teach older siblings NOT to give small items or toys to younger children
· Know how to give first aid to a choking child
If you suspect that a child has choked on an object, please explain that to medical personnel as soon as possible. Bring an example of the foreign body if possible. A Heimlich maneuver is necessary only if someone is unable to speak clearly and is turning blue.
The Bill #HR 2773 - Food Choking Prevention Act of 2003
Childhood Choking Prevention Tips:
1. Keep the following items away from infants and young children: Latex balloons, Coins, Marbles, Toys with small parts, Toys that can be compressed to fit entirely into a child's mouth, Small balls, Pen or marker caps, Small button-type batteries, Medicine syringes.
2. Before a child begins to crawl, get down on his level and look for dangerous items. If you have older children, pay extra attention to their toys and be sure your younger child can't get into them.
3. Be aware that balloons pose a choking risk to children of any age.
4. Keep the following foods from children until 4 years of age: Hot dogs, Nuts and seeds, Chunks of meat or cheese, Whole grapes, (Hard, gooey, or sticky) candy, Popcorn, Chunks of peanut butter, Raw vegetables, Raisins, Chewing gum.
5. Insist that children eat at the table, or at least while sitting down. They should never run, walk, play or lie down with food in their mouths.

Food preparation safety tips
Here are some suggestions to modify potentially hazardous foods to reduce the risk of choking and make them safer for children:
· Remove the skin from hotdogs, sausages, and frankfurters; cut them lengthwise, then cut them into small pieces or thin strips.
· Chop, grind, or dice meats.
· Chop nuts and grind seeds finely.
· Dice or grate raw vegetables.
· Steam, then slice or dice vegetables.
· Remove the pit, then dice fruits like cherries, apricots, and peaches.
· Spread peanut butter thinly over crackers or wheat bread.
· Blend peanut butter with applesauce or jam before serving.
· Serve bow-tie pretzels instead of pretzel sticks or potato chips.
· Remove the bones from fish or serve fish pieces that have been boned.
· Include plenty of liquids such as water, milk, or juice at meal and snack times and encourage children to sip in between mouthfuls
Prevention of Choking
1. Avoid small hard pieces of food (as listed above)
2.Cook food and cut it into small pieces
3. Don't let your infant run around with food in the mouth: encourage them to sit at the table while eating.
4. Model the kind of behavior you want for your child. I.e. sit at the table until you have finished eating (if you can!) and avoid putting pins etc in your own mouth.
5. Have a crawl around on the floor with your baby and check out potential choking hazards. Get rid of these!
6. Store batteries and beads etc where your child cannot get them
7. Tell your older children about the sorts of things that can cause choking for their young sibling.

Diabetes Mellitus Foot, Wagner II

2008-03-15T08:33:00.000-07:00

Diabetes mellitus is a group of metabolic disorders characterized by elevated levels of blood glucose (hyperglycemia) resulting from defects in insulin production and secretion, decreased cellular response to insulin, or both. This leads to hyperglycemia, which may lead to acute metabolic complications, such as diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNS). Longterm hyperglycemia may contribute to chronic microvascular complications (kidney and eye disease) and neuropahtic complications. Diabetes is also associated with an increased occurrence of macrovascular disease, icluding coronay artery disease, (myocardial infarction), cerebrovascular disease (stroke) and peripheral vascular disease.

Types of Diabetes
Type 1 (Formerly Insulin-Dependent Diabetes Mellitus)
About 5%-10% of diabetic patients have type 1 diabetes. Beta cells of the pancreas that normally produce insulin are destroyed by an autoimmune process. Insulin injections are needed to control the blood glucose levels.
Type 1 diabetes has a sudden onset, usually before the age of 30 years.

Type 2 (Formerly Non-Insulin Dependent Diabetes Mellitus)
About 90% to 95% of diabetics have type 2 diabetes. It results from a decrease sensitivity to insulin (insulin resistance) or from a decreased amount of insulin production.
Type 2 diabetes is first treated with diet and exercise, then oral hypoglycemic agents as needed.
Type 2 diabetes occurs most frequently in patients older than 30 years of age and in obese patients.

