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[ { "answer_id": 8814, "body": "<p>Short answer: <strong>No.</strong> Using water, mouth rince, floss, toothpics or other <strong>means of removing debris between teeth should not cause dental movement</strong>.</p>\n\n<p>Long answer: To cause dental movement, a <em>continuous pression or pull</em> has to be applied for <em>many</em> hours per day, over the span of weeks/months/years to make teeth move. That is why head gears have to be worn at least 12h everyday, and why braces are kept on at all times. Other problems, such as a bad occlusion (the way your teeth close together can also cause movements.</p>\n\n<p>Therefore, weak and inetermitant forces (such as cleaning between your teeth) will have little effect on your dentition.</p>\n\n<p>Sources: <a href=\"http://www.gillettedental.com/blog/post/orthodontic-headgear-what-it-is-and-why-it-may-be-needed.html\" rel=\"nofollow\">http://www.gillettedental.com/blog/post/orthodontic-headgear-what-it-is-and-why-it-may-be-needed.html</a></p>\n", "score": 3 } ]

[ "dentistry", "gargling-gargle", "rinsing-mouth", "teeth-alignment", "diastema-teeth-gaps" ]

[ { "answer_id": 14690, "body": "<p>Thank you for the very interesting question regarding the prostate. Let me first briefly explain a few historical confusions regarding the nomenclature of prostatic disorders with particular attention to your ‘<strong><em>congestive prostatitis</em></strong>’, which may be called an almost extinct creature!</p>\n\n<h2>Classifications of Prostatic Disorders</h2>\n\n<p><a href=\"http://www.jstor.org/stable/23996298?seq=1#page_scan_tab_contents\" rel=\"nofollow noreferrer\">Meares and Stamey (1968)</a> suggested a classification of prostatic disorders based on clinical and bacterial culture findings, and their classification had been widely used at least until 1995. <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/1785024?dopt=Abstract\" rel=\"nofollow noreferrer\">Doble (1994)</a> identified <strong>Meares and Stamey’s traditional classification of prostatic disorders</strong> as:</p>\n\n<blockquote>\n <ol>\n <li>Acute prostatitis </li>\n <li>Chronic bacterial prostatitis </li>\n <li>Non-bacterial prostatitis </li>\n <li>Prostatodynia</li>\n </ol>\n</blockquote>\n\n<p>In the traditional classification, non-bacterial prostatitis refers to a condition that presents with similar clinical features as chronic bacterial prostatitis, including pyuria, but except that the cultures of urine and expressed prostatic secretions are negative. Prostatodynia also presents with similar clinical features as chronic bacterial prostatitis but excluding pyuria, and the cultures are negative. It is important to note that prostatodynia is more a symptom than a condition itself. </p>\n\n<p>As noted by <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/10422990\" rel=\"nofollow noreferrer\">Krieger, Nyberg &amp; Nickel (1999)</a>, the US <strong>National Institute of Health (NIH)</strong> standardised the classification of prostatic disorders in 1995 by adding a disease entity as asymptomatic inflammatory prostatitis, and combining non-bacterial prostatitis and prostatodynia into an entity as chronic prostatitis/pelvic pain syndrome. Thus, the NIH classifications can be listed as:</p>\n\n<blockquote>\n <p><strong>I.</strong> Acute Prostatitis </p>\n \n <p><strong>II.</strong> Chronic bacterial prostatitis </p>\n \n <p><strong>III A.</strong> Chronic prostatitis/chronic pelvic pain syndrome,\n inflammatory </p>\n \n <p><strong>III B.</strong> Chronic prostatitis/chronic pelvic pain syndrome,\n non-inflammatory </p>\n \n <p><strong>IV.</strong> Asymptomatic inflammatory prostatitis</p>\n</blockquote>\n\n<p><br></p>\n\n<h2>Historical Relationship between Congestive Prostatitis &amp; Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)</h2>\n\n<p>Congestive prostatitis is an outdated nomenclature for a constellation of mostly ill-defined urological and pain symptoms, and a few signs; it had been a poorly understood entity for the most of its time in use. Congestive prostatitis is clinically characterised by urological symptoms, such as urinary frequency, dysuria, and strangury; and pain or discomfort in urogenital and anal areas, such as pain in the inguinal region radiating sometimes even to the testicles, burning in the urethra, and pressure in the perianal region (<a href=\"https://link.springer.com/chapter/10.1007/978-3-642-73412-0_9\" rel=\"nofollow noreferrer\">Diederichs, 1988</a>). It is not clear whether the patients experience an actual pain or just a discomfort. According to <a href=\"https://scholar.google.com/scholar_lookup?title=Prostatitis%20aus%20psychosomatischer%20Sicht&amp;author=EA.%20G%C3%BCnthert&amp;publication_year=1983\" rel=\"nofollow noreferrer\">Günthert (1983)</a>, as mentioned by, <a href=\"https://link.springer.com/chapter/10.1007/978-3-642-73412-0_9\" rel=\"nofollow noreferrer\">Diederichs (1988)</a>, many patients, without being asked, stress the fact that they do not experience actual pain, but rather a very unpleasant, disturbing feeling. Some of them cannot even sit comfortably. According to <a href=\"https://scholar.google.com/scholar_lookup?title=Prostatitis%20aus%20psychosomatischer%20Sicht&amp;author=EA.%20G%C3%BCnthert&amp;publication_year=1983\" rel=\"nofollow noreferrer\">Günthert (1983)</a> and <a href=\"http://www.jstor.org/stable/23996298?seq=1#page_scan_tab_contents\" rel=\"nofollow noreferrer\">Janssen et al. (1983) </a>as mentioned by <a href=\"https://link.springer.com/chapter/10.1007/978-3-642-73412-0_9\" rel=\"nofollow noreferrer\">Diederichs (1988)</a>, over 50% of these patients also complain about sexual disorders, such as erection difficulties, or painful or premature ejaculation. </p>\n\n<p>Poorly defined symptomatology and pathophysiology of congestive prostatitis, along with a host of associated psychological manifestations, either as aetiology or as sequelae, had tempted many to classify congestive prostatitis as a psychosomatic clinical condition in which urological examination may show an actual swelling of the prostate, but where neither bacteria in the expressed prostatic secretions nor any other organic disease can be found (<a href=\"http://www.jstor.org/stable/23996298?seq=1#page_scan_tab_contents\" rel=\"nofollow noreferrer\">Janssen et al., 1983</a>; <a href=\"https://link.springer.com/chapter/10.1007/978-3-642-73412-0_9\" rel=\"nofollow noreferrer\">Diederichs, 1988</a>; <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/1785024?dopt=Abstract\" rel=\"nofollow noreferrer\">Pavone-Macaluso, di Trapani &amp; Pavone, 1991</a>).</p>\n\n<p>As mentioned initially, congestive prostatitis is an outdated name for the condition it refers to, and there had been a myriad of names used synonymously to the same condition, perhaps reflecting the poor understanding of the condition itself: <strong>prostatosis, chronic prostatitis, prostate congestion, chronic congestive prostatitis, prostate neurosis, urogenital neurosis, autonomic urogenital syndrome, chronic recurrent prostatitis, and abacterial prostatitis</strong> (<a href=\"http://go.galegroup.com/ps/anonymous?id=GALE%7CA3896974&amp;sid=googleScholar&amp;v=2.1&amp;it=r&amp;linkaccess=fulltext&amp;issn=0031305X&amp;p=AONE&amp;sw=w&amp;authCount=1&amp;isAnonymousEntry=true\" rel=\"nofollow noreferrer\">Peterson, 1985</a>; <a href=\"https://link.springer.com/chapter/10.1007/978-3-642-73412-0_9\" rel=\"nofollow noreferrer\">Diederichs, 1988</a>). </p>\n\n<p>Considering the current understanding of the pathophysiology and aetiology that ranges from prostatic to extraprostatic causes, diverse nature of the symptomatology, therapeutic options available, and the need to facilitate research with a consistent nomenclature, <strong><em>the condition previously called as congestive prostatitis (and the other names mentioned above) is now included in the broad entity called chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)</em></strong>. <strong>The use of the other names is discouraged to minimise the confusions and ensure consistency in medical literature.</strong> Terms such as congestive prostatitis, congested prostate, and prostate congestion <em>should only be used, if unavoidable, to describe a particular state or condition of the prostate rather than disease entities themselves</em>. </p>\n\n<p>Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a clinical syndrome described based on urological symptoms and/or, pain or discomfort. It is defined as chronic pelvic pain for at least three of the proceeding six months in the absence of other identifiable aetiologies. Inflammatory and non-inflammatory sub-classification is done on the presence or absence of inflammatory cells in expressed prostatic secretions, post-prostate massage urine, or seminal fluid (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/10443716\" rel=\"nofollow noreferrer\">Nickel, Nyberg &amp; Hennenfent, 1999</a>; <a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2005.05373.x/full\" rel=\"nofollow noreferrer\">Schneider et al., 2005</a>).</p>\n\n<p>In this discussion, the name ‘<em>congestive prostatitis</em>’ will be used only for the sake of answering the original question. Let us now look into the queries that the original question asks about.</p>\n\n<p><strong>1. Is there any cure apart from ejaculation?</strong></p>\n\n<p><strong>2. Can the condition be improved/helped by,</strong></p>\n\n<p><strong>• Exercise?</strong></p>\n\n<p><strong>• Dietary modifications?</strong></p>\n\n<p>As we have discussed above, '<em>Congestive Prostatitis</em>' is an outdated name for the vague disease entity it refers to, and the name should be and is avoided in current medical literature. The term congestive prostatitis itself signifies only a state or condition of the prostate rather than a distinct disease entity itself. <strong><em>Whatever constellation of symptoms and signs attributed to congestive prostatitis in the past is now classified and named as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)</em></strong>. </p>\n\n<p>Although CP/CPPS still remains a poorly understood disease entity, as reflected by the many hypotheses of its cause, there have been tremendous improvements in its evaluation, diagnosis, and management (<a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2005.05373.x/full\" rel=\"nofollow noreferrer\">Schneider et al., 2005</a>). The symptoms seem to have a multifactorial origin so it is very important, yet difficult, to exclude underlying diseases with similar symptoms. The identification of the origin of the symptoms is crucial for the effective management; therefore, various attempts have been made to formulate tools to facilitate the evaluation and diagnosis of CP/CPPS, such as <strong><a href=\"http://www.upointmd.com/NIHCPSIEnglish.pdf\" rel=\"nofollow noreferrer\">NIH-CPSI</a></strong>, <strong><a href=\"http://www.urospec.com/uro/Forms/ipss.pdf\" rel=\"nofollow noreferrer\">I-PSS</a></strong>, and <strong><a href=\"http://www.upointmd.com\" rel=\"nofollow noreferrer\">UPOINT</a></strong> (<a href=\"http://onlinelibrary.wiley.com/store/10.1111/j.1464-410X.2010.09701.x/asset/j.1464-410X.2010.09701.x.pdf?v=1&amp;t=jb5dofqr&amp;s=3dbe2cd4dd1c308104e815a489f4d2050beb1408\" rel=\"nofollow noreferrer\">Nickel &amp; Shoskes, 2010</a>). </p>\n\n<p>Because of the multifactorial origin of CP/CPPS, there are a number of therapeutic modalities for CP/CPPS. However, <strong>there is no universally a accepted treatment regime. In fact, none of the therapeutic options hitherto available is a cure for CP/CPPS.</strong> However, many medications and other forms of treatment can help to alleviate the symptoms and make CP/CPPS more bearable. Over time, this condition may improve or stabilise on its own (<a href=\"https://emedicine.medscape.com/article/437745-overview\" rel=\"nofollow noreferrer\">Watson, 2017</a>). Few guidelines have been published based on clinical evidence to provide recommendations for the treatment, eg <strong><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008168/#!po=1.04167\" rel=\"nofollow noreferrer\">The Prostatitis Expert Reference Group (PERG) consensus guideline</a></strong>, <strong><a href=\"https://www.cua.org/themes/web/assets/files/guidelines/en/1121__1_.pdf\" rel=\"nofollow noreferrer\">Canadian Urological Association (CUA) guideline</a></strong>. </p>\n\n<p>Although this answer is not intended for a detail discussion on each treatment option available, the overall treatment strategies can be outlined as follows:</p>\n\n<p><br></p>\n\n<h2>1. Pharmacological treatments –</h2>\n\n<p>Alpha-blockers (eg tamsulosin, alfuzosin, doxazosin, terazosin, and silodosin), antibiotics (eg ciprofloxacin, levofloxacin, and ofloxacin), and 5-alpha-reductase inhibitors (eg finasteride) are the most efficacious medications for CP/CPPS, provided with they are used judicially considering the nature of individual cases. Anti-inflammatory medication treatment, such as cyclooxygenase-2 inhibitors (eg celecoxib) and glucocorticoids (eg prednisolone), are generally given when pain is not controlled with initial therapy. </p>\n\n<p>The clinical significance of pharmacological treatment for CP/CPPS has been questioned (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21205969\" rel=\"nofollow noreferrer\">Anothaisintawee et al., 2011</a>; <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22870266\" rel=\"nofollow noreferrer\">Cohen et al., 2012</a>). <strong>PEGR</strong> recommend the following based on the best clinical evidence:</p>\n\n<blockquote>\n <p>• α‐adrenergic antagonists may have a modest treatment effect\n regarding total, urinary symptom, pain and QoL scores in CBP and\n CP/CPPS, and should be considered as an initial treatment option\n (<strong>Level 1</strong>).</p>\n \n <p>• Antimicrobial therapy may have a moderate effect on total, urinary,\n pain and QoL scores in CBP and CP/CPPS and should be considered as an\n initial treatment option (<strong>Level 1</strong>). </p>\n \n <p>• There is insufficient evidence to warrant recommending 5α‐reductase\n inhibitors as monotherapy in CP/CPPS, unless co‐existing BPE is\n present (<strong>Level 2</strong>). </p>\n \n <p>• In patients with early‐stage disease who present with pain\n symptoms, regular paracetamol may be offered. NSAIDs should be offered\n only for short‐term treatment of pain, to patients with early‐stage\n CBP or CP/CPPS whose symptoms are suspected to be due to an\n inflammatory process, or those judged to be experiencing an\n inflammatory flare. If pain is considered to be neuropathic in origin,\n treatment with a gabapentinoid (e.g. pregabalin or gabapentin), a\n tricyclic antidepressant (e.g. amitriptyline, nortriptyline or\n trimipramine) or a selective serotonin‐noradrenaline (known in the USA\n as norepinephrine) reuptake inhibitor (SNRI; e.g. duloxetine) is\n warranted (<strong>Level 5</strong>). </p>\n \n <p>• Multimodal/combined therapy should be uniquely designed for each\n individual patient, according to history, physical examination and\n investigations. Depending on the symptoms at presentation, the\n following may be considered for adding to first‐line antibiotic\n therapy (<strong>Level 5</strong>).</p>\n \n <p>o An α‐blocker and/or an NSAID.</p>\n \n <p>o An agent targeting neuropathic pain (e.g. pregabalin).</p>\n \n <p>o A 5α‐reductase inhibitor (predominantly for patients with\n coexisting LUTS with BPE).</p>\n</blockquote>\n\n<p><br></p>\n\n<h2>2. Invasive treatments and other non-pharmacological treatments –</h2>\n\n<p>In some cases of refractory CP/CPPS, invasive surgical treatments such as prostatectomy, transurethral resection of the prostate (TURP), transrectal high‐intensity focused ultrasound (HIFU), transurethral needle ablation (TUNA) of the prostate, and transurethral microwave thermotherapy have been used. The evidence on such invasive surgical management techniques is very limited. </p>\n\n<p>Other non-pharmacological treatments such as repetitive prostatic massage, therapeutic ejaculation, neuromodulation techniques (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/19641356\" rel=\"nofollow noreferrer\">Kabay et al., 2009</a>), and various phytotherapies, including pollen extracts, bioflavonoids and/or Serenoa repens (saw palmetto), have been reported as being successful in treating some cases of CP/CPPS. </p>\n\n<p>Physical dysfunction, such as abnormal pelvic muscle spasm and muscle tenderness, is associated with some cases of CP/CPPS (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12913709\" rel=\"nofollow noreferrer\">Hetrick et al., 2003</a>; <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/18082223\" rel=\"nofollow noreferrer\">Shoskes et al., 2008</a>). <strong><em>Therefore, specialist physiotherapy that aim to improve relaxation and coordinated use of the pelvic floor muscles, such as biofeedback physical therapy and pelvic floor re‐education, as well as myofascial trigger point release, may play a role in providing symptom improvement in patients with CP/CPPS. However, the evidence on such treatments is also scarce.</em></strong> </p>\n\n<p><strong>PEGR</strong> recommend the following based on the best clinical evidence:</p>\n\n<blockquote>\n <p>• There is insufficient evidence to warrant recommending surgical\n techniques, including radical prostatectomy, TURP, HIFU or prostatic\n massage for the treatment of CBP or CP/CPPS, except in the context of\n a clinical trial setting (<strong>Level 3</strong>). </p>\n \n <p>• The following specialist physiotherapy treatment options may be\n considered: pelvic floor re‐education; local pelvic floor relaxation;\n biofeedback; general relaxation; deep relaxation/mindfulness; trigger\n point release; myofascial release; stretches; exercise for pain\n management; TENS; acupuncture for trigger point release and pain\n management; bladder retraining (<strong>Level 5</strong>). </p>\n \n <p>• Phytotherapy has a modest beneficial effect on symptom improvement\n in CBP and CP/CPPS and may be considered as a treatment option in\n treatment‐refractory patients (<strong>Level 2</strong>).</p>\n</blockquote>\n\n<p><strong><em>Since the original question mentions ‘ejaculation’ specifically, a brief historical note is made here. According to <a href=\"https://scholar.google.com/scholar_lookup?title=Trieb%20und%20Kultur&amp;author=H.%20Christoffel&amp;publication_year=1944\" rel=\"nofollow noreferrer\">Christoffel (1944)</a> as cited by <a href=\"https://link.springer.com/chapter/10.1007/978-3-642-73412-0_9\" rel=\"nofollow noreferrer\">Diederichs (1988)</a>, the <a href=\"https://www.gutenberg.org/files/3913/3913-h/3913-h.htm\" rel=\"nofollow noreferrer\">Confessions</a> of Jean Jacques Rousseau (1767) reveals that Rousseau was plagued by the frequent urge to urinate, which disappeared after a visit to a Venetian brothel but reappeared in connection with hypochondriac fears of having a venereal disease. \nThe role of frequent ejaculation in either producing or reducing CPPS symptoms remains controversial. Although patients with enlarged, symptomatically congested prostate glands are often advised that regular sexual intercourse may alleviate their symptoms, the role of frequent ejaculation in either producing or reducing CP/CPPS symptoms remains controversial, and there is little objective evidence if at all (<a href=\"https://emedicine.medscape.com/article/456165-overview\" rel=\"nofollow noreferrer\">Ahuja, 2016</a>; <a href=\"https://emedicine.medscape.com/article/437745-overview\" rel=\"nofollow noreferrer\">Watson, 2017</a>).</em></strong> </p>\n\n<p><br></p>\n\n<h2>3. Psychological interventions –</h2>\n\n<p>CP/CPPS is associated with a host of psychological manifestations, either as aetiology or as sequelae. Accordingly, various psychological treatment modalities have been used to treat CP/CPPS. However, no evidence from randomised clinical trials or comparative studies is available to support the use of psychological treatment or cognitive behavioural therapy (CBT) in these settings. When referring a patient for psychological treatment, it is important to reassure the patient that his condition is real and that his suffering is not imaginary. Psychological support is appropriate in helping the patient cope more effectively with his serious, real-life problem (<a href=\"https://emedicine.medscape.com/article/437745-overview\" rel=\"nofollow noreferrer\">Watson, 2017</a>). </p>\n\n<p><strong>PEGR</strong> recommend the following based on the best clinical evidence:</p>\n\n<blockquote>\n <p>• Psychosocial symptoms should be assessed in both the early and late\n stages of CBP and CP/CPPS. If there is a significant suspicion of\n psychological factors contributing to a patient's condition, these\n should be screened for (<strong>Level 5</strong>).</p>\n \n <p>• CBT should be considered in conjunction with other treatments in\n later‐stage CBP and CP/CPPS, as it may improve pain and QoL (<strong>Level 5</strong>).</p>\n</blockquote>\n\n<p><br></p>\n\n<h2>4. Dietary and lifestyle interventions –</h2>\n\n<p><strong><em>Traditionally, patients have been warned to avoid excessive intake of prostate irritants, such as tobacco (smoking), coffee, tea, caffeine, carbonated drinks, spicy foods, acidic foods, cranberry juice/cranberries, lemon juice, alcohol, and chocolate. However, none of these items is known to cause actual physical damage or to worsen the long-term prognosis. The reported success of this approach is anecdotal, and it will not work for all patients. Nevertheless, responsible limitation of these items may help to control the day-to-day symptoms (<a href=\"http://www.sciencedirect.com/science/article/pii/S0090429513008546\" rel=\"nofollow noreferrer\">Herati et al., 2013</a>; <a href=\"https://emedicine.medscape.com/article/456165-overview\" rel=\"nofollow noreferrer\">Ahuja, 2016</a>; <a href=\"https://emedicine.medscape.com/article/437745-overview\" rel=\"nofollow noreferrer\">Watson, 2017</a>). A glass or two of wine or sherry may lessen nocturia symptoms. Alkalinisation of the urine seems to help some patients (<a href=\"https://emedicine.medscape.com/article/437745-overview\" rel=\"nofollow noreferrer\">Watson, 2017</a>).</em></strong> </p>\n\n<p>The benefits of frequent ejaculation and specific exercises have been discussed above. Sitz baths may provide partial relief from acute exacerbations. Perianal self-massage may also also offer some relief, but the reported success is anecdotal (<a href=\"https://emedicine.medscape.com/article/456165-overview\" rel=\"nofollow noreferrer\">Ahuja, 2016</a>; <a href=\"https://emedicine.medscape.com/article/437745-overview\" rel=\"nofollow noreferrer\">Watson, 2017</a>). Sedentary lifestyle is associated with severe pain in patients with CP/CPPS; therefore, the modification of such lifestyle is a potential target for treatment (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26666410\" rel=\"nofollow noreferrer\">Chen et al., 2016</a>). </p>\n", "score": 5 } ]

[ "exercise", "reproduction", "ejaculation", "prostate", "prostatitis" ]

[ { "answer_id": 7109, "body": "<p>just a short answer, since no-one has responded yet:</p>\n\n<p><strong>Diaphragm</strong></p>\n\n<p>Except from deepening your breath by expanding the volume of the lungs down towards the belly,</p>\n\n<blockquote>\n <p>the diaphragm is also involved in non-respiratory functions, helping to expel vomit, feces, and urine from the body by increasing intra-abdominal pressure, and preventing acid reflux by exerting pressure on the esophagus as it passes through the esophageal hiatus.</p>\n</blockquote>\n\n<p>From <a href=\"https://en.wikipedia.org/wiki/Thoracic_diaphragm#Function\" rel=\"nofollow\">wikipedia</a>.</p>\n\n<p>But this is only one aspect of many more, others are</p>\n\n<ul>\n<li>posture -> since the diaphragm inserts at the lower ribs and the vertebrae it influences the way you spine is aligned</li>\n<li>lung volume -> when the diaphragm contracts during inhalation, it expands downwards and gives way to the lungs to expand as well. thus you have a bigger volume and can breath in more air.</li>\n<li>slower breathing -> the more air you breath in, the slower you breath, this may lead to a relaxation during stress situations.</li>\n</ul>\n\n<p><strong>Nasal breathing</strong></p>\n\n<blockquote>\n <p>It is often considered superior to mouth breathing[6][7] for several reasons. Air travels to and from the external environment and the lungs through the nasal passages, as opposed to the mouth. The nasal passages do a better job of filtering the air as it enters the lungs. In addition, the smaller diameter of the nasal passages creates pressure in the lungs during exhalation, allowing the lungs to have more time to extract oxygen from them. When there is proper oxygen-carbon dioxide exchange, the blood will maintain a balanced pH. If carbon dioxide is lost too quickly, as in mouth breathing, oxygen absorption decreases. Nasal breathing is especially important in certain situations such as dehydration, cold weather, laryngitis, and when the throat is sore or dry because it does not dry the throat as much.</p>\n</blockquote>\n\n<p>From <a href=\"https://en.wikipedia.org/wiki/Breathing#Nasal_breathing\" rel=\"nofollow\">wikipedia</a> as well.</p>\n", "score": 1 } ]

[ "exercise", "stomach", "breathing", "nose" ]

[ { "answer_id": 4822, "body": "<p>If observing surgery might cause you to faint then there are two things you can do:</p>\n\n<ol>\n<li><p>Avoid observing surgeries.</p></li>\n<li><p>Desensitize yourself with videos and photos of surgeries in a controlled environment where fainting won't injure you or disrupt an actual surgery.</p></li>\n</ol>\n\n<p>Number two is quite easy to accomplish in this era of the internet*. There are thousands of videos and photos online to choose from, and as anyone with experience in medicine, emergency services, or combat will tell you, you <em>will</em> get used to seeing it and the autonomic response that causes you to faint will dissipate over time. However, if your reaction is so strong that fainting is a real possibility, you might want to consider visiting a psychologist for <a href=\"http://www.simplypsychology.org/Systematic-Desensitisation.html\" rel=\"nofollow\">desensitization therapy</a>. </p>\n\n<ul>\n<li><em>I would advise avoiding the so-called \"gore sites\" and sticking to real medical procedures on youtube and the like. The gore sites can be far, far worse than you might be prepared for.</em></li>\n</ul>\n", "score": 3 }, { "answer_id": 4824, "body": "<p><em><strong>How to Avoid Fainting During Surgery?</strong></em></p>\n<p>Fainting during surgery can be caused by the situations outlined below. Below are solutions, as well.</p>\n<ul>\n<li>Standing to long. When observing a surgery you may be asked to stand for long periods of time which can cause inadequate blood flow to the brain.</li>\n</ul>\n<blockquote>\n<p>This pooling lowers the blood pressure and the amount of blood the\nheart pumps to the brain. <a href=\"http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/symptoms-of-heart-and-blood-vessel-disorders/dizziness-or-light-headedness-when-standing-up\" rel=\"nofollow noreferrer\">Merck Manuals</a></p>\n</blockquote>\n<p>Solutions are: Sitting if possible, moving around as much as possible and not standing completely still. Some conditions can make this fainting a greater risk so know if you have hypovolemia, a heart disorder or defect, etc.</p>\n<ul>\n<li>Lower blood sugar from not being able to eat a adequate amount. Before the surgery you may be anxious, under stress, or etc. This can cause you to not consume enough food or not consume the right foods. This can lead to <a href=\"http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?referrer=https://www.google.com/\" rel=\"nofollow noreferrer\">hypoglycemia</a> and low energy levels.</li>\n</ul>\n<p>Solutions: Eat a adequate meal, and maybe a snack before. If your going to get squeamish before and may vomit try eating the meal a bit before and try to calm down. Test your blood sugar before if possible and know your signs of hypoglycemia.</p>\n<ul>\n<li>Disturbing images. Surgery can be quite disturbing to some people and some people are scared of <a href=\"https://en.wikipedia.org/wiki/Blood_phobia\" rel=\"nofollow noreferrer\">blood</a> and <a href=\"http://common-phobias.com/tomo/phobia.htm\" rel=\"nofollow noreferrer\">surgery</a>. If this is the case, watching surgery may not be the right thing for you, unless you fix these circumstances before. You can try to watch surgeries under controlled circumstances to help you be less afraid.</li>\n</ul>\n<p><a href=\"http://www.webmd.com/brain/understanding-fainting-basics\" rel=\"nofollow noreferrer\">From WebMD.com:</a></p>\n<blockquote>\n<p>Some people have a problem with the way their body regulates their\nblood pressure, particularly when they move too quickly from a lying\nor sitting position to a standing position. This condition is called\npostural hypotension and may be severe enough to cause fainting.</p>\n<p>Hyperventilation. If you become intensely anxious or panicked and\nbreathe too quickly, you may feel faint from hyperventilation (taking\nin too much oxygen and getting rid of too much carbon dioxide too\nquickly).</p>\n</blockquote>\n<p>You can <a href=\"http://www.wikihow.com/Stop-Hyperventilatings://www.google.com/\" rel=\"nofollow noreferrer\">stop Hyperventilation</a> by taking deep breathes and trying to calm down. Also, not looking directly at what is going on may help.</p>\n<p><a href=\"http://www.healthline.com/symptom/fainting\" rel=\"nofollow noreferrer\">Fainting Causes:</a></p>\n<blockquote>\n<p>fear or other emotional trauma. severe pain. a sudden drop in blood\npressure. low blood sugar due to diabetes or from going too long\nwithout eating. hyperventilation (rapid, shallow breathing)\ndehydration. standing in one position for too long.</p>\n</blockquote>\n<p>Going off of this some other advice is to hydrate appropriately(64 ounces of water a day on average), don't take any unnecessary drugs and take drugs prescribed as prescribed.</p>\n<p>For those watching videos take measures to take breaks, sit comfortably, don't stare at the screen for to long and use sound control to not have the sound blaring in your ears. Also, stand carefully after sitting for a long time and make sure you can mute or stop the video if things become to much.</p>\n", "score": 2 } ]

