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[ { "answer_id": 9153, "body": "<p><strong>Diagnosis of gout is based on clinical examination and arthrocentesis (to detect the presence of monosodium urate crystals in the synovial fluid).</strong></p>\n\n<p><strong>The use of serum uric acid (sUA) levels is</strong> <strong>limited</strong> <strong>in acute gout flare</strong> and can be difficult to interpret. If acute gout attack is suspected in a patient, an elevated sUA (≥6.8 mg/dL) can lend support to the diagnosis but is neither diagnostic nor required to establish the diagnosis. Normal sUA levels have been reported in patients with acute gout flare <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25581951\" rel=\"nofollow\">1</a></p>\n\n<p><strong>To your question:</strong></p>\n\n<p><strong>The most accurate time for assessment of serum uric acid levels (and establishment of a baseline value) is two weeks or more after complete subsidence of an acute gout flare.</strong></p>\n\n<p><em>Sources:</em></p>\n\n<p>Becker MA. Clinical manifestations and diagnosis of gout. UpToDate. Jun 2016. <a href=\"http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-gout\" rel=\"nofollow\">http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-gout</a></p>\n\n<p>Hainer BL et al. Diagnosis, treatment and prevention of gout. Am Fam Physician. 2014 Dec 15;90(12):831-6.</p>\n", "score": 4 } ]

[ "blood-tests", "gout", "uric-acid" ]

[ { "answer_id": 9192, "body": "<p>As per <a href=\"https://www.drugs.com/mtm/neosporin-topical.html\" rel=\"nofollow noreferrer\">its description</a>, Neosporin <em>can</em> be used for minor cuts and scrapes, which seem to fit well to your description of opened blister. </p>\n\n<p>The picture provided shows a shallow opening. I doubt something like that would be much of a concern. It would be better to cleanly cut of the loose cut skin to a comfortable level and wait for the healing process to complete. \nIf the loose skin is left uncut, it would have the risk of becoming a handle to rip the skin further. If the wound is deeper, then treat the wound <a href=\"https://www.drugs.com/cdi/neosporin-ointment.html\" rel=\"nofollow noreferrer\">as prescribed</a>.</p>\n", "score": 5 }, { "answer_id": 9212, "body": "<p><a href=\"https://www.aad.org/public/skin-hair-nails/injured-skin/wound-care\" rel=\"nofollow\">See this from the AAD about wound care.</a></p>\n\n<p><a href=\"http://emedicine.medscape.com/article/884594-overview#showall\" rel=\"nofollow\">See this from Medscape for interesting info on wound healing.</a></p>\n\n<ol>\n<li>Studies are mixed whether there are clear improved outcomes from using antibiotic ointments (like neosporin) over petroleum jelly (like vaseline) on wounds that are cleaned and kept clean. There is a little more evidence for benefit in wounds acquired in dirty circumstances, and in partial thickness burns.</li>\n<li>That article, as well as all dermatologists I work with, recommend sterile petroleum jelly (or antibiotic ointment) to SCAR less than using nothing, and say it may heal faster. </li>\n<li>Since it has medication in it, antibiotic ointment can have more side effects (like allergic reactions); it's not without risk. Petroleum jelly has no active ingredients.</li>\n<li>Always keep it covered with a clean bandaid for 24-48 hrs. </li>\n<li>You can use neosporin (or vaseline) on shallow open wounds safely if you have no allergic reaction to it. (If it goes down to fascia/muscle/bone, don't - but you should be in a medical office having that looked at anyway.)</li>\n<li>TRY TO NEVER POP BLISTERS. A blister is sterile inside until you puncture it, which lets tons of bacteria come party inside your body. (And viruses, and fungus, and...)</li>\n<li>If a blister pops, try to wash the area with soap/water, lay the skin back down to cover it, and put a bandaid on - with or without vaseline or antibiotic ointment.</li>\n<li>Tip: Use vaseline tubes to deposit a dab onto the clean bandaid, QTip, or a tissue to be more sanitary.</li>\n<li>For my 2 cents, I prefer using vaseline and a clean bandaid. If it was a dirty wound or large deroofed blister, after washing it, I may use antibiotic ointment for first 24 hrs as if it were a burn.</li>\n</ol>\n", "score": 4 } ]

[ "dermatology", "wound-care", "neosporin", "blister" ]

[ { "answer_id": 9277, "body": "<p><em>Very interesting question. Thank you.</em></p>\n\n<p><strong>The pathophysiology of photosensibility in lupus patients is related to the effect of ultraviolet radiation (UVR) on cells of the immune system.</strong> UVR stimulates lymphocytes recruitment and antibody-mediated cytotoxicity, which are involved in the pathogenesis of lupus.</p>\n\n<p><strong>The mechanisms by which ultraviolet-A (UVA) (320–400 nm) and ultraviolet-B (UVB) (290–320 nm) induces photosensibility are however different.</strong> Following picture provides a good overview of our current understanding:</p>\n\n<p><a href=\"https://i.stack.imgur.com/VhYTd.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/VhYTd.png\" alt=\"enter image description here\"></a></p>\n\n<p><em>Recently, a review written by Kim et al (from which the above figure was taken), addressed the issue of photosensibility in patients with cutaneous lupus erythematosus. The paper is open-access if you wish to have further information (in particular on the possible treatments):</em></p>\n\n<p>Kim A, Chong BF. Photosensitivity in Cutaneous Lupus Erythematosus. Photodermatology, photoimmunology &amp; photomedicine. 2013;29(1):4-11. doi:10.1111/phpp.12018.\n<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539182/\" rel=\"nofollow noreferrer\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3539182/</a></p>\n", "score": 5 } ]

[ "autoimmune-disease", "lupus", "sunlight", "triggers" ]

[ { "answer_id": 15985, "body": "<p>People who are deficient in Omega-3, Omega-6 and/or Omega-9 would benefit from a 3/6/9 supplement.</p>\n\n<p>However it is difficult to envisage a scenario in which omega-6/9 intake would be lacking, since both are so abundant, and Omega-9 can also by synthesized in the human body. A \"zero fat\" diet or a survival situation perhaps. </p>\n\n<p>Omega-3 on the other hand, is less abundant. More importantly, Omega-3 is <em>group</em> of 3 fatty acids: ALA, EPA and DHA. ALA is an essential fatty acid, whereas EPA and DHA are synthesized from ALA within the body. However, the conversion rates are low and variable, and there is evidence that excess Omega-6 can inhibit the conversion of ALA into EPA and DHA. Therefore it is desirable to maintain a low ratio of Omega-3 : Omega-6 in the diet. <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12442909\" rel=\"nofollow noreferrer\">Studies</a> suggest a ratio of between 1 and 3 to 1. Western diets typically have a ratio of 1:20 or even higher. <a href=\"https://www.nature.com/articles/tp2017190\" rel=\"nofollow noreferrer\">Berger et al (2017)</a> found that high ratios were associated with increased risk of mood disorders</p>\n\n<p>EPA and DHA are synthesized by algae, which are then eaten by krill which are in turn eaten by fish. This is why fish oil is a great source of Omega-3. For those who do not eat fish or consume fish products, an algal-oil-based supplement would be needed.</p>\n\n<p>Sources:</p>\n\n<p>Berger, M. E., et al. \"Omega-6 to omega-3 polyunsaturated fatty acid ratio and subsequent mood disorders in young people with at-risk mental states: a 7-year longitudinal study.\" Translational psychiatry 7.8 (2017): e1220.</p>\n\n<p>Simopoulos, A. P. (2002). The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine &amp; pharmacotherapy, 56(8), 365-379.</p>\n", "score": 1 }, { "answer_id": 15988, "body": "<p>In alpha-linolenic (omega-3) and linoleic (omega-6) deficiency, the production of <strong>mead acid (omega-9)</strong> in the body <em>increases</em> (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26187936\" rel=\"nofollow noreferrer\">PubMed</a>). Judging from this fact alone, supplementation with omega-9 sounds counterintuitive. I have also found no evidence of \"omega-9 deficiency\" or \"omega-9 supplementation benefits.\"</p>\n\n<p>Supplementation with <strong>linoleic acid (omega-6)</strong> makes sense in essential fatty acid deficiency (usually due to parenteral nutrition or severe fat malabsorption) (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/406855\" rel=\"nofollow noreferrer\">PubMed</a>). Apart from that, there is <em>insufficient evidence</em> of omega-6 supplements benefits (<a href=\"https://medlineplus.gov/druginfo/natural/496.html\" rel=\"nofollow noreferrer\">MedlinePlus</a>).</p>\n\n<p><a href=\"https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/\" rel=\"nofollow noreferrer\">Office of Dietary Supplements</a> mentions several study reviews that question the benefits of <strong>fish oil supplements (omega-3).</strong></p>\n\n<blockquote>\n <p>Higher consumption of seafood, such as fatty fish, appears to provide\n protection from many adverse CVD outcomes. However, many studies have\n shown that taking omega-3 dietary supplements, such as fish oil\n supplements, might not provide the same protection.</p>\n</blockquote>\n\n<p><strong>Conclusion:</strong> I have found no evidence about omega-3,6,9 supplements being more beneficial than omega-3 supplements.</p>\n", "score": 1 } ]

[ "nutrition", "micronutrients", "supplement", "oil", "omega-3" ]

[ { "answer_id": 9569, "body": "<p>According to Dr. Sera Young of Cornell University, the most likely of the theories is that eating mud protects the body from pathogens, parasites, and plant toxins. It's suspected to be due to the clay's ability to bind things — perhaps the clay is binding the toxins before they can make you sick. This theory would explain why children and pregnant women are the most common dirt eaters; they are the most susceptible to illness. Clay may even have properties that protect against malaria.</p>\n\n<p><a href=\"http://abcnews.go.com/Health/Diet/story?id=1167623&amp;page=1\" rel=\"nofollow\">http://abcnews.go.com/Health/Diet/story?id=1167623&amp;page=1</a></p>\n", "score": 1 } ]

[ "nutrition", "diet", "food-safety", "food-poisoning", "toxins" ]

[ { "answer_id": 9478, "body": "<p>For a healthy individual there are 2 main ways to lose water weight:</p>\n\n<ul>\n<li>To decrease sodium intake (this may take several days to become effective).</li>\n<li>A low-carb diet that results in ketosis (in as little as 2 days). This means that you burn all glycogen you have in the liver and muscles. If you have 500 grams of glycogen stores and if each gram of glycogen can bind up to 4 grams of water (<a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1748-1716.1970.tb04764.x/abstract\" rel=\"nofollow\">Wiley Online</a>), you can lose 2,000 grams (~4 pounds) of water. I'm not saying I recommend this.</li>\n</ul>\n\n<p>The other cause of \"bloating\" is abdominal fat.</p>\n\n<p>The other real cause of abdominal bloating (abdominal distension) is excessive production of gas in the bowel. This usually occurs after consumption of foods high in soluble fiber (oats, legumes, fruits and some vegetables) (<a href=\"http://my.clevelandclinic.org/health/diseases_conditions/hic_Gas\" rel=\"nofollow\">Cleveland Clinic</a>) or after drinking milk (in people with lactose intolerance) or consumption of fructose (in those with fructose malabsorption). This type of bloating does not increase body weight.</p>\n", "score": 4 } ]

[ "diet", "sodium", "water-weight", "water-retention", "bloated-bloating" ]

[ { "answer_id": 9698, "body": "<p>One of the possible solutions might be to try decaf tea. Although decaffeination also reduces the amount of polyphenols to some extent, in many cases there is still a lot of them left. The reduction of polyphenols seems to vary among different brands according to <a href=\"http://www.isaet.org/images/extraimages/IJCEBS%200101112.pdf\" rel=\"nofollow noreferrer\">this article</a> so it might be worthwile to try several brands before you come to a conclusion.</p>\n\n<p>Another approach might be to try tea with milk, since milk proteins precipitate tannins. However, this reaction is pH dependant and works better with other types of polyphenols than those found in tea, as shown in <a href=\"http://www.ijfans.com/Volume%204%20Issue%201/3.%20IJFANS%20A0377-15.pdf\" rel=\"nofollow noreferrer\">this research</a>, but if you compare it with how you reacted to decaf tea, you might come to a conclusion.</p>\n\n<p>It is important to stress that your stomach ache, even though exacerbated by tea, might have a different underlying cause. If it occurs regularly with tea drinking or if it is not regular but causes great discomfort, you should talk to your doctor to get to the bottom of the problem and receive adequate treatment.</p>\n\n<hr>\n\n<p>References:</p>\n\n<ol>\n<li><p><a href=\"http://www.isaet.org/images/extraimages/IJCEBS%200101112.pdf\" rel=\"nofollow noreferrer\">The Bioactive Compounds of Tea and Decaffeinated Tea (<em>Camellia sinensis</em>)</a></p></li>\n<li><p><a href=\"http://www.ijfans.com/Volume%204%20Issue%201/3.%20IJFANS%20A0377-15.pdf\" rel=\"nofollow noreferrer\">Interaction between some plants tannins and milk protein</a></p></li>\n</ol>\n", "score": 1 } ]

[ "caffeine", "tea" ]

[ { "answer_id": 9595, "body": "<p><strong>1</strong>. NSAIDs can increase the chance of heart attack or stroke. This risk may be greater if you have heart disease or risk factors (for example, smoking, high blood pressure, high cholesterol, diabetes) for heart disease. However, the risk may also be increased in people who do not have heart disease or those risk factors.</p>\n\n<p>Heart problems caused by NSAIDs can happen within the first weeks of use, and may happen more frequently with higher doses or with long-term use.</p>\n\n<p>NSAIDs should not be used right before or after heart bypass surgery.</p>\n\n<p>NSAIDs may increase the chance of serious stomach and bowel side effects like ulcers and bleeding. This risk may be greater in older individuals. These side effects can occur without warning signs.</p>\n\n<p><a href=\"http://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Non-Steroidal_Anti-Inflammatory_Medicines_NSAIDs\" rel=\"nofollow\">http://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Non-Steroidal_Anti-Inflammatory_Medicines_NSAIDs</a></p>\n\n<p><strong>2.</strong> Acetaminophen is most suitable for relieving the symptoms of cold and flu. Acetaminophen affect the areas of your brain that control body temperature and pain. These medications can fight fevers and chills, ease headaches, and soothe sore throats and body aches. NSAIDs surpass paracetamol only when relieving the symptoms of fever.</p>\n\n<p><a href=\"http://www.webmd.com/allergies/sinus-nose-tool/treat-aches-pain-fever\" rel=\"nofollow\">http://www.webmd.com/allergies/sinus-nose-tool/treat-aches-pain-fever</a></p>\n\n<p><strong>3</strong>. Acetaminophen is the most suitable for relieving pain caused by physical injury than NSAIDs. </p>\n\n<p>Acetaminophen works by inhibiting the synthesis of chemical messengers called prostaglandins, which help to transmit pain signals and induce fever. The body produces prostaglandins in response to an injury or illness. Acetaminophen reduces the pain by helping to block this signaling.</p>\n\n<p><a href=\"http://www.chemistryexplained.com/A-Ar/Acetaminophen.html\" rel=\"nofollow\">http://www.chemistryexplained.com/A-Ar/Acetaminophen.html</a></p>\n\n<p>While NSAIDs work on a chemical level. They block the effects of special enzymes -- specifically Cox-1 and Cox-2 enzymes. These enzymes play a key role in making prostaglandins. By blocking the Cox enzymes, NSAIDs stop your body from making as many prostaglandins. </p>\n\n<p><a href=\"http://www.webmd.com/arthritis/features/pain-relief-how-nsaids-work#1\" rel=\"nofollow\">http://www.webmd.com/arthritis/features/pain-relief-how-nsaids-work#1</a></p>\n", "score": 1 } ]