Gestational Diabetes Mellitus
Gestational diabetes is characterized by any degree of glucose intolerance with onset during pregnancy (2nd or 3rd trimester).
It occurs in women 25 years of age or older, women younger than 25 years of age who are obese, women with a family history of diabetes in first-degree relatives, member of certain ethnical racial groups (eg, Hispanic Americans, Native Americans, or Pacific Islander). It increases their risk for hypertensive disorders of pregnancy.

Clinical Manifestations
Polyuria, polydipsia, and polyphagia
Fatigue and weakness, sudden vision changes, tingling or numbness in hands or
feet, dry skin, sores that heal slowly and recurrent infections.
Onset of type 1 diabetes may be associated with nausea, vomiting, or stomach pains.
Type 2 diabetes results from a slow (over years, progressive glucose intolerance and results in longterm complications if diabetes goes undetected fro many years (eg, eye disease, peripheral neuropathy, peripheral vascular disease). Complications may have developed before the actual diagnosis is made.
Signs and symptoms of DKA include abdominal pain, nausea, vomiting, hyperventilation, and a fruity breath odor. Untreated DKA may result in altered level of consciousness, coma, and death.

Assessment and Diagnostic Methods
High blood glucose levels: fasting plasma glucose levels 126 mg/dl or more, or random plasma glucose levels more than 200 mg/dl on more than one occasion.
Evaluation for complications.

Prevention
For obese patients (especially those with type 2 diabetes): weight loss is the key to treatment and major preventive factor for the development of diabetes.

Complications of Diabetes
Complications associated with both types of diabetes are classified as acute or chronic. Acute complications occur from short-term imbalances in blood glucose and include:
Hypoglycemia
DKA (Diabetic Ketoacidosis)
HHNS (Hyperglycemic Hyperosmolar Nonketotic Syndrome)
Chronic complications generally occur 10 to 15 years after the onset of diabetes mellitus. They include:
Macrovascular (large vessel) disease: affects coronary, peripheral vascular and cerebral vascular circulations.
Microvascular (small vessel) disease: affects the eyes (retinopathy) and kidneys (nephropathy); control blood glucose levels to delay or avoid onset of both microvascular and macrovascular complications.
Neuropathic disease: affects sensory motor and autonomic nerves and contributes to such problems as impotence or foot ulcers.

Gerontologic Considerations
Because the incidence of elevated blood glucose levels increases with advancing age, elderly adults should be advised that physical activity that is consistent and realistic is beneficial to those with diabetes. Advantages of exercise include a decrease in hyperglycemia, a general sense of well-being, metabolism of ingested calories, and weight reduction. Consider physical impairment from other chronic diseases when planning an exercise regimen for elderly diabetic patients.

Medical Management
The main goal of treatment is to normalize insulin activity and blood glucose levels to reduce the development of vascular and neuropathic complications. The therapeutic goal within each type of diabetes is to achieve normal blood glucose levels without hypoglycemia and without seriously disrupting patient’s usual activities. There are five components of management for diabetes: nutrition, exercise, monitoring, pharmacologic therapy and education.
Primary treatment of type 1 diabetes is insulin.
Primary treatment of type 2 diabetes is weight loss.
Exercise is important in enhancing the effectiveness of insulin.
Use oral hypoglycemic agents if diet and exercise are not successful in controlling blood glucose levels. Insulin injections may be used in acute situations.
Because treatment varies throughout course because of changes in lifestyle and physical and emotional status as well as advances in therapy, continuously assess and modify treatment plan as well as daily adjustments in therapy.
Education is needed for both patient and family.