[ "surgery", "syncope" ]

[ { "answer_id": 4144, "body": "<p>In short, <strong>Yes</strong>. In an otherwise healthy immune system you'd expect that someone with Lyme disease <em>will</em> eventually test positive with Western Blot.</p>\n\n<p>The \"whatever it is that Lyme Disease produces that this Western Blot tests for\" is worth discussing in some detail. Lyme Disease is caused by a bacterial infection, transmitted by tick bites. As you guessed, there are different strains of bacteria that can cause the disease. They're all members of the genus <em>Borrelia</em> in the phylum <em>Spirochette</em>. In North America, the disease is caused by <em>Borrelia burgdorferi</em>.</p>\n\n<p>Our bodies will respond to the presence of these bacteria by producing molecules to fight the infection called <em>antibodies</em>. The Western Blot tests for the presence of these antibodies (in this case, <em>Immunoglobulin M</em> and <em>Immunoglobulin G</em>) in our system.</p>\n\n<p>In the early stages of the disease, there may not be enough of the antibodies in circulation to show up on the Western Blot. That's where the false negatives come in. In the later stages of the disease (after 4-8 weeks) the sensitivity and specificity of the test goes up to 99%¹.</p>\n\n<ol>\n<li>Harrison's Principles of Internal Medicine. Nineteenth Edition. page 1152 </li>\n</ol>\n", "score": 2 } ]

[ "blood-tests", "infectious-diseases", "lyme-disease" ]

[ { "answer_id": 8976, "body": "<p>This might be true for some substances and false for others. For example, might be true for beta-carotene:</p>\n\n<blockquote>\n <p>Soluble fiber may inhibit ß-carotene absorption; therefore, consumption of juice may increase plasma ß-carotene concentrations more than whole fruits/vegetables in free-living populations.</p>\n</blockquote>\n\n<p>Although,</p>\n\n<blockquote>\n <p>(...) most of this research was conducted in laboratory-based settings.</p>\n</blockquote>\n\n<p>Source: \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/23127215\" rel=\"nofollow\">Associations of soluble fiber, whole fruits/vegetables, and juice with plasma Beta-carotene concentrations in a free-living population of breast cancer survivors.</a>\" (2012)</p>\n\n<p>But lack of fiber may not be good for pectin:</p>\n\n<blockquote>\n <p>Apples are rich in polyphenols and pectin, two potentially bioactive constituents; however, these constituents segregate differently during processing into juice products and clear juice is free of pectin and other cell wall components. We conclude that <strong>the fibre component is necessary</strong> for the cholesterol-lowering effect of apples in healthy humans and that <strong>clear apple juice may not be a suitable surrogate for the whole fruit</strong> in nutritional recommendations.</p>\n</blockquote>\n\n<p>Source: \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/23271615\" rel=\"nofollow\">Intake of whole apples or clear apple juice has contrasting effects on plasma lipids in healthy volunteers.</a>\"</p>\n", "score": 4 } ]

[ "nutrition", "micronutrients" ]

[ { "answer_id": 4206, "body": "<p>I've found a supporting source for the fluid retention claim, in <a href=\"http://www.ncbi.nlm.nih.gov/books/NBK13780/\" rel=\"nofollow\">an excerpt from <em>Holland-Frei Cancer Medicine, 6th edition</em></a> (from 2003). This separates the effects on the kidney into two categories, depending in part on the drug: mineralocorticoid and glucocorticoid.</p>\n\n<p>Mineralocorticoid effects include</p>\n\n<ul>\n<li>Loss of potassium and hydrogen</li>\n<li>Increase in extracellular fluid volume</li>\n<li>Increase in sodium retention</li>\n</ul>\n\n<p>Glucocorticoid effects include</p>\n\n<ul>\n<li>Increase in plasma flow in the kidney</li>\n<li>Increase in sodium retention</li>\n</ul>\n\n<p>Both types of effects can occur in limited frequencies outside the kidney, generally in the gastrointestinal system.</p>\n\n<hr>\n\n<p>These effects can then lead to a variety of symptoms, including high blood pressure. Mineralocorticoids can cause chronic arterial hypertension through long-term sodium retention. Glucocorticoids can do the same, through several factors (the details of which are unknown):</p>\n\n<ul>\n<li>Increase in filtration fraction, the ratio of glomerular filtration rate to renal plasma flow^{<a href=\"https://books.google.com/books?id=otvv8dXuzP0C&amp;pg=PA166&amp;dq=filtration+fraction&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjZwcKZtPzJAhWMNSYKHePHDs0Q6AEIKDAC#v=onepage&amp;q=filtration%20fraction&amp;f=false\" rel=\"nofollow\">[1]</a>}</li>\n<li>Increase in glomerular hypertension, high pressure in the glomerular capillaries^{<a href=\"https://books.google.com/books?id=XHlBhXZAiQ4C&amp;pg=PA115&amp;dq=glomerular+hypertension&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjz2fjNtfzJAhUMTCYKHeHCBEAQ6AEIVDAH#v=onepage&amp;q=glomerular%20hypertension&amp;f=false\" rel=\"nofollow\">[2]</a>}</li>\n<li>Increase in synthesis of angiotensinogen, a protein involved in regulating blood pressure,^{<a href=\"http://www.ncbi.nlm.nih.gov/gene/183\" rel=\"nofollow\">[3]</a>} and atrial natriuretic peptide^{<a href=\"https://books.google.com/books?id=XkKn96HThzEC&amp;pg=PA429&amp;dq=atrial+natriuretic+peptide&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwi45_mQt_zJAhVH7yYKHd6rAtUQ6AEINTAE#v=onepage&amp;q=atrial%20natriuretic%20peptide&amp;f=false\" rel=\"nofollow\">[4]</a>}, a peptide involved in regulating renal blood flow and sodium excretion</li>\n<li>Decrease in the synthesis of prostaglandin, lipids that in the kidney regulate blood flow and vasodilation^{<a href=\"https://books.google.com/books?id=-MaTY4EBoqUC&amp;pg=PR9&amp;dq=prostaglandin&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwintdSGuPzJAhUB5iYKHfEYCg0Q6AEIQDAF#v=onepage&amp;q=prostaglandin&amp;f=false\" rel=\"nofollow\">[5]</a>}</li>\n<li>Increase in vasopressor responsiveness (interestingly enough, this can be related to angiotensin II; see <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/6386579\" rel=\"nofollow\">Drury et al. (1984)</a>)</li>\n</ul>\n\n<p>Vasodilation refers to the size of the capillaries; dilation of the capillaries decreases blood pressure, while the reverse increases blood pressure. This is perhaps the most direct effect of corticosteroids on hypertension and blood pressure.</p>\n\n<p>Note: Here, the superscripts indicate secondary sources that explained the significances of these in more detail (which I included); the textbook merely listed them.</p>\n\n<hr>\n\n<p><strong>Additional sources cited:</strong></p>\n\n<p>^{[1]: <a href=\"https://books.google.com/books?id=otvv8dXuzP0C&amp;pg=PA166&amp;dq=filtration+fraction&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjZwcKZtPzJAhWMNSYKHePHDs0Q6AEIKDAC#v=onepage&amp;q=filtration%20fraction&amp;f=false\" rel=\"nofollow\">Costnazo, Linda. <em>Physiology: Cases and Problems</em></a>}\n<br>\n^{[2]: <a href=\"https://books.google.com/books?id=XHlBhXZAiQ4C&amp;pg=PA115&amp;dq=glomerular+hypertension&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjz2fjNtfzJAhUMTCYKHeHCBEAQ6AEIVDAH#v=onepage&amp;q=glomerular%20hypertension&amp;f=false\" rel=\"nofollow\">Juan Macías-Núñez et al. <em>The Aging Kidney in Health and Disease</em></a>}\n<br>\n^{[3]: <a href=\"http://www.ncbi.nlm.nih.gov/gene/183\" rel=\"nofollow\">AGT angiotensinogen (serpin peptidase inhibitor, clade A, member 8) [ Homo sapiens (human) ]</a>}\n<br>\n^{[4]: <a href=\"https://books.google.com/books?id=XkKn96HThzEC&amp;pg=PA429&amp;dq=atrial+natriuretic+peptide&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwi45_mQt_zJAhVH7yYKHd6rAtUQ6AEINTAE#v=onepage&amp;q=atrial%20natriuretic%20peptide&amp;f=false\" rel=\"nofollow\">Claudio Ronco et al. <em>Critical Care Nephorology</em></a>}\n<br>\n^{[5]: <a href=\"https://books.google.com/books?id=-MaTY4EBoqUC&amp;pg=PR9&amp;dq=prostaglandin&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwintdSGuPzJAhUB5iYKHfEYCg0Q6AEIQDAF#v=onepage&amp;q=prostaglandin&amp;f=false\" rel=\"nofollow\">Jasjit Bindra. <em>Prostaglandin Synthesis</em></a>}</p>\n", "score": 2 } ]

[ "side-effects", "blood-pressure", "steroids" ]

[ { "answer_id": 13474, "body": "<p>The Therapeutic Goods Administration (TGA) of Australia states that tolerance does develop upon repeated use 'Tolerance and dependence of the amfetamine type develop on repeated administration of \ndexamfetamine.' (1). This document only mentions tolerance in the general sense. </p>\n\n<p>One article on the use of amphetamine and its derivatives for Treatment Resistant Depression (TRD) note that its effect on psychomotor retardation does not attenuate over time. (2). However, they do note that tolerance does develop to its effects like 'hyperthermia, hypertonia, and anorexia' (2)</p>\n\n<p>In the same article, it is mentioned that other authors have observed declining efficacy over time (2).</p>\n\n<p>These are the most pertinent sources I could find on the question within humans. Animal studies seem to support the notion that tolerance does indeed develop (3).</p>\n\n<p>Considering that the TGA remarks on the tolerance phenomenon, and that there is evidence from other sources to support this notion, I'm inclined to suggest that tolerance does indeed develop with repeated use. </p>\n\n<p>References</p>\n\n<ol>\n<li><a href=\"https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2017-PI-01667-1\" rel=\"nofollow noreferrer\">https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2017-PI-01667-1</a></li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181580/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181580/</a></li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/1257363\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/1257363</a></li>\n</ol>\n", "score": 0 } ]

[ "medications", "adhd", "drug-tolerance", "effectiveness", "mood-moodiness" ]

[ { "answer_id": 4331, "body": "<p>The active ingredient in Ponstan is <a href=\"http://www.netdoctor.co.uk/medicines/aches-and-pains/a7366/ponstan-mefenamic-acid/\" rel=\"nofollow\">mefenamic acid</a>. It is categorized as a non-steroidal anti-inflammatory drug (NSAID). </p>\n\n<p>It works <a href=\"http://livertox.nih.gov/MefenamicAcid.htm\" rel=\"nofollow\">because it</a> </p>\n\n<blockquote>\n <p>is a cyclo-oxygenase (Cox-1 and -2) inhibitor and blocks the production of intracellular prostaglandins that are important in pain and inflammatory pathways. Mefenamic acid has analgesic as well as anti-pyretic and anti-inflammatory activities, but is used largely for treatment of pain. </p>\n</blockquote>\n\n<p>Basically, like a lot of painkillers, it inhibits the transmission of pain signaling. </p>\n\n<p>As for speed, how fast NSAIDs lead to less pain depends on a lot of things, including the severity of the pain or when the patient last ate, it can't really be generalized. A very fast relief might also be caused by <a href=\"http://www.sciencedaily.com/releases/2011/05/110523075010.htm\" rel=\"nofollow\">the placebo effect just by having taking medication.</a> </p>\n", "score": 3 } ]

[ "medications", "pain", "headache" ]

[ { "answer_id": 16920, "body": "<h2>Safety of Loperamide</h2>\n\n<p>Loperamide (<a href=\"https://beta.nhs.uk/medicines/loperamide\" rel=\"nofollow noreferrer\">anti-diarrhoea medication such as Dioraleze or Imodium</a>) is often the go-to treatment for diarrhoea. As the medication only acts on the digestive tract, there appears to be little risk associated with long-term or frequent use of Loperamide, and the medication is considered to be a <a href=\"https://www.verywellhealth.com/how-safe-is-imodium-1945154\" rel=\"nofollow noreferrer\">relatively safe, well-tolerated option for dealing with diarrhoea.</a></p>\n\n<p>There are precautions to be followed however, if you take them long term <strong>and/or suffer from inflammatory bowel disease (IBD)</strong>.</p>\n\n<p>A prescription is required for</p>\n\n<ul>\n<li>a child under 12 years old</li>\n<li>a child aged 12 to 17 years old with IBS or long lasting diarrhoea</li>\n<li>an adult aged 18 years and older with long lasting diarrhoea</li>\n</ul>\n\n<h2>Precautions</h2>\n\n<p><a href=\"https://beta.nhs.uk/medicines/loperamide\" rel=\"nofollow noreferrer\">Amongst other precautions</a>,</p>\n\n<ul>\n<li><p>Do not take any more Loperamide and drink plenty of water if you become <a href=\"https://www.nhs.uk/conditions/constipation\" rel=\"nofollow noreferrer\">constipated</a>. If you are told to take Loperamide long-term, wait for the constipation to go before taking more.</p></li>\n<li><p>Do not take more than the recommended amount. Too much loperamide can cause serious heart problems (including a fast or irregular heartbeat).</p></li>\n<li><p>You must never take Loperamide for more than 48 hours <a href=\"https://beta.nhs.uk/medicines/loperamide\" rel=\"nofollow noreferrer\">without seeking advice from your doctor or gastroenterologist.</a></p></li>\n<li><p>Seek medical advice if you have blood in your poo and/or a temperature (more than 38&deg;C).</p></li>\n</ul>\n\n<h2>People who suffer from IBD</h2>\n\n<p><strong><a href=\"http://patients.gi.org/topics/inflammatory-bowel-disease/#tabs2\" rel=\"nofollow noreferrer\">This is different to IBS</a></strong></p>\n\n<p>You should not take Loperamide without permission from your doctor. The use of anti-diarrhea medications such as Imodium places IBD patients at risk for the development of <a href=\"http://aia5.adam.com/content.aspx?productId=117&amp;pid=1&amp;gid=000248\" rel=\"nofollow noreferrer\">toxic megacolon</a>, a potentially life-threatening disorder.</p>\n\n<h2>Sources</h2>\n\n<p><a href=\"http://aia5.adam.com/content.aspx?productId=117&amp;pid=1&amp;gid=000248\" rel=\"nofollow noreferrer\">A.D.A.M.: \"Toxic Megacolon.\"</a></p>\n\n<p><a href=\"http://patients.gi.org/topics/inflammatory-bowel-disease/#tabs2\" rel=\"nofollow noreferrer\">American College of Gastroenterology : \"IBD.\"</a></p>\n\n<p><a href=\"https://beta.nhs.uk/medicines/loperamide\" rel=\"nofollow noreferrer\">NHS : \"Imodium (Loperamide)</a>\"</p>\n\n<p><a href=\"https://www.verywellhealth.com/how-safe-is-imodium-1945154\" rel=\"nofollow noreferrer\">VeryWell Health: \"Imodium (Loperamide)\"</a></p>\n", "score": 2 } ]

[ "lasting-effects-duration", "irritable-bowel-syndrome", "diarrhea", "otc-over-the-counter" ]

[ { "answer_id": 4307, "body": "<p>The pictures you posted are simply light microscopy of tissue (and prepared quite well). For a source, just look at the illustrations to Wikipedia's <a href=\"https://en.wikipedia.org/wiki/Histopathology\">histopathology</a> article and see for yourself what this type of picture looks like. Even if you could get a non-invasive imaging from a patient with that resolution (and I don't know of any which can do that, not even a 7 Tesla MRI), it won't look similar enough to be compared to the pictures from your post.</p>\n\n<p>You'd need a biopsy of the tendon to get these images, and given how slow tendons are in healing, and that we are presumably dealing with an already damaged tendon, punching a piece out of it just to take a look is probably not a good clinical decision. Also, I don't know how easy or hard it is to get the tissue prepared in this quality in medical practice, I have seen such slides mostly in the context of research biology. </p>\n\n<p>To make the answer complete: There are <a href=\"http://www3.mpibpc.mpg.de/groups/hell/STED.htm\">light microscope types</a> which can be used in vivo, but they are certainly not yet ready for commercial use, not even in reasearch, much less in a clinical setting. And again, you're not really getting the same type of picture with them. So they are not a practical solution for what you want. </p>\n", "score": 5 } ]

[ "tendinopathy", "medical-imaging" ]

[ { "answer_id": 4377, "body": "<p>Yes, <em>E. coli</em> is definitely contagious through direct contact. In fact your girlfriend's <a href=\"https://en.m.wikipedia.org/wiki/Pyelonephritis\" rel=\"nofollow\">pyelonephritis</a> could have come from you after sexual intercourse.</p>\n\n<p>The general mechanism for this would be that you had the pathogenic <em>E. coli</em> on your penis, and then it traveled up her urethra to the kidney. This is why there is a recommendation for women to <a href=\"http://www.urologyhealth.org/urologic-conditions/kidney-(renal)-infection-pyelonephritis\" rel=\"nofollow\">urinate after sex</a>. That very same <em>E. coli</em> on your penis is unlikely to cause you an infection.</p>\n\n<p>Note that <em>E. coli</em> is common in the GI tract, and not uncommonly found on the skin. Not all strains are pathogenic and most aren't within the GI tract. Having a conversation as a couple with a health provider is a very good idea.</p>\n\n<p>There is a lot of hygiene that everyone sexually active should consider, but is unfortunately not taught.</p>\n", "score": 4 } ]

[ "infection", "disease-transmission", "infectious-diseases", "kidney", "e-coli" ]

[ { "answer_id": 4445, "body": "<p>The easy answer is that skin turns over, and rather quickly at that. Specialized skin cells called melanocytes impart more or less melanin (through granules called melanosomes) to keratinocytes; these cells then are what give you a tan. The keratinocytes undergo constant turnover, so are eventually shed, and in the absence of continued exposure to UV radiation, there is no need to keep producing melanin-heavy keratinocytes. (It's a bit more complicated, but that's the basic idea.) </p>\n\n<p><a href=\"https://i.stack.imgur.com/H6jJW.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/H6jJW.jpg\" alt=\"enter image description here\"></a></p>\n\n<blockquote>\n <p>The keratins and proteins within the stratum corneum act mainly by scattering and absorbing the UV. UV-R sets in action an integrated mechanism for the formation and delivery of melanin within melanosomes from melanocytes to keratinocytes. This mechanism is probably triggered by keratinocytes, which respond to UV-R with bursts of mitoses and with increased production of ET-1 and POMC, thus creating a new demand for melanosomes. The mitotic rate of basal keratinocytes increases a day after UV exposure, reaches a maximum 2 days later, and maintains this level for ∼1 wk. It then declines, and the skin regains its original thickness after 1–2 months if there has been no subsequent exposure.</p>\n</blockquote>\n\n<p>In other words, for a light-skinned individual, light skin is normal, healthy, and appropriate. A tan represents response to a level of damage. When the damage ceases, the skin stops producing the unnecessary cells and the unnecessary pigmentation.</p>\n\n<blockquote>\n <p>Is there is any medical disadvantage of a high melanin level during periods of reduced sun exposure[?]</p>\n</blockquote>\n\n<p>Yes. Darker skin is less conducive to production of Vitamin D. This is why Southern Asians living in northern European cities are more prone to Vitamin D deficiency.</p>\n\n<p>Also, when exposed to UV radiation, melanin can itself become somewhat toxic to cells, the photosensitization generating superoxide radicals which can injure individual cells. So the risk having melanin must be outweighed by the protective effect of melanin against UV light. It's a delicate balance. </p>\n\n<p>Continued exposure to UV light stimulates the melanocytes to grow. This increases the chance of the development of melanomas. Since skin cells containing melanin are shed (there's no getting around that), in light-skinned individuals, keeping a tan is to keep injuring the skin and risking carcinogenesis.</p>\n\n<p>_{<a href=\"http://physrev.physiology.org/content/84/4/1155\" rel=\"nofollow noreferrer\">Melanin Pigmentation in Mammalian Skin and Its Hormonal Regulation</a>}<br>\n_{<a href=\"http://www.fasebj.org/content/21/4/976.full\" rel=\"nofollow noreferrer\">Human skin pigmentation: melanocytes modulate skin color in response to stress</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564815/\" rel=\"nofollow noreferrer\">Mechanism of UV-related carcinogenesis and its contribution to nevi/melanoma</a>} </p>\n", "score": 2 } ]

[ "dermatology" ]

[ { "answer_id": 4431, "body": "<p>Calcium-rich food interferes with absorption of tetracycline considerably:</p>\n\n<blockquote>\n <p>Milk and other dairy products, antacids containing polyvalent cations, as well as various iron salts ingested simultaneously with tetracycline derivatives, might interfere with their absorption by <strong>50 to 90% or even more</strong>. </p>\n</blockquote>\n\n<p><a href=\"http://link.springer.com/article/10.2165/00003495-197611010-00004\" rel=\"nofollow\">Interactions with the Absorption of Tetracyclines</a></p>\n\n<p>However, you can't <em>calculate</em> with that, by for example just taking twice the dosage. The safe method is to not ingest milk or any other calcium-rich food together with the tetracycline. The recommendation appears to be to <a href=\"http://www.mayoclinic.org/drugs-supplements/tetracycline-class-oral-route-parenteral-route/proper-use/drg-20069585\" rel=\"nofollow\">leave one to two hours between the antibiotics and milk</a> (taking the antibiotics first) :</p>\n\n<blockquote>\n <p>Do not take milk, milk formulas, or other dairy products within 1 to 2 hours of the time you take tetracyclines (except doxycycline and minocycline) by mouth</p>\n</blockquote>\n\n<p>The study referenced above recommends an even more cautious three hours. </p>\n", "score": 3 } ]

[ "medications", "antibiotics" ]

[ { "answer_id": 4528, "body": "<p>To provide a brief answer, as I think a sufficient answer would be far beyond the scope of this site, the symptoms that are \"generic\" to the common colds are all caused by the body's response to a pathogen (it's why they are generic). Specific pathogens tend to cause additional symptoms on top of that, some of which seem to be directly related to viral damage.</p>\n\n<hr>\n\n<p>First, I want to point out to a very nice <a href=\"http://www.cmu.edu/common-cold-project/how-to-use-this-website/index.html\" rel=\"nofollow noreferrer\">website/data set</a> from the <strong>Common Cold Project</strong> (CCP). The <a href=\"http://www.cmu.edu/common-cold-project/publications/index.html\" rel=\"nofollow noreferrer\">publications</a> from the comprising trails is a good repository for information on the common cold. </p>\n\n<p>*It should be noted that there were a few experimental design problems that they were unable to avoid (for a combination of cost and lack of knowledge). It turned out the the <a href=\"https://en.wikipedia.org/wiki/Respiratory_syncytial_virus\" rel=\"nofollow noreferrer\">RSV</a> challenge strain used in the British study was not a very <a href=\"http://www.tulane.edu/~wiser/protozoology/notes/Path.html\" rel=\"nofollow noreferrer\">pathogenic</a> strain. Further, as it has <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271186/?page=7\" rel=\"nofollow noreferrer\">delayed onset</a> of symptoms meant that it wasn't well studied with in the time frame of the trial. That said, it provides a good deal of details on <a href=\"https://en.wikipedia.org/wiki/Rhinovirus\" rel=\"nofollow noreferrer\">HRV</a>, and the \"common cold\" more generally.</p>\n\n<hr>\n\n<h2>What are the common symptoms of the common cold?</h2>\n\n<p>This might seem like a more obvious question, but it's what must be answered first before the broader question of what is being caused by the virus is addressed.</p>\n\n<p>One of the better lists of symptoms comes from the first <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2271186/\" rel=\"nofollow noreferrer\">British study</a> mentioned in the CCP:</p>\n\n<ol>\n<li>Cough</li>\n<li>Hoarseness</li>\n<li>Sore throat</li>\n<li>Nasal obstruction</li>\n<li>Sneezing</li>\n<li>Increased tissue usage</li>\n<li>Nasal stuffiness</li>\n<li>Sinus Pain</li>\n<li>Post-nasal discharge</li>\n<li><a href=\"http://www.uofmmedicalcenter.org/HealthLibrary/Article/511842EN\" rel=\"nofollow noreferrer\">Cervical adenitis</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Sputum\" rel=\"nofollow noreferrer\">Sputum</a></li>\n<li>Chills</li>\n<li>Extra bed rest</li>\n<li>Watering Eyes</li>\n<li>Headache</li>\n<li>Malaise</li>\n<li>Myalgia [muscle pain]</li>\n<li><a href=\"https://en.wikipedia.org/wiki/Mucopurulent_discharge\" rel=\"nofollow noreferrer\">Mucopurulent discharge</a></li>\n<li>Temperature increase in the day</li>\n<li>Temperature increase at night</li>\n</ol>\n\n<p>[Table 3, ibid]</p>\n\n<p>Not a single one of these is actually caused \"directly\" by the virus, but it kind of get's back to what can the virus do? Viruses are very small obligate parasites that rely on changing host systems to replicate and spread their genetic material.</p>\n\n<p>If we take a look at the snotty, cough, and sneezy symptoms (cough, bronchoconstriction and airway mucus secretion), they are all \"<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11240151\" rel=\"nofollow noreferrer\">caused</a>\" by <a href=\"https://en.wikipedia.org/wiki/Mechanoreceptor#By_rate_of_adaptation\" rel=\"nofollow noreferrer\">rapidly adapting receptors</a> (RARs) along the airway. That is to say, the damage the viruses do actually cause to cells along the airway is detected by RARs either through the cell debris, chemical signaling (indirect activation from other cells), or direct interaction of immune cells.</p>\n\n<p>If we look at a runny and stuffed up nose (rhinorrhea and nasal obstruction) specifically, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378761/\" rel=\"nofollow noreferrer\">we know</a> that <a href=\"https://en.wikipedia.org/wiki/Neutrophil_granulocyte\" rel=\"nofollow noreferrer\">neutrophils</a> are coming to the sinuses and inducing inflammation and mucus over production.</p>\n\n<h2>What do the viruses actually do then?</h2>\n\n<p>This is where the question gets very broad very quickly. I will deal with three viruses as examples: HRV, RSV, and influenza. Some of the best sentinel data on colds, at least <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750056/\" rel=\"nofollow noreferrer\">colds severe enough</a> to seek medical treatment, has been coming from China. The two leading candidates from <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22321179\" rel=\"nofollow noreferrer\">these studies</a> are HRV and RSV (also true in US, see a related <a href=\"https://biology.stackexchange.com/questions/21507/why-dont-we-develop-immunity-against-common-cold/21802#21802\">SE.BIO awnser</a> of mine). I want add in flu because it has some other interesting traits.</p>\n\n<p>Both HRV and RSV often are <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22321179\" rel=\"nofollow noreferrer\">found with co-infection</a> of other viruses or bacteria, but RSV is more likely to have this problem [ibid]. While \"drained\" resources while fighting the common infection might be a partial explanation for this, <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26557722\" rel=\"nofollow noreferrer\">we know</a> that RSV produces two proteins, NS1 and NS2, which directly inhibit the innate immune system. This could explain the high rate of co-infection with RSV. Which leads me to the first general thing that viruses do, directly counter the immune system of a host.</p>\n\n<p>Another <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/2158258\" rel=\"nofollow noreferrer\">comparison</a> would be what kind of direct cell damage (<a href=\"https://en.wikipedia.org/wiki/Cytopathology\" rel=\"nofollow noreferrer\">cytopathology</a>) the virus might do. <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/17557802\" rel=\"nofollow noreferrer\">RSV</a> and <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/2158258\" rel=\"nofollow noreferrer\">flu</a> tends to destroy the airway epithelial barrier by infecting and killing the epithelial cells (this sets of the RARs). HRV on the other hand, doesn't often kill the cells off, but just disrupts their function [ibid]. Thus the second general thing viruses do is \"kill\" or \"disrupt\" the cells they infect.</p>\n\n<p>The final action of a virus I want to look at goes back to a symptom that is on our list, myalgia. Of our three viruses, this is most closely associated with flu. Though the exact mechanisms may vary, it is <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24530048\" rel=\"nofollow noreferrer\">believed</a> to be caused <a href=\"https://en.wikipedia.org/wiki/Cytokine\" rel=\"nofollow noreferrer\">cytokine</a> release.</p>\n\n<p>Here's a good example where answering the question of what is \"caused\" by the virus is tricky. Some influenza strains produce proteins where a main function seems to be inducing cytokines. This can lead to all kinds of bad things like a <a href=\"https://en.wikipedia.org/wiki/Cytokine_storm\" rel=\"nofollow noreferrer\">cytokine storm</a>. But flu also needs to cause an up regulation of <a href=\"https://en.wikipedia.org/wiki/Trypsin\" rel=\"nofollow noreferrer\">trypsin</a> to help process it's proteins. This might be done indirectly through a cytokine or directly from a viral protein. Either way the trypsin can remain in the tissue causing damage to host proteins after the virus has moved on (been cleared). So would we say this was tissue damage caused by the virus? It wasn't an immune response in the normal sense, and it was started by the virus, but then again the trypsin is not a viral protein.</p>\n\n<p>That leads to my final overly generic statement about viruses, they activate complicated pathways with all kinds of incidental downstream consequences (normally bad). Imagine if someone was in front of a power breaker box randomly turning off and on switches. If the food was spoiled in the refrigerator would you say it was because the refrigerator wasn't on, or because somebody pulled the fuse out?</p>\n", "score": 8 } ]