[ "medications", "side-effects", "nsaids-pain-meds", "analgesics", "acetaminophen" ]

[ { "answer_id": 9620, "body": "<p>The main energy emissions (i.e. ways of affecting its surroundings) of a laptop computer are—</p>\n\n<ul>\n<li><p><strong>Sound</strong>: Unless your laptop has extravagant bass speakers that can physically rattle your organs hard enough to be painful, this will have no effect.</p></li>\n<li><p><strong>Heat</strong>: A laptop can run quite hot, and <a href=\"http://malecontraceptives.org/methods/heat_biology.php\" rel=\"nofollow noreferrer\">heating the testes can be used as a method of contraception</a>, as the ideal temperature for sperm to survive is a little lower than your body temperature otherwise. The effect is not permanent—heat strong enough to cause lasting damage would be physically painful.</p>\n\n<p>However, I think the effect of a laptop on the user's testes is likely to be negligible. A usual sitting position puts lots of room between the testes and the laptop, allowing most of the heat to dissipate (see <a href=\"https://en.wikipedia.org/wiki/Inverse-square_law\" rel=\"nofollow noreferrer\">inverse-square law</a>). If you are trying to conceive, and your laptop runs very hot, and you use it in your lap for a large part of your waking hours, <em>then</em> its positioning may be worth considering.</p></li>\n<li><p><strong>Radio waves</strong>: Computers use low-power non-ionising radiation for WiFi communication channels. Such radiation has <a href=\"https://skeptics.stackexchange.com/questions/1178/are-wifi-waves-harmful\">not been shown to damage human tissue in any way</a>.</p>\n\n<p>Cutting-edge devices with a wireless charging feature also receive low frequency radiation from a base station. <a href=\"https://skeptics.stackexchange.com/questions/31385/is-wireless-charging-harmful\">This radiation is also non-ionising and safe</a>.</p></li>\n</ul>\n\n<p>I see no way a laptop could cause skin discoloration, except unless ⓐ the skin was burned because the laptop was hot, or ⓑ if the skin's blood supply was cut off due to long-lasting pressure from a very heavy laptop in the same position.</p>\n\n<hr>\n\n<p>In summary, the only health concern with having a laptop in your lap is <em>heat</em>. Treat a hot laptop like any other hot object: carefully!</p>\n", "score": 9 } ]

[ "side-effects", "fertility", "coloration-discoloration", "infertile" ]

[ { "answer_id": 14769, "body": "<p>Premature ejaculation has variable definitions, which cause some difficulties in diagnosis. The main <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5565560/\" rel=\"nofollow noreferrer\">treatment methods</a> are psychological counseling, behavioral therapy, drug therapy and surgical treatment.</p>\n\n<blockquote>\n <p>Drug therapy including topical drugs, serotonin reuptake inhibitors (SSRi), receptor blockers, type 5 phosphodiesterase inhibitors (PDE5i), etc., of the latest medications can choose hydrochloric acid of dapoxetine (Priligy) treatment.</p>\n</blockquote>\n\n<p>The <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5717471/\" rel=\"nofollow noreferrer\">oxytocin antagonists</a> shows good results, but they demands further reserches.</p>\n\n<blockquote>\n <p>Oxytocin is a peptide hormone that is believed to shorten ejaculatory latency times through central and peripheral pathways in animal models. The ejaculatory delay observed with SSRIs may be mediated by alterations in the central release of oxytocin. This has formed the basis of the development of oxytocin receptor antagonists. The first drug used in human clinical trials was epelsiban. This is a highly selective oxytocin receptor antagonist with rapid absorption and elimination. It had been shown to delay ejaculatory latency in animal models. In this multicentre study, men were randomly assigned to placebo or epelsiban (50 mg/150 mg). Study inclusion was based on the ISSM definition of PE, and IELT was measured with the use of a stopwatch. There was no significant difference in the baseline IELT measurements between the groups. Following 8 weeks of treatment, there were no significant clinical or statistically significant differences in IELT between the groups. The authors speculated that efficacy may be linked to centrally acting oxytocin antagonist activity. There is some evidence from animal studies to support this hypothesis. This has led to the development of the most recent oxytocin antagonist. This is a small molecule with good central penetration and rapid absorption with potent antagonism of the oxytocin receptor. A total of 88 men with LPE were randomly assigned to either placebo or active drug (400 mg/800 mg). Inclusion appeared to be based on ISSM criteria. Following 8 weeks of treatment, IX-01 resulted in a 3-fold increase in IELT (1.6 in the placebo group). This improvement was observed as early as 2 weeks after starting treatment. The drug was well tolerated with no serious or severe adverse events; 21% reported at least one adverse event (30% in the placebo group). The dropout rate was high: 21% with the active drug and 27% in the placebo arm. This is obviously encouraging news for the field, and we should expect larger trials involving a more diverse population.</p>\n</blockquote>\n\n<p>The combination of <a href=\"http://www.pagepressjournals.org/index.php/aiua/article/view/aiua.2017.2.148\" rel=\"nofollow noreferrer\">drug and behavioural therapy</a> shows more effective results.</p>\n\n<blockquote>\n <p>MATERIALS AND METHODS:\n 18 patients were enrolled, aged between 25 and 55 (mean: 40), all with primary PE, free of comorbidities and with their partners involved. Six patients were prescribed 30 mg dapoxetine two hours before sexual relations for 3 months (group A); 6 patients began the dynamic rehabilitative treatment (group B); 6 other couples were assigned to pharmacological treatment in association with dynamic rehabilitative behavioural treatment for 3 months (group C). Division of subjects was carried out by simple randomisation, excluding patients with a short frenulum, phimosis, ED, chronic prostatitis or experiencing results from previous treatment.</p>\n \n <p>RESULTS:\n Outcomes of treatment were evaluated at the end of the 3 months of treatment and 3 months after discontinuing treatment. In Group A 75% of patients were cured at 3 months and 25% at 6 months. In Group B 25% patients were cured at 3 months and 25% at 6 months. In Group C 75% of patients were cured 3 months and 50% at 6 months. \"Cured\" means a Premature Ejaculation Diagnostic Tool (PEDT) score reduced from an average of 12 to an average of 6 and Intravaginal Ejaculation Latency Time (IELT) values from &lt; 1 to &gt; 6 minutes.</p>\n</blockquote>\n\n<p>Sometimes keeping to healthy lifestile can prevent medical treatment. First of all the <a href=\"http://potencyup.com/how-to-stop-premature-ejaculation-best-pills-for-treatment-and-home-remedies/\" rel=\"nofollow noreferrer\">diet that helps cure premature ejaculation</a> includes such foods as green onions, boiled asparagus, ginger, almonds, honey etc. The <a href=\"https://clinicaltrials.gov/ct2/show/study/NCT02984592\" rel=\"nofollow noreferrer\">study</a> devoted to the connection between physical activity and premature ejaculation is being conducted (completion date is January 31, 2017). </p>\n", "score": 2 } ]

[ "sex" ]

[ { "answer_id": 9703, "body": "<p>Saliva is safe to apply to the sexual organs. While it is true that <a href=\"https://en.wikipedia.org/wiki/Oral_microbiology\" rel=\"noreferrer\">the mouth contains lots of micro-organisms</a>, the same varieties are also commonly thrive elsewhere in the body, and are all harmless against a normally functioning immune system. Saliva also contains antibacterials, has skin-like acidity, and acts as a pH buffer.</p>\n\n<p>The only concern is that it may also contain anything that has recently been in your mouth. For example, using saliva as a sexual lubricant may be risky if you—</p>\n\n<ul>\n<li><p>have a topical infection around your mouth or lips, or have recently licked a location of such an infection,</p></li>\n<li><p>have recently eaten a food that can irritate sensitive skin or mucous membranes (e.g. vinegar, salt, or anything abrasive), or</p></li>\n<li><p>have recently kissed or had oral sex with anyone who might have a sexually transmissible illness.</p></li>\n</ul>\n\n<p>In cases that you're unsure, other water-based lubricants sold in supermarkets and pharmacies are a safe alternative.</p>\n", "score": 7 } ]

[ "penis", "masturbation", "saliva", "circumcision", "lubrication" ]

[ { "answer_id": 9728, "body": "<p><strong>Fruits (both fresh and dried) should not contain bugs.</strong> Their presence indicates that the fruit hasn't been preserved well, or that their producer has made some other mistake. They may be unsafe to eat.</p>\n\n<p>If you're in any doubt, dispose of it.</p>\n\n<hr>\n\n<p>Also, let's talk in some more detail about figs, because I also love figs, and because they have a special relationship with bugs.</p>\n\n<p>Figs you want to eat should not contain bugs either. However, if you pick the fig yourself, or if the grower who sold it to you was incompetent, you may one day open an undamaged fresh fruit of a <a href=\"https://en.wikipedia.org/wiki/Ficus\" rel=\"noreferrer\">fig tree</a> and find little critters. Those are <a href=\"https://en.wikipedia.org/wiki/Fig_wasp\" rel=\"noreferrer\">fig wasps</a>, or larvae thereof. They are about 2mm long and a normal part of the lifecycle of figs, and render the fruit inedible. However, they are completely avoidable by growers who know what they're doing.</p>\n\n<p>Each fig species has a unique symbiotic reproductive relationship with a species of fig wasp. The wasps pollinate the plants, and hermaphroditic plants (only some of all figs) produce flowers that wasps can also lay eggs in.</p>\n\n<p>We can however guarantee no bugs if we choose to pick only from plants that are—</p>\n\n<ul>\n<li><p><a href=\"https://en.wikipedia.org/wiki/Parthenocarpy\" rel=\"noreferrer\">parthenocarpic</a>, which produce mature fruit even when not pollinated, as long as they are in an area without wasps that could pollinate them, or</p></li>\n<li><p>a gynodioecious species' female trees, in which flowers are shaped such that while wasps can pollinate them, they cannot lay eggs there.</p></li>\n</ul>\n\n<p>I think the grower of those suspicious dried figs you linked (with many negative Amazon reviews) must have made a mistake of either—</p>\n\n<ul>\n<li><p>growing a parthenocarpic fig species in an area that <em>has</em> wasps of the species that pollinates it, or</p></li>\n<li><p>misplacing their female trees, and accidentally picking from a hermaphroditic tree.</p></li>\n</ul>\n\n<p>Or perhaps they had just stored the fruit badly and the bugs that reviewers found were unrelated. Either way, it's a shame this supplier is giving dried fruit a bad name. I'm convinced they are the exception, as that is the first case I've heard of, and certainly not the way fruit should be.</p>\n", "score": 5 }, { "answer_id": 9750, "body": "<p>It sounds like they've been harvested too soon so that the larvae haven't had a chance to escape. The pollinating dead insect is normally absorbed inside the fruit.</p>\n\n<p>Very doubtful that they're poisonous since they're a natural part of the figs life cycle, and people have been eating them since Adam.</p>\n", "score": 0 } ]

[ "nutrition", "food-safety" ]

[ { "answer_id": 9739, "body": "<p>Actually lack of sleep leads to weight gain and not weight loss.</p>\n\n<p>Losing out on sleep creates a viscous cycle in your body, making you more prone to various factors contributing to weight gain. “The more sleep-deprived you are, the higher your levels of the stress hormone cortisol, which increases your appetite,”.</p>\n\n<p>When you’re stressed, your body tries to produce serotonin to calm you down. The easiest way to do that is by eating high-fat, high-carb foods that produce a neurochemical reaction,”says Breus</p>\n\n<p><a href=\"http://dailyburn.com/life/lifestyle/sleep-deprivation-effects-weight-loss/\">http://dailyburn.com/life/lifestyle/sleep-deprivation-effects-weight-loss/</a></p>\n", "score": 5 } ]

[ "side-effects", "weight-loss", "sleep-cycles", "body-weight" ]

[ { "answer_id": 9823, "body": "<p>The phenomenon you are describing of the pupils dilating when telling a lie has to do with the way the muscles around the eye are wired to the nervous system, and more specifically, the autonomic nervous system.</p>\n\n<p>For better understanding, I suggest reading the chapter about neurotransmission in any introductory pharmacology book, such as <a href=\"http://rads.stackoverflow.com/amzn/click/0071764011\" rel=\"nofollow\">Katzung's Basic and Clinical Pharmacology</a> (chapter 6 in 12th edition), or <a href=\"http://rads.stackoverflow.com/amzn/click/0071624422\" rel=\"nofollow\">Goodman &amp; Gilman's The Pharmacological Basis of Therapeutics</a> (chapter 8 in 12th edition). However, I will try to explain it briefly here.</p>\n\n<p>The autonomic nervous system (ANS) regulates bodily functions that occur without conscious control (involuntary actions). This system is divided into two branches: The sympathetic nervous system and the parasympathetic nervous system; each can be described by a short general statement, as follows: The sympathetic system is more active in a \"fight or flight\" situations, and the parasympathetic system is more active in a \"rest and digest\" state. In other words, the sympathetic nervous system adjusts your body to deal with some kind of threat to your safety, whereas the parasympathetic nervous system adjusts your body to conserve energy and be efficient when resting (i.e. good sleep,good digestion etc.)</p>\n\n<p>Now, lying usually involves some level of tension or anxiety (unless you are a very good liar), because you might be worried to a certain degree that the lie will be revealed. This tension subconsciously triggers the sympathetic nervous system, which will cause certain effects throughout your body. Sympathetic stimulation to the eye will cause contraction of the radially oriented pupillary dilator muscle fibers in the iris and will result in mydriasis (dilation of the pupil). An opposite effect is achieved when the eye receives parasympathetic stimulation (i.e. when you are calmer, maybe after confessing the truth...), and the pupil undergoes miosis (constriction).</p>\n\n<p>In short, since lying usually involves tension, and tension is associated with increased sympathetic activity, the pupil will dilate following sympathetic stimulation.</p>\n\n<p>This point leads us to the other part of your question: other physical symptoms of lying are actually other manifestations of increased sympathetic activity (for a more thorough review, please see the texts I recommended above). Among others, common effects are: rise in blood pressure,increased heart rate, and increased sweating.</p>\n", "score": 3 } ]