Nutritional Management
Meal plan should be based on patient’s usual eating habits and lifestyle and should provide all essential food constituents (eg, vitamins and minerals).
Goals are to achieve and maintain ideal weight, meet energy needs, prevent wide daily fluctuations in blood glucose levels (keep as close to normal as is safe and practical), and decrease blood lipid levels, if elevated.
For patients who require insulin to help control blood glucose levels, consistency is required in maintaining calories and carbohydrates consumed at different meals.
Consult dietician for diabetes management planning to gradually increase or add fiber in meal plan (grains, vegetables).

Caloric Requirements
Determine basic caloric requirements, taking into consideration age, gender, body weight, and height and factoring in degree of activity.
Long-term weight reduction can be achieved by reducing basic caloric intake by 500 to 1,000 calories from calculated basic caloric requirements.

Teaching Patients About Self Care
Teach patient about proper foot care since diabetic patients are prone to development of wounds due to diminished sensation on the extremities.
Instruct patient not to submit self to pedicure or manicure because it can cause wound or abrasions that may heal solely and could predispose the client to development of infection.
Inform patient not to use any sharp objects in cleaning the nails on foot.
Instruct significant others to assess for temperature of hot items to be utilized by the patient to prevent burns or skin abrasions.
Nutrition
Initial education addresses the importance of consistency in eating habits, the relationship of food and insulin, and provision of individualized meal plan.
Teach patient to read food labels and adjusting meal for exercise, illness and special occasions.
Teach patients to read labels of “health” foods because they often contain sugar products (ie, brown sugar, honey, and corn syrup and may contain saturated vegetable fats, hydrogenated vegetable fats, or animal fats that may be contraindicated with elevated blood lipids.

Exercise
* Exercise is very important because of its effects on lowering blood glucose levels and reducing cardiovascular risk factors. Exercise is useful in losing weight, easing stress, and maintaining a feeling of well-being.
* Encourage patient to eat a 15-g carbohydrate snack (fruit exchange) or a snack of complex carbohydrates with protein before moderate exercise to prevent hypoglycemia.
* Warn patient about postexercise hypoglycemia, which occurs many hours after exercise.
* Discuss testing blood glucose before, during and after exercise and eating carbohydrate snacks to maintain blood glucose.
* Encourage regular exercise rather than sporadic exercise.
* Advise all patients with diabetes to discuss an exercise program with the physician.

Self-monitoring and Drug administration
* Teach patient self-monitoring of blood glucose levels. Instruct patient to keep a record of blood glucose test results.
* Teach patient on the administration of insulin and taking oral hypoglycemic agents.

Source: Johnson, J.Y., Handbook for Brunner and Suddharth’s Textbook of Medical-Surgical Nursing 10th edition.

Rheumatic Heart Disease

2008-03-08T08:38:00.000-08:00

· Almost one out of every 2.7 deaths results from cardiovascular disease.
Rheumatic heart disease/rheumatic fever kills 3,554 Americans each year. Almost one out of every 2.7 deaths results from cardiovascular disease. Since 1900, cardiovascular disease has been the leading cause of death in every year but one - 1918. More than 2,600 Americans die of cardiovascular disease each day, an average of one death every 33 seconds. Cardiovascular disease is the cause of more deaths than the next seven causes of death combined. It is a myth that heart disease is a man's disease. In fact, cardiovascular diseases are the number one killer of women (and men). These diseases currently claim the lives of nearly a half a million females every year. In 1999, approximately one-third (33 percent) of cardiovascular disease deaths occurred prematurely (before age 75, the approximate average life expectancy in that year). The cost of cardiovascular diseases and stroke in 2002 is estimated at $329.2 billion. Stroke killed 167,366 people in 1999 - on average, someone in the US suffers a stroke every 53 seconds; someone dies every 3 minutes from stroke. Stroke is a leading cause of serious, long-term disability that accounts for more than half of all patients hospitalized for a neurological disease. Stroke deaths have been increasing in recent days.