[ "infection", "immune-system", "symptoms", "disease", "virus" ]

[ { "answer_id": 11395, "body": "<p>There's no established lower or upper intake level, but there's data showing that the average human body contains around 3ppb of gold, mostly in the form of nanoparticles.</p>\n\n<p>Here's a long review of the academic literature on medical uses of gold nanoparticles: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3347577/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3347577/</a></p>\n\n<p>In particular, it has a lot of effects on the immune system and it has been used as an adjuvant.</p>\n", "score": 1 } ]

[ "diet", "metabolism" ]

[ { "answer_id": 11463, "body": "<p>\"The closest thing the Google Gods suggest is allopecia, but I don't think allopecia does this\"...</p>\n\n<p>YES! Alopecia does do this!<br>\nAlopcia affects more than the hair on your head. It can manifest itself on other parts of your body where hair grows..including legs, arms and private areas. You say you don't want to see a doctor, but this may be a reason to see one.\nYou may want to check out the National Alopecia Areata Foundation website (<a href=\"http://www.naaf.org\" rel=\"nofollow noreferrer\">http://www.naaf.org</a>) for more information.\nGood luck to you.</p>\n", "score": 1 } ]

[ "hairloss" ]

[ { "answer_id": 4932, "body": "<h2>What causes these stretch marks?</h2>\n\n<p>Stretch marks (striae) are caused by intradermal tears, that means tears that occur within the skin layers. These tears are caused when two things happen at the same time.</p>\n\n<ol>\n<li><p>The skin is stretching at a high rate. This happens when you gain weight rapidly, are pregnant, or are otherwise undergoing changes in body shape - as happens during the adolescent and teenage years.</p></li>\n<li><p>There's not enough new collagen being synthesized in the skin to accommodate that stretching.</p></li>\n</ol>\n\n<h2>Is it common to get them at a young age?</h2>\n\n<p>Yes - in this case meaning adolescent and teenage years. The reasons are twofold:</p>\n\n<p>First, these are years when your body is undergoing changes in shape and composition. The skin has to stretch to accommodate these changes.</p>\n\n<p>Second, something we haven't discussed yet is the effect of cortisol on collagen synthesis. Cortisone is a steroid hormone produced by the adrenal gland in response to stress among other things. It's been shown to inhibit collagen synthesis, effectively making the skin (and cartilage in the joints) less stretchy.</p>\n\n<h2>Are they more common in some people than others (besides what was mentioned above?)</h2>\n\n<p>People with increased adrenal cortical activity, such as teenagers and those with Cushing's disease.</p>\n\n<h3>References</h3>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/294092\" rel=\"noreferrer\">\"The cause of striae distensae\"</a></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/196590\" rel=\"noreferrer\">\"Effects of cortisol acetate on collagen biosynthesis...\"</a></p>\n", "score": 5 } ]

[ "dermatology", "scar-tissue-scars", "age", "blemishes", "stretch-marks-striae" ]

[ { "answer_id": 4695, "body": "<p>The overdose range of sertraline varies between individual to individual. For instance, in Reference 1, it is reported that an ingestion 13,500 mg did not result in a fatality. Another individual was not so fortunate. He died after taking 2,500 mg.</p>\n\n<p>Long term effects do not appear to be common with SSRI overdosage (let alone sertraline). It would stand to reason that papers concerning sertraline overdosage would note any untoward long-term effects due to overdosage (References 2 and 3). However, Reference 4 does mention that \"The incidence of seizures was 1.9% and coma was 2.4%\" with SSRI medication. </p>\n\n<p><strong>References</strong></p>\n\n<ol>\n<li>OVERDOSE, HUMAN EXPERIENCE, <a href=\"http://www.rxlist.com/zoloft-drug/overdosage-contraindications.htm\" rel=\"nofollow\">http://www.rxlist.com/zoloft-drug/overdosage-contraindications.htm</a> (Unsure of this source. Could not find references)</li>\n<li><p>Suicidality and Suicide Attempt in a Young Female on Long-Term Sertraline Treatment, <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662142/\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662142/</a></p></li>\n<li><p>Sertraline overdose, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8808373\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/8808373</a></p></li>\n<li>Relative toxicity of selective serotonin reuptake inhibitors (SSRIs) in overdose, <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/15362595\" rel=\"nofollow\">https://www.ncbi.nlm.nih.gov/pubmed/15362595</a></li>\n</ol>\n", "score": 3 } ]

[ "medications", "mental-health", "overdose", "side-effects" ]

[ { "answer_id": 13197, "body": "<p>It is generally considered that less than 50kcal is acceptable during periods of fasting. This obviously doesn't mean 10 50kcal in quick succession is acceptable (that is considered a 500kcal meal). I personally would not be held-up on the fact.</p>\n\n<p>In terms of calcium and vitamin supplementation it is generally advised that they are consumed with a meal. <a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/calcium-supplements/faq-20058238\" rel=\"nofollow noreferrer\">In particular calcium carbonate should be consumed with a meal</a>. The first meal of the day after you break the fast, is indeed by definition 'breakfast'.</p>\n\n<p><strong>So either take your supplements but very little else until you break the fast, or take them with your first meal.</strong></p>\n\n<p>In response to the comment on ketosis; that is something very different again. While in a fasted state it is unlikely you are also in a ketogenic state. Ketogenic diets are high protein, higher-fat diets with little carbohydrate — unless you ate very little carbohydrate during feeding you would not be in a state of ketosis.</p>\n\n<p>In conclusion:</p>\n\n<ul>\n<li>Take calcium with a meal</li>\n<li>Very small amounts of food/supplementation (less than 50kcal) during a fast is unlikely to bring you into a 'fed state'</li>\n<li>IF is not a Ketogenic diet</li>\n</ul>\n\n<p>From (albeit anecdotal) personal experience focus on consistency and building healthy habits rather than getting hung-up on the details.</p>\n", "score": 4 } ]

[ "frequency", "fad-diet", "fasting" ]

[ { "answer_id": 4662, "body": "<p>It's actually the other way around. Oil coming from your pores causes dead skin cells to clump together, blocking the pore. Acne is a blocked or infected pore.</p>\n\n<p>When your skin is oily, the oil actually comes from pores that are not clogged. So the oil you feel when you touch your pimple (which BTW is a bad idea) is probably coming from surrounding pores .</p>\n\n<p>Reference:<a href=\"https://www.aad.org/public/diseases/acne-and-rosacea/acne\">American Academy of Dermatology</a></p>\n\n<p>As for treatment, you can try over the counter acne products. If those don't work or your acne is severe, see a dermatologist. </p>\n", "score": 11 }, { "answer_id": 4664, "body": "<p><a href=\"https://health.stackexchange.com/a/4662/2848\">Robin</a> got it right, any extra oil, grease, dirt, or other foreign matter will aggravate pimples. I had a moderate acne problem through most of my teenage years, and here are some things I learned:</p>\n\n<ol>\n<li><p>Keep affected areas, especially face, as clean as possible. Do this by:</p>\n\n<p>a. scrubbing them well with soap daily; and</p>\n\n<p>b. thoroughly cleansing with rubbing alcohol subsequent to soapy scrub. </p></li>\n<li><p>Avoid rubbing affected areas throughout the day; the oils and trace soils from your hands may seem negligible, but they contribute a great deal to the problem. </p></li>\n<li><p>Warm pimples pop best (what? Do you think this is gross? Well, it's not, it's life.). Right after showers are the perfect time, and be sure to follow up with rubbing alcohol. </p></li>\n</ol>\n\n<p>The rubbing alcohol helps prevent new pimples and gets rid of some small ones, but doesn't touch the big ones. I tried Acne-Free Severe for a while, and although it worked fine, it irritated my skin, which would get dry, itchy, and sometimes experienced a sensation approaching tingling. I hardly used it after a while because of that. Believing that the treatment was too severe, I tried Neutrogena Daily Scrub, along with their On the Spot treatment. It worked well for me without the dryness. </p>\n\n<p>Edit: As I have mentioned, cleanliness seems to affect acne a great deal, and triggers eruptions, but it should be understood that the dirt is not what <em>causes</em> acne . I highly recommend reading the page at <a href=\"http://www.sciencedaily.com/releases/2014/07/140717124728.htm\" rel=\"nofollow noreferrer\">this link</a>. Among other things, it states that acne isn't caused by dirt, and gives a professional assessment of a few related factors, as well as mentioning some possible courses of treatment. For severe cases, even some antibiotics can be prescribed by physicians. (But if it's not absolutely necessary, this course of treatment should be avoided, of course. :) </p>\n\n<p>Also see <a href=\"http://www.news-medical.net/health/Acne-Causes.aspx\" rel=\"nofollow noreferrer\">this page</a>, from which I quote, \"Acne is not caused by lack of cleanliness. Although not cleaning the affected or prone areas leads to accumulation of sebum and dirt in susceptible persons raising risk of acne.\" (Sebum and dirt cause pore blockage, resulting in acne breakouts.) </p>\n\n<p>Also see <a href=\"http://www.everydayhealth.com/acne/bad-skin-habits.aspx\" rel=\"nofollow noreferrer\">this page</a>. Some of the content seems to contradict other sources, specifically, claiming that fatty foods make acne worse. While other sources refute this idea, this page points out the increased likelihood that your skin will become greasy from contact with such foods. (I would note that other health effects of avoiding fats are somewhat controversial, but since this is well beyond the realm of this discussion, I'll spare you from my viewpoint on the subject this time.) </p>\n", "score": 6 } ]

[ "acne", "face", "oil-of-skin", "pimple" ]

[ { "answer_id": 4768, "body": "<p>The short answer is no, your metabolism isn't really driven by your heart rate. </p>\n\n<p>The <a href=\"http://www.britannica.com/science/metabolism\">basic definition of metabolism</a> is that it is the process by which your body converts the food and liquid that you consume into energy to fuel the body. This can be generally divided into two components, <em>catabolism</em>, which is the breaking down of ingested items into energy, and <em>anabolism</em>, which is the building up of cells with proteins and nucleic acids. The link I provided gives a basic definition and a basic writeup relating metabolism to weight loss.</p>\n\n<p>The heart has a role in this, in that it delivers oxygen to the body which is used in metabolic processes, but part of <a href=\"http://www.cdc.gov/nccdphp/sgr/pdf/chap3.pdf\">the adaptation to exercise</a> is that the cardiovascular system gets more efficient at delivering oxygen where and when needed. This is (in part) why your heart rate slows as you get fit. These adaptations include neovascularization (more capillaries/blood vessels grow into working muscles), stronger pumping action, and ventricular enlargement so the heart can pump more blood per beat. Oxygen delivery remains stable and adapts to deliver what is needed according to activity.</p>\n\n<p>Your most likely culprit for the weight gain is that you are exchanging muscle for fat. Muscle is denser and weighs more than fat does, so if you lose a proportion of fat and replace it with an equal proportion of muscle, you will weigh more at the end of that process.</p>\n", "score": 5 } ]

[ "exercise", "weight", "body-fat", "weight-loss" ]

[ { "answer_id": 10713, "body": "<p>Superficially, yes, that sounds like fairly poor sleep. Don't loose hope entirely, though - in general, when people say \"I never fell asleep all night\" or \"I kept waking up in the middle of the night\", but are observed while sleeping, many still do have periods of uninterrupted sleep that they don't remember.</p>\n\n<p>So, nights like you describe sound like you are getting poor sleep, but chances are you're getting <em>some</em> sleep.</p>\n\n<p>Still, it sounds rough! I'm sorry this is an issue you deal with.</p>\n", "score": 1 } ]

[ "sleep" ]

[ { "answer_id": 4789, "body": "<p>First you should know more than <strong>75 percent of the sodium</strong> in the average American diet <strong>comes from salt</strong> added to processed foods (based on <a href=\"http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/About-Sodium-Salt_UCM_463416_Article.jsp#.Vr3olSB95hE\" rel=\"nofollow\">American heart association)</a> <strong>other impotent food ingredient</strong> with sodium are monosodium glutamate (MSG), sodium nitrite, sodium saccharin, baking soda (sodium bicarbonate), and sodium benzoate and etc <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/002415.htm\" rel=\"nofollow\">(1)</a> ... which added for different purposes like perservant and flavorant. of course sodium exist in foods naturally (vegetable,grain,fruit,meat and etc..) as one of the most important biological Ion we need sodium as an critical nutrition in every day diet(1.2 to 1.5 gram ) of course most of us consume more than adequate need in our diet (about average 3.4 gram in USA) <a href=\"http://iom.nationalacademies.org/Reports/2004/Dietary-Reference-Intakes-Water-Potassium-Sodium-Chloride-and-Sulfate.aspx\" rel=\"nofollow\">(2)</a><a href=\"http://www.medicinenet.com/electrolytes/article.htm#sodium\" rel=\"nofollow\">(3)</a> </p>\n\n<p><strong>Sodium plays many roles in our foods</strong> (based on <a href=\"http://www.cdc.gov/salt/pdfs/role_of_sodium.pdf\" rel=\"nofollow\">Centers for Disease Control and Prevention</a> ):</p>\n\n<p>1- <strong>Mainly To Enhance Flavor</strong> (Adds a salty taste,Boosts flavor balance and can enhance the sweetness of sugary items, Masks “off notes,”such as bitterness and strange tastes, that can result from food processing, Makes some types of processed foods more palatable)</p>\n\n<p>2- <strong>To Preserve Freshness</strong> (Increases shelf life, Helps prevent growth of bacteria and other disease-causing agents)</p>\n\n<p>3- <strong>To Improve Texture and Appearance</strong> (Makes the product seem thicker or fuller\n,Enhances color and hue, Helps retain moisture in processed meat products\nas a trade-off for saturated fat,Stabilizes texture, allowing bread to rise and cheese to stick together ,Prevents unwanted chemical changes to other ingredients in many baked items) <a href=\"http://foodreference.about.com/od/Ingredients_Basics/a/Functions-Of-Salt-In-Food.htm\" rel=\"nofollow\">(4)</a></p>\n\n<p><strong>Top Sources of Sodium</strong></p>\n\n<p>Breads and rolls ,Cold cuts and cured meats , Pizza ,Poultry, Soups, Sandwiches, Cheese, Pasta dishes, Meat dishes, Snacks.<a href=\"http://www.cdc.gov/salt/sources.htm\" rel=\"nofollow\">(5)</a></p>\n\n<p>For more information checkout <a href=\"http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/About-Sodium-Salt_UCM_463416_Article.jsp#.Vr3olSB95hE\" rel=\"nofollow\">American heart association</a> , <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/002415.htm\" rel=\"nofollow\">Medlineplus</a>. </p>\n", "score": 2 } ]

[ "nutrition" ]

[ { "answer_id": 15367, "body": "<p><strong>Yes, unfortunately, Ritalin produces a tolerance in individuals who take it.</strong></p>\n\n<p>In the conclusion of this double blind trial, the author notes, </p>\n\n<blockquote>\n <p><strong>Acute tolerance to methylphenidate appears to exist.</strong> This should be\n considered in the design of an optimal dosing regimen for the\n treatment of children with attention deficit hyperactivity disorder.</p>\n</blockquote>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/10511066\" rel=\"nofollow noreferrer\">Acute tolerance to methylphenidate in the treatment of attention deficit hyperactivity disorder in children.</a></p>\n\n<p><strong>Addendum:</strong></p>\n\n<p>This might be a useful reference for ADHD in general:\n<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22420012\" rel=\"nofollow noreferrer\">Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults.</a></p>\n", "score": 3 } ]

[ "medications", "insomnia", "stimulants", "add-adhd", "drug-tolerance" ]

[ { "answer_id": 8898, "body": "<blockquote>\n <p>Bagot, K. S. and Kaminer, Y. (2014), Efficacy of stimulants for cognitive enhancement in non-attention deficit hyperactivity disorder youth: a systematic review. Addiction, 109: 547–557. doi:10.1111/add.12460</p>\n</blockquote>\n\n<p>Briefly glanced at this study today</p>\n\n<p>Short answer is: Generally yes, most youth studied showed an increase in performance in measured tasks during this study.</p>\n\n<p>Longer answer: This is a review of current literature, not an individual study. It only reviewed 14 studies most of which had fairly small population sizes. Many of the studies focused on different medications/dosages and assessed performance in different ways. There's no easy way to assess total mental \"improvement\" with these medications; you have to have certain tasks that you can quantify. So while these medications may help in some areas (reaction time, logical reasoning, attention based tasks) they might not provide any benefit in others (critical thinking, articulating thoughts, imagination). </p>\n\n<p>So, to me, it depends on the person and the task, not just medication vs no medication.</p>\n", "score": 4 } ]

[ "medications" ]

[ { "answer_id": 15402, "body": "<p>Head sweating and flushing after eating or just smelling or thinking about a certain food is called <strong>gustatory sweating.</strong></p>\n\n<p><a href=\"https://www.medicinenet.com/script/main/art.asp?articlekey=9270\" rel=\"nofollow noreferrer\">MedicineNet</a>:</p>\n\n<blockquote>\n <p>Gustatory sweating: Sweating on the forehead, face, scalp, and neck\n occurring soon after ingesting food. Some gustatory sweating is normal\n after eating hot, spicy foods. Otherwise, gustatory sweating is most\n commonly a result of damage to a nerve that goes to the parotid gland,\n the large salivary gland in the cheek. In this setting, referred to as\n <strong>Frey syndrome,</strong> the sweating is usually <em>on one side</em> of the head.\n Gustatory sweating is also a rare complication of diabetes mellitus.\n In this case sweating may occur on both sides of the head, with mild\n or substantial severity.</p>\n</blockquote>\n\n<p><a href=\"https://www.medicalnewstoday.com/articles/320734.php\" rel=\"nofollow noreferrer\">Medical News Today</a> has an easy to read article about Frey syndrome and other types of gustatory sweating. The main point is that the nerve that supplies the parotid gland is affected in some way: congenitally, by trauma, surgery, tumor, etc.</p>\n\n<p>There are several reports about such sweating triggered by sour foods, orange juice, tomatoes, onions, candies, various snacks...(<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/9532317\" rel=\"nofollow noreferrer\">PubMed</a>) and there are several articles about Frey syndrome.</p>\n\n<p>A doctor can make a diagnosis of Frey syndrome by performing a simple iodine-starch test.</p>\n\n<p>Treatment is by removal of an underlying cause, but often no cause can be identified.</p>\n\n<p><strong>Food allergy</strong> or <strong>intolerance to histamine</strong> can cause head sweating, usually associated with itching around the mouth and in the throat (<a href=\"https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/food-allergy-and-intolerance\" rel=\"nofollow noreferrer\">Better Health Channel</a>).</p>\n", "score": 3 } ]

[ "fruits", "acidic", "drinks", "sweat" ]

[ { "answer_id": 4878, "body": "<p>It means that the receptors are blocked forever. A cell is a living thing, continuously producing new proteins (including receptors) and recycling old ones. So the cell is not defective forever, it will slowly phase out its blocked receptors and replace them with new ones. </p>\n\n<p>You can read the basics of the way receptors work in textbooks on cell signalling, such as <a href=\"http://rads.stackoverflow.com/amzn/click/0815342152\" rel=\"noreferrer\">http://www.amazon.com/Cellular-Signal-Processing-Introduction-Transduction/dp/0815342152/</a>. A topic of special interest would be ubiquitination, <a href=\"https://en.wikipedia.org/wiki/Ubiquitin#Ubiquitination\" rel=\"noreferrer\">https://en.wikipedia.org/wiki/Ubiquitin#Ubiquitination</a>. </p>\n", "score": 5 }, { "answer_id": 4890, "body": "<p>I’ve found a quotation that sheds some light on the topic:</p>\n\n<blockquote>\n <p>The rate of termination of the action of a reversible<br>\n antagonist is largely dependent on the half-life of the<br>\n drug as well as the rate at which it dissociates from its<br>\n receptor: the shorter the half-life, the less time it takes<br>\n until the effects of the drug are dissipated. However, the<br>\n effects of an irreversible antagonist may persist long after<br>\n the drug has been cleared from the plasma. In the case of<br>\n phenoxybenzamine, <strong>the restoration of tissue responsive-<br>\n ness after extensive α-receptor blockade is dependent on<br>\n synthesis of new receptors, which may take several days</strong>.</p>\n</blockquote>\n\n<p><em>(Peter D. Bryson: Comprehensive Reviews in Toxicology: For Emergency Clinicians)</em></p>\n", "score": 1 } ]

[ "allergy", "antihistamines", "half-life" ]

[ { "answer_id": 15366, "body": "<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777265/\" rel=\"nofollow noreferrer\">According to this case report</a>, </p>\n\n<blockquote>\n <p>Testing should be considered if the patient is not meeting goals of\n rehabilitation, because <strong>altered taste perception may lead to\n depression, weight loss, and malnutrition</strong>, all of which may act to\n confound rehabilitation efforts.</p>\n</blockquote>\n\n<p>I could not find research about directly re-stimulating the taste buds, but at the very least, supporting the person emotionally and helping them reach nutritional goals should contribute to the rehabilitation efforts by their own body. </p>\n\n<p>It seems that recovery is slow, but possible.</p>\n\n<blockquote>\n <p>... by 9 months post stroke [she] had identified several foods that she could\n taste and enjoy. She found that tomato sauce with pasta or beef dishes\n were the most palatable, and she replaced coffee with tea. <strong>She noted\n that sweet foods and sugar tasted as expected, and she was able to\n enjoy chocolate.</strong> One year following the stroke, she continued to\n perceive the taste of chicken and potatoes as “sawdust.”</p>\n</blockquote>\n\n<p>Best wishes to anyone recovering from a stroke and their families.</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777265/\" rel=\"nofollow noreferrer\">Altered Taste and Stroke: A Case Report and Literature Review</a></p>\n", "score": 2 } ]

[ "medications", "neurology", "recovery", "stroke", "taste-buds" ]

[ { "answer_id": 4918, "body": "<p>Water is typically pH neutral at around pH7. Sometimes you can also buy bottled varieties with a more alkaline character so something closer to pH8. Now there's a basic chemical reaction called <a href=\"https://en.wikipedia.org/wiki/Neutralization_(chemistry)\">neutralization</a>. In essence, all you have to do is rinse your mouth with water several times to neutralize the acid.</p>\n", "score": 4 }, { "answer_id": 8891, "body": "<p>There are many possible products that can be used to restore pH. Some work faster, some have some additional properties. See this quote from \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21726291\" rel=\"nofollow\">Influence of five neutralizing products on intra-oral pH after rinsing with simulated gastric acid</a>\" (DOI: 10.1111/j.1600-0722.2011.00841.x.):</p>\n\n<blockquote>\n <p>After rinsing with the two acid solutions (pH 1 and pH 2), the following products were used: (i) antacid tablet; (ii) gum arabic lozenge; (iii) mineral water; (iv) milk; and (v) tap water (positive control). (...) The five test products were used for 2 min after the erosive challenge. All the products produced an initially higher pH compared with the negative control. The antacid tablet resulted in the greatest and most rapid increase in pH, followed by the lozenge. In dental practice, the use of any of the neutralizing products tested, especially the antacid tablet, could be recommended in order to increase the intra-oral pH after an erosive challenge.</p>\n</blockquote>\n", "score": 0 } ]

[ "nutrition", "dentistry" ]

[ { "answer_id": 4948, "body": "<p>Yes avoid getting too much water inside your ears</p>\n\n<p>I would recommend against using ear buds they do more harm than any good. Stop poking inside your ear</p>\n\n<p>Regarding your existing condition please go see an ENT specialist </p>\n", "score": 1 } ]

[ "hearing", "soap", "earwax", "ear-infection", "ear-irrigation" ]

[ { "answer_id": 5010, "body": "<p>Yes, clonazepam is known to cause tolerance, as well as other side effects (such as dependence) after a prolonged use.</p>\n<p>From the medication Summary of Product Characteristics (SmPC):</p>\n<blockquote>\n<p>Prolonged use of benzodiazepines may result in dependence with withdrawal symptoms on cessation of use. [...]</p>\n<p>In particular long-term or high-dose treatment, may lead to reversible disorders such as dysarthria, reduced coordination of movements and gait disorder (ataxia), nystagmus and double vision (diplopia).</p>\n</blockquote>\n<p>NHS also states:</p>\n<blockquote>\n<p>Long-term treatment with benzodiazepines isn't usually recommended because they can become less effective over time and some people become dependent upon them.</p>\n</blockquote>\n<p>What's more, Martindale: The Complete Drug Reference doesn't list clonazepam as a medication of choice for insomnia. Nor does NHS article on the treatment of insomnia. Although clonazepam does belong to benzodiazepines, group of medication that is used to treat insomnia, other medicines are recommended. Clonazepam has other indications, such as epilepsy.</p>\n<hr />\n<p>Clonazepam, same as other benzodiazepines, is a prescription-only medicine. This means that you shouldn't be able to purchase it, without physician's recommendation. Your physician is able to explain to you the dosage, duration of use, and possible side-effects.</p>\n<hr />\n<p>References:</p>\n<p><a href=\"https://www.medicines.org.uk/emc/medicine/31166\" rel=\"nofollow noreferrer\">Clonazepam SPC</a></p>\n<p><a href=\"http://www.nhs.uk/Conditions/Insomnia/Pages/Treatment.aspx\" rel=\"nofollow noreferrer\">NHS: Insomnia - Treatment </a></p>\n<p>Martindale: The Complete Drug Reference, 2005 The Pharmaceutical Press.</p>\n", "score": 3 } ]

[ "medications", "sleep", "side-effects" ]

[ { "answer_id": 4999, "body": "<ul>\n<li><p>Retainers prevent the teeth from reverting to their original position, and therefore progressively force the <strong>p</strong>erio<strong>d</strong>ontal <strong>l</strong>igament (PDL) to adapt itself to the new position. Doing a Fiberotomy accelerated the process by detaching the fibers of the PDL that are still trying to hold and/or bring back the tooth in the previous position.</p></li>\n<li><p>This does not negate the need for a retainer, since there is no guarentee that all the fibers that could cause unwanted movement have been cut, or that other causes have been eliminated. In other words, your mileage might vary, depending on how much was cut and how many other factors are at play...</p></li>\n<li><p>...Which bring me to the last point: Even if the fiberotomy was performed on the bottom teeth (of the jaw), the crowding would have happened anyways, and would have required a fixed appliance (lingual wire) to prevent the crowding. The reason for that is the \"Late Mandibular Incisor Crowding\" caused by the remodelling of the jaws, shown on the image bellow.</p></li>\n</ul>\n\n<blockquote>\n <p><a href=\"https://i.stack.imgur.com/tCW71.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/tCW71.jpg\" alt=\"Schematic representation of the remodeling of the jaw\"></a> Notice how near the front teeth, who are in a kind of half-circle, the reformation is inward. The diameter of the arch (half-circle) is reduced throughout life, and therefore the teeth are forced to get crowded to fit in the reduced space. This can even happen to older people who did not get an orthodontic treatment!</p>\n</blockquote>\n\n<p>Sources:</p>\n\n<ul>\n<li>(image) <a href=\"http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S2176-94512014000300026\" rel=\"nofollow noreferrer\">http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S2176-94512014000300026</a></li>\n<li>(image explaination) Taken from another thread: <a href=\"https://health.stackexchange.com/questions/4868/ive-always-worn-my-clear-nighttime-retainers-religiously-can-i-get-my-permanen/4990#4990\">I&#39;ve always worn my clear nighttime retainers religiously. Can I get my permanent metal retainers taken out?</a></li>\n<li>(Explaination of Late Mandibular Incisor Crowding) <a href=\"http://www.braceplace.com/assets/docs/Newsletter_23.pdf\" rel=\"nofollow noreferrer\">http://www.braceplace.com/assets/docs/Newsletter_23.pdf</a></li>\n</ul>\n", "score": 4 } ]

[ "dentistry", "effectiveness", "retainers", "teeth-alignment" ]