[ "medical-myths", "behavior", "pupil", "dialation" ]

[ { "answer_id": 9931, "body": "<p>Currently, the only real way to \"get rid of acne once and for all\" is through the use of the prescription medication <a href=\"https://en.wikipedia.org/wiki/Isotretinoin\" rel=\"nofollow noreferrer\">isotretinoin</a>. It works to reduce sebum production and thusly decreases the incidence of new spots.</p>\n\n<p>Warning: It's a serious medication with serious side effects -- for me most notably it was severely dry skin on every inch of my body. I've also personally done 2 rounds, as the dosage on the first go was not high enough to achieve desired (permanent) effects. Having said that, after the second course of treatment my skin improved dramatically and I only get a rare tiny pimple or two each month. It was (and can be) life-changing.</p>\n\n<p>Do your resarch and speak with a doctor about options available to you specific to your personal skin situation.</p>\n", "score": 3 } ]

[ "dermatology", "acne", "topical-cream-gel", "benzoyl-peroxide", "blemishes" ]

[ { "answer_id": 9895, "body": "<p>A Universal childhood virus is inherited in DNA. </p>\n\n<blockquote>\n <p>A virus that causes a universal childhood infection is often passed\n from parent to child at birth, not in the blood but in the DNA,\n according to a new study.</p>\n</blockquote>\n\n<p>... Her team is now investigating what this means for the children.</p>\n\n<blockquote>\n <p>Researchers found that most babies infected with the HHV-6 virus,\n which causes roseola, had the virus integrated into their chromosomes.\n Not only that, but either the father or mother also had the virus in\n the chromosomes, suggesting it was a germline transmission – passed on\n in egg or sperm.</p>\n</blockquote>\n\n<p><a href=\"https://www.newscientist.com/article/dn14658-universal-childhood-virus-is-inherited-in-dna/\" rel=\"nofollow noreferrer\">https://www.newscientist.com/article/dn14658-universal-childhood-virus-is-inherited-in-dna/</a></p>\n", "score": 1 } ]

[ "infection", "disease-transmission", "infectious-diseases", "virus", "genetics" ]

[ { "answer_id": 10491, "body": "<p>I think, at this point, the answer to the question: \"does ALA alone have any important/essential roles\" is not yet known, but here are few hints:</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12617463\" rel=\"nofollow noreferrer\">What is the role of alpha-linolenic acid for mammals? (PubMed, 2002)</a></p>\n\n<blockquote>\n <p>The main role of ALA was assumed to be as a precursor to the\n longer-chain n-3 PUFA, EPA and DHA...ALA accumulates in specific sites\n in the body of mammals (carcass, adipose, and skin).... <strong>There is\n some evidence that ALA may be involved with skin and fur function.</strong>\n There is continuing debate regarding whether ALA has actions of its\n own in relation to the <strong>cardiovascular system and neural function.</strong></p>\n</blockquote>\n", "score": 1 }, { "answer_id": 10470, "body": "<p>ALA does have importance beyond being converted to DHA and EPA, although it is found to be less efficacious. See this <a href=\"http://www.sciencedirect.com/science/article/pii/S0163782716300303\" rel=\"nofollow noreferrer\">study</a>: </p>\n\n<p>The conversion of ALA to EPA lies between 8-12%, while it's conversion to DHA is less than 1%. ALA is either eliminated from the body by metabolism in the liver (eliminated as in chemically altered to be excreted. stored as a monounsaturated fatty acid, or utilized as energy) or stored (without being altered) in cell membranes. </p>\n\n<p>The <a href=\"https://www.cancertutor.com/budwig/\" rel=\"nofollow noreferrer\">Budwig Protocol</a> is an interesting theory about ALA storage in cell membrane and it's application through diet. </p>\n\n<p>I hope this helps. </p>\n\n<p>[EDIT] To better answer your question, according to the study I linked above, you would not need ALA if you are able to eat adequate amounts of DHA and EPA. ALA's most unique function (according to Budwig protocol, which is still speculative but very intuitive) is it's desired health effects when it accumulates in cell membranes. </p>\n", "score": 0 } ]

[ "micronutrients", "omega-3", "dha-docosahexaenoic-acid", "epa-eicosapentaenoic-acid" ]

[ { "answer_id": 18271, "body": "<p>Most drugs have wanted (main) and unwanted (side) effects, but neither of them are guaranteed. For example, aspirin may or may not relieve your headache and may or may not upset your stomach.</p>\n\n<p>The lists of drug side effects base on decades of studies and consumers' reports, such as <a href=\"https://www.fda.gov/safety/medwatch/howtoreport/ucm053074.htm\" rel=\"nofollow noreferrer\">FDA (US)</a>, <a href=\"https://yellowcard.mhra.gov.uk/\" rel=\"nofollow noreferrer\">YellowCard (UK)</a>, <a href=\"http://www.adrreports.eu/\" rel=\"nofollow noreferrer\">Adreports (EU)</a> and <a href=\"https://medsafe.govt.nz/consumers/side.asp\" rel=\"nofollow noreferrer\">Medsafe (NZ)</a>, but if, let's say, <a href=\"https://www.drugs.com/sfx/ibuprofen-side-effects.html\" rel=\"nofollow noreferrer\">ibuprofen</a> has 100+ reported side effects, you as a single user will likely experience only few, if any.</p>\n\n<p><strong>The differences in side effects can depend on:</strong></p>\n\n<p><strong>1. Drug factors:</strong></p>\n\n<ul>\n<li><strong>Chemical</strong> form: <a href=\"http://www.nutrientsreview.com/minerals/iron.html\" rel=\"nofollow noreferrer\">Supplemental</a> carbonyl iron can have less side effects that iron sulfate.</li>\n<li><strong>Physical</strong> form: Capsules may upset your gut less than tablets.</li>\n<li><strong>Administration:</strong> Iron by mouth can cause severe stomach irritation, while intravenous iron usually does not.</li>\n<li><a href=\"https://www.cc.nih.gov/ccc/patient_education/drug_nutrient/maoi1.pdf\" rel=\"nofollow noreferrer\"><strong>Taking certain foods</strong> (aged cheeses, sauerkraut...) along with the antidepressants called MAO inhibitors</a> can severely increase your blood pressure.</li>\n<li><strong>Not taking enough water and dietary fiber</strong> can cause <a href=\"https://www.news-medical.net/health/Drugs-that-Cause-Constipation.aspx\" rel=\"nofollow noreferrer\">severe constipation when taking certain drugs, such as calcium, opiates, antihistamines or antidepressants...</a>.</li>\n<li><strong><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872714/\" rel=\"nofollow noreferrer\">Toxicity</strong> of statins</a> can make you gradually intolerant to them.</li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21322119\" rel=\"nofollow noreferrer\"><strong>Adulteration</strong> of heroin or cocaine with fentanyl</a> can have life-threatening effects.</li>\n</ul>\n\n<p><strong>2. Personal factors:</strong></p>\n\n<ul>\n<li><strong>Genetics</strong> (body size, high threshold for side effects) can greatly affect your susceptibility for side effects.</li>\n<li><strong>Developed tolerance</strong> (metabolic or behavioral) to alcohol, cocaine, heroin, morphine or marijuana can greatly decrease their adverse effects (<a href=\"https://drugabuse.com/library/tolerance-dependence-addiction/\" rel=\"nofollow noreferrer\">Drug Abuse</a>).</li>\n<li><strong>Empty stomach</strong> is often more prone for irritation by a drug.</li>\n<li><strong>The social atmosphere</strong> in which the drug, such as alcohol or <a href=\"https://www.drugs.com/illicit/mdma.html\" rel=\"nofollow noreferrer\">ecstasy</a>, is taken can significantly influence side effects.</li>\n<li><strong>Initial psychological state</strong> in which one takes a drug: if worried, <a href=\"http://www.nutrientsreview.com/alcohol/intoxication-symptoms-signs.html\" rel=\"nofollow noreferrer\">alcohol</a> may make you more worried; if relaxed, it will likely make you more relaxed.</li>\n<li><strong>Allergy</strong> to a drug</li>\n<li><strong>Liver or kidney disease</strong> can slow down the breakdown of a drug and increase its side/effects.</li>\n<li><strong>Drug-disease reactions:</strong> Aspirin given to children with a viral infection, such as chickenpox or flu, can cause a fatal damage of the liver and brain (<a href=\"https://www.ninds.nih.gov/Disorders/All-Disorders/Reyes-Syndrome-Information-Page\" rel=\"nofollow noreferrer\">Reye's syndrome</a>).</li>\n</ul>\n\n<hr>\n\n<p>The bottom line: A side effect is not necessary an inherent property of a drug.</p>\n\n<hr>\n\n<p>Bonus: Side effects, interactions and contraindications of medications, supplements and herbs (<a href=\"https://medlineplus.gov/druginformation.html\" rel=\"nofollow noreferrer\">MedlinePlus</a>, <a href=\"https://www.mayoclinic.org/drugs-supplements\" rel=\"nofollow noreferrer\">Mayo Clinic</a>, <a href=\"https://www.drugs.com/\" rel=\"nofollow noreferrer\">Drugs.com</a>, <a href=\"https://dailymed.nlm.nih.gov/dailymed/browse-drug-classes.cfm\" rel=\"nofollow noreferrer\">DailyMed</a>) </p>\n", "score": 4 }, { "answer_id": 18260, "body": "<p>One of the major things about <a href=\"https://addictionblog.org/infographics/heroin-metabolism-in-the-body-how-heroin-affects-the-brain-infographic/\" rel=\"nofollow noreferrer\">heroin is that it is metabolized by the body as morphine</a> and, if this person in the throes of <a href=\"https://www.addictions.com/heroin/\" rel=\"nofollow noreferrer\">heroin withdrawal</a> were given medication like <a href=\"https://www.drugs.com/methadone.html\" rel=\"nofollow noreferrer\">methadone</a>, it couldn't be done without medical supervision as these are both really powerful drugs. Did the article say anything about the patient's daily ANYTHING?</p>\n\n<p>With the assistance of doctors and others they're not obligated to divulge - <a href=\"https://www.hhs.gov/hipaa/for-professionals/security/laws-regulations/index.html\" rel=\"nofollow noreferrer\">HIPPA, the Health Information and Patient Protection Act</a> would prevent the magazine from posting without express permission from the subject written about, and by 'subject', I mean the patient, not the point of the article.</p>\n\n<p>That said, everyone has a different constitution regarding narcotics and other drugs. For some, the first exposure is deadly (<a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/chloroform\" rel=\"nofollow noreferrer\">chloroform</a>, for example), others can handle much bigger exposure to multiple drugs because their constitution has been 'amped up', let's say, by usage of <em>other drugs</em> that we know nothing about, especially since no one can force a patient to be completely honest about their drug intake for any reason, nor is it a good idea to take someone else's word at the drop of a hat because people can simply write down their lies.</p>\n\n<p>It's entirely possible that the businessman experiences withdrawal symptoms that are very well hidden by other drug use, or sedatives like the aforementioned methadone, especially if the patient is as heavy a user as you state.</p>\n", "score": 2 } ]

[ "medications", "side-effects", "recreational-drugs", "drug-metabolism" ]

[ { "answer_id": 11181, "body": "<p>In addition to alcohol, benzodiazepines and the opiates (rare), another class of drugs that can cause lethal withdrawal symptoms is the barbiturates. In fact, they present the most dangerous withdrawal of all. Their use has largely been replaced with the benzodiazepines, so abuse is much less common today than it was in the 1960s and 1970s.</p>\n\n<p><a href=\"https://rehabthailand.com/blog/2016/09/26/barbiturate-abuse-and-its-potentially-deadly-withdrawal/\" rel=\"noreferrer\">https://rehabthailand.com/blog/2016/09/26/barbiturate-abuse-and-its-potentially-deadly-withdrawal/</a></p>\n\n<blockquote>\n <p><strong>Withdrawing from Barbiturates</strong></p>\n \n <p>Within 2 to 3 months of consistent barbiturate use, a person can\n develop a tolerance and addiction. Once this has happened, it is\n important to understand that a doctor or rehab for barbiturates should\n be [employed] to come off of the medication. As a “GABAergic” drug;\n <strong>barbiturate withdrawal can produce life threatening effects, like\n seizures, which are similar to those of delirium tremens and\n benzodiazepine withdrawals. However, the barbiturate withdrawal can be\n even more severe than the aforementioned making it one of the most\n dangerous withdrawals out of every known drug.</strong> Like benzodiazepines,\n the longer acting the barbiturate drug is, the less severe the\n withdrawal will be.</p>\n</blockquote>\n", "score": 7 }, { "answer_id": 14034, "body": "<p><a href=\"https://americanaddictioncenters.org/withdrawal-timelines-treatments/alcohol/\" rel=\"nofollow noreferrer\">American Addiction Centers</a></p>\n\n<p>The symptoms are </p>\n\n<ul>\n<li>Stage 1: Anxiety, insomnia, nausea, and abdominal pain characterize\nthis stage, which begins 8 hours after the last drink.</li>\n<li>Stage 2: High blood pressure, increased body temperature, unusual\nheart rate, and confusion come with this stage, which begins 24-72\nhours after the last drink.</li>\n<li>Stage 3: Hallucinations, fever, seizures, and agitation come with\nthis stage, which tends to begin 72+ hours after the last drink</li>\n</ul>\n\n<p>It is stage 3 that can kill you. Fever and seizure can kill you. <a href=\"https://en.wikipedia.org/wiki/Delirium_tremens\" rel=\"nofollow noreferrer\">Stage 3 / DT</a></p>\n\n<p>What is scary is you can have very few stage 1 and stage 2 symptoms and still develop stage 3 symptoms. A seizure is not directly related to other symptoms.</p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Delirium_tremens\" rel=\"nofollow noreferrer\">Alcohol is one of the most dangerous drugs from which to withdraw.</a></p>\n\n<p>Clearly it is not the only drug withdrawal you can die from.</p>\n", "score": 1 } ]