·At least 71 million people in this country suffer from some form of heart disease.
·One person in four suffers from some form of cardiovascular disease, including:
high blood pressure - 65,000,000
coronary heart disease - 13,000,000
angina pectoris - 6,400,000
myocardial infarction (heart attack) - 7,500,000
stroke - 5,400,000
congenital cardiovascular defects - 1,000,000
congestive heart failure - 5,000,000
·Rheumatic heart disease / rheumatic fever kills 3,554 Americans each year.

myLot User Profile

Essential Vitamins and Minerals in Foods

2008-03-05T08:53:00.000-08:00

Vitamin A promotes vision in dim light, mucous membranes, bones, teeth and skin. Carrots, pumpkin, sweet potatoes, spinach, butternut squash, cantaloupe, mangoes, apricots, broccoli, watermelon, tuna.

Vitamins B

Thiamin keeps carbohydrate metabolism and nervous system in good condition. Pasta, peanuts, legumes, watermelon, oranges, brown rice, oatmeal, eggs.

Riboflavin takes care of the skin, and fat / protein / carbohydrate metabolism. Milk, avocadoes, tangerines, prunes, asparagus, broccoli, mushrooms, salmon, turkey.

Niacin promotes effective use of oxygen by our cells, fat / protein / carbohydrate metabolism, and the nervous system. Peanut butter, legumes, soybeans, whole-grain cereals, broccoli, asparagus, baked potatoes, fish.

Vitamin B6 is for protein metabolism. Soybeans, avocadoes, lima beans, bananas, cauliflower, green peppers, potatoes, spinach, raisins, fish.

Folate is the same as folic acid, which is good for red blood cell tissue growth and repair. Legumes, mushrooms, oranges, asparagus, broccoli, spinach, bananas, strawberries, cantaloupe, tuna.

Vitamin B12 promotes new tissue growth, red blood cells, the nervous system and the skin. Eggs, salmon, swordfish, tuna, clams, crab, mussels, oysters.

Biotin metabolizes fat, protein and carbohydrates. Peanut butter, oatmeal, nuts, cauliflower, legumes, eggs.

Pantothenic Acid aids in the metabolism of fat, protein and carbohydrates. Whole-grain cereals, mushrooms, avocadoes, broccoli, peanuts, cashews, lentils, soybeans, eggs, fish.

Vitamin C builds collagen, healthy gums, teeth and blood vessels. Oranges, grapefruit, bell peppers, strawberries, tomatoes, spinach, cabbage, melons, broccoli, kiwi, raspberries, blueberries.

Vitamin D is good for calcium absorption, bones and teeth. Sunlight, cereals, eggs, milk, butter, tuna and salmon.

Vitamin E protects cells from damage. Nut and vegetable oils, mangoes, blackberries, apples, broccoli, peanuts, spinach.

Vitamin K prevents blood clotting. Spinach, broccoli, brussels sprouts, cabbage, parsley, carrots, avocadoes, tomatoes, eggs, dairy.

Calcium builds strong bones and teeth, muscles and nerves, and prevents blood from clotting. Broccoli, green beans, almonds, turnip greens, orange juice, milk, cheese, yogurt, salmon and sardines with bones.

Chloride aids in digestion. It works with sodium to maintain fluid balance. Salt.

Chromium assists in metabolism of carbohydrates. Whole grains, broccoli, grape juice, orange juice, black pepper.

Copper is good for the blood cells and connective tissues. Nuts, cherries, cocoa, mushrooms, gelatin, legumes, oysters, shellfish, fish, eggs.

Flouride protects the tooth enamel. Tea, fish.
Iodine promotes thyroid function. Spinach, iodized salt, lobster, shrimp, oysters, milk.

Iron brings oxygen in blood and is good for metabolizing energy. Asparagus, spinach, pumpkin seeds, soybeans, tofu, clams.

Magnesium protects the bones, nerve and muscle function. Molasses, nuts, spinach, pumpkin seeds, baked potatoes, broccoli, bananas, seafood, dairy.

Manganese is good for the bones, connective tissues and fat / carbohydrate metabolism. Nuts, legumes, tea, dried fruits, spinach, green leafy vegetables.