[ { "answer_id": 5151, "body": "<p>The simplest answer is that <strong>both types of systems are more or less equal</strong>.</p>\n\n<p>Long answer:\nIt's actually the dentist that needs to be aware of a few concepts:</p>\n\n<ol>\n<li><p>The angle of the bone in which the implant is placed relative to the position of the crown that will be on top of it. they are not always in line. The ideal scenario is second from left, while the worst one is 3rd from the left. Nobody wants a screw to show up in the front of the crown! To remedy this problem it is possible to use the second stage in a 2-piece system to reangulate the crown.\n<a href=\"https://i.stack.imgur.com/9TONv.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/9TONv.png\" alt=\"enter image description here\"></a><a href=\"https://i.stack.imgur.com/CPQ1F.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/CPQ1F.jpg\" alt=\"enter image description here\"></a></p></li>\n<li><p>Amount of gingival tissue between the bone and the mouth. If the gingiva isn't very thick, it might be advantageous to remove the intermediate step, so that as little as possible metal shows through the gingiva.</p></li>\n<li><p>Ability of the bone to endure immediate loading of the implant. If both the implant and the platform come in one piece, the implant will be exposed to forces in the mouth immediately after being placed, while the two piece option permits us to temporarily bury and avoid putting immediate stress on the implant, thereby enabling it to better integrate the bone, especially if the later is of poor quality. </p></li>\n<li><p><strong>To address your concern about a micro crack appearing between the two pieces, it is most often due to the insufficient tightening of the screw</strong>. At least 15-25 Newtons need to be applied, using an implant screw, to sufficiently tighten the the pieces to avoid the appearance of a micro crack and further of the screw.</p></li>\n</ol>\n\n<p>My source, excluding professional formation:</p>\n\n<pre><code>http://www.oralhealthgroup.com/features/the-one-piece-implant-design-prospective-case-report/\n</code></pre>\n", "score": 3 }, { "answer_id": 24422, "body": "<p>Today, there is a trend to go for two-piece restoration. One pice (base) is placed on the day of surgery on the implant and remains there. the second piece (abutment with crown, or one-piece implant-crow) comes o top.</p>\n<p>The recent scientific evidence shows that keeping the biological barrier around the implant and base intact. This limits the chances to see bacteria migrating along with the prosthesis towards the implant - often cause of mucositis/peri-implantitis. See an illustration here: <a href=\"https://www.teeth4all.org/getting-treated-with-dental-implants/complications-with-implants/\" rel=\"nofollow noreferrer\">https://www.teeth4all.org/getting-treated-with-dental-implants/complications-with-implants/</a></p>\n<p>With regards to the crown, a one-piece solution where the abutment and crown are 'merged' together present better longevity and less need of repairs (due to porcelain chipping). This option is esthetic enough for prosthesis not too visible when smiling (i.e. posterior region).</p>\n<p>For the anterior region, visible when smiling, two-pieces solution offers the flexibility to the dental technician to produce highly esthetic prosthesis. In the anterior region, as the chewing forces are lower, the problem of chipping is less frequent.</p>\n<p>See an illustration here: <a href=\"https://www.teeth4all.org/all-about-dental-implants/dental-prosthesis/#Prosthesis-type\" rel=\"nofollow noreferrer\">https://www.teeth4all.org/all-about-dental-implants/dental-prosthesis/#Prosthesis-type</a></p>\n<p>Overall the one-piece solution is cheaper than the two-piece one, but the level of aesthetics might be lower while its strength is higher.</p>\n<p>The explanation above was for the restorative part. For the implant part, the trend is to use the two-piece part. The rationale is the following:</p>\n<p>Having an implant at the bone level and the restoration screwed on top, through the gingiva offers flexibility. Always consider the future development of the patient condition: if there is some gingiva recession, then the restoration can then be swapped for a shorter one and the implant will not show up. New implants/prostheses might be added and, and, being bone level offers more flexibility if the prosthesis must be changed (insertion angle, implant height,...).</p>\n<p>With regards to the trans-gingival implant (tissue level implant) thew offer through the assurance that the peri-implant soft tissue will never be disturbed, and thus, the biological seal around the implant limits the risk of bacteria navigating along with the implant towards the bone (cause of mucositis and peri-implantations). this is tough dependent on many other factors as well (implant surface, patient hygiene,...).</p>\n", "score": 1 } ]

[ "dentistry", "bacteria", "implant", "diastema-teeth-gaps", "periodontal-pathogen" ]

[ { "answer_id": 5070, "body": "<p><a href=\"http://askforevidence.org/articles/breathe-deeply-and-nod-off\" rel=\"nofollow\">There is no evidence</a>:</p>\n\n<p>\"Despite a potential bit of miscommunication about the technique's effect on insomnia, there’s one thing I can be certain about – there doesn’t appear to be any reliable evidence that the 4-7-8 breathing method works.\"</p>\n", "score": 1 } ]

[ "sleep-deprivation", "sleep-aids", "oxygen", "calm-soothing-strategies", "induce" ]

[ { "answer_id": 15654, "body": "<p>There are a number of indices used to assess bleeding risk </p>\n\n<blockquote>\n <p>Bleeding risk scores to quantify hemorrhage risk include HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/alcohol concomitantly), RIETE (Computerized Registry of Patients With Venous Thromboembolism), HEMORR2HAGES (Hepatic or Renal Disease, Ethanol Abuse, Malignancy, Older Age, Reduced Platelet Count or Function, Rebleeding, Hypertension, Anemia, Genetic Factors, Excessive Fall Risk and Stroke), and ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation) (206-208). </p>\n</blockquote>\n\n<p>but at present ( 2014 ) </p>\n\n<blockquote>\n <p>Although these scores may be helpful in defining patients at elevated bleeding risk, <strong>their clinical utility is insufficient for use as evidence for the recommendations in this guideline</strong>. [2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation]</p>\n</blockquote>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676081/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676081/</a></p>\n\n<p>However, there are some guidelines for oncology patients though they are old (2007)</p>\n\n<p><a href=\"https://i.stack.imgur.com/SHrZ9.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/SHrZ9.jpg\" alt=\"Oncology guideliness\"></a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/17968019\" rel=\"nofollow noreferrer\">American Society of Clinical Oncology guideline: recommendations for venous thromboembolism prophylaxis and treatment in patients with cancer.</a></p>\n\n<p>So, your only recourse is to seek local expert opinion in non-oncology patients.</p>\n", "score": 3 } ]

[ "cardiology", "hematology", "platelet-count", "thrombocytopenia" ]

[ { "answer_id": 5102, "body": "<p>Diet Pepsi is sweetened with sucralose (diet coke is sweetened with aspartame). Sucralose ha been found in studies to not affect blood sugar levels:</p>\n\n<blockquote>\n <p>This study demonstrated that, similar to cellulose, sucralose consumption for 3 months at doses of 7.5 mg/kg/day, which is approximately three times the estimated maximum intake, had no effect on glucose homeostasis in individuals with type 2 diabetes. Additionally, this study showed that sucralose was as well-tolerated by the study subjects as was the placebo.</p>\n</blockquote>\n\n<p><a href=\"http://www.sciencedirect.com/science/article/pii/S0002822303013646\" rel=\"nofollow\">Lack of effect of sucralose on glucose homeostasis in subjects with type 2 diabetes</a></p>\n\n<p>Diet Pepsi <a href=\"http://static.diabetesselfmanagement.com/pdfs/DSM0310_012.pdf\" rel=\"nofollow\">contains about 40 mg of sucralose per 8 ounces</a> (about 250 milliliters). At 4 liters per day, that's about 640 mg of sucralose, and at a weight of 125 kilograms that's equivalent to about 5 mg/kg/day, less than the 7.5 mg/kg/day in this study. </p>\n\n<p>Since that study might be called biased because of the funding, here's another one, where patients received a one time dose of 1 gram of sucralose that had no effect on blood sugar: <a href=\"http://m.care.diabetesjournals.org/content/19/9/1004.short\" rel=\"nofollow\">Glycemic Effect of a Single High Oral Dose of the Novel Sweetener Sucralose in Patients With Diabetes</a></p>\n\n<p>However, 4 liters of Diet Pepsi puts your relative at the upper limit of the <a href=\"http://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397725.htm#SummaryTable\" rel=\"nofollow\">Acceptable Daily Intake as defined by the FDA</a>, which is 5 milligrams per day and kilogram. From the <a href=\"http://www.fda.gov/food/ingredientspackaginglabeling/foodadditivesingredients/ucm397716.htm\" rel=\"nofollow\">FDA</a>:</p>\n\n<blockquote>\n <p>Generally, an additive does not present safety concerns if the estimated daily intake is less than the ADI.</p>\n</blockquote>\n\n<p>Your relative might want to reduce his intake. Reducing his intake to a maximum of two instead of four liters would put him firmly below the ADI. Four liters od a pretty high intake of fluids anyway. If this is because of thirst, that in itself is a sign of badly managed diabetes and requires medical attention. </p>\n\n<p>In summary, no, noone can say that drinking diet drinks is completely safe. That's true of most substances, and so far sucralose has not shown to be unsafe. It is generally thought to be better for diabetes patients than <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2862465/\" rel=\"nofollow\">drinking sugar-sweetened drinks</a> which make blood sugar control harder. The American Diabetes Association lists diet drinks <a href=\"http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/what-can-i-drink.html\" rel=\"nofollow\">on their page on What to Drink?</a>, alongside, of course, unsweetened beverages, which are preferable. </p>\n\n<p>But I'd estimate that the smoking and weight puts him more at a health risk than the Diet Pepsi. Smoking and diabetes have been <a href=\"http://www.cdc.gov/tobacco/campaign/tips/diseases/diabetes.html\" rel=\"nofollow\">shown to be major health risk</a>. Your relative hopefully has a doctor who knows how to treat diabetes, and needs to talk to them about how to control the diabetes. </p>\n", "score": 4 } ]

[ "nutrition", "diabetes", "risks", "drinks", "carbonated-carbonation" ]

[ { "answer_id": 10284, "body": "<p>Occupational therapists primarily use functional activities to assess and treat individuals who have lost independence due to illness or injury. It is uncommon to use craft type activities outside of mental health and paediatrics unless it holds some specific meaning for the individual undergoing treatment.</p>\n\n<p>In assessing an individual who has undergone cardiac surgery and is looking to regain independence, I would observe/assist them with a regular activity, such as getting dressed or preparing a hot drink depending on their current level of function. I would specifically be looking at standing and exercise tolerance, functional mobility within the area, balance, and fine motor function. Observing the activity would allow me to ensure other functions were intact - for example, those related to cognition. Once I understood their present physical presentation, I would prepare a treatment plan that enabled me to work on the skills required to develop their independence. </p>\n\n<p>The key thing, for me as a therapist, is to ensure that the treatment activities I am preparing are meaningful to the individual, and that they address the areas identified within my assessment. Every treatment session is also an assessment so that treatment is fluid and adapts as the needs of the individual change. If your father's current treatment is not meaningful and is not helping him to progress, I would certainly speak to his therapist in order to understand why they believe the activities are beneficial and what the goals of the intervention are.</p>\n\n<p>About me:\nOccupational therapist of 13 years.</p>\n", "score": 1 } ]

[ "heart-attack", "post-surgical", "occupational-therapy" ]

[ { "answer_id": 5176, "body": "<p>Ah, but they can and do. A non-rebreather (NRB) mask with 100% O2 flowing at 12-15 L/min will provide about 90% O2 concentration to an adult. This is true even for the largest adult in severe respiratory distress.</p>\n\n<p>There are a couple of reasons for this. First, the 3 liters figure you cited is the inspiratory reserve volume (IRV). Here are two definitions you need to consider:</p>\n\n<p><a href=\"http://faculty.etsu.edu/currie/respvolumes.htm\" rel=\"nofollow noreferrer\">http://faculty.etsu.edu/currie/respvolumes.htm</a></p>\n\n<blockquote>\n <p>Resting Tidal Volume (VT): This is the volume of air taken into the\n lungs when you inhale. Tidal volume increases with exercise or\n activity.</p>\n \n <p>Inspiratory Reserve Volume (IRV): Total lung capacity minus the\n volume of air in the lung at the end of a normal inspiration. This\n means that we have a reserve volume that we can tap into as tidal\n volume increases with exercise or activity.</p>\n</blockquote>\n\n<p>Average capacities are 500 mL for VT and 3000 mL for IRV.</p>\n\n<p>Note that the IRV is the volume of air that can be <strong>forcibly</strong> inhaled. It's not something anyone normally does except during extreme exertion (eg, athletics) or when directed in a breathing test. So the 3 liters you cite isn't the amount of air someone normally inhales; the TV of 500 mL is much more typical, meaning the bag provides two full breaths of reserve and the flow of 12-15 L/min O2 completely refills that bag every 3-4 seconds.</p>\n\n<p>So a 1 mL reservoir bag being fed by O2 flowing at 15 mL/min is in fact more than adequate to supply 90% O2 concentrations to even a large adult in extreme respiratory distress. It can and will raise their SpO2 significantly in a short period of time if their cardio-pulmonary system is capable of absorbing and delivering it (which may not be the case if they're in need of such measures, but that's another issue). </p>\n\n<p>Note that a NRB only works with a patient who is breathing adequately on their own. If a patient isn't breathing, or isn't breathing adequately, the next step up is a <a href=\"https://en.wikipedia.org/wiki/Bag_valve_mask\" rel=\"nofollow noreferrer\">bag valve mask</a>.</p>\n\n<p><a href=\"https://i.stack.imgur.com/NlZKb.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/NlZKb.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>A BVM allows a medical provider to mechanically breath for the patient. The tubing you see coiled up next to the reservoir would be attached to an O2 source delivering 100% O2 at 12-15 L/min and then the provider would squeeze the bag at a normal breathing rate, forcing O2 into the patient's lungs. With this device O2 can be forced into the lungs of a non-breathing patient, or assisted into the lungs of a patient too sick or too weak to breath normally on their own.</p>\n\n<p>Generally, once a BVM has been employed the next step will be <a href=\"https://en.wikipedia.org/wiki/Tracheal_intubation\" rel=\"nofollow noreferrer\">tracheal intubation</a>. </p>\n\n<p><a href=\"https://i.stack.imgur.com/eZCVD.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/eZCVD.png\" alt=\"enter image description here\"></a></p>\n\n<p>As the diagram shows, a plastic tube is inserted into the patient's trachea and then a BVM or mechanical respirator is attached to the other end. A source of O2 is also attached. Once intubated, 100% O2 can be supplied to the patient at any volume desired. And once a mechanical ventilator is attached, much finer control of O2 concentration, volume, and other parameters are possible. </p>\n\n<p>Not shown in the diagram is the small balloon on the tube at the end inserted into the trachea. Once the tube is in place, that balloon is inflated, which holds the tube in place and completely seals the trachea from anything entering or leaving except via the tube. In this way, the patient is also protected by the tube from aspirating vomit, blood, broken teeth, or whatever else might be present in the throat. </p>\n\n<p><strong>Edit:</strong></p>\n\n<p>The OP stated in the comments that he can deflate the reservoir by donning a NRB with a 25 L/min flow of air and then doing strenuous exercises. Specifically:</p>\n\n<blockquote>\n <p>I put the NRB on and I'm sucking the full bag down in less than half a\n breath, after which I'm fighting the safety valve and mask seal to get\n enough air.</p>\n</blockquote>\n\n<p>Two things explain this. First, he's a healthy person able to do vigorous exercises and then inhale fully to his full lung capacity. Sick people who need supplemental O2 rarely fit that description. In many cases they literally cannot fully fill their lungs with a breath no matter how hard they try, and they are often in distress, which leads to very rapid, shallow respirations. </p>\n\n<p>Second, he was breathing plain air, which is 21% O2. A patient on a NRB will be breathing supplemental O2 at a concentration of about 90%. In other words, every breath the OP took contained 1/5th as much oxygen as the breaths a patient would be taking. I think that if the OP repeated his experiment using 100% O2 instead of plain air, he would get very different results and wouldn't find himself struggling to get enough air.</p>\n", "score": 7 } ]

[ "first-aid", "medical-device", "oxygenation" ]

[ { "answer_id": 5192, "body": "<p>Taken from <a href=\"https://skeptics.stackexchange.com/a/32238/31863\">skeptics.stackexchange.com</a>:</p>\n<p>Summary: There is not yet enough evidence to form an opinion.</p>\n<p>The 2014 Cochrane review, <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006206.pub4/full\" rel=\"nofollow noreferrer\">Garlic for the common cold by Elizabeth Lissiman, Alice L Bhasale and Marc Cohen</a>, examined the study <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/11697022\" rel=\"nofollow noreferrer\">Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey shows</a>, and concluded it wasn't too bad:</p>\n<blockquote>\n<p>The included trial was of reasonable quality</p>\n</blockquote>\n<p>but still not perfect:</p>\n<blockquote>\n<p><a href=\"https://i.stack.imgur.com/TDi45.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/TDi45.png\" alt=\"bias assessment\" /></a></p>\n<p>Figure 1. 'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.</p>\n</blockquote>\n<p>Cochrane reviews normally systematic examine many different papers. However, this review was unable to find any other high quality papers on the subject, and concluded:</p>\n<blockquote>\n<h2>Implications for practice</h2>\n<p>There is no conclusive evidence to recommend garlic supplements as a preventative or treatment option for the common cold. A single, small trial was found suggesting garlic might reduce the incidence of the common cold if taken continuously as a daily prophylactic (preventive treatment) but the results require validation. There is currently no evidence to help decide whether treating common colds with garlic will reduce symptom severity or days of illness. Anecdotally, adverse events reported include odour and minor skin or respiratory irritation. The frequency of adverse effects could not be determined from the evidence available.</p>\n</blockquote>\n<p>We need more evidence though to seriously recommend such supplements. I hope there will be more studies in the future.</p>\n", "score": 3 } ]

[ "common-cold" ]

[ { "answer_id": 5479, "body": "<p>You're asking if there is a dose response relationship for ibuprofen, and what does it look like. For most people the analgesic effect (surrogate for inflammation) flattens out at 400 mg, but 20% might get a better response with a higher dose. <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2000723/\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2000723/</a></p>\n", "score": 3 } ]

[ "medications", "pain" ]

[ { "answer_id": 5229, "body": "<p>It seems to be unclear and likely some kind of combination of several factors. </p>\n\n<p>The paper <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3491681/\" rel=\"nofollow\">Fecal microbiota transplantation in relapsing <em>Clostridium difficile</em> infection</a> mentions two theories as to why it works (and works very well):</p>\n\n<ol>\n<li>The introduction of bacteria able to compete with <em>C. difficile</em> rebalances the fecal microbiota - under normal circumstances, CD is outcompeted by other bacteria (not always enough to vanish, it can be found <a href=\"http://www.nhs.uk/conditions/clostridium-difficile/pages/introduction.aspx\" rel=\"nofollow\">in about 1 in 30 healthy people</a>, but enough to not be problematic), and it can only thrive after the use of antibiotics. A FMT reintroduces its competitors </li>\n<li>The introduction of the 'new' bacteria leads to an immune response that helps eradicating <em>C. difficile</em></li>\n</ol>\n\n<p>The first mechanism is what I found mentioned in a few other sources as well, for example on <a href=\"http://www.openbiome.org/about-fmt/\" rel=\"nofollow\">OpenBiome</a>:</p>\n\n<blockquote>\n <p>Though the mechanism has yet to be determined, it is believed that FMT works by repopulating the patient’s microbiome with diverse microorganisms that competitively exclude <em>C. difficile</em></p>\n</blockquote>\n\n<p>Another hypothesis is that the acid composition in the feces is significantly altered and inhibits growth of CD, see <a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0147210\" rel=\"nofollow\">Changes in Colonic Bile Acid Composition following Fecal Microbiota Transplantation Are Sufficient to Control <em>Clostridium difficile</em> Germination and Growth</a>.</p>\n", "score": 4 }, { "answer_id": 14691, "body": "<p>As an updating addendum to <a href=\"https://health.stackexchange.com/a/5229/11231\">YviDe's answer</a>:</p>\n\n<p>While still very far from being completely understood fecal matter transplants are more than just the commensal <em>bacteria</em> that are beneficial to gut health and able to \"just outcompete\" Clostridium difficile (CD).</p>\n\n<p>Humans are not only human dna-derived cells and many many bacteria. One part often overlooked is that the human microbiome is also populated with a an abundance of viruses that are surprisingly beneficial for the host's health.</p>\n\n<p>Healthy subjects may be hosts to viruses that not only eat away the food of CD or produce substances that are a bit harmful to CD's metabolism. A healthy gut contains some viruses called <a href=\"https://en.wikipedia.org/wiki/Bacteriophage\" rel=\"nofollow noreferrer\">bacteriophages</a> that actively seek and destroy CD.</p>\n\n<blockquote>\n <p><a href=\"http://gut.bmj.com/content/early/2017/05/24/gutjnl-2017-313952\" rel=\"nofollow noreferrer\"><strong>Bacteriophage transfer during faecal microbiota transplantation in Clostridium difficile infection is associated with treatment outcome:</strong></a><br>\n _{(<a href=\"http://dx.doi.org/10.1136/gutjnl-2017-313952\" rel=\"nofollow noreferrer\">http://dx.doi.org/10.1136/gutjnl-2017-313952</a>)}</p>\n \n <p><strong>Results:</strong> Subjects with CDI demonstrated a significantly higher abundance of bacteriophage Caudovirales and a lower Caudovirales diversity, richness and evenness compared with healthy household controls. Significant correlations were observed between bacterial families Proteobacteria, Actinobacteria and Caudovirales taxa in CDI. FMT treatment resulted in a significant decrease in the abundance of Caudovirales in CDI. Cure after FMT was observed when donor-derived Caudovirales contigs occupied a larger fraction of the enteric virome in the recipients (p=0.024). In treatment responders, FMT was associated with alterations in the virome and the bacterial microbiome, while vancomycin treatment led to alterations in the bacterial community alone.</p>\n \n <p><strong>Conclusions:</strong> In a preliminary study, CDI is characterised by enteric virome dysbiosis. Treatment response in FMT was associated with a high colonisation level of donor-derived Caudovirales taxa in the recipient. Caudovirales bacteriophages may play a role in the efficacy of FMT in CDI.</p>\n \n <p><strong>Discussion:</strong>\n Faecal microbiota transplantation (FMT) is highly effective for the treatment of recurrent Clostridium difficile infection (CDI).</p>\n \n <p>Studies have shown bacterial colonisation after FMT, but data on viral alterations in CDI and the association between viral colonisation and treatment outcome are largely unknown.</p>\n \n <p>CDI was characterised by a high abundance of Caudovirales bacteriophages and a low Caudovirales diversity, richness and evenness compared with healthy household controls.</p>\n \n <p>Donor-derived Caudovirales taxa occupied a significantly larger fraction of the enteric virome in CDI subjects who responded to FMT compared with those who did not.</p>\n \n <p>FMT was associated with alterations in the enteric virome and bacterial microbiome, while vancomycin treatment was associated with alterations of the bacterial microbiome only.</p>\n \n <p>Recipients infused with donor faeces consisting of a higher richness of Caudovirales than that of recipient were all cured with FMT. CDI subjects who had restoration of bacteria community only were found to have disease recurrence.</p>\n \n <p>The restoration of virome community is as important as that of bacterial microbiome in FMT.</p>\n \n <p>Donor selection based on virome characteristics should be considered in FMT practice.</p>\n</blockquote>\n\n<p>This means that the explanation models given in the first answer are not wrong, but likely incomplete. </p>\n\n<p>Further links:<br> </p>\n\n<p><a href=\"http://jcm.asm.org/content/17/6/1148.short\" rel=\"nofollow noreferrer\">Bacteriophage and bacteriocin typing scheme for Clostridium difficile.</a><br>\n<a href=\"http://www.sciencedirect.com/science/article/pii/S1075996499901920\" rel=\"nofollow noreferrer\">Prevention of Clostridium difficile -induced ileocecitis with Bacteriophage</a>(Hamster model)<br>\n<a href=\"http://jb.asm.org/content/190/20/6734.short\" rel=\"nofollow noreferrer\">Molecular Characterization of a Clostridium difficile Bacteriophage and Its Cloned Biologically Active Endolysin</a><br>\n<a href=\"http://jb.asm.org/content/188/7/2568.short\" rel=\"nofollow noreferrer\">Genomic Organization and Molecular Characterization of Clostridium difficile Bacteriophage ΦCD119</a></p>\n", "score": 1 } ]

[ "infection", "treatment", "effectiveness", "clostridium-difficile" ]

[ { "answer_id": 16641, "body": "<p>Yes. </p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/?term=ORAL+CONTRACEPTIVES+AND+MOOD%2FSEXUAL+DISORDERS+IN+WOMEN\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/?term=ORAL+CONTRACEPTIVES+AND+MOOD%2FSEXUAL+DISORDERS+IN+WOMEN</a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24014598\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/24014598</a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29145752\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/29145752</a></p>\n\n<p>Increased risk of depression, sexual dysfunction, breast cancer, nutritional deficiencies, stroke, blood clots among other issues.</p>\n\n<p>Some studies have also shown that the hormones going into the water supply effect male fertility as well as fish fertility:</p>\n\n<p><a href=\"https://www.scientificamerican.com/article/birth-control-in-water-supply/\" rel=\"nofollow noreferrer\">https://www.scientificamerican.com/article/birth-control-in-water-supply/</a></p>\n\n<p><a href=\"https://www.sciencedaily.com/releases/2016/03/160304092230.htm\" rel=\"nofollow noreferrer\">https://www.sciencedaily.com/releases/2016/03/160304092230.htm</a></p>\n\n<p>Hormonal contraceptives are not recommended during breastfeeding because it can decrease the milk supply and the hormones will pass into the breastmilk and the baby will drink the hormones. Can you imagine a baby boy drinking estrogen?</p>\n\n<p>Physicians’ desk reference 2005. 59th ed. Montvale, N.J.:Thompson PDR, 2005.\nThe Physicians’ Desk Reference advises that a nursing mother should not use oral contraceptives but should use other forms of contraception until she has completely weaned her infant. </p>\n\n<p>As for becoming pregnant on the pill... more research is needed:\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703703/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4703703/</a>\n<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/744667\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/744667</a>\n<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/5576004\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/5576004</a>\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400183/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400183/</a></p>\n", "score": 1 } ]

[ "medications", "side-effects", "obstetrics", "contraception" ]

[ { "answer_id": 9164, "body": "<p><strong>In the Morning on an Empty Stomach/Between Meals</strong> - Fruits are recommended to be eaten on an empty stomach or in between meals because at this time digestion happens fairly quick and also different types of enzymes are used by the body to digest the fruit. Fruits contain simple sugars, which need time to be completely absorbed by the body. When fruits are eaten in between meals or on empty stomach, all the nutrients, the fiber and simple sugars are processed well in the body.</p>\n\n<p><strong>Pre/Post Workout</strong> -\nThe sugars of fruits will be used by the body for getting immediate energy before workout and helps in refilling the emptied energy stores in the body after workout.</p>\n\n<p>Source : <a href=\"http://www.md-health.com/Best-Time-to-Eat-Fruits.html\" rel=\"nofollow\">http://www.md-health.com/Best-Time-to-Eat-Fruits.html</a></p>\n", "score": 2 } ]

[ "nutrition", "fruits", "time-of-day", "meal", "guidelines" ]

[ { "answer_id": 5277, "body": "<p>Assuming that you are asking about the US, the documents explaining the RDA (recommended dietary allowance), AI (adequate intake), and UL (tolerable upper intake level) are available on the website of the <a href=\"https://ods.od.nih.gov/Health_Information/Dietary_Reference_Intakes.aspx\" rel=\"nofollow\">National Institutes of Health</a>. They are written by \"The Food and Nutrition Board, Institute of Medicine, National Academy of Sciences\". </p>\n\n<p>Going into these in detail is way too broad because these are long - for example, there is a <a href=\"http://www.nap.edu/read/13050/chapter/1\" rel=\"nofollow\">1000 page document on the RDI of calcium and vitamin D</a>. Far from being \"a shot in the dark\", this details a lot of the research those values are based on. </p>\n\n<p>It also says when insufficient data is available to establish these values (for example RDA for calcium for infants). Far from being only the value you might see on the label of your food, the recommendations are are actually different for different age groups, sexes, and life stages (for example pregnancy), as can be seen in the detailed recommendations for <a href=\"https://www.nlm.nih.gov/medlineplus/magazine/issues/winter11/articles/winter11pg12.html\" rel=\"nofollow\">vitamin D and calcium</a>, for example. The quality needs to be judged for each individual recommendation, there is no single definitive answer. </p>\n\n<blockquote>\n <p>Where can I look at a study that proves that a human eating less than RDI will become deficient</p>\n</blockquote>\n\n<p>The reasoning behind the AI should be listed in the documents I linked to. For calcium in adults, for example, the AI is based on <a href=\"http://m.ajcn.nutrition.org/content/86/4/1054.long?view=long&amp;pmid=17921384\" rel=\"nofollow\">Calcium requirements: new estimations for men and women by cross-sectional statistical analyses of calcium balance data from metabolic studies</a>. </p>\n\n<p>Be aware, though, that \"proving\" this isn't as straight forward as you might think it is. You can't just deprive people of a nutrient and look at what happens - a study like that will usually be considered unethical. Instead, researchers look at what people with existing symptoms of malnutrition are ingesting, for example. </p>\n", "score": 4 } ]

[ "nutrition", "micronutrients" ]