[ "medical-myths", "drug-withdrawal", "alcoholism", "alcohol-withdrawal" ]

[ { "answer_id": 14055, "body": "<p>You can look up practically any medicine that exists and you will find long lists of all of the possible side effects, risks and interactions.</p>\n<p>Manufacturers have to list everything that could possibly go wrong, in order to cover their butts legally, in this &quot;<em>Caution: Coffee May Be Hot!</em>&quot; world that we live in. Medical companies have to do <a href=\"https://www.fda.gov/drugs/resourcesforyou/consumers/ucm143531.htm\" rel=\"nofollow noreferrer\">extensive testing</a> of every product and document possible side effects that might not even be related. The U.S. spends <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/\" rel=\"nofollow noreferrer\">$55 billion/year</a> on liability insurance.</p>\n<p>Neosporin (aka Polysporin where I live) is something I always keep on hand. The tiniest scrape could become infected if not kept clean. Use it sparingly and a tube lasts for years.</p>\n<p>During that time, the sun is damaging you more than the eating a tube of Neosporin would! Neosporin is <a href=\"https://www.drugs.com/pro/neosporin.html\" rel=\"nofollow noreferrer\">0.0004%</a> medicine and the other 99.9994% is basically <a href=\"https://link.springer.com/chapter/10.1007%2F978-0-387-69007-0_136\" rel=\"nofollow noreferrer\">Vaseline</a> (to keep it from rubbing off, and as an inert germ barrier.</p>\n<hr />\n<p>@Prince states &quot;[Neosporin] is said to speed up healing but <a href=\"http://www.care2.com/greenliving/4-reasons-to-throw-your-neosporin-in-the-garbage.html\" rel=\"nofollow noreferrer\">most</a> cases <strong>prove</strong> that Neosporin is actually one of the antibacterial ointments behind the spread of a lethal strain of MRSA&quot;.</p>\n<p>The &quot;evidence&quot; provided is a lone link to an article written by a <a href=\"https://twitter.com/maryamhenein?lang=en\" rel=\"nofollow noreferrer\">self-proclaimed bee-keeping entrepreneur</a> with no medical background, whose primary cause appears to be promoting a movie she directed.</p>\n<h2><strong>Let's walk through the article's &quot;proof&quot; piece by piece:</strong></h2>\n<ul>\n<li><p>Antibiotic resistance (MRSA) is bad. It has even killed people. The example given: like vulnerable babies &amp; elderly in India.</p>\n</li>\n<li><p>the author is allergic to one antimicrobial ingredient in Neosporin. This allergy affect <a href=\"https://www.verywell.com/sulfa-drug-allergy-83067\" rel=\"nofollow noreferrer\">3%</a> of people, which &quot;<em>is similar rate as allergies to other antibiotics, such as penicillin</em>&quot;.</p>\n</li>\n<li><p>The referenced 'study' <em>&quot;Antimicrobial Ointments and Methicillin-\nResistant Staphylococcus aureus USA300&quot;</em> <a href=\"https://wwwnc.cdc.gov/eid/pdfs/10-1365-ahead_of_print.pdf\" rel=\"nofollow noreferrer\">mentions Neosporin only once</a>, stating that in some cases, patients tried to treat MRSA with only large amounts of Neosporin -- <em>which didn't cure them</em>. I guess that proves there should be a warning on the tube: &quot;<em>Neosporin will not cure life threatening infections. If you have one, see a doctor.</em>&quot;</p>\n</li>\n<li><p>When animals eat antibiotics and then humans eat animals, traces of antibiotics might show up in the humans.</p>\n</li>\n<li><p><strong>My favorite part</strong> is her tangent about how &quot;in ancient times&quot; people thought consuming Silver would fight infection. Later they realized eating Silver didn't cure them and instead caused different problems. Then <strong>in the very next paragraph</strong> she recommends using Silver Oxide instead of Neosporin. The only application of Silver Oxide states in Wikipedia is use as <em>an ingredient in batteries</em>. <a href=\"https://en.wikipedia.org/wiki/Silver_oxide\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Silver_oxide</a></p>\n</li>\n<li><p>The article's only link from a doctor is a two-page opinion <em>essay</em> (far from clinical evidence) written by a single doctor stating that people sometimes think they can use Neosporin to treat major illnesses instead of seeing their doctor, including one idiot who's foot was almost amputated after treating a visibly disgusting infection with nothing but Neosporin once a day. <strong>Note the category in which the essay is classified</strong> (below the document): <strong><em>Entertainment &amp; Humor</em></strong></p>\n</li>\n</ul>\n<p>So, <strong>using the same logic as the author's case against Neosporin</strong>:</p>\n<ol>\n<li><p>Gun-crimes kill a lot of people</p>\n</li>\n<li><p>Nerf guns are a readily-available, gentler form of a gun but sometimes people misuse them and get hurt.</p>\n</li>\n<li><p>Therefore nobody should ever use Nerf Guns. That will <strong>solve</strong> the gun-crime problem.</p>\n</li>\n</ol>\n<p>Or one more:</p>\n<ol>\n<li><p>If you have HIV, eating lots of bubblegum doesn't cure you.</p>\n</li>\n<li><p>Therefore, bubblegum is responsible for the HIV epidemic.</p>\n</li>\n</ol>\n", "score": 5 }, { "answer_id": 10128, "body": "<p>Neosporin has its advantages but also has way too many disadvantages. It is said to speed up healing but <a href=\"http://www.care2.com/greenliving/4-reasons-to-throw-your-neosporin-in-the-garbage.html\" rel=\"nofollow noreferrer\">most</a> cases prove that Neosporin is actually one of the antibacterial ointments behind the spread of a lethal strain of MRSA (<a href=\"http://www.webmd.com/parenting/news/20110914/study-antibiotic-ointments-may-spread-of-mrsa%20\" rel=\"nofollow noreferrer\">methicillin-resistant Staphylococcus aureus</a>) called USA 300.</p>\n\n<p>So it'll be highly recommended to resist and desist from the use of Neosporin.</p>\n", "score": 4 } ]

[ "allergy", "wound-care", "neosporin", "antibiotic-cream" ]

[ { "answer_id": 10169, "body": "<p>There are a number of issues wrapped up in this question. The first, which deteriorates faster treble or bass, is that <a href=\"https://en.wikipedia.org/wiki/Presbycusis\" rel=\"nofollow noreferrer\">Presbycusis</a>, age related hearing loss, is a high frequency (i.e., treble) phenomenon. While hearing loss can occur due to damage of the tympanic membrane (i.e., ear drum), this is a <a href=\"https://en.wikipedia.org/wiki/Conductive_hearing_loss\" rel=\"nofollow noreferrer\">conductive hearing loss</a> that can be generally be well treated with hearing aids. Presbycusis and <a href=\"https://en.wikipedia.org/wiki/Noise-induced_hearing_loss\" rel=\"nofollow noreferrer\">noise induced hearing loss</a> are generally <a href=\"https://en.wikipedia.org/wiki/Sensorineural_hearing_loss\" rel=\"nofollow noreferrer\">sensorinerual</a> in nature.</p>\n\n<p>Given how the <a href=\"https://en.wikipedia.org/wiki/Inner_ear\" rel=\"nofollow noreferrer\">inner ear</a> works, noise induced hearing loss generally occurs at the frequency of the noise. As the sound waves travel through the <a href=\"https://en.wikipedia.org/wiki/Cochlea\" rel=\"nofollow noreferrer\">cochlea</a> they undergo <a href=\"https://en.wikipedia.org/wiki/Basilar_membrane#Frequency_dispersion\" rel=\"nofollow noreferrer\">frequency dispersion</a>. This means that a low frequency sound (bass) only \"travels\" the whole length of the cochlea all the way to the apex while high frequency sounds are transmitted only to the base. This means that low frequency sounds are slightly more \"dangerous\" to the inner ear than high frequency sounds.</p>\n\n<p>The final piece to realize is that not all frequencies have the same importance. For speech the <a href=\"https://en.wikipedia.org/wiki/Articulation_Index\" rel=\"nofollow noreferrer\">articulation index</a>, and the more recent speech intelligibility index, give more weight to frequencies in the 1-3 kHz range.</p>\n\n<p>In summary, you should turn everything down and not just one particular region. If you can only turn down one region, you should attempt to preserve your hearing in the 1-3 kHz range so that you will be able to understand speech.</p>\n", "score": 1 } ]

[ "hearing", "otolaryngology", "irreversible-damage", "noise-induce-hearing-harm", "soundwaves" ]

[ { "answer_id": 10167, "body": "<p>Cosmetics sold in China are subject to control by administrative licensing under the “Supervising Rules of Cosmetics Hygiene” regulations published by the Ministry of Health of the People’s Republic of China (MOH) and the “Rules for Acceptance of Application to Cosmetics Administrative License” published by the State Food and Drug Administration (SFDA).</p>\n\n<p><a href=\"http://www.intertek.com/cosmetics/exporting-to-china/\" rel=\"nofollow noreferrer\">http://www.intertek.com/cosmetics/exporting-to-china/</a></p>\n", "score": 2 } ]

[ "fda", "dyes", "cosmetics", "carcinogens", "pesticides" ]

[ { "answer_id": 10245, "body": "<p><em>\"water of really any temperature does that if I'm not mistaken\"</em></p>\n\n<p>Sorry but you <strong>are</strong> mistaken. Water temperature is an important factor in dissolving lipids. You can ask anyone who washes dishes regularly whether they prefer hot or cold water to remove fat from pans and dishes. Soap and heat remove fat. Butter is solid when kept in cold places and melts as you heat it. The same thing happens to skin lipids, hot water melts them and they are removed by soap.</p>\n", "score": 1 } ]

[ "dermatology", "water-temperature", "dehydration", "dry-skin" ]

[ { "answer_id": 10359, "body": "<p>That is because your body isn't used to that much sleep. If you usually wake up after 6 hours and then one day after 8 or 9 hours, your body is kind of 'confused' and the metabolism falls asleep again, as you don't need it after the usual 6 hours of sleep.</p>\n\n<p><a href=\"https://www.wired.com/2014/07/whats-up-with-that-why-does-sleeping-in-just-make-me-more-tired/\" rel=\"nofollow noreferrer\">https://www.wired.com/2014/07/whats-up-with-that-why-does-sleeping-in-just-make-me-more-tired/</a></p>\n", "score": 2 }, { "answer_id": 10377, "body": "<p>Good question Tehp,\nYou know what I also experienced that, according to <a href=\"http://www.huffingtonpost.com/dr-michael-j-breus/how-come-i-feel-more-tire_b_428928.html\" rel=\"nofollow noreferrer\">Dr. Michael Breus, a Sleep Doctor</a> that a Sleep has its own cycle. The sleep-wake cycle follows a regular pattern (circadian rhythm) and when you sleep “too much” that pattern shifts. Circadian rhythms are the patterns of repeated activity associated with the environmental cycles of day and night that are repeated every 24 hours.\nOnce our body clocks start to tell our body the wrong time we feel it in lethargy and fatigue. The clock says one thing and your body says another, very similar to jet lag. \nThe average sleep cycle lasts between 80-120 minutes (the average is 90 minutes) and the average person has five of these every night (totaling about 7.5 hours of deep sleep).<br>\nTo avoid this feeling, you should go to bed and wake up at the same time every day. When you get up in the morning expose yourself to sunlight to boost your energy naturally and have regular exercise. </p>\n", "score": 2 } ]

[ "sleep", "sleep-cycles" ]

[ { "answer_id": 17008, "body": "<p><a href=\"https://www.remploy.co.uk/employers\" rel=\"nofollow noreferrer\">Remploy</a> provide support and guidance to employers through services such as training, workshops, events and other resources.</p>\n\n<blockquote>\n <p>We will work with your organisation to create the conditions for success that will allow your people to flourish.</p>\n</blockquote>\n\n<p>For diversity issues involving the LGBTQIA community, on top of involving <a href=\"https://www.stonewall.org.uk\" rel=\"nofollow noreferrer\">Stonewall</a>, there is also <a href=\"http://www.pinktherapy.com\" rel=\"nofollow noreferrer\">Pink Therapy</a> who also have a regular newsletter available through email.</p>\n\n<p>As a personal observation, some organisations <em>”talk the talk but don’t walk the walk”</em>. It is all well and good to put on websites and flyers etc. that you support diversity and support those with mental health problems, but it doesn’t help your employees if you are not visibly supportive. I suggest a notice board in a discrete area for reading in order for notices to be put up showing a company mental health policy detailing anyone in the workplace they can speak to in confidence, along with other organisations they can go to.</p>\n\n<p>As well as the organisations I have mentioned above, the <a href=\"http://thesurvivorstrust.org\" rel=\"nofollow noreferrer\">Survivors Trust</a> also provides a <a href=\"http://thesurvivorstrust.org/find-support\" rel=\"nofollow noreferrer\">list of contacts</a> for Rape and Sexual Abuse Crisis Centres, who you can contact for leaflets, posters etc. which you can put up and make available to all employees to show commitment to support without prejudice.</p>\n", "score": 1 } ]

[ "mental-health" ]