Molybdenum helps in nitrogen metabolism. Legumes, whole-grain cereals, dairy.

Phosphorus metabolizes energy. It works with Calcium for healthy bones and teeth. Cereals, fish, eggs, dairy.

Potassium keeps acids balanced. It also works with Sodium to maintain fluid balance. Baked potatoes, avocadoes, dried fruit, yogurt, cantaloupe, spinach, bananas, mushrooms, tomatoes.

Selenium works with Vitamin E to protect cells and body tissue. Whole grain cereals, mushrooms, Brazil nuts, dairy, fish and shellfish.

Sodium keeps the fluid balanced and the nervous system in good condition. Salt, soy sauce, seasonings.

Zinc aids in wound healing, growth, appetite and sperm production. Lima beans, legumes, nuts, oysters, seafood, dairy

Malnutrition

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Malnutrition is the condition that develops when the body does not get the right amount of the vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.

Undernutrition
Malnutrition occurs in people who are either undernourished or overnourished.

Undernutrition is a consequence of consuming too few essential nutrients or using or excreting them more rapidly than they can be replaced.
Infants, young children, and teenagers need additional nutrients. So do women who are pregnant or breastfeeding. Nutrient loss can be accelerated by diarrhea, excessive sweating, heavy bleeding (hemorrhage), or kidney failure. Nutrient intake can be restricted by age-related illnesses and conditions, excessive dieting, food allergies, severe injury, serious illness, a lengthy hospitalization, or substance abuse.

The leading cause of death in children in developing countries is protein-energy malnutrition. This type of malnutrition is the result of inadequate intake of calories from proteins, vitamins, and minerals. Children who are already undernourished can suffer from protein-energy malnutrition (PEM) when rapid growth, infection, or disease increases the need for protein and essential minerals. These essential minerals are known as micronutrients or trace elements.
Two types of protein-energy malnutrition have been described-kwashiorkor and marasmus. Kwashiorkor occurs with fair or adequate calorie intake but inadequate protein intake, while marasmus occurs when the diet is inadequate in both calories and protein.

About 1% of children in the United States suffer from chronic malnutrition, in comparison to 50% of children in southeast Asia. About two-thirds of all the malnourished children in the world are in Asia, with another one-fourth in Africa.

Overnutrition

In the United States, nutritional deficiencies have generally been replaced by dietary imbalances or excesses associated with many of the leading causes of death and disability. Overnutrition results from eating too much, eating too many of the wrong things, not exercising enough, or taking too many vitamins or other dietary replacements.

Risk of overnutrition is also increased by being more than 20% overweight, consuming a diet high in fat and salt, and taking high doses of:
· Nicotinic acid (niacin) to lower elevated cholesterol levels
· Vitamin B6 to relieve premenstrual syndrome
· Vitamin A to clear up skin problems
· Iron or other trace minerals not prescribed by a doctor.

Nutritional disorders can affect any system in the body and the senses of sight, taste, and smell. They may also produce anxiety, changes in mood, and other psychiatric symptoms. Malnutrition begins with changes in nutrient levels in blood and tissues. Alterations in enzyme levels, tissue abnormalities, and organ malfunction may be followed by illness and death.

Causes and symptoms

Causes

Poverty and lack of food are the primary reasons why malnutrition occurs in the United States. Ten percent of all members of low income households do not always have enough healthful food to eat. Protein-energy malnutrition occurs in 50% of surgical patients and in 48% of all other hospital patients.
Loss of appetite associated with the aging process. Malnutrition affects one in four elderly Americans, in part because they may lose interest in eating. In addition, such dementing illnesses as Alzheimer's disease may cause elderly persons to forget to eat.

There is an increased risk of malnutrition associated with chronic diseases, especially disease of the intestinal tract, kidneys, and liver. Patients with chronic diseases like cancer, AIDS, intestinal parasites, and other gastric disorders may lose weight rapidly and become susceptible to undernourishment because they cannot absorb valuable vitamins, calories, and iron.