[ { "answer_id": 5312, "body": "<p>Be sure to supplement enough iron (about 18 mg per day)! Take your iron with vitamin C and avoid tea and coffee. American Red Cross: <a href=\"http://www.redcrossblood.org/learn-about-blood/iron-and-blood-donation/iron-info-frequent-donors\" rel=\"nofollow\">\"The American Red Cross now recommends that individuals who give blood frequently should take a multivitamin with iron or an iron-only supplement to replace the iron lost through blood donation. Before taking a multivitamin with iron or an iron-only supplement, you should consult with your health-care provider.\"</a> About 200 mg of iron will be lost during your donation: <a href=\"http://ayubmed.edu.pk/JAMC/PAST/14-2/AhmedBadar.htm\" rel=\"nofollow\">\"A donor generally donates approximately 450 ml blood at the time of donation. One gram of haemoglobin contains 3.4 mg of iron. In a normal individual with 15 g of haemoglobin per dl, 100 ml of blood contains approximately 50 mg of iron. Thus removal of only 2 ml of blood results in the loss of 1 mg of iron3. If 450 ml of blood are taken in a donation approximately 225 mg of iron will be lost.\"</a> <a href=\"http://ajcn.nutrition.org/content/73/1/93.full\" rel=\"nofollow\">Vitamin C helps iron absorbtion.</a> <a href=\"https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/\" rel=\"nofollow\">You need about 90 mg of Vitamin C per day - feel free to take more as it won't hurt - vitamin C is soluble in water and body can easily get rid of excess.</a> <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/11029010\" rel=\"nofollow\">Watch out for coffee and tea, they block iron absorbtion: \"Recommendations with respect to tea consumption (when in a critical group) include: consume tea between meals instead of during the meal; simultaneously consume ascorbic acid and/or meat, fish and poultry.\"</a></p>\n", "score": 1 } ]

[ "blood-donation" ]

[]

[ "diet", "body-fat", "metabolism" ]

[ { "answer_id": 5427, "body": "<p>It sounds as though you're developing a conditioned response or allergy to some smell of the aircraft insides. Insecticides are used in some international flights but this is prior to disembarkation, and should have cleared by the time you embark. If it's linked to a particular airline, it may be the air freshener they use, and as your flight proceeds, the internal air recirculation systems scrub the air of it. So, you could ask the airlines if they all use a particular product.</p>\n\n<p>Perhaps you could try some nasal filters with activated charcoal to scrub the air for you to see if it helps in that first 20 minutes.</p>\n", "score": 2 } ]

[ "nausea", "travel", "motion-sickness", "aviation" ]

[ { "answer_id": 5353, "body": "<p>Not too many studies showed any correlation between smoking and risk of epicondylitis but only one study mentioned it. They say:</p>\n\n<blockquote>\n <p><em>Smoking may interfere with the circulation to tendons, which not only places these tissues at risk for injury but also slows or prevents their healing during a recovery period. That former smokers are also at higher risk of epicondylitis suggests that previous exposure to tobacco may have persistent effects on the vascular system. Increased risk of epicondylitis among smokers may also be due to other lifestyle factors associated with smoking.</em></p>\n</blockquote>\n\n<p>(<a href=\"http://aje.oxfordjournals.org/content/164/11/1065.full\" rel=\"nofollow\">Prevalence and Determinants of Lateral and Medial Epicondylitis</a>)</p>\n", "score": 3 } ]

[ "smoking", "tendinopathy", "epicondylitis" ]

[ { "answer_id": 5484, "body": "<p>The main risk is to children and pregnant women associating with the person receiving I-131 treatment. Since I-131 is excreted in bodily fluids and taken up into the thyroid, those susceptible populations are at increased risk for thyroid cancer if they ingest contaminated bodily fluids. The person receiving the treatment is not because the cells that might become malignant are destroyed by the treatment.</p>\n\n<p>I-131 is a major product of nuclear fallout, and is thought to have contributed to significant thyroid cancer in the USA from Nevada weapons testing.</p>\n\n<blockquote>\n <p>In 1997, NCI conducted a detailed evaluation of dose to the thyroid glands of U.S. residents from I-131 in fallout from tests in Nevada. In a related activity, we evaluated the risks of thyroid cancer from that exposure and estimated that about 49,000 fallout-related cases might occur in the United States, almost all of them among persons who were under age 20 at some time during the period 1951-57, with 95-percent uncertainty limits of 11,300 and 212,000. The estimated risk may be compared with some 400,000 lifetime thyroid cancers expected in the same population in the absence of any fallout exposure.</p>\n</blockquote>\n\n<p><a href=\"http://www.americanscientist.org/issues/feature/2006/1/fallout-from-nuclear-weapons-tests-and-cancer-risks/99999\" rel=\"nofollow\">http://www.americanscientist.org/issues/feature/2006/1/fallout-from-nuclear-weapons-tests-and-cancer-risks/99999</a></p>\n\n<p>I presume that distance is advised to avoid gamma radiation emitted by the I-131 in the patient's body rather then the beta radiation which would be largely confined to the thyroid gland, and to emphasize a practical distance to minimize the ingestion of any contaminated fluids.</p>\n\n<p>The question then arises as to what is the safe dose of gamma radiation for a person in whom there is no therapeutic benefit. The answer has to be extrapolated from biophysics and the effect of higher doses since looking at low doses in a population requires too large a number of subjects.</p>\n\n<blockquote>\n <p>In summary, given our current state of knowledge, the most reasonable assumption is that the cancer risks from low doses of x- or γ-rays decrease linearly with decreasing dose. In light of the evidence for downwardly curving dose responses (see Figs. 2 and 4), this linear assumption is not necessarily the most conservative approach, as sometimes has been suggested (63, 64), and it is likely that it will result in an underestimate of some radiation risks and an overestimate of others. Given that it is supported by experimentally grounded, quantifiable, biophysical arguments, a linear extrapolation of cancer risks from intermediate to very low doses currently appears to be the most appropriate methodology. </p>\n</blockquote>\n\n<p><a href=\"http://www.pnas.org/content/100/24/13761.full\" rel=\"nofollow\">http://www.pnas.org/content/100/24/13761.full</a></p>\n\n<p>Since these are assumptions, the precautionary principle applies. Since the gamma radiation from the body of the treated patient can travel several meters through air, and beta radiation from excreted I-131 <a href=\"http://www.oseh.umich.edu/radiation/I131.shtml\" rel=\"nofollow\">1.65 m</a>, then restricting the contact to outside these areas would limit unnecessary exposure.</p>\n", "score": 3 } ]

[ "thyroid", "hyperthyroid", "radiation", "iodine" ]

[ { "answer_id": 5511, "body": "<p><strong>Simple answer</strong>: Because that is just the medication guidelines. Some medications, because of onset of actions, effect of stomach acid, upsetting stomach and other factors need to be taken on or off a full stomach. The doctors know this, because there is evidence based practice proving what works the best. To make sure the meds work best for you it is best to consult your prescriber on how best to take a pill, there are many routes. </p>\n\n<p><a href=\"http://www.nhs.uk/chq/Pages/866.aspx?CategoryID=73\">NHS.UK</a> showed some common reasons:</p>\n\n<p>To take meds with food:</p>\n\n<ul>\n<li><p>NSAIDS and Corticosteroids can cause stomach irritation</p></li>\n<li><p>Some HIV medicines (ritonavir, saquinavir and nelfinavir) </p></li>\n<li><p>Oral diabetic meds are usually taken with foods to lower blood sugar afterwards.</p></li>\n</ul>\n\n<p>Meds taken after meals:</p>\n\n<ul>\n<li><p>Nystatin when used orally can be washed away with food.</p></li>\n<li><p>Antiacids can be taken immediately after or before a meal for heartburn.</p></li>\n</ul>\n\n<p>Meds taken before meals:</p>\n\n<ul>\n<li>Vitamin C absorbs better in a acidic environment so before meals is better. </li>\n</ul>\n\n<p><a href=\"http://m.globalrph.com/?url=http%3A%2F%2Fwww.globalrph.com%2Fdrugfoodrxn.htm&amp;utm_referrer=#2865\">Graph</a> that shows med times</p>\n", "score": 5 } ]

[ "medications", "practice-of-medicine", "time-of-day", "meal" ]

[ { "answer_id": 5495, "body": "<p>The treatment for uremic encephalopathy is dialysis of some sort - peritoneal, etc. - or a kidney transplant, of course. But the latter is not the immediate treatment of choice.</p>\n\n<p>Looking for why delirium suddenly occurred is important; not all delirium in dialysis patients is due to uremic encephalopathy (e.g. rule out rule out cerebrovascular accident, intracranial mass, hyper/hyponatremia, hyperglycemia, and hyperosmolar syndromes as the cause of encephalopathy, etc.)</p>\n\n<p>If the cause is uremic encephaopathy, maybe one can mitigate the symptoms by correction of any existing anemia or calcium and phosphate abnormalities, but the fact remains: assessing the adequacy of dialysis and restarting adequate dialysis is the treatment.</p>\n\n<p>_{<a href=\"http://emedicine.medscape.com/article/239191-overview\" rel=\"nofollow\">Uremic Encephalopathy</a>}</p>\n", "score": 2 } ]

[ "medications", "mental-health", "treatment", "diabetes", "diagnostics" ]

[ { "answer_id": 5601, "body": "<p>It might not directly answer your question, but I have read a few studies that claimed that the body does not develop a tolerance to melatonin, even after long-term usage. This means that the effect should not vanish nor diminish after some time.</p>\n\n<p>The thing is, some over-the-counter melatonin supplements does not contain the claim dosage of melatonin, maybe even not contain melatonin at all (being non-prescriptions medication). I would only rely on a prescription, pharmaceutical-quality melatonin to contain the required dosage.</p>\n\n<p>Also notice, that when you do not optimize the sleeping conditions, mainly not eliminate the presence of blue light from LED (mainly LCD laptop monitors and smartphones), the melatonin would not kick in, as it would be eliminated by the blue light. This is an advice from an expert on sleep disorders, I have not confirmed it in any literature. </p>\n\n<p>By the way, you might also consider asking your doctor about trazodone. It is also not habbit forming, is effective and can be used long term. </p>\n\n<p><strong>UPDATE</strong>: </p>\n\n<p>I'd like to <strong>discourage</strong> a bit from my <strong>trazodone</strong> advice. I still believe its not habit forming, is effective and can be used long term. </p>\n\n<p>The thing is, it has some nasty side-effects even on the lowest effective dosage (which is 50mg for me). It causes a noticable dizziness in the morning, even nausea and vertigo. Definitely worth consideration if driving. Also causes nose congestion, difficulty breathing. But what's more important, it does not increase the sleep quality, provided your sleep quality is reasonable. </p>\n\n<p>I'd opt for <strong>agomelatine</strong>, which is <strong>melatonin antagonist</strong>, which is why I'm mentioning it. Has all the benefits w/o any side effects. And it is not \"addictive\". Personally, I slept perfectly after abrupt withdrawal after one month use. </p>\n\n<p>Still, your <strong>question</strong>, whether production of melatonin is <strong>decreased</strong> after artificial intake OR inhibition of its re-uptake <strong>remains unanswered</strong>.</p>\n", "score": 1 } ]

[ "sleep", "brain", "endocrinology", "melatonin" ]

[ { "answer_id": 5592, "body": "<p><a href=\"http://www.sportsinjuryclinic.net/sport-injuries/chest-abdomen-pain/winded\" rel=\"nofollow\">Winded (Solar Plexus Syndrome)</a></p>\n\n<ol>\n<li><p>Blow to abdomen region</p></li>\n<li><p>Compresses <a href=\"https://en.m.wikipedia.org/wiki/Celiac_plexus\" rel=\"nofollow\">solar plexus</a> or nerves behind stomach</p></li>\n<li><p>Diaphragm contracts and spasms. Which also may explain the rushing out of air. </p></li>\n</ol>\n\n<p>Yes.It is how you described, but above shows some deeper pathophysiology of the situation. </p>\n\n<p>Based on this <a href=\"https://books.google.com/books?id=LBLwDtx2_qcC&amp;pg=PA93&amp;lpg=PA93&amp;dq=preventibg%20getting%20wind%20knocked%20out%20of%20you&amp;source=bl&amp;ots=S_gK1oW9a0&amp;sig=A2cpgXVPKO7jUxwPNJpBwQMG-lI&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjw9tHv3KPMAhXBK8AKHbYhDrEQ6AEILzAF#v=onepage&amp;q=preventibg%20getting%20wind%20knocked%20out%20of%20you&amp;f=false\" rel=\"nofollow\">link</a>, because you are having a spasm and can't breathe properly for a bit taking a good breath before can help breathlessnessin theory. As for other prevention, I couldn't find anything, but since nerves are involved taking breaths shouldn't have that much affect preventing the situation.</p>\n", "score": 1 } ]

[ "lungs", "injury", "breathing", "sports" ]

[ { "answer_id": 15088, "body": "<p>If post gastric bypass patients can eat solid food they can eat <a href=\"https://www.mayoclinic.org/tests-procedures/bariatric-surgery/in-depth/gastric-bypass-diet/art-20048472\" rel=\"nofollow noreferrer\">soft fruit</a>. And before that they can puree food with fruit juices. As for supplements, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616370/\" rel=\"nofollow noreferrer\">vitamin tablets are recommended</a> for most patients after surgery. Most vitamin tablets contain about 60 mg of Vitamin C with the RDA being 90 mg for men.</p>\n\n<p>And if they don't consume nutritious food after surgery, and take their supplements, then the outcome can be a <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3320124/\" rel=\"nofollow noreferrer\">devastating case of scurvy</a> which can nevertheless be treated by enteral vitamin C.</p>\n", "score": 3 }, { "answer_id": 15091, "body": "<p>Certain cooked foods, for example, sweet potatoes, will still have some vitamin C (1 cup potatoes, 328 g = 42 mg vit C) (<a href=\"http://nutritiondata.self.com/facts/vegetables-and-vegetable-products/2668/2\" rel=\"nofollow noreferrer\">NutritionData</a>).</p>\n\n<p>Vitamin-enriched cereals are available.</p>\n\n<p>Vitamin capsules and enteric-coated tablets should not irritate the esophagus and stomach.</p>\n", "score": 1 } ]

[ "cancer", "digestion", "micronutrients" ]

[ { "answer_id": 5736, "body": "<p>A symptom of GERD is <a href=\"http://www.mayoclinic.org/diseases-conditions/heartburn/basics/symptoms/con-20019545\" rel=\"nofollow\">heartburn</a> which is characterized by burning pain in chest.</p>\n\n<p>Heart Burn is usually chronic in GERD and can include: </p>\n\n<p><a href=\"http://www.m.webmd.com/heartburn-gerd/diagnose\" rel=\"nofollow\">WebMD</a></p>\n\n<blockquote>\n <p>Burning in the throat -- or hot, sour, acidic or salty-tasting fluid\n at the back of the throat.</p>\n</blockquote>\n\n<p>The heartburn <a href=\"http://www.m.webmd.com/heartburn-gerd/guide/understanding-gerd-symptoms\" rel=\"nofollow\">doesn't always occur</a> in GERD as a symptom immediately, but can develop after a time. </p>\n\n<p>Exercise(moderate, vigorous can aggravate it) can help reduce GERD symptoms and <a href=\"https://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000381.htm\" rel=\"nofollow\">PPI's</a> decrease stomach acid produced. </p>\n\n<p><a href=\"http://www.m.webmd.com/heartburn-gerd/features/heartburn-concern\" rel=\"nofollow\">What is happening:</a> </p>\n\n<blockquote>\n <p>Heartburn, also called acid indigestion, is a symptom of\n gastroesophageal reflux (GERD). It can occur when acid or other\n contents from your stomach \"back up\" into the esophagus. That’s the\n tube food passes through going from your mouth to your stomach.</p>\n \n <p>The problem stems from a muscle that may be weak or may relax at\n inappropriate times. It’s called the lower esophageal sphincter or\n LES, and it’s located between your stomach and your esophagus. If it\n doesn't close quickly enough, it can’t prevent the acid backwash. That\n results in heartburn.</p>\n</blockquote>\n", "score": 2 }, { "answer_id": 7406, "body": "<p>You could be experiencing what's known as esophageal spasms<a href=\"https://en.wikipedia.org/wiki/Esophageal_spasm\" rel=\"nofollow noreferrer\">1</a>, which can cause considerable pain. The food doesn't go down or acid coming up doesn't move smoothly like it should. Instead the esophagus kind of hiccups and the food gets stuck temporarily. I've had it for years. It can mimic a heart attack and if you're concerned about it there are tests available to diagnose it. One treatment is with nitroglycerin tablets that dissolve under your tongue--the same rx given to those who have angina.</p>\n", "score": 1 } ]

[ "pain", "digestion" ]

[ { "answer_id": 5807, "body": "<p>Somehow today I had a bit more luck in addressing my own question. It seems that many of the online blood testing services do offer tests on a disaggregated basis. Their more popular products are bundled tests that include some of the typical overall blood tests for an annual physical. But, several of those enterprises also offer unbundled tests of more esoteric yet very important tests such as for C-Reactive protein and Fibrinogen. The latter is a very good check to see how granular can you go in terms of specific independent blood tests you can order from such services. Today, I found two companies that passed that check. One is Accesa Labs that operates through Quest Diagnostics. The other one is Health Tests Direct (HTD). HTD is actually very interesting because they operate through both Quest Diagnostics and LabCorp. As a result, HTD allows you to do some comparative shopping in terms of test prices between those two market leaders. </p>\n\n<p>Although the above answer is reasonably inclusive, it does not preclude that others may uncover specific companies that could be equal if not superior to the two I mentioned above. </p>\n\n<p>This is a short update as of December 2017. As we know Theranos has run into all sorts of legal and regulatory troubles since I first wrote this answer. They are now I think very much out of this business. After considering many online lab testing providers I recently chose Personalabs.com. They allowed you to select your blood test on a disaggregated basis as well as any other online competitors. What differentiated them is that their website and their blood test selections were so much clearer than competitors. They operated through Quest Diagnostics and LabCorp just like the other better services. Interestingly enough, I got my lab test results through Personalabs.com within 5 days. Yet, over 10 days later, I still could not get the same from Quest Diagnostics (QD). I am still interested in getting the results from QD just to check that their interpretation of the results (healthy acceptable range of values) are the same as for Personalabs. </p>\n", "score": 5 } ]

[ "blood", "blood-tests", "diagnostics" ]

[ { "answer_id": 5875, "body": "<p>Yes, it is true that Zika can be transmitted sexually (from <a href=\"http://www.cdc.gov/zika/transmission/sexual-transmission.html\" rel=\"nofollow\">the CDC</a>). However, Zika is generally classified as a mosquito-borne disease, not an STD, as mosquitoes are by far the most common vector of passage. I am not aware of transmission of \"typical\" STDs by mosquitoes, most likely because, as you say, the amounts of pathogenic material are <em>extremely</em> small, and the body's immune system can pretty easily clear it without difficulties. </p>\n\n<p>Many of the organisms that cause STDs (including HIV) are quite sensitive to the environment, and cannot survive for long, if at all, outside the human body, which is why you can't get AIDS from a dirty soup spoon, or even an old bloody bandage. However, mosquito-borne pathogens like <a href=\"https://en.wikipedia.org/wiki/Plasmodium\" rel=\"nofollow\"><em>Plasmodium sp.</em></a> (the parasites which cause malaria) are highly adapted to living part of their life cycle within the mosquito itself, as well as in the human host. </p>\n", "score": 4 } ]

[ "sti", "mosquito", "syphilis" ]

[ { "answer_id": 10556, "body": "<p>Only a study in which someone would put different vitamins in a blender and measure the eventual changes in their activities could answer this question. Everything else is just a guess or estimation.</p>\n\n<p>Next, the question would need to be for a specific vitamin in a specific chemical form and in a specific tablet.</p>\n\n<p>My estimation is that nothing significant would happen. Some vitamins could be partly destroyed by heat, but blending alone does not produce much heat, anyway. Crushing of the tablet could affect the physical composition of the tablet and result in either slightly decreased or increased absorption of the vitamin. </p>\n\n<p>On <a href=\"http://nutritiondata.self.com/topics/processing\" rel=\"nofollow noreferrer\">NutritionData</a>, there is a chart with estimated effects of drying, cooking and freezing on the vitamin content of foods. For example, cooking (it does not say for how long) can destroy 25% of vitamin A, 50% of vitamin C and 70% of folic acid.</p>\n\n<p>I think, in general, blending would not do nearly as much damage as cooking.</p>\n", "score": 3 }, { "answer_id": 5904, "body": "<p>From a chemical point of view, no. Vitamins are fairly stable molecules, so they can live into acidic media (like lemon, vitamin C) or other life media which are generally not prone for chemical species stability.</p>\n\n<p>Avoid heating though, this <em>will</em> alter them.</p>\n", "score": 1 } ]

[ "nutrition", "micronutrients" ]

[ { "answer_id": 7019, "body": "<p>Ok so the semi-permanent solution that I have found is to cover school uniforms with <a href=\"https://en.wikipedia.org/wiki/Permethrin\" rel=\"nofollow\">Permethrin</a>.</p>\n\n<p>Permethrin is neurotoxin that is used to repel/kill ticks, fleas, and other insects and is used by <a href=\"https://en.wikipedia.org/wiki/Permethrin#Military_use\" rel=\"nofollow\">US and UK militaries</a> in jungle warfare. It is considered not to be harmful to humans, but might irritate skin for some.</p>\n\n<p>One can buy it on Amazon in <a href=\"http://rads.stackoverflow.com/amzn/click/B00061MSS0\" rel=\"nofollow\">US</a> or <a href=\"https://www.amazon.co.uk/SAWYER-PREMIUM-CLOTHING-REPELLENT-Trigger/dp/B001ANQVYU/ref=sr_1_1?ie=UTF8&amp;qid=1465309512&amp;sr=8-1&amp;keywords=Permethrin\" rel=\"nofollow\">UK</a>, simply spray it on clothes after washing it should last for about 4-5 washes.</p>\n", "score": 2 } ]

[ "treatment", "prevention", "parasites" ]

[ { "answer_id": 5931, "body": "<p>There are 2 types of blood thinners anticoagulants and antiplatelets. Simply:</p>\n\n<p><a href=\"http://www.nhs.uk/conditions/Anticoagulant-medicines/Pages/Introduction.aspx\" rel=\"nofollow\">Anticoagulants</a> </p>\n\n<blockquote>\n <p>Anticoagulants work by interrupting the process involved in the\n formation of blood clots. They're sometimes called \"blood-thinning\"\n medicines, although they don't actually make the blood thinner</p>\n</blockquote>\n\n<p><a href=\"https://www.google.com/url?sa=t&amp;source=web&amp;rct=j&amp;url=http://www.cc.nih.gov/ccc/patient_education/drug_nutrient/coumadin1.pdf&amp;q=how%20does%20coumadin%20work%20nih&amp;ved=0ahUKEwilvp_p8_fMAhWNdSYKHfp5CxkQFggaMAA&amp;usg=AFQjCNHspcUllIe74wCYjz4dfErkUV5Scg\" rel=\"nofollow\">NIH</a></p>\n\n<blockquote>\n <p>Vitamin K is essential for those reactions. Warfarin (Coumadin) works\n by decreasing the activity of vitamin K; lengthening the time it takes\n for a clot to form.</p>\n</blockquote>\n\n<p><a href=\"https://www.nlm.nih.gov/medlineplus/bloodthinners.html\" rel=\"nofollow\">Antiplatelets</a></p>\n\n<blockquote>\n <p>Antiplatelet drugs, such as aspirin, prevent blood cells called\n platelets from clumping together to form a clot.</p>\n</blockquote>\n\n<p>A deeper understanding can be derived from looking up the individual medications: <a href=\"http://www.webmd.com/drugs/2/drug-5190/clopidogrel-oral/details\" rel=\"nofollow\">Clopidogrel</a> (Antiplatelet) and <a href=\"https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682277.html\" rel=\"nofollow\">Coumadin</a>(Anticoagulant). I don't know which type your refering to, but they:</p>\n\n<ul>\n<li><a href=\"http://www.healthline.com/health/anticoagulant-and-antiplatelet-drugs\" rel=\"nofollow\">Dont actually thin the blood</a>. They really just interfere with processes to stop and prevent blood clots. </li>\n</ul>\n\n<blockquote>\n <p>Anticoagulant and antiplatelet drugs work by stopping platelets from\n adhering to one another and clotting proteins from binding together.</p>\n</blockquote>\n\n<ul>\n<li>Blood thinners can cause <a href=\"http://www.medicinenet.com/script/main/mobileart.asp?articlekey=100173&amp;page=2\" rel=\"nofollow\">thrombocytopenia</a> (low platelets). However, the platelets have to be severely low beneath 100,000 to cause spontaneous and uncontrollable bleeding that may cause death usually. </li>\n</ul>\n\n<blockquote>\n <p>Many medications can cause low platelet count by causing immunologic\n reaction against platelets, called drug-induced thrombocytopenia.</p>\n</blockquote>\n\n<p>So basically on this stuff it takes you longer to clot and therefore increased the time you bleed. </p>\n", "score": 3 }, { "answer_id": 26170, "body": "<p>As far as I know, the only blood thinner that is known for its potential to reduce platelet count is Heparine. See e.g. Wikipedia, HIT - heparin induced thrombocytopenia, <a href=\"http://www.en.wikipedia.org/wiki/Heparin-induced_thrombocytopenia\" rel=\"nofollow noreferrer\">www.en.wikipedia.org/wiki/Heparin-induced_thrombocytopenia</a></p>\n<p>&quot;If someone receiving heparin develops new or worsening thrombosis, or if the platelet count falls, HIT can be confirmed with specific blood tests.&quot;</p>\n<p>Some other link on &quot;HIT&quot;: <a href=\"https://www.ahajournals.org/doi/full/10.1161/circulationaha.106.632653\" rel=\"nofollow noreferrer\">https://www.ahajournals.org/doi/full/10.1161/circulationaha.106.632653</a></p>\n<p>For a popular blood thinner that seems to be based on heparin see <a href=\"https://en.wikipedia.org/wiki/Enoxaparin_sodium\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Enoxaparin_sodium</a></p>\n<p>For several other substances of the same category see e.g.\n<a href=\"https://www.ahajournals.org/doi/full/10.1161/circulationaha.106.632653\" rel=\"nofollow noreferrer\">https://www.ahajournals.org/doi/full/10.1161/circulationaha.106.632653</a></p>\n<p>The question says: &quot;creation&quot; of platelets. There is not known any &quot;blood thinner&quot; that prevents the creation of platelets. Typically, Vitamin K which is blocked by certain blood thinners, is needed for the creation of factors of the coagulation cascade. Thus, blood thinners interfering with vitamine K do not prevent the &quot;creation&quot; of platelets/thrombocytes (which medication blocking cell division does, cp. cancer medication), but the creation of coagulation factors.</p>\n<p>Creation of platelets is different from &quot;creation of blood clots&quot; and its prevention. The question is not coherent in respect of its explanatory text. The answer to the question reformulated in the explanatory note &quot;...platelets are used to prevent ... blood loss from the wound, so how do Blood Thinners prevent this?&quot;:</p>\n<p>They inhibit the aggregation of platelets by interfering with the thrombocyte's signaling hormone thromboxane.</p>\n<p>See <a href=\"https://en.wikipedia.org/wiki/Thromboxane#Inhibitors\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Thromboxane#Inhibitors</a>\n&quot;The widely used drug aspirin acts by inhibiting the ability of the COX enzyme to synthesize the precursors of thromboxane within platelets.&quot;\n<a href=\"https://en.wikipedia.org/wiki/Thromboxane#Inhibitors\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Thromboxane#Inhibitors</a></p>\n<p>There are blood thinners that do not directly act on platelets but on the coagulation cascade.The question does not seem to refer to these. What's more, they do not lead to low platelet count and do not interfere with cell devision i.e. creation of platelets. However, for some dispute on Thrombocytopenia in the context of novel blood thinners see e.g. <a href=\"https://pubmed.ncbi.nlm.nih.gov/3219062\" rel=\"nofollow noreferrer\">https://pubmed.ncbi.nlm.nih.gov/3219062</a></p>\n", "score": 1 } ]

[ "blood", "wound" ]

[ { "answer_id": 5947, "body": "<p>No one can tell you what is going to happen to a patient exactly, because every Patient is different. However, the risk are: </p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/hip-fracture/basics/complications/con-20021033\" rel=\"nofollow\">Mayo Clinic</a></p>\n\n<blockquote>\n <p>A hip fracture can reduce your future independence and sometimes even\n shorten your life. About half of people who have a hip fracture aren't\n able to regain their ability to live independently.</p>\n \n <p>If a hip fracture keeps you immobile for a long time, the\n complications can include:\n Blood clots in your legs or lungs Bedsores Urinary tract infection\n Pneumonia Further loss of muscle mass, increasing your risk of falls\n and injury Additionally, people who've had a hip fracture are at\n increased risk of weakened bones and further falls — which means a\n significantly higher risk of having another hip fracture.</p>\n</blockquote>\n\n<p>If you have a hip fracture you are at a higher risk for negative and life threatening complications and decreased independence and quality of life as you can do less (mobility, etc). Therapy and rehab can help you, however the hip is still fractured and if the patient has dementia they generally do not follow all of what the doctor prescribes. </p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102807/\" rel=\"nofollow\">Ncbi.nlm.nih.gov</a></p>\n", "score": 1 } ]

[ "hips", "dementia" ]