[ { "answer_id": 10494, "body": "<p>Some extended release products do remain in the stomach while the drug is being released but how they remain in the stomach is often not a function of the size of the tablet itself. To help explain I have included some background information about drug formulation. I am referencing the text, Applied Biopharmaceutics &amp; Pharmacokinetics, and my experience as a pharmacy student. </p>\n\n<p>Another term used to describe extended release products is modified release products, this is differentiated from conventional immediate release products. However, even within immediate release formulations, absorption can be slowed due to the drug itself being in an inactive form or if the drug is very lipophilic resulting in slower absorption by the GI tract itself. </p>\n\n<p>Among modified release products, there are several different types of technologies which provide different mechanisms for slowing the release of drugs or altering the drug release mechanism. Some examples of modified release formulations are delayed release (generally include enteric coated), extended release and orally disintegrating. </p>\n\n<p>Delayed release tablets are sometimes enteric coated. This enteric coat is specifically designed to prevent dissolution of the tablet in the stomach. This is sometimes meant to protect the drug from the acidic environment of the stomach, but also sometimes meant to protect the stomach from the disrupting presence of the drug. </p>\n\n<p>Specifically, extended release refers to a drug formulation where the rate of drug release is engineered by a special coating, membrane infused with the drug, capsule with a special opening, a capsule containing special beads, or difficult to dissolve tablet. Some products use multiple mechanisms to achieve the desired rate of drug release. Referencing your question specifically, there are many drugs that remain in the stomach while the release of the drug takes place but this not true of all extended-release formulations (ex: some drugs are designed to remain in the small intestine). Products that remain in the stomach while the drug is released are known as gastroretentive systems. </p>\n\n<p>There are several designs that have been used to maintain the drug in the stomach. A few of these include but are not limited to high-density systems, floating systems, expandable systems, and mucoadhesive or bioadhesive systems. In the expandable systems, one example being metformin ER, a diabetes drug, the tablet unfolds or expands preventing passage through the pyloric sphincter. These expandable tablets make up only a small portion of gastroretentive products. A more common form being the floating or mucoadhesive systems. In the floating systems, the tablet or capsule is designed to be less dense than the stomach contents and thus remain at the top of the stomach while the drug is released. In the mucoadhesive/bioadhesive formulation, the drug has a special coating that allows it to adhere to the wall of the stomach and prevent it from passing through to the small intestine. </p>\n\n<p>Ultimately there are many technologies that allow for extended release products to function. While the overall concept is the same, how it is achieved can be quite different from drug to drug.</p>\n", "score": 3 } ]

[ "medications", "digestion" ]

[ { "answer_id": 10455, "body": "<p>Your body should tightly control the water concentration (osmolality) via sensors in the brain (osmoreceptors) which send chemical signals (vasopressin) to the kidneys. <strong>These receptors are very sensitive and are capable of making you thirsty with only 1% dehydration.</strong></p>\n\n<p>So a normal person drinking extra water will just make more urine and pee it out. An abnormal person (elderly, alcoholic or brain/kidney-damaged) may not be able to produce/react to these chemical messages properly.</p>\n\n<p>However the kidneys need to make sure that this extra urine doesn't take salt (predominantly sodium chloride) with it - the salt concentration is also tightly regulated. The urine it makes must therefore be dilute.</p>\n\n<p>If you drink too much water for a prolonged period of time, you wash concentrated salt from the part of the kidney that works to concentrate urine (the renal medulla).</p>\n\n<p>So when you <em>don't</em> drink all that extra water, your kidneys are less able to conserve water, you will not be able to make concentrated urine and you will actually become dehydrated (volume deplete).</p>\n\n<p><strong>Moral of the story: your body knows what it is doing. Drink when you are thirsty.</strong></p>\n", "score": 3 } ]

[ "water", "hydration", "sodium", "water-retention" ]

[ { "answer_id": 10441, "body": "<p>Just because there may exist some patients who are going to lose consciousness (or die) no matter what doesn't mean this technique has no value. </p>\n\n<p>Imagine this. It's the middle of the night. You're in awful pain. Something horrible and unexpected has happened - a car accident, a crime, a house explosion - and you've seen awful things or you're worried about your loved ones on top of everything else. You don't want this to be real. You don't want to experience this. Going away, by zoning out, letting yourself fall asleep, co-operating with the pull you feel towards unconsciousness - that may seem like a good idea. A person telling you not to may actually keep you from letting go and going under, because some part of it is your choice whether to stay conscious or not, at least for some kinds of injury or trauma.</p>\n\n<p>As to why a care provider wants to keep you awake, it's generally so they can ask you things, or get you to help them treat you. This was my experience when a 3am gallbladder attack took me to the ER. It hurt so much and I was so tired and this nurse was all in my face, demanding I categorize my pain \"on a scale of 1 to 10\" which I find pointless since they never ask you what a 10 would be, and she wouldn't take no for an answer so I basically closed my eyes and wished she would go away, and I would have happily gone to sleep right there, or at my pain level you could have called it passing out from the pain. But she wouldn't let me. She was firm to the point of rudeness and she was demanding. Her position was \"I need you to talk to me so I can help you.\" And in the end I did and she did. </p>\n\n<p>The point is there is much use to the patient staying conscious - it lets you see if things are getting worse or better, lets you gather information, lets you ask them to roll over or sit up - and in at least some cases, asking (along perhaps with slapping as in the movies, shoulder-shaking, or at least physical contact like taking someone's chin and using it to turn their face towards you) does work to keep people from slipping away.</p>\n", "score": 2 }, { "answer_id": 14417, "body": "<p>No, I don't think keeping a patient awake has any treatment value in trauma cases. I'm skeptical there even are situations where you could override the effects of traumatic injury by simply talking. </p>\n\n<p>However, it has significant value in assessment. Level of consciousness is the first and most significant vital sign, and being able to monitor it in trauma is crucial. Declines in many body systems will be signaled by the brain first, so you always want to be aware of the patient's mental status. You do that by talking to them. </p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129809/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129809/</a></p>\n", "score": 2 }, { "answer_id": 10439, "body": "<p>This is certainly an interesting question. From a trauma perspective, I would advocate using the ATLS / ACLS rules to stabilize the patient. Controlling the airway, breathing, and circulation are the first priorities in these patients.</p>\n\n<p>With that said, there is not much published on PubMed that answers this question. However, I did find an article in Nursing Times that talks about some value in talking to patients - whether they are conscious or unconscious. This has been shown to improve survival in a very limited sample. However, I would caution using this as \"evidence-based\" literature and would always focus on the ABCs.</p>\n\n<p>Here is the article: <a href=\"https://www.nursingtimes.net/communicating-with-unconscious-patients/200542.article\" rel=\"nofollow noreferrer\">Nursing Times</a></p>\n", "score": 1 } ]

[ "emergency", "emt" ]

[ { "answer_id": 10477, "body": "<p>Here are some ways to tame those sugar cravings.</p>\n\n<p><strong>Give in a little.</strong> Eat a bit of what you’re craving, maybe a small cookie or a fun-size candy bar, suggests Kerry Neville, MS, RD, a registered dietitian and ADA spokeswoman. Enjoying a little of what you love can help you steer clear of feeling denied. Try to stick to a 150-calorie threshold, Neville says.</p>\n\n<p><strong>Combine foods.</strong> If the idea of stopping at a cookie or a baby candy bar seems impossible, you can still fill yourself up and satisfy a sugar craving, too. \"I like combining the craving food with a healthful one,\" Neville says. \"I love chocolate, for example, so sometimes I’ll dip a banana in chocolate sauce and that gives me what I’m craving, or I mix some almonds with chocolate chips.\" As a beneficial bonus, you'll satisfy a craving and get healthy nutrients from those good-for-you foods.</p>\n\n<p><strong>Go cold turkey.</strong> Cutting out all simple sugars works for some people, although \"the initial 48 to 72 hours are tough,\" Gerbstadt says. Some people find that going cold turkey helps their cravings diminish after a few days; others find they may still crave sugar but over time are able to train their taste buds to be satisfied with less.</p>\n\n<p><strong>Grab some gum.</strong> If you want to avoid giving in to a sugar craving completely, try chewing a stick of gum, says nutrition advisor Dave Grotto, RD, LDN. \"Research has shown that chewing gum can reduce food cravings,\" Grotto says.\nReach for fruit. Keep fruit handy for when sugar cravings hit. You'll get fiber and nutrients along with some sweetness. And stock up on foods like nuts, seeds, and dried fruits, says certified addiction specialist Judy Chambers, LCSW, CAS. \"Have them handy so you reach for them instead of reaching for the old [sugary] something.\"</p>\n\n<p><strong>Get up and go.</strong> When a sugar craving hits, walk away. \"Take a walk around the block or [do] something to change the scenery,\" to take your mind off the food you’re craving, Neville suggests.</p>\n\n<p><strong>Choose quality over quantity.</strong> \"If you need a sugar splurge, pick a wonderful, decadent sugary food,\" Moores says. But keep it small. For example, choose a perfect dark chocolate truffle instead of a king-sized candy bar, then \"savor every bite -- slowly,\" Moores says. Grotto agrees. \"Don’t swear off favorites -- you’ll only come back for greater portions. Learn to incorporate small amounts in the diet but concentrate on filling your stomach with less sugary and [healthier] options.\"</p>\n\n<p><strong>Eat regularly.</strong> Waiting too long between meals may set you up to choose sugary, fatty foods that cut your hunger, Moores says. Instead, eating every three to five hours can help keep blood sugar stable and help you \"avoid irrational eating behavior,\" Grotto says. Your best bets? \"Choose protein, fiber-rich foods like whole grains and produce,\" Moores says.</p>\n\n<p>But won't eating more often mean overeating? Not if you follow Neville's advice to break up your meals. For instance, have part of your breakfast -- a slice of toast with peanut butter, perhaps -- and save some yogurt for a mid-morning snack. \"Break up lunch the same way to help avoid a mid-afternoon slump,\" Neville says.</p>\n\n<p>Reference : <a href=\"http://www.webmd.com/diet/features/13-ways-to-fight-sugar-cravings#1\" rel=\"nofollow noreferrer\">http://www.webmd.com/diet/features/13-ways-to-fight-sugar-cravings#1</a></p>\n\n<p><a href=\"http://dailyburn.com/life/health/sugar-addiction-detox/\" rel=\"nofollow noreferrer\">http://dailyburn.com/life/health/sugar-addiction-detox/</a></p>\n", "score": 1 }, { "answer_id": 10479, "body": "<p>There are two aspects to feeling \"addicted\" to sugar</p>\n\n<ol>\n<li>Expecting a very sweet taste to the things you eat and drink, and not enjoying unsweetened or less sweetened versions. Maybe you like three sugars in your tea or coffee, or you sprinkle sugar on cereal, fruit, and the like</li>\n<li>Getting a \"rush\" when you eat something sweeet, and feeling a drop later, which you fix by having more sugar.</li>\n</ol>\n\n<p>Not everyone experiences the second, but many do. Your approaches to the situation depend on which thing you're trying to fix.</p>\n\n<p>For being used to a sweet taste, try a little while of not eating the things you expect to be sweet. No tea or coffee, no cereal, no toast, whatever. Then when you reintroduce the food, use half the sugar that you used to. If that sounds too unpleasant, try gradually reducing the amount of sugar you add over a few weeks. Switching to alternate sweeteners (whether \"healthier\" like honey or maple syrup, which might provide a few micronutrients as well as sweetness, or lower-calorie like Splenda, Stevia etc) isn't going to help this pattern of needing sweetness, so it's a poor solution. When you can't get diet ginger ale you'll just drink regular ginger ale because you patterns haven't changed so you don't like water. If you want to eat and drink fewer sweet things, do that, don't change where the sweetness comes from to make your old pattern ok.</p>\n\n<p>For the sugar rush/high followed by crash, things are different. Whenever you eat something sweet, be sure to eat some protein or fat at the same time or very shortly afterwards. This will mute the high a little and more importantly, prevent the crash. This was an issue for both my children and they learned how to get something other than pure sugar into their system quickly. So if you start your day with jam on toast, instead of two slices of that, have one of jam on toast and then one of peanut butter on toast. If you start your day with a bowl of fruit, how about putting some yogurt (ideally not zero fat yogurt) in there too? If you have a donut or cookies at 3pm, could you not also have a little cheese (brought from home, it won't spoil) or some almonds or peanuts (which will keep for weeks) as well? </p>\n", "score": 1 }, { "answer_id": 12067, "body": "<p>Sugar is a kind of food. So, you might want to try some food-addiction support programs.</p>\n\n<p><a href=\"https://oa.org/\" rel=\"nofollow noreferrer\">Overeaters Anonymous</a> is a good option. Sugar addicts are always welcome to join their program.</p>\n\n<p>They have:</p>\n\n<ul>\n<li>meetings you can visit</li>\n<li>a podcast</li>\n<li>books and pamphlets that you can buy</li>\n<li>and <a href=\"https://www.reddit.com/r/OvereatersAnonymous/\" rel=\"nofollow noreferrer\">a sub-Reddit where you can post</a>.</li>\n</ul>\n\n<p>Thoughts?</p>\n", "score": 1 }, { "answer_id": 12068, "body": "<p>You may want to try the following suggestions:</p>\n\n<ul>\n<li><p>Don't keep any sugary foods in your home. Instead, buy healthier options such as fruit.</p></li>\n<li><p>If you do buy sugary junk foods, buy smaller quantities. Also, put some sugary junk food in a bowl, then close the package and put it away. This will reduce your temptation to eat too much.</p></li>\n<li><p>Also, gradually change your habits. For example, instead of adding honey to breakfast cereal, add fresh or dried fruit. Raisins and dates are convenient and inexpensive.</p></li>\n<li><p>If a sugar craving hits, distract yourself. For example, you could phone a friend, or read a book, or go bicycling.</p></li>\n</ul>\n", "score": 0 } ]

[ "addiction" ]

[ { "answer_id": 10585, "body": "<p>This is certainly possible, however unlikely. It is also not possible to determine the probability that you would be infected.</p>\n\n<p>The person have a visible infection at the time of the event. This would further reduce the probability of infection.</p>\n\n<p>Symptoms can appear one to three weeks after infection.</p>\n\n<p>Alternatively a blood test can detect if you are infected even before symptoms show.</p>\n", "score": 1 }, { "answer_id": 11958, "body": "<p>It would be unlikely you catch herpes by sharing a bite or two of a hamburger with an infected person in remission. It's so unlikely that if (hypothetically) you did test positive for herpes (and it was your first time to test) that the positive exposure could have occurred from any number of situations that happen repeatedly in daily life. That's because the infection rate of herpes is so high, and the number of people who harbor it unknowingly is so high.</p>\n", "score": 0 } ]

[ "infection", "herpes", "herpes-simplex" ]

[ { "answer_id": 10478, "body": "<p>The most common side effect of loratadine is headache which has been reported in up to 12 percent of users. Other common side effects include drowsiness occurring in 8 percent of users, fatigue in 4 percent and dry mouth in three percent. Drinking plenty of water while your dose is in effect can help alleviate these symptoms. Some who use loratadine regularly report that these side effects get better with time. If your side effects appear to be severe, talk to your doctor or pharmacist about whether or not there is a better allergy medication for you.</p>\n\n<p>Common Side Effects of Loratadine</p>\n\n<ul>\n<li>Sleepiness</li>\n<li>Tiredness</li>\n<li>Stomach pain </li>\n<li>Headache Dry eyes</li>\n<li>dry mouth,dry throat</li>\n<li>Diarrhea</li>\n<li>An opposite reaction in which you feel excited, jittery, or nervous, known as paradoxical CNS stimulation instead of drowsy or sleepy</li>\n</ul>\n\n<p>Severe Side Effects of Loratadine :</p>\n\n<ul>\n<li>Liver damage or inflammation</li>\n<li>Tightness in the chest or breathing tube</li>\n<li>Passing out or fainting</li>\n<li>Seizures</li>\n<li>Low platelet count (thrombocytopenia)</li>\n</ul>\n\n<p>Reference :</p>\n\n<p><a href=\"http://www.everydayhealth.com/drugs/loratadine\" rel=\"nofollow noreferrer\">http://www.everydayhealth.com/drugs/loratadine</a></p>\n\n<p><a href=\"http://www.md-health.com/Loratadine.html\" rel=\"nofollow noreferrer\">http://www.md-health.com/Loratadine.html</a></p>\n", "score": 3 } ]