People with drug or alcohol dependencies are also at increased risk of malnutrition. These people tend to maintain inadequate diets for long periods of time and their ability to absorb nutrients is impaired by the alcohol or drug's affect on body tissues, particularly the liver, pancreas, and brain.
Eating disorders. People with anorexia or bulimia may restrict their food intake to such extremes that they become malnourished.

Food allergies. Some people with food allergies may find it difficult to obtain food that they can digest. In addition, people with food allergies often need additional calorie intake to maintain their weight.

Failure to absorb nutrients in food following bariatric (weight loss) surgery. Bariatric surgery includes such techniques as stomach stapling (gastroplasty) and various intestinal bypass procedures to help people eat less and lose weight. Malnutrition is, however, a possible side effect of bariatric surgery.

Symptoms

Unintentionally losing 10 pounds or more may be a sign of malnutrition. People who are malnourished may be skinny or bloated. Their skin is pale, thick, dry, and bruises easily. Rashes and changes in pigmentation are common.
Hair is thin, tightly curled, and pulls out easily. Joints ache and bones are soft and tender. The gums bleed easily. The tongue may be swollen or shriveled and cracked. Visual disturbances include night blindness and increased sensitivity to light and glare.

Other symptoms of malnutrition include:
· anemia
· diarrhea
· disorientation
· night blindness
· irritability, anxiety, and attention deficits
· goiter (enlarged thyroid gland)
· loss of reflexes and lack of muscular coordination
· muscle twitches
· amenorrhea (cessation of menstrual periods)
· scaling and cracking of the lips and mouth.

Malnourished children may be short for their age, thin, listless, and have weakened immune systems.

Diagnosis

Overall appearance, behavior, body-fat distribution, and organ function can alert a family physician, internist, or nutrition specialist to the presence of malnutrition. Patients may be asked to record what they eat during a specific period. X rays can determine bone density and reveal gastrointestinal disturbances, and heart and lung damage.

Blood and urine tests are used to measure the patient's levels of vitamins, minerals, and waste products. Nutritional status can also be determined by:

· Comparing a patient's weight to standardized charts
· Calculating body mass index (BMI) according to a formula that divides height into weight
· Measuring skinfold thickness or the circumference of the upper arm.

Treatment

Normalizing nutritional status starts with a nutritional assessment. This process enables a clinical nutritionist or registered dietician to confirm the presence of malnutrition, assess the effects of the disorder, and formulate diets that will restore adequate nutrition.

Patients who cannot or will not eat, or who are unable to absorb nutrients taken by mouth, may be fed intravenously (parenteral nutrition) or through a tube inserted into the gastrointestinal (GI) tract (enteral nutrition).

Tube feeding is often used to provide nutrients to patients who have suffered burns or who have inflammatory bowel disease. This procedure involves inserting a thin tube through the nose and carefully guiding it along the throat until it reaches the stomach or small intestine. If long-term tube feeding is necessary, the tube may be placed directly into the stomach or small intestine through an incision in the abdomen.

Tube feeding cannot always deliver adequate nutrients to patients who:
· Are severely malnourished
· Require surgery
· Are undergoing chemotherapy or radiation treatments
· Have been seriously burned
· Have persistent diarrhea or vomiting
· Whose gastrointestinal tract is paralyzed.
Intravenous feeding can supply some or all of the nutrients these patients need.

Prognosis

Up to 10% of a person's body weight can be lost without side effects, but if more than 40% is lost, the situation is almost always fatal. Death usually results from heart failure, electrolyte imbalance, or low body temperature. Patients with semiconsciousness, persistent diarrhea, jaundice, or low blood sodium levels have a poorer prognosis.

Some children with protein-energy malnutrition recover completely. Others have many health problems throughout life, including mental retardation and the inability to absorb nutrients through the intestinal tract. Prognosis for all patients with malnutrition seems to be dependent on the age of the patient, and the length and severity of the malnutrition, with young children and the elderly having the highest rate of long-term complications and death.