[ { "answer_id": 5954, "body": "<p><a href=\"http://www.drugs.com/sfx/tetracycline-topical-side-effects.html\" rel=\"nofollow\">Unlikely.</a> </p>\n\n<blockquote>\n <p>Tetracycline topical is generally well tolerated. Side effects\n reported with systemic administered tetracycline such as\n gastrointestinal complaints, vaginitis, hematologic abnormalities,\n dental, and skeletal disorders have not been reported and are unlikely\n to occur with topical administration.</p>\n</blockquote>\n\n<p>However,</p>\n\n<blockquote>\n <p>A faint yellowing of the skin has been reported, especially around the\n hair roots</p>\n</blockquote>\n\n<p>This <a href=\"http://www.encyclopedia.com/topic/tetracycline.aspx\" rel=\"nofollow\">link</a> agrees with the above. </p>\n", "score": 3 }, { "answer_id": 11685, "body": "<p>When taken orally tetracycline can cause discolouration in developing teeth and should be avoided - when possible - in young children.\nSystemic tetracycline will have no effects on the colour of fully erupted teeth. So not something an adult needs to worry about !</p>\n\n<blockquote>\n <p>\"Discolouration of the teeth occurs in a high proportion of children undergoing antibiotic therapy with drugs of the tetracycline group during the time of tooth development.\"</p>\n</blockquote>\n\n<p><strong>Oral Diagnosis 2nd Edition W R Tyldesley page 69</strong></p>\n", "score": 1 } ]

[ "dentistry", "side-effects", "topical-cream-gel", "antibiotics", "coloration-discoloration" ]

[ { "answer_id": 10282, "body": "<p>There is ill effect if the water contains germs. Boiling water kill the germs, and mixing them with cold water will result in a temperature low enough for the germs from the cold water to survive. That's why in some part of the world, there is some believe not to mix hot and cold water for drinking. It can really cause sickness if the water is not clean.</p>\n\n<p>Reference : \n<a href=\"https://www.quora.com/Are-there-any-ill-effects-if-you-drink-a-hot-and-cold-water-mixture\" rel=\"nofollow noreferrer\">https://www.quora.com/Are-there-any-ill-effects-if-you-drink-a-hot-and-cold-water-mixture</a></p>\n\n<p>Thus, its better you to take hot water and keep it for sometime and then drink it.</p>\n", "score": 3 } ]

[ "water" ]

[ { "answer_id": 5971, "body": "<p><strong>You should not listen to music at 85 decibels for more than 8 hours. And if it's at 88 decibels limit your time to 4 hours.</strong> </p>\n\n<p>To judge this you have to use <a href=\"https://en.m.wikipedia.org/wiki/Decibel\" rel=\"nofollow\">decibels</a>:</p>\n\n<p><a href=\"http://www.livescience.com/32783-how-loud-can-you-play-music-without-damaging-your-hearing.html\" rel=\"nofollow\">Livescience.com</a></p>\n\n<ul>\n<li><blockquote>\n <p>A person exposed to noise levels at 85 decibels or higher for a\n prolonged period of time is at risk for hearing loss</p>\n</blockquote></li>\n<li><blockquote>\n <p>You shouldn't listen to music , or be exposed to any noise, at 85\n decibels for more than 8 hours at a time, said Gordon Hughes, program\n officer of clinical trials at the National Institute on Deafness and\n Other Communication Disorders (NIDCD). If you've got the volume\n cranked to 88 decibels, then cut your listening time down to 4 hours.</p>\n</blockquote></li>\n<li><blockquote>\n <p>At its loudest, an MP3 player pumps out 105 decibels that's100 times\n more intense than 85 decibels</p>\n</blockquote></li>\n<li><blockquote>\n <p>\"One way you can tell if your music is too loud is if you're talking\n to a friend and you have to raise your voice to be heard,\" Hughes\n said. Normal conversation is around 60 decibels</p>\n</blockquote></li>\n</ul>\n\n<p>Articles that agree with the above:</p>\n\n<ul>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3205831/\" rel=\"nofollow\">Personal music players and hearing loss: Are we deaf to the risks?</a></p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406203/\" rel=\"nofollow\">Ear Infection and Hearing Loss Amongst Headphone Users</a></p></li>\n</ul>\n\n<p>You can find how may decibels your listening at by going online or looking at your manual for your device. This is more acurate as all devices are different. If that doesnt tell you there are <a href=\"http://m.wikihow.com/Measure-Decibels\" rel=\"nofollow\">apps and other devices.</a> </p>\n", "score": 2 } ]

[ "hearing", "ear" ]

[ { "answer_id": 5975, "body": "<p><a href=\"https://fitness.stackexchange.com/a/29893/8763\">Let your own body figure this out</a> You'll get better results if you increase the amounts of healthy foods, at least 400 grams of vegetables and eating only whole grain products. With only 1700 Kcal intake per day (which is pretty much what I eat for dinner alone), it's quite hard to get the large amount of nutrients you need for optimal physical performance when you are burning 700 Kcal doing exercise. Note e.g. the importance of <a href=\"https://en.wikipedia.org/wiki/Magnesium_in_biology\" rel=\"nofollow noreferrer\">magnesium for your body</a>.</p>\n\n<p>The human body is going to work hard to maintain itself. If we compare the human body to a factory and compare eating to supplying raw materials, then it's clear that a diet that is not supplying the nutrients in the right proportions will cause the body to either store or excrete the compounds it gets in relative excess. Suppose that your magnesium intake is too low compared to your calorie intake. Then the body will tend to store the calories in the form of fat, as it needs magnesium to burn calories. While this example may be a bit too simplistic, there are many biochemical pathways available for the body to do what it needs to do, it's still going to be constrained by the intake of nutrients on the long term.</p>\n", "score": 1 } ]

[ "exercise", "weight", "weight-loss", "calories" ]

[ { "answer_id": 9213, "body": "<p>There are a few ways to check that, <a href=\"http://www.allaboutvision.com/\" rel=\"nofollow\">allaboutvision.com</a> has some great information on various ways to check the orientation of a contact lens:</p>\n\n<blockquote>\n <p><strong>Method 1: The Side View</strong></p>\n \n <p>If your contact forms a perfect cup-shape with the edge perfectly\n upright, the lens is correctly oriented and is ready to be placed on\n your eye. If the edge has a noticeable outward bend (like a rimmed\n soup bowl), the contact is inside out.</p>\n \n <p><strong>Method 2: The \"Taco Test\"</strong></p>\n \n <p>Place the contact lens between the tips of your thumb and forefinger,\n grasping it near the center so the entire edge is free. Gently squeeze\n the lens, as if you are about to fold it in half.</p>\n \n <p>If the edge of the lens points upward (resembling a hard-shell taco),\n the lens is correctly oriented. If the edge bends outward (toward your\n thumb and finger), the lens is inside out.</p>\n \n <p><strong>Method 3: Check The Edge Tint</strong></p>\n \n <p>If the color of the handling tint on the lens edge looks very blue (or\n green, depending on the tint), the lens is correctly oriented. If the\n color looks pale or washed out, the lens probably is inside out.</p>\n \n <p><strong>Method 4: Look For Laser Markings</strong></p>\n \n <p>Some contact lenses have a laser marking to help you determine if your\n contact is inside out. For example, one brand has a \"123\" laser\n marking near the edge of the lens.</p>\n \n <p>If the \"123\" appears normally, the lens is correctly oriented and\n ready to be placed on your eye. If the \"123\" is backward, the contact\n is inside out. If at first you don't see the laser marking, turn the\n lens on your fingertip to make sure you check its entire surface.</p>\n</blockquote>\n\n<p>Source: <a href=\"http://www.allaboutvision.com/contacts/faq/inside-out.htm\" rel=\"nofollow\">http://www.allaboutvision.com/contacts/faq/inside-out.htm</a></p>\n", "score": 3 } ]

[ "eye", "lenses" ]

[ { "answer_id": 7020, "body": "<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/15113353\" rel=\"nofollow\">Organ donation and utilization in the USA</a></p>\n\n<ul>\n<li>States about 3.6 organs are gathered from every deceased donor</li>\n</ul>\n\n<p><strong><a href=\"http://www.organdonor.gov\" rel=\"nofollow\">Organdonor.gov</a> says a organ donor can save up to 8 lives and <a href=\"http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/organ-donation/art-20047529\" rel=\"nofollow\">Mayo Clinic</a> says you can save or improve up to 50 lives. Some sites say you can save over 50 and even <a href=\"http://www.americantransplantfoundation.org/about-transplant/facts-and-myths/\" rel=\"nofollow\">a 100 though</a>.</strong></p>\n\n<p><a href=\"http://www.liveonny.org/mobile/\" rel=\"nofollow\">liveonny.org</a></p>\n\n<blockquote>\n <p>One organ donor can save up to eight lives. The same donor can also\n save or improve the lives of up to 50 people by donating tissues and\n eyes. </p>\n</blockquote>\n\n<p>However, most deceased organ donors are brain dead about <a href=\"https://sciencelife.uchospitals.edu/2014/02/20/the-challenge-of-organ-donation-after-cardiac-death/\" rel=\"nofollow\">5%</a> have experienced cardiac arrest though. This does not affect the amount of organs donated usually, both donors give around the same amount. As for possible rejection of organs any patient with a donated organ could do that, there are some people who may have greater risk, but usually everyone needs to take meds to be safe from this. </p>\n\n<p>Survival rates:</p>\n\n<ul>\n<li><a href=\"http://www.mayoclinic.org/tests-procedures/kidney-transplant/basics/results/prc-20014007\" rel=\"nofollow\">Kidney</a>: </li>\n</ul>\n\n<blockquote>\n <p>About 98 percent of people who receive a living-donor kidney\n transplant live for at least one year after their transplant surgery.\n About 90 percent live for at least five years. About 94 percent of\n adults who receive a deceased-donor kidney transplant live for at\n least one year after their transplant surgery. About 82 percent live\n for at least five years.</p>\n</blockquote>\n\n<ul>\n<li><p><a href=\"http://www.uphs.upenn.edu/news/News_Releases/2014/07/goldberg/\" rel=\"nofollow\">Liver</a>: \nThe 3 year survival rate was 78% and the 71% survival rate was for 5 years.</p></li>\n<li><p>list of survival up to 10 years. I would have added the list, but it's very big as it includes all <a href=\"http://www.srtr.org/annual_Reports/2011/113a_dh.aspx\" rel=\"nofollow\">organs</a>. </p></li>\n</ul>\n", "score": 1 } ]

[ "surgery", "donor" ]

[ { "answer_id": 7063, "body": "<p>Candida albicans is an opportunistic, dimorphic fungal pathogen that grows both as yeast and filamentous cells(pseudohyphae, hyphae and chlamydospores). Morphogenesis is an essential trait in the pathogenic fungus C. albicans in which the transition from unicellular yeast to filamentous form takes place and vice versa,which is required for virulence.\nMorphological changes occur in response to alterations in the growth conditions. Different parameters directly or indirectly influence the process,of which variation in pH is one of them.(others being temperature, growth media, etc)</p>\n\n<blockquote>\n <p>Microtubules and microfilaments were observed in hyphal cells.The decrease of external pH did not affect microtubules directly, but long microfilaments\n disappeared from hyphal cells within 30 min after changing the external pH at 37 \"C particularly affects long microfilaments, which disappear from the cytoplasm, and consequently trigger the reversion from hyphal growth to yeast growth.</p>\n</blockquote>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8180693\" rel=\"nofollow\">Source</a>.</p>\n\n<p>In the yeast state, Candida is a non-invasive, sugar-fermenting organism, while in fungal state it is invasive and can produce rhizoids, very long root-like structures. Rhizoids can penetrate mucosa or intestinal walls, leaving microscopic holes and allowing toxins, undigested food particles and bacteria and yeast to enter the bloodstream. This condition is known as Leaky Gut Syndrome </p>\n\n<p>References</p>\n\n<p><a href=\"http://www.thecandidadiet.com/ph-levels-candida.htm\" rel=\"nofollow\">http://www.thecandidadiet.com/ph-levels-candida.htm</a></p>\n\n<p><a href=\"http://www.scirp.org/journal/PaperInformation.aspx?PaperID=37056\" rel=\"nofollow\">http://www.scirp.org/journal/PaperInformation.aspx?PaperID=37056</a></p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Candida_albicans\" rel=\"nofollow\">https://en.wikipedia.org/wiki/Candida_albicans</a></p>\n", "score": 2 } ]

[ "research", "infectious-diseases", "yeast", "fungal-infection" ]

[ { "answer_id": 7155, "body": "<p>That depends on the sort of antibiotics. E.g. Tetracyclines interacts with Ca2+ and so its absorption is massively reduced <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/946598\" rel=\"nofollow\">see here</a>, while other do interact less.</p>\n\n<p>Generally you can say, that you should never take drugs with milk or milk derivatives.</p>\n", "score": 3 } ]

[ "antibiotics", "probiotics" ]

[ { "answer_id": 7157, "body": "<p>Of course you could combat muscular degeneration. </p>\n\n<p>What you could do is </p>\n\n<ul>\n<li>Massage</li>\n<li>(Higher protein intake by infusion)</li>\n<li>(Electrical muscle stimulation (<a href=\"https://en.wikipedia.org/wiki/Electrical_muscle_stimulation\" rel=\"nofollow\">EMS</a>)</li>\n<li>(Steroids)</li>\n</ul>\n\n<p>But it's an intervention that's not essential for life and probably dangerous so this isn't practical.</p>\n", "score": 0 } ]

[ "injections", "coma-comatose", "muscular-atrophy", "muscular-dystrophy" ]

[ { "answer_id": 7200, "body": "<p>Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme that protects red blood cell against oxidative damage. G6PD deficiency is one the most common genetic disorders.</p>\n\n<p>Most of the patients with G6PD deficiency remain clinically asymptomatic. However they are at increased risk of developing acute haemolytic anemia (AHA) in the presence of oxidative agents, which can be either fava beans, infections and drugs.</p>\n\n<p>Considering that infection can precipitate acute haemolytic anemia, which can in some case have severe outcomes, vaccination would confer a solid way to prevent this. </p>\n\n<p>The question asks about any contraindications for vaccinations in G6PD deficient patients.</p>\n\n<p>Consulting the Vaccine Contraindications and Precautions provided by the Centers for Disease Control and Prevention (<a href=\"http://www.cdc.gov/vaccines/hcp/admin/contraindications.html\" rel=\"nofollow\">http://www.cdc.gov/vaccines/hcp/admin/contraindications.html</a>) did not mention G6PD deficiency as proven contraindications for vaccination. Additionally, a search in Medline (a biomedical literature referencing more than 26 millions citations from journals and online books) does not seem to provide any studies or case report concerning the occurrence of adverse events in G6PD deficient patient after immunisation either.</p>\n\n<p>One study advocated hepatitis A vaccination in patient with G6PD deficiency in order to prevent damaging consequences from intravascular hemolysis precipitated by acute hepatitis A infection in two children with G6PD deficiency.</p>\n\n<p>So far, there seems to be a lack of evidence against vaccination in G6PD patients. Like in many cases in medicine, the benefits of vaccination should be balanced with its possible adverse events. </p>\n\n<p>Sources:</p>\n\n<ul>\n<li>Ozbay Hosnut F, Ozcay F, Selda Bayrakci U, Avci Z, Ozbek N. Etiology of\nhemolysis in two patients with hepatitis A infection: glucose-6-phosphate\ndehydrogenase deficiency or autoimmune hemolytic anemia. Eur J Pediatr. 2008\nDec;167(12):1435-9.</li>\n<li>Youngster I, Arcavi L, Schechmaster R, Akayzen Y, Popliski H, Shimonov J, Beig\nS, Berkovitch M. Medications and glucose-6-phosphate dehydrogenase deficiency: an\nevidence-based review. Drug Saf. 2010 Sep 1;33(9):713-26.</li>\n</ul>\n", "score": 6 } ]

[ "side-effects", "vaccination", "deficiency" ]

[ { "answer_id": 7216, "body": "<p>Well, if you really want a website that offers easy to understand information that is based on scientific studies, then there is one site that I would recommend to you:</p>\n\n<p><a href=\"http://nutritionfacts.org/\" rel=\"noreferrer\">Nutritionfacts</a></p>\n\n<p>It's basically driven by one Guy, Michael Greger M.D., who has a team of people who constantly dig through the latest scientific papers and bundle the information into easily digestible short videos and blog posts. Each video has a small button right of it which is easily overlooked, titled \"Sources cited\", where it lists all the sources for the information listed in the video.</p>\n\n<p>Aside of these, there are longer videos at the bottom of the site titled \"Nutrition Year-in-Review\", which are recorded speeches of Mr. Greger where he summarizes the latest in nutrition science.</p>\n", "score": 5 }, { "answer_id": 7210, "body": "<p>You can try the <a href=\"https://www.hsph.harvard.edu/nutritionsource/\" rel=\"nofollow\">Harvard Nutrition Source</a>. It seems to be very science based, although outside interests are always present. I guess the best way to get scientific data is using and comparing various sources of data.</p>\n", "score": 4 }, { "answer_id": 7245, "body": "<p>NIH.gov is good for all kinds of things health, including alternative therapies and nutrition. They also have a newsletter.</p>\n", "score": 2 }, { "answer_id": 7535, "body": "<p>Good sources are review articles published in peer reviewed journals such as <a href=\"http://ajcn.nutrition.org\" rel=\"nofollow\">The American Journal of Clinical Nutrition</a>. To apply whatever information you get from there to your own diet, you need to know the content of nutrients in your food. You can obtained detailed information from <a href=\"http://nutritiondata.self.com\" rel=\"nofollow\">this website</a>. Protein content is given in terms of all the amino acids, fats in terms all the different types of fatty acids molecules.</p>\n", "score": 1 }, { "answer_id": 8745, "body": "<p><a href=\"http://examine.com\" rel=\"nofollow noreferrer\">Examine.com</a></p>\n<p>The site does not give detailed breakdown of the nutritional values of specific foods but what it does give is arguably more useful to the Average Joe.</p>\n<p>Examine.com is an independent and unbiased encyclopaedia on supplementation and nutrition. They are not affiliated in any way with any supplement company (disclosure below).</p>\n<p>The site is run by editors who examine primary research. Users are encouraged to submit corrections and any research we may have missed.</p>\n<blockquote>\n<h3>Disclosure</h3>\n<p>Examine.com is an unbiased nutrition and supplement resource. We are\nnot influenced by commercial interests, product manufacturers, or any\nother organization, and we will not advertise products or brands.\nExamine.com does not accept donations, third-party funding, or\nsponsorship of any kind. One hundred percent of our revenue is\ngenerated through our three products: the Examine.com Research Digest,\nSupplement-Goals Reference, and the Supplement Stack Guides.</p>\n</blockquote>\n<p>For nutrition specifically then go to: <a href=\"http://examine.com/nutrition/\" rel=\"nofollow noreferrer\">http://examine.com/nutrition/</a></p>\n<p>Their top Q&amp;A's are:</p>\n<ol>\n<li><a href=\"http://examine.com/nutrition/is-saturated-fat-bad-for-me/\" rel=\"nofollow noreferrer\">Is saturated fat bad for me?</a> (Saturated fat, as an all-inclusive category, has not yet been shown to beneficially or adversely affect heart health.)</li>\n<li><a href=\"http://examine.com/nutrition/is-diet-soda-bad-for-you/\" rel=\"nofollow noreferrer\">Is diet soda bad for you?</a> (There are no studies that indicate any long-term health risks from drinking diet soda)</li>\n<li><a href=\"http://examine.com/nutrition/do-i-need-to-eat-six-times-a-day-to-keep-my-metabolism-high/\" rel=\"nofollow noreferrer\">Do I need to eat six times a day to keep my metabolism high?</a> (There is no evidence to support the idea that multiple meals increases metabolic rate)</li>\n<li><a href=\"http://examine.com/nutrition/what-should-i-eat-for-weight-loss/\" rel=\"nofollow noreferrer\">What should I eat for weight loss?</a> (Eat less. Different diets can make this easier, so pick whichever one best fits your lifestyle. Ultimately, you need to reduce your caloric intake.)</li>\n<li><a href=\"http://examine.com/nutrition/is-hfcs-high-fructose-corn-syrup-worse-than-sugar/\" rel=\"nofollow noreferrer\">Is high fructose corn syrup (HFCS) worse than sugar?</a> (There currently is no good evidence to suggest that one is worse than the other; either they are both inert or they are both evil. The difference between them is too small to matter in moderate consumption, and in excess both are harmful to health)</li>\n</ol>\n<p>And my favourite hidden gem on that site is the topic on <a href=\"http://examine.com/supplements/Green+Tea+Catechins/\" rel=\"nofollow noreferrer\">green tea</a>:</p>\n<blockquote>\n<p>It has been implicated in benefiting almost every organ system in the\nbody. It is cardioprotective, neuroprotective, anti-obesity,\nanti-carcinogenic, anti-diabetic, anti-artherogenic, liver protective\nand beneficial for blood vessel health. These beneficial effects are\nseen in doses present both in green tea itself (as a drink) as well as\nfrom a supplemental form.</p>\n</blockquote>\n", "score": 1 }, { "answer_id": 7545, "body": "<p>The <a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/basics/nutrition-basics/hlv-20049477\" rel=\"nofollow\">Mayo Clinic</a> website is a great source of reliable information and a place to start. If you want to dig deeper, NIH website as someone pointed out has many comprehensive resources. See <a href=\"https://ods.od.nih.gov/factsheets/list-all/\" rel=\"nofollow\">here</a> for the Office of Dietary Supplements, for example. It's not just supplements btw, but info on e.g. how much of a given vitamin or mineral like iron a person needs given their background and which foods contain in (and how much per serving).</p>\n", "score": 0 }, { "answer_id": 16052, "body": "<p>I use this one, mainly because of it's extensive micro-nutrient details including minerals, vitamins and fatty acids, and protein/amino acid analysis:</p>\n\n<p><a href=\"http://nutritiondata.self.com\" rel=\"nofollow noreferrer\">http://nutritiondata.self.com</a></p>\n\n<p><a href=\"https://i.stack.imgur.com/l31EG.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/l31EG.png\" alt=\"enter image description here\"></a>\n<a href=\"https://i.stack.imgur.com/liCUM.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/liCUM.png\" alt=\"enter image description here\"></a></p>\n", "score": 0 }, { "answer_id": 16060, "body": "<p>One way to find reliable nutrition info is to first <strong>limit your search to an exact question,</strong> for example, can high intake of potassium from foods or supplements decrease the risk of heart disease?</p>\n\n<p>Next, put some of the keywords from the question into a search engine and add \"systematic review.\" You can often find at least 3-5 reviews.</p>\n\n<p>Examples of websites with systematic reviews:</p>\n\n<ul>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pmc/\" rel=\"nofollow noreferrer\">PubMed Central</a> (A library of articles from various peer-reviewd medical journals)</li>\n<li><a href=\"http://www.cochrane.org/what-is-cochrane-evidence\" rel=\"nofollow noreferrer\">Cochrane</a> (Strict reviews)</li>\n<li><a href=\"http://lpi.oregonstate.edu/mic\" rel=\"nofollow noreferrer\">Linus Pauling Institute</a> (One-page-one nutrient reviews of the effects of nutrients, mainly vitamins and minerals, about their effectiveness in the prevention and treatment of different diseases).</li>\n<li><a href=\"https://ods.od.nih.gov/\" rel=\"nofollow noreferrer\">Office of Dietary Supplements</a> (Similar as Linus Pauling Institute)</li>\n</ul>\n\n<p>It is then good to check few reviews, because their conclusion often differ markedly from each other. </p>\n", "score": 0 } ]

[ "nutrition", "diet" ]

[ { "answer_id": 8975, "body": "<p>Quote from \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24214851\" rel=\"nofollow\">Toxic compounds in honey.</a>\" (2014):</p>\n\n<blockquote>\n <p>(...) honey may contain compounds that may lead to toxicity. A compound not naturally present in honey, named <strong>5-hydroxymethylfurfural (HMF), may be formed during the heating</strong> or preservation processes of honey.</p>\n</blockquote>\n\n<p>Also, from <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20595027\" rel=\"nofollow\">other sources</a>:</p>\n\n<blockquote>\n <p>High concentrations of HMF in honey indicate <strong>overheating</strong>, poor storage conditions and old honey.</p>\n</blockquote>\n", "score": 2 }, { "answer_id": 8987, "body": "<p>Honey might be okey as long as you go the <a href=\"http://www.greenmedinfo.com/blog/why-you-should-ditch-sugar-favor-honey\" rel=\"nofollow\"><em>raw organic</em></a> way.<br>\nSee «<em>Why Consuming Honey Raw Is So Important</em>» section. </p>\n\n<p>This honey is much better (from the nutrients point of view) because it has not been refined and is still loaded of vitamins, minerals, etc., contrary to white sugar. For a deep analysis on raw honey versus industrial honey and how to spot artificial honey, see <a href=\"http://permaculturenews.org/2014/02/08/shocking-differences-raw-honey-processed-golden-honey-found-grocery-retailers/\" rel=\"nofollow\">this article</a>.</p>\n\n<p>You may also be interested in organic <a href=\"https://en.wikipedia.org/wiki/Muscovado\" rel=\"nofollow\">muscvado</a> sugar which is a non refined \"sugar cane\" sugar.</p>\n\n<h3>But</h3>\n\n<blockquote>\n <p>«<strong>Honey actually contains more sugar and carbohydrates per serving compared to regular table sugar.</strong> <a href=\"http://www.livestrong.com/article/471043-honey-blood-sugar/\" rel=\"nofollow\">source</a></p>\n</blockquote>\n\n<p>Honey will surely and quickly raise your blood sugar too (triggering insulin secretion from your pancreas).</p>\n\n<blockquote>\n <p>«<strong>All carbohydrates</strong>, with the exception of fiber, <strong>can raise your blood sugar levels</strong>, whether they come from honey, bread, rice, potatoes, candies, fruits or table sugar. If you have a blood glucose meter, you can do an experiment.</p>\n</blockquote>\n\n<p>I did the experiment twice with a friend of mine, a slim sportive guy (as I am) but who is diabetic <em>Type 1</em>. Results were barely the same.<br>\nExperiment: Prior to the tests, we made sure have the same meal in the morning ~9am. At 18pm, on an empty stomach, we ate a yogurt with 3 servings of organic honey each.<br>\nResults: 15 minutes after, his blood sugar raised up to over 200mg/dL whereas mine was between 110 and 120mg/dL (thanks to my body secretion of insulin I guess).</p>\n\n<blockquote>\n <p>Honey has a low to medium <a href=\"http://www.glycemicindex.com/about.php\" rel=\"nofollow\">GI</a> value, varying between 35 and 58 (…) Honey is therefore associated with a slower and smaller increase in your blood sugar levels compared with table sugar» <a href=\"http://www.livestrong.com/article/471043-honey-blood-sugar/\" rel=\"nofollow\">source</a></p>\n</blockquote>\n\n<p>Excess consumption of sugar, no matter the source it comes from, will expose one to the same kind of side effects and in the long term <em>can</em> lead to overweight or various illnesses such as Type2 diabetes.</p>\n\n<blockquote>\n <p>«Eating too much sugar can lead to weight gain, which in turn increases your risk of health conditions such as heart disease and type 2 diabetes» <a href=\"http://www.nhs.uk/Livewell/Goodfood/Pages/sugars.aspx\" rel=\"nofollow\">source</a></p>\n</blockquote>\n\n<p>Link to an interesting trial on <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26338891\" rel=\"nofollow\">«Consumption of Honey, Sucrose, and High-Fructose Corn Syrup Produces Similar Metabolic Effects in Glucose-Tolerant and -Intolerant Individuals»</a> </p>\n\n<p>Then, I would say honey is okey as long as you limit your intakes to few tea spoons a meal.</p>\n\n<blockquote>\n <p>«Honey has the same chemical backbone as table sugar, so the recommended serving size of honey is the same as it is for table sugar».<a href=\"http://www.livestrong.com/article/410468-side-effects-of-eating-too-much-honey/\" rel=\"nofollow\">Source</a></p>\n \n <p>« Like any other sweetener, honey should be used sparingly in your diet.(…) For example, try using about 1/2 teaspoon of honey to mildly sweeten your tea, plain yogurt, … » <a href=\"http://www.livestrong.com/article/471043-honey-blood-sugar/\" rel=\"nofollow\">source</a></p>\n</blockquote>\n\n<h2>Heavy edit (sources added) in response to <em>Fermi paradox's</em> comment.</h2>\n", "score": 2 }, { "answer_id": 9007, "body": "<ol>\n<li>Honey is made of (in weight):\n18% of water and 82% of sugars (and sugars are glucose and fructose in a fraction that depends on the honey kind, e.g. mixed honey, acacia honey, etc.) <a href=\"https://en.wikipedia.org/wiki/Honey\" rel=\"nofollow\">[ref.1]</a></li>\n</ol>\n\n<p>this means:<br>\n<strong>a)</strong> it's anyhow <strong>almost</strong> pure sugar, with all problems related to...<br>\n<strong>b)</strong> respect raw sugar, that's pure sucrose, this is the main and the bigger difference between honey and raw sugar; I pointed out this difference because, IMHO, this is the main <em>route</em> in where looking for disadvantages or advantages! e.g. glucose VS sucrose, and, fructose VS sucrose.</p>\n\n<ol start=\"2\">\n<li><p>honey is <em>certainly better</em> than raw sugar because contains/is rich of vitamins and minerals <a href=\"https://en.wikipedia.org/wiki/Honey\" rel=\"nofollow\">[ref.1]</a></p></li>\n<li><p>HMF compound presence means <em>bad</em> honey but it's not toxic for human; instead is toxic for bees <a href=\"https://en.wikipedia.org/wiki/Hydroxymethylfurfural#Biomedical\" rel=\"nofollow\">[ref.2]</a></p></li>\n</ol>\n", "score": 1 } ]