[ "medications", "allergy", "antihistamines" ]

[ { "answer_id": 10523, "body": "<p>This \"pre-ejaculate\" that you are talking about does contain a very small amount of sperm, and can absolutely cause pregnancy. To be clear, the alkaline fluid that comes out as the pre-ejaculate is made in Cowper's glands, which do not produce sperm. However, sperm may be present from a prior ejaculation and come out as part of the pre-ejaculate.</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564677/\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3564677/</a></p>\n\n<p>The article above goes into some detail. Basically, there is a 41% chance of the content having sperm, and a 37% chance that the sperm it contains are motile - enough to swim upstream and potentially fertilize an egg.</p>\n\n<p>Actual fertilization depends on a lot of things. However, if you do this enough, the odds of pregnancy increase.</p>\n", "score": 8 } ]

[ "obstetrics", "contraception", "pre-ejaculate-cum", "erection", "sexual-arousal" ]

[ { "answer_id": 13388, "body": "<p>Tadafil is the generic name for Cialis</p>\n\n<p>Drugs.com provide an <a href=\"https://www.drugs.com/international/tadalafil.html\" rel=\"nofollow noreferrer\">international list of brand names which includes Cialis</a> whilst MedIndia provides a <a href=\"http://www.medindia.net/drug-price/tadalafil.htm\" rel=\"nofollow noreferrer\">list which doesn't contain Cialis</a> along with their prices in in Indian Rupees (&#8377;).</p>\n\n<p>Going for Cialis is the same as going for any other brand name. They all contain the active drug (Tadafil).</p>\n", "score": 2 }, { "answer_id": 16604, "body": "<p><em>Tadalafil is the generic form of Cialis, and it is exactly the same in its effects.</em></p>\n\n<p>In the United States, the Lily company holds a patent that prevents the generic form being sold until September 27, 2018. However, the generic form is already available legally in most parts fo the world.</p>\n\n<p>I would recommend great caution when buying tadalafil. While tadalafil is safe and effective, ED medications are among the most commonly faked. Be sure you buy from an established, reputable pharmacy, and avoid buying online. </p>\n", "score": 1 } ]

[ "urology", "erectile-dysfunction" ]

[ { "answer_id": 10596, "body": "<p>I always wondered this myself and now my seven year old always ask this when in the back of the car. I came across this:</p>\n\n<blockquote>\n <p>Normally, all the parts of your body are pushing on each other because of the constant force of gravity. But in the \"free-fall\" state of plummeting down a hill, there is hardly any net force acting on you. In this case, the various pieces of your body are not pushing on each other as much. They are all, essentially, weightless, each falling individually inside your body. This is what gives you that unique sinking feeling in your stomach -- your stomach is suddenly very light because there is less force pushing on it. The same thing happens when you drive down a dip in the road in your car or descend in an elevator moving at high speed.</p>\n</blockquote>\n\n<p>So in effect your \"nads\" are weightless and I guess that's why you get the sensation.</p>\n", "score": 3 } ]

[ "testicles" ]

[ { "answer_id": 17298, "body": "<p>While the measured quantities are the same across border, both names and units can vary.</p>\n\n<p>The main difference is often the unit used for the concentration of each analyte : either mass per volume or mole per volume (eg: glucose 1g/L = 5.5 mmol/L), sometime variation on the unit prefix (eg: haemoglobin 120 g/L = 12 g/dL). It is of course possible to convert a value in another representation: here is a <a href=\"http://www.royalcollege.ca/portal/page/portal/rc/common/documents/exams/normal_values_e.pdf\" rel=\"noreferrer\">list of normal values (PDF)</a> in different units.</p>\n\n<p>This is mostly a result of differing medical traditions/habits (<a href=\"http://www.amamanualofstyle.com/view/10.1093/jama/9780195176339.001.0001/med-9780195176339-div1-192#\" rel=\"noreferrer\">AMA style guide regarding units</a>, <a href=\"https://en.m.wikipedia.org/wiki/Reference_ranges_for_blood_tests#Units\" rel=\"noreferrer\">wikipedia on units and reference ranges</a>)</p>\n", "score": 7 } ]

[ "blood-tests", "measurement", "test-results", "different-national-health", "urine-test" ]

[ { "answer_id": 16538, "body": "<p><strong>Short answer</strong><br>\nExcessive Acetylcholine (Ach) release seems to be related Calcitonin Gene-Related Peptide (CGRP) inducing Ach leakage. CGRP is part of a general inflammatory response, in turn part of the pain response associated with trigger points. </p>\n\n<p><strong>Background</strong><br>\nPhysiologically spoken, acetylcholine (Ach) is released in the neuromuscular junction by the motorneuron to activate muscle fibers to contract through nicotinic acetylcholine receptors in the postsynaptic membrane. </p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285362/\" rel=\"nofollow noreferrer\">Jafri (2010)</a> outlines a hypothesis why Ach responses are increased, leading to the development of trigger points*, based on the work of <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/14759755\" rel=\"nofollow noreferrer\">Simons (2004)</a>:</p>\n\n<p>A <em>hypothetical</em> basis for trigger points, according to Jafri is as follows: </p>\n\n<ol>\n<li>Abnormal Ach release that triggers</li>\n<li>Increased muscle fiber tension (trigger point) that constricts blood flow causing</li>\n<li>Local hypoxia, which disrupts mitochondrial function and low ATP, causing</li>\n<li>Tissue stress and </li>\n<li>Release of sensitizing substances that cause pain by activation of nociceptors and</li>\n<li>autonomic modulation that potentiates step 1 causing more Ach release.</li>\n</ol>\n\n<p>The ischemia/hypoxia leads to acidification and muscle injury, in turn releasing of potassium, bradykinins, cytokines, ATP, and substance P which might stimulate nociceptors in the muscle, in turn leading to the tenderness and pain observed with trigger points. Pain is mediated by depolarization of nociceptive neurons that in turn also release of <strong>calcitonin gene-related peptide (CGRP)</strong>. CGRP inhibits acetylcholine esterase and upregulates the amount of acetylcholine receptors and release of acetylcholine, known as acetylcholine leakage. The result is increased acetylcholine in the nerve terminal, synaptic cleft, and increased motor endplate potentials resulting in more contraction <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285362/\" rel=\"nofollow noreferrer\">(Jafri, 2010)</a>. </p>\n\n<p>Why is CGRP released? From what I know, the function of CGRP is largely unknown <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187032/\" rel=\"nofollow noreferrer\">(Russell <em>et al</em>., 2014)</a>. Its role in migraine has attracted attention, but in trigger point therapy world, it's not really elucidated as far as I can see. Moreover, Trigger Points are an established phenomenon in treatment world (physiotherapy, massage, <em>etc</em>), but scientifically their pathophysiology is based on speculations and hypotheses (educated guesses). However, tapping into CGRPs expected role in pain responses in general, I think it's safe to say that CGRP is a part of a common <strong>inflammatory response</strong> and neuroprotective agent, and quoting <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187032/\" rel=\"nofollow noreferrer\">Russel <em>et al</em> (2014)</a>: </p>\n\n<blockquote>\n <p>The regulation of CGRP synthesis is still poorly understood. CGRP synthesis is known to be upregulated in models of nerve damage, such as peripheral axotomy, and it is thought that synthesis of the peptide is enhanced in tissues that are undergoing an inflammatory response []. This may be linked to local release of nerve growth factor (NGF) from cells such as macrophages and keratinocytes. NGF is vitally important for the growth of sensory nerves and for the maintenance of function of mature nerves </p>\n</blockquote>\n\n<p>As we all know, inflammatory responses are necessary to fight back pathogens, but inflammatory responses are at the same time painful, and even outright damaging to the body </p>\n\n<p>_{<strong>References</strong><br>\n<strong>-</strong> <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4285362/\" rel=\"nofollow noreferrer\">Jafri, <em>Int Sch Res Notices</em> (2014); 523924</a><br>\n<strong>-</strong> <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4187032/\" rel=\"nofollow noreferrer\">Russell <em>et al</em>., <em>Physiol Rev</em> (2014); <strong>94</strong>(4): 1099–142</a><br>\n<strong>-</strong> <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/14759755\" rel=\"nofollow noreferrer\">Simons, <em>J Electromyogr Kinesiol</em> (2004); <strong>14</strong>(1): 95-107</a>} </p>\n", "score": 4 } ]

[ "benefits", "neuroscience", "neurotransmitter", "myofascial-pain-syndrome", "referred-pain" ]

[ { "answer_id": 10816, "body": "<p>People are more complicated than machines. First, imagine a condition like \"high blood pressure\" or \"underactive thyroid.\" It's not just a case of measuring one number about you and comparing it to one \"correct\" number. There is a normal <strong>range</strong> for healthy people. Imagine some measurement that for normal people is between 10 and 12. Imagine that you genuinely have a shortfall in this number; and you vary between 8 and 10. One doctor sees you on the day you measure 10 and tells you that you're fine. Another doctor sees you on the day you measure 8 and tells you there is a shortfall. So that's one explanation.</p>\n\n<p>But life is actually more complicated than that. Some doctors might think 9-13 is actually normal for that number, so if you measure 9 they'll say you're fine. Others might think that it depends on some other reading, so if you measure 10 but the other number is low, they'll say you're ill, while another will insist that a reading of 10 means you're fine. And doctors vary on how urgent they think certain conditions are: some think they can advise you to change your diet or to exercise, while others want to start you on medications, even when they both agree you have a particular condition.</p>\n\n<p>Then on top of all of that there's the matter of how the doctors get paid. Some want to recommend particular treatments or tests as much to ensure an income for themselves as to actually fix you. We of course all hope that such people are few and far between, but they do exist, and you may have met a few of them in your time, or your relatives may have.</p>\n\n<p>How should you behave? You have two choices. One is to focus on your symptoms: you're tired, or your eye hurts, or whatever, and ask your doctor to help you learn why and help you fix that so you feel better. If they do a measurement and say that it's fine, you ask them to do some other measurement or test so that they can suggest things to do that will help with your symptom. The other approach is to learn more about the condition you think you may have. Say you think you have high blood pressure. Learn what a normal range for each number is. When your doctor measures yours, ask what the measurement was. Learn the things you can do - how you sit, for example, that can affect the measurement. Ask the doctor's conclusion about the measurement - is it high? is it fine? - and if your conclusion is different, ask why. Why is that high? Don't people normally vary between x and y over the course of a day? Or why is that fine? Learn some of the thought processes your doctor is going through.</p>\n\n<p>Getting a second opinion is a fine strategy. But \"Dr A says I need a medication and Dr B says I do not\" is nowhere near as valuable as \"Dr A measured 8 and says normal is 10-12 so I need this medication to raise it, but Dr B measured 10 and says normal is 9-13 so I don't.\" You can now go and learn more about what a normal range is, the consequences of being low, the side effects of the medication, and so on, then make an informed decision, including which doctor you want to work with over time to maintain your health. </p>\n", "score": 5 } ]

[ "health-education", "differential-diagnosis", "different-national-health", "medical-ethics", "medical-training" ]

[ { "answer_id": 10939, "body": "<p><a href=\"https://en.wikipedia.org/wiki/Sleep_hygiene\" rel=\"nofollow noreferrer\">Sleep Hygiene</a> is the first line treatment for most insomnia. <a href=\"http://healthysleep.med.harvard.edu/healthy/getting/overcoming/tips\" rel=\"nofollow noreferrer\">This is another good list from Harvard.</a> </p>\n\n<p>Anecdotally, the principles of it that worked best for me were blackout curtains, removing everything including TV from the room (the saying is \"the bed is just for sleep and sex\"), never reading or using my phone in bed, not eating within 3 hrs, and bright lights in the morning.</p>\n\n<p>Also consider asking your doctor, since it's been going on so long, because there are a number of treatable causes of insomnia such as sleep apnea or other sleep disorders, depression, anxiety, GERD, etc. Conditions like sleep apnea can be dangerous if untreated.</p>\n", "score": 2 }, { "answer_id": 10856, "body": "<p>When I was young I had the same problem. From experience I've learned to stick to the following.</p>\n\n<p>Focus on the time you want to get up, not on bedtime. So, just get up at the time you want to get up regardless of how much sleep I got. The more physically fit you are, the less you'll be bothered by the lack of sleep for a few days. Also, by sticking to your exercise routine when changing your biorhythm (you may need to reduce the intensity and duration of exercise if you sleep less than 5 to 6 hours), you'll fall asleep at the right time. The fitter you are, the more the effects of the lack of sleep will be confined to cognitive functions, you'll still have plenty of energy to exert yourself physically.</p>\n\n<p>E.g. today I had to get up 2 hours earlier than usual, I went to bed one hour earlier, but I stayed awake for half an hour longer than usual. Nevertheless I got up at the right time and I didn't skip my exercise of one hour fast running. Now, before I started to run I felt like dozing off, so it would have been very tempting for me to skip today's exercise, but had I done that that might have affected the sleep I'm about to get in an hour from now.</p>\n", "score": 0 } ]

[ "treatment-options", "sleep-cycles", "time-of-day", "insomnia", "sleep-aids" ]

[ { "answer_id": 10933, "body": "<p>HIV blood tests (for antigens and antibodies) are, at least where I practice, 4mL. However, if your doctor wants other blood tests she might add 1-2 vials of the same size. Depends on the organisation of the clinical lab and the tests draw.</p>\n\n<p>I'm not fully familiar with how rapid HIV testing is done though. That might be slightly different.</p>\n", "score": 1 } ]

[ "blood-tests", "measurement", "hiv" ]