Prevention

Breastfeeding a baby for at least six months is considered the best way to prevent early-childhood malnutrition. The United States Department of Agriculture and Health and Human Service recommend that all Americans over the age of two:
· Consume plenty of fruits, grains, and vegetables
· Eat a variety of foods that are low in fats and cholesterols and contain only moderate amounts of salt, sugars, and sodium
· Engage in moderate physical activity for at least 30 minutes, at least several times a week
· Achieve or maintain their ideal weight
· Use alcohol sparingly or avoid it altogether.

Every patient admitted to a hospital should be screened for the presence of illnesses and conditions that could lead to protein-energy malnutrition. Patients with higher-than-average risk for malnutrition should be more closely assessed and reevaluated often during long-term hospitalization or nursing-home care.

Key Terms

Anemia
Not enough red blood cells in the blood.

Anorexia nervosa
Eating disorder marked by malnutrition and weight loss commonly occurring in young women.

Bariatric
Pertaining to the study, prevention, or treatment of overweight.

Calorie
A unit of heat measurement used in nutrition to measure the energy value of foods. A calorie is the amount of heat energy needed to raise the temperature of 1 kilogram of water 1°C.

Kwashiorkor

Severe malnutritution in children primarily caused by a protein-poor diet, characterized by growth retardation.

Marasmus

Severe malnutritution in children caused by a diet lacking in calories as well as protein.

Marasmus may also be caused by disease and parasitic infection.

Micronutrients
Essential dietary elements that are needed only in very small quantities. Micronutrients are also known as trace elements. They include copper, zinc, selenium, iodine, magnesium, iron, cobalt, and chromium.

Resources
Books
· Beers, Mark H., MD, and Robert Berkow, MD, editors. "Malnutrition." Section 1, Chapter 2. In The Merck Manual of Diagnosis and Therapy.Whitehouse Station, NJ: Merck Research Laboratories, 2004.
· Flancbaum, Louis, MD, with Erica Manfred and Deborah Biskin. The Doctor's Guide to Weight Loss Surgery. West Hurley, NY: Fredonia Communications, 2001.
Periodicals
· Alvarez-Leite, J. I. "Nutrient Deficiencies Secondary to Bariatric Surgery." Current Opinion in Clinical Nutrition and Metabolic Care 7 (September 2004): 569-575.
· Amella, E. J. "Feeding and Hydration Issues for Older Adults with Dementia." Nursing Clinics of North America 39 (September 2004): 607-623.
· Bryan, J., S. Osendorp, D. Hughes, et al. "Nutrients for Cognitive Development in School-Aged Children." Nutrition Reviews 62 (August 2004): 295-306.
· Grigsby, Donna G., MD. "Malnutrition." eMedicine December 18, 2003.
· Gums, J. G. "Magnesium in Cardiovascular and Other Disorders." American Journal of Health-System Pharmacy 61 (August 1, 2004): 1569-1576.
· Halsted, G. H. "Nutrition and Alcoholic Liver Disease." Seminars in Liver Disease 24 (August 2004): 289-304.
· Reid, C. L. "Nutritional Requirements of Surgical and Critically-Ill Patients: Do We Really Know What They Need?" Proceedings of the Nutrition Society 63 (August 2004): 467-472.
Organizations
· American College of Nutrition. 722 Robert E. Lee Drive, Wilmington, NC 20412-0927. (919) 452-1222.
· American Institute of Nutrition. 9650 Rockville Pike, Bethesda, MD 20814-3990. (301) 530-7050.
· Food and Nutrition Information Center. 10301 Baltimore Boulevard, Room 304, Beltsville, MD 20705-2351.
Other
· World Health Organization (WHO) Nutrition web site.
Gale Encyclopedia of Medicine, Published December, 2002 by the Gale Group The Essay Author is Mary K. Fyke.