[ "nutrition", "diet", "sugar" ]

[ { "answer_id": 11080, "body": "<p>The chemical name for neoprene is polychloroprene and is a polymer of chloroprene. Chloroprene is suspected of causing cancer, but that does not mean that its polymer causes cancer. For instance, ethylene is a gas used to ripen, among other things, bananas, but its polymer--poylyethylene--is the basis of many plastics; ethylene and polyethylene are nothing alike, just like chloroprene and polychloroprene.<br><br>If some substance does not cause cancer, it's highly unlikely that you will find literature that expressly states that. <br><br>That example you cite is most likely referring to the chloroprene in neoprene. However, that chloroprene is tightly locked up inside its polymer. It would take a strong chemical (stronger that your sweat) to unbind the chloroprene in neoprene.</p>\n", "score": 2 } ]

[ "cancer", "lasting-effects-duration", "risks", "weightlifting", "carcinogens" ]

[ { "answer_id": 11545, "body": "<p>Also departing from fish, hempseed oil is <a href=\"https://link.springer.com/article/10.1007%2Fs10681-004-4811-6?LI=true\" rel=\"nofollow noreferrer\">known to contain the optimal ratio of omega 3 and omega 6</a> fatty acids, and does not present any health drawback to my knowledge.</p>\n", "score": 3 }, { "answer_id": 7276, "body": "<p>(ok, the text in the comment field says clearly \"avoid answering...\", but my answer is not a direct answer to your \"which fish\" question, what should I do? ^^)</p>\n\n<p>Perhaps using supplementary oil capsules is a better alternative:</p>\n\n<blockquote>\n <p>studies have found that most of the widely available supplements contain little or no mercury, dioxins or PCBs. For one thing, most companies use species of fish that are lower on the food chain, like cod and sardines, which accumulate less mercury. And many companies distill their oils to help remove contaminants.</p>\n</blockquote>\n\n<p><a href=\"http://www.nytimes.com/2009/03/24/health/24real.html?_r=0\" rel=\"nofollow\">nytimes article</a></p>\n\n<p>Another alternative, suitable for vegetarians, would be DHA &amp; EPA containing oil extracted from algae bred in water basins (no mercury pollution).\n<a href=\"http://www.omedha.com/omega-3-pregnancy-support\" rel=\"nofollow\">Schizochytrium micro algae as an \"Excellent Source of Dietary Omega-3s\"</a></p>\n", "score": 1 } ]

[ "nutrition", "fish", "omega-3" ]

[ { "answer_id": 7299, "body": "<p><a href=\"http://www.magnetic-resonance.org/ch/21-01.html\" rel=\"nofollow\">Magnetic-resonance.org</a></p>\n\n<blockquote>\n <p>World­wide, there are approximately 36,000 MR machines. At present,\n about 2,500 MR imaging units are sold worldwide every year</p>\n</blockquote>\n\n<ul>\n<li>This <a href=\"https://www.google.com/url?sa=t&amp;source=web&amp;rct=j&amp;url=http://www.cdc.gov/nchs/data/hus/2010/120.pdf&amp;ved=0ahUKEwj9z9z77djNAhWk24MKHcpLAOMQFghHMAE&amp;usg=AFQjCNHHP_cU0QGKH00NuHSI1j6yov_sLA\" rel=\"nofollow\">CDC link</a> shows the amount per country. </li>\n</ul>\n\n<p>If you take this to be a good reference then this could be answer. </p>\n", "score": 2 } ]

[ "statistics", "mri", "medical-imaging" ]

[ { "answer_id": 7383, "body": "<p>First, <strong>what are metastases</strong>? The exact definition of metastases is more and more debated in the last decades (for an excellent review see the review by <em>Welch, 2006</em>), mainly because the advances in cancer research have permitted to unveil new characteristics (genetical, biochemical, surface membrane expression,...) of metastasic cells. </p>\n\n<p>According to Welch, <strong>metastases can be defined as</strong></p>\n\n<blockquote>\n <p>The dissemination of neoplastic cells to discontiguous nearby or\n distant secondary (or higher order) sites where they proliferate to\n form an extravascular mass of incompletely differentiated cells.</p>\n</blockquote>\n\n<p>Metastatic process is dependent on <strong>three major conditions</strong>: </p>\n\n<ol>\n<li>malignant cells need to adhere to the basement membrane</li>\n<li>local proteolysis (=breakdown of proteins into smaller<br>\npolypeptides or amino acids) of the membrane is necessary</li>\n<li>malignant cells need to pass through the rent in the membrane and\nthe extracellular matrix.</li>\n</ol>\n\n<p>Once these malignant cells are in the circulation, they have to repeat the above mentioned steps at a remote site. Additionally, in order to survive in a foreign tissue, they need to find a \"hospitable niche\", where they must avoid detection by host defences and warrant blood supply by inducing the growth of new blood vessels. </p>\n\n<p>As you see, the metastatic process is complex and depends on several factors. The rate-limiting step in the metastatic process is the ability for tumor cells to survive and expand in a novel microenvironment. Not all cells have this faculty (so called “metastatic phenotype”) and current evidence suggest that probably only small fraction of tumor cells have this capacity. </p>\n\n<p>Studies have shown that chemokine receptors play a role in the metastatic capacity of a malignant cell. Also, recently, some candidate metastasis-suppressor genes, whose loss of function was associated with metastasis have been identified. Further studies are ongoing in order to understand the genetic and molecular pathways underlying the metastatic process.</p>\n\n<p>So as suggested in one of the comment, the metastic process (and therefore spreading areas) in lung cancer (but also in other type of cancer) is dependent on the malignant cells and on their genotype/phenotype.</p>\n\n<p><em>Sources:</em></p>\n\n<ul>\n<li>Welch DR. Do we need to redefine a cancer metastasis and staging\ndefinitions? Breast disease. 2006;26:3-12.</li>\n<li>Kakinuma T1, Hwang ST. Chemokines, chemokine receptors, and cancer\nmetastasis J Leukoc Biol April 2006 79:639-651</li>\n<li>Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.\nHarrison's Principles of Internal Medicine, 18e. New York, NY:\nMcGraw-Hill; 2012.p 681</li>\n</ul>\n", "score": 4 } ]

[ "cancer", "pathophysiology" ]

[ { "answer_id": 7573, "body": "<p>The frequency response of a headphone is one of the biggest selling points with a wider and flatter response being \"better\". Ultrasound is typically defined as sounds above 20 kHz. The high end <a href=\"http://en-us.sennheiser.com/high-resolution-headphones-3d-audio-hd-800-s\" rel=\"nofollow\">Sennheiser HD 800 S</a> headphones have a flat frequency response out to 51 kHz. Even more reasonably priced headphones can still produce ultra sound (e.g., the <a href=\"http://en-us.sennheiser.com/on-ear-dj-headphone-hd25\" rel=\"nofollow\">Sennheiser HD 25</a> can produce frequencies up to 22 kHz).</p>\n", "score": 1 } ]

[ "hearing" ]

[ { "answer_id": 8882, "body": "<p>During approximately 50% of cardiac arrests, the patient continues to breathe for a time. However, this breathing is known as agonal respiration and is essentially gasping for air. This gasping is actually beneficial if CPR can be started while it is still occurring, it is believed that this may increase the chances of survival during a cardiac arrest incident and is better than any form of artificial respiration. This information was found on <a href=\"http://heart.arizona.edu/gasping-not-breathing\" rel=\"noreferrer\">Sarver Heart Center's website</a>.</p>\n\n<p>The most interesting and, I hope helpful, site I found was <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20489033\" rel=\"noreferrer\">PubMed.gov</a> which discussed this exact issue. In the article, they mention that it is not known for sure why cardiac arrest often leads very quickly (if not instantly) to apnea as the O2 levels in the brain stem don't drop immediately.</p>\n\n<p>If you have any additional questions about cardiac arrest itself or it's treatment, I highly recommend paying the <a href=\"http://www.merckmanuals.com/professional/critical-care-medicine/cardiac-arrest/cardiac-arrest\" rel=\"noreferrer\">Merck Manuals website</a> a visit.</p>\n\n<p>To sum things up a bit, it isn't known for sure why respiratory arrest often occurs at the same time as cardiac arrest, nor why cardiac arrest simply leads to agonal breathing initially in 50% of cases. </p>\n", "score": 8 } ]

[ "cardiology", "breathing", "emergency", "cpr" ]

[ { "answer_id": 7548, "body": "<p>8th Month is ~ 32 Weeks, pregnancy is usually ~40 weeks</p>\n\n<p>Up to 15 weeks' gestation, suction-aspiration or vacuum aspiration are the most common surgical methods of induced abortion. (<a href=\"http://www.webmd.com/hw/womens_conditions/tw1078.asp#tw1112\" rel=\"nofollow\">Healthwise, 2004</a>) Manual vacuum aspiration (MVA) consists of removing the fetus or embryo, placenta, and membranes by suction using a manual syringe, while electric vacuum aspiration (EVA) uses an electric pump. These techniques differ in the mechanism used to apply suction, in how early in pregnancy they can be used, and in whether cervical dilation is necessary.</p>\n\n<p>From the 15th week of gestation until approximately the 26th, other techniques must be used. Dilation and evacuation (D&amp;E) consists of opening the cervix of the uterus and emptying it using surgical instruments and suction. After the 16th week of gestation, abortions can also be induced by intact dilation and extraction (IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes called \"partial-birth abortion\", which has been federally banned in the United States. (<a href=\"https://en.wikipedia.org/wiki/Abortion#Methods\" rel=\"nofollow\">Wikipedia, 2016</a>)</p>\n\n<p><strong>In the third trimester of pregnancy, induced abortion may be performed surgically by intact dilation and extraction or by hysterotomy. Hysterotomy abortion is a procedure similar to a caesarean section and is performed under general anesthesia. It requires a smaller incision than a caesarean section and is used during later stages of pregnancy.</strong> (<a href=\"http://encarta.msn.com/encyclopedia_761553899/Abortion.html\" rel=\"nofollow\">McGee, Glenn; Jon F. Merz, 2009</a>)</p>\n\n<p>In places lacking the necessary medical skill for dilation and extraction, or where preferred by practitioners, an abortion can be induced by first inducing labor and then inducing fetal demise if necessary (<a href=\"http://www.glowm.com/section_view/heading/Labor%20Induction%20Termination%20of%20Pregnancy/item/443\" rel=\"nofollow\">Borgatta, L, 2014</a>). This is sometimes called \"induced miscarriage\". This procedure may be performed from <strong>13 weeks gestation to the third trimester</strong>. Although it is very uncommon in the United States, more than 80% of induced abortions throughout the second trimester are labor induced abortions in Sweden and other nearby countries (<a href=\"http://www.contraceptionjournal.org/article/S0010-7824(11)00057-6/pdf\" rel=\"nofollow\">Society of Family Planning, 2011</a>).</p>\n\n<p>Only limited data are available comparing this method with dilation and extraction(<a href=\"http://www.contraceptionjournal.org/article/S0010-7824(11)00057-6/pdf\" rel=\"nofollow\">Society of Family Planning, 2011</a>). Unlike D&amp;E, labor induced abortions after 18 weeks may be complicated by the occurrence of brief fetal survival, which may be legally characterized as live birth. For this reason, labor induced abortion is legally risky in the U.S.(<a href=\"http://www.contraceptionjournal.org/article/S0010-7824(11)00057-6/pdf\" rel=\"nofollow\">Society of Family Planning, 2011</a>).</p>\n\n<p>Note, unless there are severe medical complications, an induced birth will be the option because at 32 weeks there is a <a href=\"http://www.spensershope.org/chances_for_survival.htm\" rel=\"nofollow\">>95% chance</a> it will live. </p>\n\n<p>Main source: <a href=\"https://en.wikipedia.org/wiki/Abortion#Methods\" rel=\"nofollow\">Wikipedia</a></p>\n", "score": 3 } ]

[ "obstetrics", "surgery", "procedural-expectations", "fetus" ]

[ { "answer_id": 7593, "body": "<p>That 'put your arm out' scenario is a kinesiology practice. You can google it to find out more. I have known people who say it's very accurate and others who say it's hocus-pocus. </p>\n\n<p>Maybe it's similar to homeopathy that seems to work on some people but not on others. </p>\n", "score": 1 } ]

[ "dentistry" ]

[ { "answer_id": 7658, "body": "<p>Good evening,</p>\n\n<p><strong>The reason the abscesses in your mouth won't heal on their own is due to:</strong> </p>\n\n<ul>\n<li><strong>The fact that the mouth is one of the areas of the body with the most bacteria</strong></li>\n<li><strong>Therefore, the immune system cannot get ride of all bacteria, especially when they reside in or around teeth, which are relatively poorly vascularised and doesn't regenerate after being damaged, since the enamel doesn't contain cells that are remain alive after eruption.</strong></li>\n</ul>\n\n<p>If a <strong>chronic abscess</strong> (one that stays for a long time) is present in your mouth, it means that there is an underlying cause that is not being addressed, as was said in the comments bellow your question. It is not necessarily painful, since there is no build up of puss, which leaves through the opening. An <strong>acute abscess</strong> could happen if the wound in the gum closes completely and traps the pus in the gums and bone.</p>\n\n<p><strong>One could look at it like bones that are permanently sticking out of the body, a situation which would be unacceptable anywhere else in the body.</strong></p>\n\n<p>As far as dental abscesses are concerned, There are <em>generally two possible causes</em>:</p>\n\n<p><strong>Peri-apical Abscesses:</strong></p>\n\n<p><em>Cause</em> : </p>\n\n<ul>\n<li>The pulp (nerf) inside the tooth has died (necrotic) and the bacteria have reached the apex (bottom of the tooth). </li>\n</ul>\n\n<p><em>Diagnosis</em> : </p>\n\n<ul>\n<li>Clinically Performing hot&amp;cold, percussion and electrical test in the mouth</li>\n<li>Taking radiographs (X-rays) Looking for radio-transparent space around the root of the suspect tooth </li>\n</ul>\n\n<p><em>Treatment</em> :</p>\n\n<ul>\n<li>Generally a root canal therapy (RCT) is sufficient to prevent entry of further bacteria and enable the body to repair the bone and allow the abscess to heal.</li>\n<li>Another possibility is to extract the tooth, if it is not possible to perform a root canal or to restore it afterward (with a crown for example).</li>\n</ul>\n\n<p><strong>Periodontal Abscesses:</strong></p>\n\n<p><em>Cause</em> : </p>\n\n<ul>\n<li>The gums around the tooth have detached from the roots, allowing bacteria to thrive in so-called periodontal pockets between supporting tissues and the root of the tooth. if the top of the pocket closes, it can force the pus to leave via a fistule instead of the gum </li>\n</ul>\n\n<p><em>Diagnosis</em> : </p>\n\n<ul>\n<li>Clinically Performing the same test as for the first type of abscess, as well as using a probe (like in my profile picture) to measure and detect any \"deep\" pockets</li>\n<li>Taking radiographs (X-rays) Looking for bone loss and space around the root of the suspect tooth </li>\n</ul>\n\n<p><em>Treatment</em> :</p>\n\n<ul>\n<li>Depending on the state of the tooth, if it is salvageable, it will require scaling and root planing to clean the area of bacterial debris and to allow the gums to reattach to the root.</li>\n<li>Another possibility is again to extract the tooth, if there is not sufficient bone and gums to support the tooth</li>\n</ul>\n\n<p><strong>As always, only an exam by a dental professional will allow you to find and treat the cause of your abscess(es).</strong></p>\n\n<p><strong>Sources:</strong> </p>\n\n<ul>\n<li>My professional background</li>\n<li><a href=\"https://www.coeurdaleneiddentist.com/what-is-the-difference-between-a-periapical-and-periodontal-abscess/\" rel=\"nofollow\">https://www.coeurdaleneiddentist.com/what-is-the-difference-between-a-periapical-and-periodontal-abscess/</a></li>\n</ul>\n", "score": 6 } ]

[ "dermatology", "dentistry", "infection", "oral-health", "gums" ]

[ { "answer_id": 15580, "body": "<p>Although phytic acid has some anti-nutrient properties, the issue in the western world is not undernutrition but over nutrition!</p>\n\n<p>And there is some suggestive evidence that phytates may have a role to play in anti-cancer activity in the large bowel.</p>\n\n<blockquote>\n <p>The authors have found that phytic acid is a potent inhibitor of iron-mediated generation of the hazardous oxidant, hydroxyl radical. Herein, the authors propose that inhibition of intracolonic hydroxyl radical generation, via the chelation of reactive iron by phytic acid, may help explain the suppression of colonic carcinogenesis and other inflammatory bowel diseases by diets rich in phytic acid.</p>\n</blockquote>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/2990653\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/2990653</a></p>\n", "score": 4 } ]

[ "nutrition" ]

[ { "answer_id": 7620, "body": "<p>No, \"aluminum encapsulated\" means the pan has a layer of aluminum bonded on to the <strong>exterior</strong> of the pan. The inner surface is stainless steel and perfectly safe because the aluminum never touches food.</p>\n\n<p>This is just a less expensive version of copper-bottomed cookware. The copper is added for the same reason (heat distribution), but it's entirely on the exterior so never touches food.</p>\n", "score": 3 } ]

[ "cooking" ]

[ { "answer_id": 7653, "body": "<p>Water intoxication is possible; it seems that realistic danger starts when you (as an adult) drink 2 liters or more water per hour for several hours in a row. In small children this amount is obviously lower, and in infants as little as 1 cup (237 mL) of water can cause intoxication. </p>\n\n<p>Two things to consider:</p>\n\n<ol>\n<li><p>Water intoxication does not occur because of toxic effect of water itself, but because a large amount of water causes a drop of blood sodium levels (hyponatremia). So, water intoxication occurs when you drink a lot of water and you do not ingest any (or too little) sodium. If you drink a lot of water (but not >1.5 L/hour) and ingest enough sodium (by eating regular foods) and you are an otherwise healthy young or middle-aged adult, you should not have any problem.</p></li>\n<li><p>It is not possible to say, which exact amount of water can cause intoxication, because--from obvious reasons--no human studies have been done about this, so we can make conclusions only from newspaper reports and \"cases\" described by doctors. Personal differences, sodium intake and the speed of water drinking also affect the outcome.</p></li>\n</ol>\n\n<p>Here is a more detailed explanation with several reports of\n<a href=\"http://www.ehealthstar.com/conditions/water-intoxication\" rel=\"nofollow noreferrer\">water intoxication</a></p>\n\n<p>The kidney water excretion capacity mentioned in the question is about right (800-1,000 mL of water/hour), but you need to understand this correctly. </p>\n\n<p>If you, as an adult, drink, for example, 3 liters of water in one hour (not in successive hours), this should not really be a problem. First, you have probably drunk that because you were thirsty, so dehydrated, which means you have just replaced the water you have been missing. </p>\n\n<p>Even if you drink 3 liters of water in one hour when you are already well hydrated, this should not be a big problem. Water needs some time to be absorbed and the circulatory system has some capacity to expand. Your blood sodium levels will fall a bit (within normal range) without any damage and your kidneys will eventually excrete the excess of water in 3 hours or so. But, 3 liters in one hour and 3 liters next hour...it can be a big problem.</p>\n\n<p>In conclusion, it's not likely you will get intoxicated with water by accident. For that, you usually need to consciously exaggerate with drinking for several hours in a row while ingesting no or only little sodium. </p>\n", "score": 5 } ]

[ "water" ]

[ { "answer_id": 9819, "body": "<ol>\n<li>An accident left Derek Amato with a severe concussion and a surprising ability to play the piano. One theory is that his brain reorganized, making accessible existing memories of music. Another is that his brain no longer filters sensory input, enabling him to hear individual notes rather than melodies.</li>\n</ol>\n\n<p><a href=\"http://www.popsci.com/science/article/2013-02/when-brain-damage-unlocks-genius-within\" rel=\"nofollow\">http://www.popsci.com/science/article/2013-02/when-brain-damage-unlocks-genius-within</a></p>\n\n<p>2.Shortly after her accident, the US-based woman, who has chosen to remain anonymous, began to develop extraordinary precise memories\n•She is now able to recall exact details about every single place she has ever seen - and can draw a map or diagram of each location and building</p>\n\n<p><a href=\"http://www.dailymail.co.uk/femail/article-3040907/Woman-reveals-ski-accident-left-phenomenally-advanced-mental-abilities-head-injury-developed-rare-brain-condition-known-acquired-savant-syndrome.html\" rel=\"nofollow\">http://www.dailymail.co.uk/femail/article-3040907/Woman-reveals-ski-accident-left-phenomenally-advanced-mental-abilities-head-injury-developed-rare-brain-condition-known-acquired-savant-syndrome.html</a></p>\n", "score": 3 } ]

[ "brain", "injury" ]

[ { "answer_id": 8839, "body": "<p>I am really happy that I found Krill oil. It's an omega 3,6,9 oil made from krill. (a sea creature similar to shrimp but much smaller). It makes this choice the strongest choice in benefits of any fish oil, but no yucky taste if you burp. I can't take NSAIDS anymore, but I found that after a few days of taking krill oil, it works as an anti-inflammatory pain killer for me when I take an extra one when pain comes on. No side effects, no drug interactions. \nSource: <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17353582\" rel=\"nofollow\"> National Institute of Health</a></p>\n", "score": 1 } ]

[ "treatment-options", "headache", "nsaids-pain-meds", "analgesics" ]

[ { "answer_id": 8740, "body": "<blockquote>\n<p>conscious tighten abdominal muscles would help me reduce abdominal fat.</p>\n</blockquote>\n<p><strong>No it wont.</strong></p>\n<blockquote>\n<p>Does tightening abdominal muscles all the time not harm my body?</p>\n</blockquote>\n<p>To build muscle you essentially need to damage it so that it comes back stronger when it recovers/rebuilds. This is the foundation of developing strength and building muscle (Cell water/glucose biology aside). Exercises like squats and deadlifts mean you need to brace your core (tense your abs), the muscle development from this isn't that fact you are bracing but is caused by the really heavy weight you are trying to move, the muscles are doing work to stabilise.</p>\n<p>You might cause yourself to get haemorrhoids (I have heard this can happen) or you may develop really good kegal muscles (I know this can happen) but you won't build abs or reduce belly fat.</p>\n<hr />\n<h1>However...</h1>\n<p>There is a big glaring issue with answering the question &quot;it is suitable to do this exercise to reduce my belly fat&quot; in the assumption that ANY exercise will spot reduce fat deposits.</p>\n<h1><a href=\"https://fitness.stackexchange.com/questions/869/best-exercise-to-lose-belly-fat-fast\">You cannot target weight loss to anywhere on your body. It is not possible</a>.</h1>\n<p>On the physical fitness SE and <a href=\"https://fitness.stackexchange.com/search?q=belly%20fat%20abdominals\">we get this question a lot</a>.</p>\n<h2>we get it nearly every day...</h2>\n<p><a href=\"https://fitness.stackexchange.com/questions/9581/are-ab-exercises-more-useful-to-reduce-belly-fat-than-other-exercises\">https://fitness.stackexchange.com/questions/9581/are-ab-exercises-more-useful-to-reduce-belly-fat-than-other-exercises</a></p>\n<p><a href=\"https://fitness.stackexchange.com/questions/118/will-daily-push-ups-help-to-get-rid-of-my-belly-fat\">https://fitness.stackexchange.com/questions/118/will-daily-push-ups-help-to-get-rid-of-my-belly-fat</a></p>\n<p><a href=\"https://fitness.stackexchange.com/questions/6677/what-should-i-do-to-remove-my-belly-fat\">https://fitness.stackexchange.com/questions/6677/what-should-i-do-to-remove-my-belly-fat</a></p>\n<p><a href=\"https://fitness.stackexchange.com/questions/2338/is-it-possible-to-lose-weight-on-some-special-parts-of-body\">https://fitness.stackexchange.com/questions/2338/is-it-possible-to-lose-weight-on-some-special-parts-of-body</a></p>\n<p><a href=\"https://fitness.stackexchange.com/questions/6677/what-should-i-do-to-remove-my-belly-fat\">https://fitness.stackexchange.com/questions/6677/what-should-i-do-to-remove-my-belly-fat</a></p>\n<p><a href=\"https://fitness.stackexchange.com/questions/6249/when-fat-is-burnt-where-is-it-taken-from/6251#6251\">https://fitness.stackexchange.com/questions/6249/when-fat-is-burnt-where-is-it-taken-from/6251#6251</a></p>\n", "score": 2 }, { "answer_id": 8793, "body": "<p>There's two myths with a grain of truth a the root in your question.</p>\n\n<p><strong>The myth of spot reduction</strong><br>\nYou can't influence where your body loses fat, only if and how much. See <a href=\"https://health.stackexchange.com/a/8740/413\">JJosaur's great answer</a> to this.<br>\nThe kernel of truth is that if you improve your posture by strenghtening your core muscle, you may appear to have less belly fat. The appearance of a fat belly is often partially due to a hollow back. I don't know you and your back so I don't know if this applies to you.</p>\n\n<p><strong>The myth of multitasking</strong><br>\nYou won't do an effective exercise without dedicating time and concentration to it. Fortunately 10-20 min every few days can help a lot. But when you train, you need to train, you need to concentrate on the exercises and your body. Form the habit, stick with it for a while, then it will become normal and easy to dedicate some time to your body.<br>\nThe kernel of truth: When you develop a proper feel for your body and where your spine should be in a neutral position through exercise, you can should self check your posture often to make sure you don't slouch in an unhealthy way. This is helpful and healthy, just not exercise.</p>\n\n<p>I suggest to think more about what your goals are (why do you want to loose belly fat) and then come back here or to fitness.SE for targeted training advice.</p>\n", "score": 1 } ]

[ "exercise", "body-fat" ]

[ { "answer_id": 8781, "body": "<p><em>I had the same concern and asked my family doctor. He showed me the recommendations from the American College of Chest Physicians.\nBelow you can find an extract:</em></p>\n\n<p>VTE = Venous Thromboembolism (includes Pulmonary Embolism, Deep Vein Thrombosis)</p>\n\n<p>GCS = Graduated compression stockings</p>\n\n<blockquote>\n <p><strong>6.0 Persons Traveling Long-Distance</strong></p>\n \n <p>6.1.1. For long-distance travelers at increased risk of VTE (including previous VTE, recent surgery or trauma, active malignancy, pregnancy,\n estrogen use, advanced age, limited mobility, severe obesity, or known\n thrombophilic disorder), we suggest frequent ambulation, calf muscle\n exercise, or sitting in an aisle seat if feasible (Grade 2C).</p>\n \n <p>6.1.2. For long-distance travelers at increased risk of VTE (including previous VTE, recent surgery or trauma, active malignancy, pregnancy,\n estrogen use, advanced age, limited mobility, severe obesity, or known\n thrombophilic disorder), we suggest use of properly fitted, below-knee\n GCS providing 15 to 30 mm Hg of pressure at the ankle during travel\n (Grade 2C). For all other long-distance travelers, we suggest against\n the use of GCS (Grade 2C).</p>\n \n <p>6.1.3. For long-distance travelers, we suggest against the use of aspirin or anticoagulants to prevent VTE (Grade 2C).</p>\n</blockquote>\n\n<p>You can find the complete version here: <a href=\"http://www.chestnet.org/Guidelines-and-Resources/CHEST-Guideline-Topic-Areas/Pulmonary-Vascular\" rel=\"nofollow\">http://www.chestnet.org/Guidelines-and-Resources/CHEST-Guideline-Topic-Areas/Pulmonary-Vascular</a></p>\n\n<p><em>Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ. Chest. 2012;141(2_suppl):7S-47S. doi:10.1378/chest.1412S3.</em></p>\n\n<p>P.S (if like me, you are wondering what the grading means): the grading corresponds to the level of \"evidence\" for this recommendation. Grade 2C means that randomized trials are still missing, and that this decision was made by balancing the risk and benefits of the intervention. This website gives a good explanation of the grade system: <a href=\"http://www.medicographia.com/2011/12/rating-the-quality-of-evidence-and-the-strength-of-recommendationsthe-new-grade-system-in-venous-disease/\" rel=\"nofollow\">http://www.medicographia.com/2011/12/rating-the-quality-of-evidence-and-the-strength-of-recommendationsthe-new-grade-system-in-venous-disease/</a></p>\n", "score": 9 }, { "answer_id": 8754, "body": "<p>If you are overall healthy, I don't think it would be wise to go so far as to use an antithrombotic drug; as that will also thin your blood and may cause other issues. </p>\n\n<p>There are a variety of dietary supplements that claim to aid in circulation; however, I can't prove that they will - or won't - work. </p>\n\n<p>So, my best advice would be to obviously, get up and move when you can. Since that isn't always possible, I will give you some ideas for stretches you can do that won't take up too much space. </p>\n\n<p>You can tap your feet and circle your ankles. Try not to cross your legs; however, most of us do - especially if we're on a long trip -, so at least try to frequently change your leg position. If you are sitting in a seat that causes your feet not to touch the floor/ground, try to keep your legs swinging and again, change positions as often as possible. Try to keep your legs from falling asleep, that would certainly be a sign that you've been in one position for too long.</p>\n\n<p>If you have never had a thrombus (DVT) before, some things to watch for are: swelling in one and, rarely, both legs; as well as pain that feels something like a cramp. If the clot moves to your lung, which is a risk, you can expect to feel non-radiating chest pain and difficulty breathing. If you would like additional information on <a href=\"http://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/basics/symptoms/con-20031922\" rel=\"noreferrer\">DVT</a> as well as some <a href=\"http://www.ahrq.gov/patients-consumers/prevention/disease/bloodclots.html\" rel=\"noreferrer\">preventative measures</a>, please see the provided links.</p>\n", "score": 7 } ]