[ { "answer_id": 10963, "body": "<p>When you have a laptop on your thighs and you type, the wrists are bent upwards (forcedly) more than when you have a laptop on the table (higher).</p>\n\n<p>Also, arms bent forward and without support can pose a lot of burden on the upper back muscles.</p>\n\n<p>Some sort of table (even portable) can help.</p>\n", "score": 1 }, { "answer_id": 12286, "body": "<p>I actually did a study on this (pains relation to posture) providing ergonomic assessments and follow ups for office workers.</p>\n\n<p>Ideally you'd look something like this:</p>\n\n<p><a href=\"http://www.victoriamassagetherapy.ca/userfiles/image/Ergonomics2.jpg\" rel=\"nofollow noreferrer\">http://www.victoriamassagetherapy.ca/userfiles/image/Ergonomics2.jpg</a></p>\n\n<p>They have carpal tunnel wrist guards that I'm sure you'd love to wear. </p>\n\n<p>I'd sit on a Swiss Ball -- doubt this is possible either but your innercore is key to preventing lower back pain and possible surgery (you don't want this).</p>\n\n<p>The good news is carpel tunnel surgery is just snipping your flexor retinaculum so that is a pretty simple fix.</p>\n\n<p>Prioritize watching your back and neck regions for sure. A workspace that's properly setup would be great too.</p>\n", "score": 1 } ]

[ "prevention", "computers", "repetitive-strain-injury", "wrist", "frequency" ]

[ { "answer_id": 14086, "body": "<p>Not much. Unless your vegetables or teas do contain tobacco or some exotic weeds. </p>\n\n<p>In the <a href=\"http://www.nejm.org/doi/pdf/10.1056/NEJM199308053290619\" rel=\"nofollow noreferrer\">letter</a> mentioned in the comments was an interesting table listing different plant sources of nicotine. The highest amount was reported for eggplant containing 100ng/g of nicotine. In that letter this was translated into 10g of plant material needed for a consumer to ingest 1 µg of nicotine. These values were used because this level of exposure was deemed equivalent with the amount of nicotine obtained by a passive indoor smoker. An average cigarette contains around 10mg nicotine. (Take note of the different units of measurement.)</p>\n\n<p>That would mean an <em>unhealthy amount</em> of vegetable is needed to be eaten to approach the nicotine levels of just one cigarette for a smoker.</p>\n\n<p>Although this should have been clear from the start given the different magnitudes this letter provoked quite some reactions:</p>\n\n<blockquote>\n <p><a href=\"http://www.nejm.org/doi/full/10.1056/NEJM199311183292118\" rel=\"nofollow noreferrer\">The main problem with the inferences in these authors' letter is a 500-fold error in the calculations used to determine the vegetable equivalent of toxicologically meaningful exposure to tobacco smoke.<br>\n Determining the amount of vegetable consumption suggestive of exposure to cigarette smoke is also more complicated and physiologically difficult than implied by Domino et al. <br>First, it would take an approximately 500-fold increase in the amount of vegetables estimated by Domino et al. to produce exposure equivalent to half a cigarette a day -- e.g., <strong>more than 100 kg of tomatoes would have to be consumed in one day.</strong><br> Second, as acknowledged by Domino et al., nicotine exposure would be greatly reduced if vegetable skins, which contain most of the nicotine, were not eaten or if they were cooked in water, thereby extracting the nicotine.<br> <strong>Third, ingesting nicotine is not equivalent to inhaling it, since absorption from the stomach is poor and 70 percent of the nicotine entering the circulation is metabolized during its first pass through the liver.</strong><br> Finally, it has been well confirmed that the exposure to tobacco smoke indicated by a plasma concentration of 5 to 10 ng of cotinine per milliliter is of clear toxicologic importance,3 whereas there is no evidence that daily exposure to the equivalent of 1 percent of the smoke from one puff of a cigarette would be of toxicologic importance or could possibly confound assessment of environmental exposure.</a>[formatting and emphasis added]</p>\n</blockquote>\n\n<p>To which the original author responded:</p>\n\n<blockquote>\n <p>The amount of nicotine in certain vegetables is obviously too small to produce any pharmacologic or toxicologic effects. <strong>The difference between the small amount of nicotine in certain vegetables and the large amount in one average tobacco cigarette offers a marvelous lesson, both pharmacologic and toxicologic, on the importance of dose-effect relations.</strong> We never intended to suggest that vegetarians could become nicotine addicts, or that children who hate vegetables have a legitimate reason for refusing to eat them.</p>\n</blockquote>\n\n<p>Many plants, only especially those of the nightshade family, contain chemicals that are classified as active drugs; like nicotine. But tobacco is specifically breed for nicotine content and cigarettes are standardised for its content.</p>\n\n<p><a href=\"http://pubs.acs.org/doi/abs/10.1021/jf990089w\" rel=\"nofollow noreferrer\">Determination of the Nicotine Content of Various Edible Nightshades (Solanaceae) and Their Products and Estimation of the Associated Dietary Nicotine Intake:</a></p>\n\n<blockquote>\n <p><strong>Aubergines.</strong> Aubergines were investigated by Castro and Monji (1986), Sheen (1988), and Davis et al. (1991) with inconsistent results. The concentrations published previously include not detectable (Davis et al., 1991), >100 μg kg-1 wet weight (Castro and Monji, 1986), and 2.65 mg kg-1 dry weight (Sheen, 1988). <strong>We investigated four different types of aubergines, and nicotine could only be quantified in one sample. In two of the remaining samples, nicotine was detected but could not be quantified.</strong> […]<br> <strong>Tea.</strong> Conflicting results are found in the literature concerning nicotine concentrations in black tea (Sheen, 1998; Davis et al., 1991; Domino et al., 1993). Therefore, tea samples were analyzed for nicotine to address these contradictory results. The concentrations that were found in the dry tea leaves (Table 6) were surprisingly high in concentration, ranging from 163 to 1600 μg kg-1. Large variations were found within the types of black tea, whereas the concentrations were more or less consistent within the green teas. For an estimation of the dietary nicotine intake from tea, the nicotine concentration of the tea leaves is less relevant than that in brewed tea. Tea was brewed using common amounts of tea leaves and water. The results show that nicotine is not efficiently extracted by conventional brewing techniques (Table 7). Even tea with very high nicotine concentrations in the leaves (e.g., teas 3 and 4) do not show high amounts in the brewed tea. If detectable, the extraction yield is in a range of 20-25%. </p>\n</blockquote>\n\n<pre><code>Averaged Nicotine Concentrations \n Based on the Observed Nicotine Concentrations\nsource nicotine (ng/g) SD (ng/g)\nnicotine from potatoes 4.5 1.9\nnicotine from tomatoes 2.7 0.7\nnicotine from tomato paste 5.3 0.6\nnicotine from tomato sauce 4.5 1.5\nnicotine from ketchup 7.3 1.5\nnicotine from aubergine 2.1 0.5\nnicotine from brewed tea 4.0 0.3\n</code></pre>\n\n<blockquote>\n <p>The edible Solanaceae analyzed in this investigation were found to contain relatively consistent amounts of nicotine in the range of 2-7 μg/kg for fresh fruits. These results are in agreement with most but not all of the previous results reported in the literature. Nicotine appears to survive a variety of processing operations such as the preparation of tomato ketchup, sauces, and pastes as well as frying and boiling of potatoes. These products showed slightly higher concentrations in comparison to the related fresh fruits. Relatively large concentrations of nicotine found in tea leaves were not reflected in brewed tea. <strong>Using food consumption data from government sources, a mean estimated daily dietary intake of nicotine is approximately 1.4 and 2.25 μg/day</strong> at the 95th percentile based on the nicotine content and consumption data discussed in this report. It is possible that these estimates are low because of incomplete food consumption data. Further work is required to relate the estimated dietary nicotine intake to nicotine metabolite concentrations in biological fluids to be able to make reliable statements about the importance of dietary nicotine intake in comparison to environmental tobacco smoke exposure.</p>\n</blockquote>\n\n<p>To bring that back into perspective, a reminder on <a href=\"https://en.wikipedia.org/wiki/Kilogram#SI_multiples\" rel=\"nofollow noreferrer\">SI units of magnitud</a>e seems appropriate:</p>\n\n<blockquote>\n <p>10⁻³g = mg = milligram<br>\n 10⁻⁶g = µg = microgram<br>\n 10⁻⁹g = ng = nanogram</p>\n</blockquote>\n\n<p>And:</p>\n\n<blockquote>\n <p>Nicotine is the principal alkaloid in commercial tobacco, N. tabacum, usually accounting for >90% of the alkaloid fraction whereas nornicotine, anabasine, and anatabine seldom accumulate to >5%. Further nicotinoids are present only in very small concentrations in tobacco (Bush et al. 1999).[…]<br>\n Nicotinoid Content of Cured Tobacco Leaves and Tobacco Smoke. Of course there are differences concerning the qualitative alkaloid profile of green tobacco leaves, cured leaves, and tobacco smoke. This is also true from the quantitative point of view. Thus, due to enzymatic transformation during senescence and air-curing, e.g., the nicotine content may be reduced in favour of an increased amount of nornicotine. This may happen even to an extreme extent. Due to individual genetic conversion so-called “converters” are able to metabolize leaf nicotine to its nor congener up to 95% (Siminszky et al. 2005 and references therein). This happens more frequently in burley cultivars than in flue-cured tobaccos. Moreover, aging and flue-curing turned out to lead to a reduction on the concentrations of minor nicotinoid components.<br>\n <strong>The accumulation of <em>large</em> amounts of nicotine and/or its congeners is confined to four solanaceous genera belonging to two clades of the subfamily Nicotianoideae</strong> (Nicotianeae clade: Nicotiana; Cyphanthera clade: Crenidium, Cyphanthera, Duboisia).<br>\n Eckart Eich: \"Solanaceae and Convolvulaceae: Secondary Metabolites: Biosynthesis, Chemotaxonomy, Biological and Economic Significance\", Springer: New York, 2008, Ch 3.3 Nicotinoids (Tobacco Alkaloids) p83</p>\n</blockquote>\n\n<p>Perhaps the eggplant/aubergine is one species to really worry about?</p>\n\n<blockquote>\n <p>Particularly high levels of <a href=\"http://www.lci-koeln.de/deutsch/veroeffentlichungen/lci-focus/tropane-alkaloids-and-calystegines-occurrence-toxicity-analytical-methods-maximum-levels\" rel=\"nofollow noreferrer\">calystegines</a> have been determined in Solunum melongena, eggplant/aubergine, and Capsicum annuum var. annuum, bell pepper/paprika. (Eich, p165.)<br>\n N-trans-Feruloyltyramine (E-feruloyltyramine) and its octopamine [2-hydroxytyramine = 1-(p-hydroxyphe- nyl)-2-aminoethanol] congener as well as N-trans-p-coumaroyloctopamine were discovered in the roots of S. melongena L., eggplant/aubergine. Furthermore, the already known N-trans-p-coumaroyltyramine was detected in this sample (Yoshihara et al. 1978).(Eich, p 299.) </p>\n</blockquote>\n\n<p>These changes in the nicotin content are in the order of </p>\n\n<blockquote>\n <p><a href=\"http://www.tis-gdv.de/tis_e/ware/genuss/tabak/tabak.htm\" rel=\"nofollow noreferrer\">The nicotine content in the tobacco leaves varies between 0.05% (Virginia tobacco) through 3 - 4% (\"Burley\") to 7.5% (\"Machorka\", Russia)</a></p>\n</blockquote>\n\n<p>To compare that value for tobacco of the mild Virginia kind again with the eggplant from the letter in the first paragraph with the <em>absurdly</em> high values given there, assuming both kinds of plant material were ingested:</p>\n\n<pre><code> source nicotine (ng/g) \n\n nicotine from eggplant ~100\n nicotine from tobacco ~500000 \n</code></pre>\n\n<p>Keep in mind that eggplant values seem to be a sensational result of the unreplicated kind.<br>\nFirst hand smoking means not everything of that material is inhaled, some is burnt, some is lost to the environment. This concentration is much higher in commercial blends of tobacco found in cigarettes. The effect of second hand smoke is further diluted.</p>\n\n<blockquote>\n <p>Nicotine is a very potent poison for most animals from protozoa to humans. The acutely fatal peroral dose for an adult is probably 60mg (Taylor 1995) which is equivalent to the nicotine content of five cigarettes or one cigar. However, smoking results in a considerable decomposition of this alkaloid due to pyrolysis; furthermore, much of the remaining volatile nicotine is not absorbed due to exhalation. (Eich, p98.)</p>\n</blockquote>\n\n<p>The strict Swedish and Danish Health Council members conclude that </p>\n\n<blockquote>\n <p>The average dietary exposure to nicotine from the food plants mentioned above was calculated to be 1.1 μg/day (88% from potatoes) in Sweden and 1.3 μg/day (70% from potatoes) in Denmark.<br>\n Nicotine is very toxic at high doses. The lethal dose in man is 50-100 mg, which approximately corresponds to the nicotine content of tobacco in 5 cigarettes. At lower doses it has many pharmacological effects.<br>\n In comparison, the total dietary exposure to nicotine is very low, and seems to be insignificant in relation to exposures giving rise to toxic and/or pharmacological effects.<br>\n The dietary exposure to nicotine is about two orders of magnitude lower than the exposure in passive smoking and around three orders of magnitude lower than the direct exposure during cigarette smoking (around 900 - 1 700 μg nicotine is assumed to be absorbed from a single cigarette). In addition to the difference in exposure level, absorption is much lower when exposure occurs in the diet than when by the inhalation route. Absorption from the stomach is poor and 60 to 70 percent of the nicotine is metabolised during the first pass through the liver, whereas absorption in the lungs is good and distributes nicotine systemically. Thus, it seems very unlikely that the low nicotine levels from dietary exposure would cause any toxicological harm in human.^<br>\n _{<a href=\"https://www.foedevarestyrelsen.dk/SiteCollectionDocuments/25_PDF_word_filer%20til%20download/06kontor/Nikotinalkaloider%20i%20planter%20fra%20natskyggefamilien.pdf\" rel=\"nofollow noreferrer\">Christer Andersson &amp; Paula Wennström &amp; Jørn Gry: \"Nicotine alkaloids in Solanaceous food plants\", TemaNord 2003:531</a>}</p>\n</blockquote>\n\n<h1>Summary</h1>\n\n<p>Yes, nicotine can be <em>detected</em> in vegetables. Although this is quoted above, it worth repetition: \"it would take an approximately 500-fold increase in the amount of vegetables estimated by Domino et al. to produce exposure equivalent to half a cigarette a day –– e.g more than 100 kg of tomatoes would have to be consumed in one day.\"\nUnless one employs very sophisticated concentration and purification methods (or plays the long game in breeding those plants for nicotine content) the concentrations of nicotine in commonly consumed vegetables are much too low as to be of any concern (or value, depending on perspective).</p>\n", "score": 3 } ]