[ "prevention", "thrombosis", "calf-muscles-calves" ]

[ { "answer_id": 8851, "body": "<p>Utter nonsense. Many common recipes combine bananas and eggs. People eat bananas with eggs all the time without harm. I've had some of these myself and they're tasty. </p>\n\n<p><a href=\"http://www.thekitchn.com/how-to-make-2-ingredient-banana-pancakes-cooking-lessons-from-the-kitchn-218658\" rel=\"noreferrer\">Banana pancakes</a></p>\n\n<p><a href=\"http://allrecipes.com/recipe/20144/banana-banana-bread/\" rel=\"noreferrer\">Banana bread</a></p>\n\n<p><a href=\"http://www.feedingfinn.com/fruity-egg-muffins-3-ingredients/\" rel=\"noreferrer\">Fruity egg muffins</a></p>\n\n<p><a href=\"http://www.safeeggs.com/recipes/banana-licuado-recipe\" rel=\"noreferrer\">Banana Licuado</a> </p>\n", "score": 7 }, { "answer_id": 8862, "body": "<blockquote>\n <p>I read that the combination of bananas and eggs is poisonous.</p>\n</blockquote>\n\n<p>Can you please give the exact links? Google does <a href=\"https://www.google.co.in/webhp?sourceid=chrome-instant&amp;ion=1&amp;espv=2&amp;ie=UTF-8#q=banana%20and%20eggs%20poison\" rel=\"noreferrer\">auto-suggest</a> a link but as Carey has also mentioned, it doesn't make any sense.</p>\n\n<p>It is highly unlikely that a fruit (banana which is rich in Potassium, Vitamins C &amp; B6, Fibre and fats) and egg( rich in Fats, protein, and cholesterol) would mix up together to form anything toxic.<br>\nInstead, they are generally mixed together, to make different recipes like <a href=\"http://www.huffingtonpost.in/entry/2-ingredient-banana-pancake-recipe_us_565c4682e4b08e945feb9a3c\" rel=\"noreferrer\">pancake</a>. Please try looking <a href=\"https://scholar.google.co.in/scholar?hl=en&amp;q=egg%2Bbanana&amp;btnG=\" rel=\"noreferrer\">at right places to read</a>, and yes, do NOT always believe in what you read online!</p>\n", "score": 5 } ]

[ "nutrition", "food-poisoning" ]

[ { "answer_id": 9020, "body": "<p>This is an interesting question. The role of deep brain stimulation in Parkinson's disease has increased in the last years.</p>\n\n<p>Recently, de Souza et al adressed your concern and reviewed studies investigating the <strong>timing of DBS in PD</strong>. Here are their conclusion:</p>\n\n<blockquote>\n <p>From the evidence available, we conclude that surgical management of\n PD alone or in combination with medical therapy results in greater\n improvement of motor symptoms and quality of life than medical\n treatment alone. <strong>There is evidence to support the use of DBS in less\n advanced PD and that it may be appropriate for earlier stages of the\n disease than for which it is currently used. The improving short and\n long-term safety profile of DBS makes early application a realistic\n possibility.</strong></p>\n</blockquote>\n\n<p><em>To your question regarding why DBS is not used as first line therapy:</em>\nWell, while various studies have shown a significant reduction of dyskinesias, improvement of motor symptoms and significant improvement of quality of life when compared with best medical treatment, <strong>DBS is also associated with side effects (surgery related, device related and stimulus related)</strong>.</p>\n\n<p>Concerning stimulus related side effects (ie other structures than the targeted Subthalamic Nucleus or Globus Pallidus Interna get stimulated through the produced electric potential), you have to imagine, that the <strong>electrical field produced by DBS can propagate to other brain regions and may therefore lead to psychological symptoms or motor symptoms</strong>. Research on this field is ongoing but because \"in vivo\" testing can't be undertaken (it would not be unethical), bioengineers are creating \"models\" than enable to stimulate DBS electrical field distribution.</p>\n\n<p><strong>Overall, yes, DBS is promising and current debate suggests it should be used earlier. BUT our current understanding on how DBS works (on neuronal level) is still poor and further research is needed.</strong></p>\n\n<p><em>Sources (both are open access):</em></p>\n\n<p>Groiss SJ, Wojtecki L, Südmeyer M, Schnitzler A. Deep Brain Stimulation in Parkinson’s Disease. Therapeutic Advances in Neurological Disorders. 2009;2(6):20-28. doi:10.1177/1756285609339382.</p>\n\n<p>deSouza R-M, Moro E, Lang AE, Schapira AHV. Timing of Deep Brain Stimulation in Parkinson Disease: A Need for Reappraisal? Annals of Neurology. 2013;73(5):565-575. doi:10.1002/ana.23890.</p>\n", "score": 4 } ]

[ "neurology" ]

[ { "answer_id": 8960, "body": "<p>This study was examining the effects of metformin on hormone levels responding to hypoglycemia. It found that metformin did not significantly alter the body's hormonal response to hypoglycemia in their study population.</p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/11549648\" rel=\"nofollow\">Study</a></p>\n\n<p>It looks like according to the study that recurring hypoglycemia can cause a lowering of cortisol:</p>\n\n<blockquote>\n <p>Antecedent hypoglycemia significantly reduced epinephrine, ACTH, cortisol, glucagon, GH, and symptomatic responses to hypoglycemia (P &lt; 0.05 for all variables)</p>\n</blockquote>\n\n<p>This may have been partially misconstrued; since metformin helps lower blood glucose, and low blood glucose is associated with decreased cortisol levels, one could assume that metformin could in theory lower cortisol levels, but this does not seem to be the case at least according to this study.</p>\n\n<p>Metformin works by decreasing the absorption of glucose, decreasing the amount of glucose the liver produces, and by improving insulin sensitivity. It does not directly stimulate insulin release or mimic the actions of insulin; therefore it is not linked to much hypoglycemia.</p>\n\n<p>When checking interactions between hydrocortisone (cortisol as a medication) and metformin the only interaction reported was: cortisol may decrease the effect of metformin and other anti-diabetic agents.</p>\n", "score": 1 } ]

[ "medications", "cortisol", "metformin" ]

[ { "answer_id": 9013, "body": "<p>Your question is difficult to answer (but still interesting) because lupus is a highly heterogeneous condition which can present various symptoms and organ involvement. <strong>Choice of therapy will be tailored on the patient symptoms and his disease activity and severity.</strong></p>\n\n<p>Here a broad overview of the current management strategies of lupus:</p>\n\n<ul>\n<li>The most frequent used of therapy in lupus patients (with any degree\nof disease activity) should be <strong>hydroxychloroquine or chloroquine</strong>\n(which are actually antimalarial drugs). These two drugs are associated with\nsymptoms relief and reduction of lupus flares, thrombotic events and\norgane damage.</li>\n<li>Other therapies can be used, depending on the severity of the disease\nand the activity such as NSAID, prednison (short term therapy) or\nsteroid-sparing immunosuppressive therapy such as azathioprine or\nmethotrexate.</li>\n</ul>\n\n<p>Recently, rituximab, cyclophosphamide, cyclosporine and rituximab have been increasing used as long term therapy in lupus patients.</p>\n\n<p>Finally, depending on the organ system involved, additionally strategies can be used. I don't know your case and why Lyrica (=pregabalin) or Cymbalta (=duloxetine) have been suggested by your physician. Some studies suggest that both pregabalin and duloxetine can be used as second line treatment in arthritis-related pain.</p>\n\n<p>All above mentioned treatment should be started by a health professional as most of them need close monitoring and blood/radiological tests before some of these drugs are started.</p>\n\n<p>I would suggest following website, which contains very useful information for patients with lupus:\n<a href=\"http://www.uptodate.com/contents/systemic-lupus-erythematosus-sle-beyond-the-basics\">http://www.uptodate.com/contents/systemic-lupus-erythematosus-sle-beyond-the-basics</a></p>\n\n<p><em>Sources:</em></p>\n\n<ul>\n<li>van Laar et al. Pain treatment in arthritis related pain: Beyond\nNSAIDs. Open Rheumatol J. 2012. 6: 320-330</li>\n<li>Wallace DF. Overview of the management and prognosis of systemic\nlupus erythrematosus in adults. Uptodate. 07.2016</li>\n</ul>\n", "score": 7 } ]

[ "medications", "symptoms", "autoimmune-disease", "prescription", "lupus" ]

[ { "answer_id": 12127, "body": "<p>The short answer is <strong>NO</strong></p>\n\n<p>The long answer is: <strong>If time is of concern, ask your oral health professional whether an electric toothbrush can improve your cleaning enough so that 2 minutes of brushing are sufficient.</strong></p>\n\n<p>As stated in another question on Health.Stackexchange:</p>\n\n<blockquote>\n <p>it is the physical movement of the bristles of the brush that removes\n plaque that accumulates on and between the teeth and gums.</p>\n</blockquote>\n\n<p><strong>No matter what tool you use, contact is unavoidable with the teeth.</strong></p>\n\n<p>I currently have not seen good scientific papers that endorse using high-pressure water or air as a substitute for a toothbrush and floss to clean teeth. </p>\n\n<p>Here is an article that discusses plaque control using a toothbrush:\n<a href=\"http://www.aapd.org/assets/1/25/Axelsson-03-S1.pdf\" rel=\"nofollow noreferrer\">http://www.aapd.org/assets/1/25/Axelsson-03-S1.pdf</a></p>\n\n<p>The Health.Stackexchange question I sited from:\n<a href=\"https://health.stackexchange.com/questions/1143/is-brushing-teeth-without-toothpaste-actually-harmful/1366#1366\">Is brushing teeth without toothpaste actually harmful?</a></p>\n", "score": 4 } ]

[ "dentistry", "brushing-teeth", "toothpaste", "mouthwash", "toothbrush" ]

[ { "answer_id": 9021, "body": "<p><em>I will try to answer your question by using another perspective (risk factors for infertility).</em> </p>\n\n<p><strong>MALE</strong></p>\n\n<p>Among the <strong>main causes of male infertility</strong>, \"idiopathic\" causes (ie not du to endocrine problems, genetic defects or sperm transport problems) represent 40%.</p>\n\n<p>In the last decades, increasing attention has been given to <strong>environmental factors</strong>. Here a brief overview:</p>\n\n<ul>\n<li>The <strong>pesticide dibromochloropropane is a well-known cause, as are\nlead, cadmium, and mercury</strong>.</li>\n<li>The possibility that chemicals with estrogenic or antiandrogenic\nactivity (“endocrine disruptors”), including insecticides and\nfungicides, may lower sperm counts has attracted much attention\nlately, although direct proof of an effect in men is lacking.</li>\n<li>Occupational and environmental exposure has been associated with\nlower quality semen analyses; <strong>limited data suggest that consumption\nof fruits and vegetables with high pesticide residues may also be\nassociated with lower semen quality</strong>.</li>\n<li>Because of the rapid increase in cell phone use around the world,\nstudies have been done to investigate whether cell phone usage has\nany detrimental effects on sperm parameters. This issue is\ncontroversial and definitive data are not yet available.</li>\n<li><strong>Smoking</strong> – Data on cigarette smoking and its possible effect on sperm\ncounts are inconsistent. However, in a meta-analysis of 20\nobservational studies, men who smoked cigarettes were more likely to\nhave low sperm counts.</li>\n<li><strong>Hyperthermia</strong> – Hyperthermia has long been thought to impair\nspermatogenesis. Prolonged high testicular temperature may explain\nthe infertility associated with spinal cord injuries, varicocele, and\nchronic sauna and Jacuzzi exposure. <strong>Similarly, febrile illness,\nprolonged sitting during work or truck driving, welding, baking,\ntight fitting underwear, and laptop use with increased heat to the\ntestes have been proposed to adversely affect male fertility. The\ndata to support these associations are inconsistent and may be a very\nweak risk factor for infertility</strong>.</li>\n</ul>\n\n<p><strong>FEMALE</strong></p>\n\n<p><strong>Similarly to male infertility, idiophatic female infertility has been associated with similar risks factors, although some of them show conflicting results and have still to be confirmed.</strong> Here additional information regarding some risk factors:</p>\n\n<ul>\n<li><strong>Smoking:</strong> Most series report that <strong>fecundability is decreased if the female partner smokes more than 10 cigarettes per day.</strong> In a 1998 meta-analysis including data from almost 11,000 smoking women and over 19,000 nonsmokers, cigarette smoking by the female partner was associated with a statistically significant increase in infertility compared to nonsmokers (OR 1.60, 95% CI 1.34-1.91)</li>\n<li><strong>Weight:</strong> most studies report a BMI greater than 27 kg/m2 or a BMI less than 17 kg/m2 is associated with increased ovulatory dysfunction and resultant infertility</li>\n</ul>\n\n<p>Regarding your two specific questions about diet and exercise:</p>\n\n<p><strong>DIET</strong></p>\n\n<blockquote>\n <p>In healthy couples, there is no strong evidence that dietary\n variations such as vegetarian diets, low-fat diets, and vitamin or\n antioxidant-enriched diets improve fertility.</p>\n</blockquote>\n\n<p><strong>EXERCISE</strong></p>\n\n<blockquote>\n <p>The intensity and duration of exercise can affect female fertility,\n but the specific type of exercise does not appear to be a factor. In\n some epidemiological studies, vigorous/intense physical activity was\n associated with ovulatory infertility, while others have not\n observed a significant association</p>\n</blockquote>\n\n<p><strong>So avoiding some of those proven risk factors, may reduce your risk of developing infertility. I haven't found any evidenced based data of fertility \"stimulants\".</strong></p>\n\n<p>Sources: Swerdloff et al. Causes of male infertility. Uptodate.com. Jul 2016, Hornstein et al. Optimizing natural fertility in healthy couples. Uptodate.com. Jul 2016</p>\n", "score": 12 }, { "answer_id": 9019, "body": "<p>As far as I know taking zinc pills increase the volume of your sperm. Also avoiding hot baths/creating a fresh environment for your scrotum increases the sperm count. </p>\n\n<p>Maybe some exercises to increase testosterone helps too. For best advice man you gotta see a health care professional. </p>\n", "score": 1 } ]

[ "nutrition", "medications", "exercise", "oral-health", "fertility" ]

[ { "answer_id": 9527, "body": "<p>Having done more searching over the last month, I thought it might be helpful to others if I answered my own question. I came to three realizations:</p>\n\n<p>First, this is like asking, \"Dear Google, when am I going to die?\" It's impossible to know for sure and it's unnerving to even ask.</p>\n\n<p>Second, searching for \"older people with cerebral palsy\" on the internet is a tricky proposition. Suppose that a person is 80 today (in 2016), and living with cerebral palsy. That means he/she was born in 1936. Would a person with a mild CP impairment even have been diagnosed as such, given the social stigma? Unlikely. Would such a person be tech savvy enough to be posting on message boards? Also unlikely. Would such a person be posting <em>specifically about CP</em>? Extremely unlikely. Looking for such people is like hunting for unicorns.</p>\n\n<p>All that said, <a href=\"http://www.griswoldhomecare.com/blog/spotlight-on-cerebral-palsy-1-cerebral-palsy-and-aging/\" rel=\"noreferrer\">this comment thread</a> features several older people with CP chiming in. I also found a few scattered forum posts from people in their 60s and 70s living with CP. The oldest person I was able to find was Maureen Arcand, who <a href=\"http://www.wi-bpdd.org/publications/2010/OnePersonsJourneyAgingCPCollection.pdf\" rel=\"noreferrer\">wrote extensively</a> about living with CP and lived to be 86, despite considerable mobility impairments. That's actually above the current US average life expectancy of 81.6 years for women.</p>\n\n<p>Third, there has indeed been some research on this topic, though it can be hard to find. Hutton and Pharoah (<a href=\"https://www.researchgate.net/publication/7284164_Life_expectancy_in_cerebral_palsy\" rel=\"noreferrer\">2006</a>) distinguish between cases with and without severe impairments, and found that in cases where there were no severe impairments (i.e., able to stand and walk, able to care for oneself, no comorbid disorders such as epilepsy), survival outcomes were similar to the general population. Strauss <em>et al</em> (<a href=\"http://onlinelibrary.wiley.com/store/10.1111/j.1469-8749.2008.03000.x/asset/j.1469-8749.2008.03000.x.pdf?v=1&amp;t=ityq6pbw&amp;s=b1e1bb571bed8e9a62cc9b6738df8b20b5812488\" rel=\"noreferrer\">2008</a>) found that in their highest-functioning category, survival rates were slightly reduced compared to the general population, but they go on to caution that, \"if a person's pattern of disabilities is at an extreme end of the range for a given group, their life expectancy may differ substantially\nfrom the group average.\" As Hutton says in <a href=\"http://www2.warwick.ac.uk/fac/sci/statistics/staff/academic-research/hutton/scope4.pdf\" rel=\"noreferrer\">this summary document</a>, \"A child who is mildly affected by CP can expect to have much the same length of life as\na child without CP.\"</p>\n\n<p>To sum up, for those of us fortunate enough to be on the extreme mild end of the CP spectrum, all available evidence suggests that the CP itself doesn't put a drag on our lifespans. If you go to Dr. Google, you can find CP resource websites claiming that CP \"puts extra strain on the heart\" or that people with CP \"don't build up a reserve of energy when resting\". That may be true in more moderate or severe cases, but it seems to be an unlikely risk factor for mild cases.</p>\n\n<p>Will I live to be 101, like my grandfather has done (and, unaccountably, continues to do)? Probably not, but then, that's true for most people. Just like everyone else, I don't know how long I've got, but the research says my odds are just about as good as anyone else's.</p>\n", "score": 5 } ]

[ "muscle", "physical-therapy" ]

[ { "answer_id": 9098, "body": "<p>To make it simple: There are two types of fat: unsaturated (\"good fat\") and saturated and trans fat (\"bad fat\").</p>\n\n<p>Current dietary guidelines (American Heart Association, WHO) suggest that saturated fats should be limited to &lt;10% (5-6% for those who would benefit from lowering of LDL cholesterol), and trans fats to &lt;1% of energy or as low as possible. The main purpose of these restrictions is to reduce risk of ischemic heart disease and stroke.</p>\n\n<p>WebMD (<a href=\"http://www.webmd.com/cholesterol-management/features/cholesterol-and-cooking-fats-and-oils?page=2\">http://www.webmd.com/cholesterol-management/features/cholesterol-and-cooking-fats-and-oils?page=2</a>) provides an exhaustive list, where unsaturated and saturated fat can be found:</p>\n\n<p><strong>Unsaturated fat:</strong></p>\n\n<blockquote>\n <p><strong>Monounsaturated fat</strong> is the primary type found in olive, canola, and sesame oils, as well as in avocados and avocado oil, and in nuts\n and their oils. <strong>Polyunsaturated fat</strong> is prevalent in corn, cottonseed,\n and safflower oils; sunflower seeds and sunflower oil; flaxseed and\n flaxseed oil; soybeans and soybean oil; tub margarine and soft\n spreads; and seafood.</p>\n</blockquote>\n\n<p><strong>Saturated fat:</strong></p>\n\n<blockquote>\n <p>Coconut oil, palm, palm kernel oil, and cocoa butter supply large\n amounts of saturated fat, too, but are cholesterol-free. (...) Trans fat is\n found in stick margarine, some tub margarine, and in shortening, as\n well as in some processed foods such as cookies, crackers, and pastry.</p>\n</blockquote>\n\n<p>Interestingly a recent meta-analysis published (aggregation and synthetising of different studies) in the BMJ (<a href=\"http://www.bmj.com/content/351/bmj.h3978\">http://www.bmj.com/content/351/bmj.h3978</a>) has somehow questioned the \"negative effect\" of saturated fat on cardiovascular disease. But considering that their results were associated with a high heterogeneity (= how consistent the effect across the combined studies is, ie in this case low), larger studies are needed to confirm their results.</p>\n\n<p>To your question: I have not found any study comparing directly different \"good fat\" oils together, so probably, considering one of the oils which contains unsaturated fat would be a wise choise (if you respect the dietary guidelines). Although, olive oil has been increasingly associated with reduced cardiovascular risk (<a href=\"http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-78\">http://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-12-78</a>), depending on your geographic location, this oil can be difficult to find.</p>\n", "score": 6 }, { "answer_id": 12733, "body": "<p>No cooking oils at all should be used. While saturated fats are very unhealthy as pointed out in M. Arrowsmith's answer, there is a problem with using unsaturated oils as well. We should first note that there is no need to fry food, you can steam or boil your food, and add whole foods containing fats like avocados, walnuts, and chia seeds. There are no proven nutritional health benefits of frying foods in refined oils over a plant based diet that includes all the fats in the form of the above mentioned whole foods. </p>\n\n<p>Conversely, we know from many observational studies that diets that include cooking oils in any form are worse w.r.t. atherosclerosis compared to plant based diets in which no or very small amounts of cooking oils are used. Such diets do contain some amount of fat, this comes mainly from nuts, seeds and certain oily vegetables like avocados. A very recent <a href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30752-3/fulltext\" rel=\"nofollow noreferrer\">study of the indigenous Tsimané people</a> reported:</p>\n\n<blockquote>\n <p>... the Tsimané, a forager-horticulturalist population of the Bolivian Amazon with few coronary artery disease risk factors, have the lowest reported levels of coronary artery disease of any population recorded to date.</p>\n</blockquote>\n\n<p>Other such results had been obtained previously in other indigenous or rural populations who stick to a low fat diet containing a lot of fruits and vegetables and who get a lot of physical activity. But in the Tsimané study, research have been able to bring CT scanners to the remote locations where the Tsimané live to directly measure coronary artery calcium scores, while the older studies used more indirect methods. E.g. as <a href=\"https://academic.oup.com/ije/article/41/5/1221/712631/Serum-cholesterol-diet-and-coronary-heart-disease\" rel=\"nofollow noreferrer\">reported in the landmark article that made the link between cholesterol and heart disease</a></p>\n\n<blockquote>\n <p>In the African population of Uganda coronary heart disease is almost non-existent. This statement is confirmed by adequate necropsy evidence. In the Asian community, on the other hand, coronary heart disease is a major problem. </p>\n</blockquote>\n\n<p>The article goes on to link the differences to the differences in cholesterol level which is then argued to be due to the differences in the percentage of calories coming from oils, it was 30–45% in the Asian community while 10-15% in the African community. Note that the Tsimané also get 14% of their calories from fats.</p>\n\n<p>Then having established that a low fat diet and a generally healthy lifestyle that includes eating lots of vegetables and getting plenty of exercise yields a low rates of heart disease in indigenous populations, one also needs to consider how other indigenous populations fare who eat a high fat diet. E.g. there exists a popular myth about Eskimos having very low rates of heart disease despite eating a high fat, meat based diet containing hardly any fruits and vegetables. But as <a href=\"http://www.onlinecjc.ca/article/S0828-282X(14)00237-2/fulltext\" rel=\"nofollow noreferrer\">pointed out here:</a></p>\n\n<blockquote>\n <p>During the 1970s, 2 Danish investigators, Bang and Dyerberg, on being informed that the Greenland Eskimos had a low prevalence of coronary artery disease (CAD) set out to study the diet of this population. Bang and Dyerberg described the “Eskimo diet” as consisting of large amounts of seal and whale blubber (ie, fats of animal origin) and suggested that this diet was a key factor in the alleged low incidence of CAD. This was the beginning of a proliferation of studies that focused on the cardioprotective effects of the “Eskimo diet.” In view of data, which accumulated on this topic during the past 40 years, we conducted a review of published literature to examine whether mortality and morbidity due to CAD are indeed lower in Eskimo/Inuit populations compared with their Caucasian counterparts. Most studies found that the Greenland Eskimos and the Canadian and Alaskan Inuit have CAD as often as the non-Eskimo populations. Notably, Bang and Dyerberg's studies from the 1970s did not investigate the prevalence of CAD in this population; however, their reports are still routinely cited as evidence for the cardioprotective effect of the “Eskimo diet.”</p>\n</blockquote>\n\n<p>So, the known facts on heart disease prevalence and diets in different populations paints a clear picture: using cooking oils is done at your own peril. But what about using only the healthy unsaturated oils, surely we can evade problems by using, say, olive oil? The main problem with this is that you're going to eat much more oil than the typical 10 to 15% of the natural intake that is seen in indigenous populations that are free of heart disease. This especially in case of a 90 year old grandmother as mentioned in the OP's question whose energy intake and use will be quite low. A few tablespoons of oil will already get you over this limit which makes frying food quite difficult. But why would that be a problem?</p>\n\n<p>The problem is due to the \"empty calories effect\", the larger the fraction of the oil of the total energy intake, the less room will be left for energy in the form of whole grain carbs such as brown rice, whole grain bread and whole grain pasta. Even if you use the most healthy oils known like olive oil, the more you use of such oils the more you're going to miss out on the health benefits of the whole grain carbs. These health benefits come from not only the vitamins and minerals in whole grain carbs, but also from the fibers. </p>\n\n<p>Fibers are converted in the intestines by gut bacteria to short chained fatty acids (SCFAs) which the body uses for a whole host of things. It has been shown that SCFAs <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3735932/\" rel=\"nofollow noreferrer\">reduce cholesterol levels</a>. Besides whole grains, whole foods that contain fats such as walnuts and chia seeds also contain a lot of useful nutrients including fibers. We have to note here that <a href=\"https://www.ucsfhealth.org/education/increasing_fiber_intake/\" rel=\"nofollow noreferrer\">Total dietary fiber intake should be 25 to 30 grams a day from food, not supplements. Currently, dietary fiber intakes among adults in the United States average about 15 grams a day.</a> Indigenous populations like the Tsimané get more than twice the recommended amounts (I checked this from my own diet which is similar to what the Tsimané eat), suggesting that the recommended amount is way too low. A 20 year-old may then be able to boost fiber intake while still using using significant amounts of cooking oils, but what about a sedentary 90 year old?</p>\n\n<p>In summary, cooking oils have no health benefits, we don't need to use them. Using the healthier unsaturated oils is not a good option either compared to not using any cooking oils, because you're going to get less nutrients as a result. This is going to be more of a problem the older and less physically active you are. </p>\n", "score": 1 } ]

[ "heart-disease", "food-safety", "heart" ]

[ { "answer_id": 9106, "body": "<p>A recent literature review of the evidence regarding long term effects of cannabis (3 weeks or longer since last use) reported:</p>\n\n<blockquote>\n <p>Cannabis appears to continue to exert impairing effects in <strong>executive\n functions</strong> even after 3 weeks of abstinence and beyond. While basic\n attentional and working memory abilities are largely restored, t<strong>he\n most enduring and detectable deficits are seen in decision-making,\n concept formation and planning.</strong> Verbal fluency impairments are\n somewhat mixed at this stage. <strong>Similar to the residual effects of\n cannabis use, those studies with subjects having chronic, heavy\n cannabis use show the most enduring deficits</strong>.</p>\n</blockquote>\n\n<p>The complete review is open access and available here: </p>\n\n<p>Crean RD, Crane NA, Mason BJ. An Evidence Based Review of Acute and Long-Term Effects of Cannabis Use on Executive Cognitive Functions. Journal of addiction medicine. 2011;5(1):1-8. doi:10.1097/ADM.0b013e31820c23fa.</p>\n", "score": 5 } ]

[ "mental-health", "marijuana" ]

[ { "answer_id": 9135, "body": "<p><em>Dog bites are the most common type of animal bites. Only 5% of dog bites lead to local infection.</em></p>\n\n<p><strong>No, echinococcus can't be transmitted through dog bites.</strong> Pathogens which can be transmitted by the saliva of the dog are rabies, pasteurella, capnocytophaga and brucella.</p>\n\n<p><strong>Echinococcus could be transmitted by dogs but through fecal transmission.</strong> Dogs are the definitive hosts for the tapeworm, Echinococcus granulosus. The adult tapeworm is present in the dog's small intestine and produces eggs that are excreted in the feces contaminating the environment. These eggs are infective to humans once ingested.</p>\n\n<p><em>References:</em> \nKotton C. Zoonoses from dogs. Aug 2016. Uptodate. <a href=\"http://www.uptodate.com/contents/zoonoses-from-dogs?source=search_result&amp;search=echinocoque&amp;selectedTitle=6~49#H6\" rel=\"nofollow\">http://www.uptodate.com/contents/zoonoses-from-dogs?source=search_result&amp;search=echinocoque&amp;selectedTitle=6~49#H6</a></p>\n", "score": 6 } ]

[ "infection", "prevention" ]