[ "nicotine" ]

[ { "answer_id": 11040, "body": "<p>Let's look up Ibuprofen up in a <a href=\"https://www.drugs.com/monograph/ibuprofen.html\" rel=\"noreferrer\">reliable source</a>. We can read there that:</p>\n\n<blockquote>\n <p><strong>Cardiovascular Risk</strong></p>\n \n <p>Increased risk of serious (sometimes fatal) cardiovascular thrombotic events (e.g., MI, stroke). Risk may occur early in treatment and may increase with duration of use. (See Cardiovascular Thrombotic Effects under Cautions.)\n Contraindicated in the setting of CABG surgery.</p>\n \n <p><strong>GI Risk</strong></p>\n \n <p>Increased risk of serious (sometimes fatal) GI events (e.g., bleeding, ulceration, perforation of the stomach or intestine). Serious GI events can occur at any time and may not be preceded by warning signs and symptoms. Geriatric individuals are at greater risk for serious GI events. (See GI Effects under Cautions.)</p>\n</blockquote>\n\n<p>This tells me enough, this is a drug that should not be used unless there is no other viable alternative with less side effects. Depending on the dose and duration of the treatment, you have to consider using a drug to protect your stomach. I would leave making that decision to my doctor. </p>\n\n<p>Turmeric, in contrast, does not have side effects. We can <a href=\"https://en.wikipedia.org/wiki/Turmeric#Research\" rel=\"noreferrer\">read here</a> that the claims of it helping to reduce inflammation are not supported by strong studies. It may work, but it's not going to have a very strong effect on the short term similar to powerful painkillers, otherwise the evidence of its efficacy would have been clear. However, if someone stops using Ibuprofen and starts to use turmeric and is able to tolerate not using Ibuprofen, then the simple act of stopping to use Ibuprofen is a good thing. Whether turmeric itself works or not doesn't matter all that much.</p>\n", "score": 4 }, { "answer_id": 11108, "body": "<p>Ibuprofen is a very-standard NSAID, and generally speaking it is a pretty safe drug when taken in an appropriate dose.</p>\n\n<p>All medications have side-effects, Ibuprofen is not the exception. Now, usually these things are not an issue for healthy individuals. Mostly they can be a problem for people with pre-existing conditions.</p>\n\n<p>Ibuprofen is not recommended for people with increased stroke or thrombotic risk (No NSAIDs are recommended for them, actually) but I don't think it is actually cardiotoxic.</p>\n\n<p>The potential of GI bleeding can actually be more of an issue as it is an effect directly related to the mechanism of action. Ibuprofen prevents the formation of Prostaglandins that a) Are responsible for inflammation but b) Are also responsible for secreting the protective layer of the gastric mucosa. Nonetheless, it's still generally safe if used in the proper doses and for few days at a time. (Usually, I don't recommend it over 5 days; when I do, I generally prescribe a proton-pump inhibitor also). Note that this risk is further increased if the patient is on corticosteroids.</p>\n\n<p>Ibuprofen can also be harmful for the kidneys (it reduces blood flow to kidneys), so it is not recommended in people with kidney disease. And, this is rare but I've seen it happen, in some cases it can cause an interstitial nephritis that can be very bad, most commonly when abused for a very long time.</p>\n\n<p>As for turmeric... I've never read any actual evidence that it acts as an anti-inflammatory.</p>\n", "score": 1 } ]

[ "medications", "side-effects", "osteoarthritis", "pain-management", "turmeric" ]

[ { "answer_id": 11256, "body": "<p>The thing to recognize is that until the past century, they didn't know that a cold was a virus, but may well have associated it more with actual effects caused by the cold. Indeed, this line at <a href=\"https://en.wikipedia.org/wiki/Common_cold\" rel=\"nofollow noreferrer\">Wikipedia</a> agrees with that:</p>\n\n<p>The name \"cold\" came into use in the 16th century, due to the similarity between its symptoms and those of exposure to cold weather.</p>\n\n<p>And it references this listing at <a href=\"http://www.etymonline.com/index.php?term=cold\" rel=\"nofollow noreferrer\">Etymology Online</a> supporting this thinking.</p>\n\n<p>So it's neither based upon the fact the cold can help you catch the virus, as your mom suggests, nor the feelings during the cold. Instead, it was an archaic belief that the cold made the disease itself.</p>\n\n<p>As to your question on whether cold can help encourage the common cold, <a href=\"http://sitn.hms.harvard.edu/flash/2014/the-reason-for-the-season-why-flu-strikes-in-winter/\" rel=\"nofollow noreferrer\">this Blog from Harvard</a> appears to goes into great detail on the related question for the flu. They mention the theory that altered human habits in winter very much benefit communicability; we are less active, stay inside more, and have school and large indoor holiday gatherings.</p>\n\n<p>But the summary also references studies investigating direct impacts of temperature. There were indications that the flu spreads well at any temperature... if the air is dry. But it only does well in moist air if it is cold. So it's not all about the temperature, but the moisture/temperature combination. The blog does mention that there were some oddities to this thinking, though (in tropical locations, they get the flu the worst when it is rainy and slightly cooler).<br>\nSo a bit of confusion on some points, but additional studies did show that the flu survives in the air better at cooler temperature.</p>\n\n<p>However, the big answer directly to your question is </p>\n\n<blockquote>\n <p>Palese tested the immune systems of the animals to find out if the\n immune system functions poorly at low temperatures and low humidity,\n but he found no difference in innate immunity among the guinea pigs.</p>\n</blockquote>\n\n<p><strong>So, long story short, studies on the flu suggest that the temperature doesn't weaken your body (though certainly it seems likely it would if you were exposed for extreme periods of time!), but that it does offer some conditions which help the germs survive better.</strong></p>\n", "score": 3 } ]

[ "common-cold" ]

[ { "answer_id": 31651, "body": "<p><strong>Are painkillers curative for migraine headaches?</strong></p>\n<p>No, they are not, but they are therapeutic.</p>\n<p>Similarly to user @De Novo's comment, the main problem in migraine headaches is the pain. Although the source of the pain doesn't go away and you may still feel pain some time afterwards, symptomatic treatment of migraines with painkillers is still an effective form of management.\nYou will not &quot;damage&quot; your body further by continuing whatever activity triggers the headache, you will only feel more pain. There is also the issue of adverse effects following long term use of pain medications, but that is beyond the scope of this answer.</p>\n<p>However, relying purely on pain management in all headaches is not a good idea. Some headaches have different underlying causes, brain bleeds, lesions, hypertension, infectious and febrile illnesses, etc.</p>\n<p>Of course preventive medicine is always the best, so if you get headaches from doing X activity, please avoid X activity.</p>\n<p>I hope this answers your question :)</p>\n<p>Sources:</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740949/\" rel=\"nofollow noreferrer\">Management of migraines</a></p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/9482363/\" rel=\"nofollow noreferrer\">Efficacy of some painkillers</a></p>\n<p><a href=\"https://www.google.com/url?sa=t&amp;rct=j&amp;q=&amp;esrc=s&amp;source=web&amp;cd=&amp;ved=2ahUKEwjC1cqv1uT6AhUaLOwKHdz6BgMQFnoECAsQAQ&amp;url=https%3A%2F%2Fjag.journalagent.com%2Ftjn%2Fpdfs%2FTJN_22_1_3_7%5BA%5D.pdf&amp;usg=AOvVaw11aGcg8qdfd5pVMC_7-njD\" rel=\"nofollow noreferrer\">Effectiveness of some current headache therapies</a></p>\n", "score": 3 }, { "answer_id": 11274, "body": "<p><strong>How do painkillers work?</strong></p>\n\n<p>When part of your body is injured, special nerve endings send pain messages back to your brain. \nPainkilling drugs interfere with these messages, either at the site of the injury, in the spinal cord or in the brain itself. </p>\n\n<p>Many painkillers are based on one of two naturally occurring drugs: aspirin and opiates. Aspirin uses a chemical found in willow bark, used by the Ancient Greeks to relieve pain. Opiates all work in a similar way to opium, which is extracted from poppies.</p>\n\n<p>Other Source: <a href=\"http://mentalfloss.com/article/18615/how-do-painkillers-find-kill-pain\" rel=\"nofollow noreferrer\">http://mentalfloss.com/article/18615/how-do-painkillers-find-kill-pain</a></p>\n", "score": 2 } ]

[ "headache", "migraine", "nsaids-pain-meds", "analgesics", "acetaminophen" ]

[ { "answer_id": 11380, "body": "<p>I am certainly no expert, however I had a hip replacement in August 2015 and I know I have a slight leg length difference now. It's very common in hip surgery but I think we are so pleased to be out of pain it doesn't seem important until we are fully recovered as you are and then possibly left with a limp.</p>\n\n<p>I was measured about 8 weeks after surgery and there was a difference but they said it can a couple of years for everything to 'bed in' and I think they were right except I feel that my left leg is longer than my right and some days it seems more apparent than others. For me I think unless I start getting pain somewhere I'm not worried, I have got used to it. Saying that I did have to retrain myself to stop limping as it had become a habit. Have you had help with strengthening your core and your leg? Once you find the right physiotherapist they are amazing. I go to Pilates and it has made such a difference.</p>\n\n<p>I know people who use the little insole in their shoes and they work fantastically. A friend of mine had a really bad back and sciatica and could hardly walk but just by wearing an insole and levelling him up, he is now pain free and has been for years. He has one pair for his shoes, another for his wellies and a third for his trainers now!</p>\n\n<p>I would definitely go for a second opinion as it is your health and you have a right to ask questions and be in control. Sometimes we just need to speak to the right person and get peace of mind. I think it is different for everyone, some don't notice or can live with it and some people are more aware, as I am. </p>\n\n<p>Sorry to hear you have been through so much but sounds like you have recovered really well which is fantastic. Good luck!</p>\n\n<p>Take care</p>\n", "score": 3 }, { "answer_id": 26386, "body": "<ul>\n<li>Question: Is it normal to expect this &quot;alignment margin&quot; in this type of surgery? Any statistics that says a broken femur is likely to remain slightly off after surgery?</li>\n</ul>\n<p>Faye Loughenbury, <a href=\"https://www.expertscape.com/ar/leg+length+inequality/a/McWilliams%2C+Anthony+B\" rel=\"nofollow noreferrer\">Anthony McWilliams</a> and their colleagues have conducted several studies that may in part answer your questions. I quote from &quot;<a href=\"https://journals.sagepub.com/doi/10.1177/1120700018777858\" rel=\"nofollow noreferrer\">Hip surgeons and leg length inequality after primary hip replacement</a>&quot;:</p>\n<p>&quot;89% of surgeons agreed that 15 mm of leg length inequality (LLI) after primary uncomplicated total hip replacement (THR) was always acceptable. 90% of surgeons felt that LLI more than 22.74 mm was never acceptable.&quot;</p>\n<ul>\n<li>Question: Is this something i could potentially never be able to correct either via exercising or possibly other kinds of medical intervention?</li>\n</ul>\n<p>While you cannot correct the relative difference that the operated leg has towards the other, a heel lift with the specific - exact (!) - height offers a tolerable compensation. Current focus is on leg length inequalities not mattering much if lower than 1,5 cm or 1 cm or, at best, 5 mm. If all lower extremity joints are examined for sufficient support of range of movement (patients may ask their physiotherapists) contributing to a well compensated overall functional leg length (that includes slightly extension-limited knee joints you might not have noticed, or missing arch support on the side of the (previously) anatomically longer leg) - you should live a happy life after all. If you are very technical about your question, and should doctors recommend THR of the second hip, some counter-compensation may be achieved when well planned. It may also help to be aware that the average LLI/LLD of the general population is <a href=\"https://chiromt.biomedcentral.com/articles/10.1186/1746-1340-13-11\" rel=\"nofollow noreferrer\">5 mm</a>. However, the sensation of &quot;limping&quot; may intensify if the naturally shorter leg has become even shorter or the longer even longer. Anybody should use a heel lift, for fun, and compare sides. Most people will notice &quot;a funny feeling&quot; only with the heel lift under <em>one</em> of the two legs, specifically, as compared to the lift under the other heel. (It also may help to know that, clinically, hip arthroplasty patients that have a <a href=\"https://doi.org/10.1016/j.surneu.2008.08.073\" rel=\"nofollow noreferrer\">referring pain from the spine</a> (<a href=\"https://journals.lww.com/spinejournal/Citation/1993/03000/The_Effect_of_Imposed_Leg_Length_Difference_on.12.aspx\" rel=\"nofollow noreferrer\">reacting to the hip via the mediation of the pelvis</a>) are not too seldom - at the same time there seems to be evidence that this would not matter - circumstances are unique, that is why stackexchange is serious about avoiding personal medical advice).</p>\n<ul>\n<li>Could the difference in length be more than 5mm, and they said that to sound &quot;optimistic&quot;?</li>\n</ul>\n<p>A tough question, to me, because we cannot know what &quot;they&quot; really thought. Considering the cited statistics, a patient with 5 mm length difference after THR is lucky with a relatively small &quot;off&quot; value. However, since in the general population the left leg is longer than the shorter right leg, it may add up to a centimetre in your case. To my personal clinical experience - that will most likely sound blasphemic - every millimeter matters, even less than a tenth. If clinical collaborateurs learn to palpate the effect of marginal leg length on the joints of the spine in bilateral comparison and for several segments, they may easily reproduce the causes for my judgment to consider less than a tenth of a millimeter important. I believe that future direction of reasearch will head there - however, I experience disbelief in clinical partners whenever I tell them what I palpate there - you can hardly find any reference in the literature to such manual precision yet, also not in functional radiography or MRI. Given the likelyhood of pain overlooked in its functional genesis, it is very likely that doctors really think that patients should not have pain (while they may have) after THR, as we may also think that patients should accept a limp if they would not wear a heel lift or have their shoes prepared by a orthopedic shoe specialist, which can most certainly be a fantastic relief in having done (if as exact as is possible).</p>\n<ul>\n<li>Question: If the difference is real (and it feels like it could be, since i am still limping a bit) and i am never able to correct it in any way, what kind of side effects should i expect?</li>\n</ul>\n<p>You'll see that my answers will repeat a little bit, but that should not matter much. If the patient made sure that his or her joints have no movement restrictions (knee joint extension in particular), checks if an arch support would be necessary and makes sure the person asked sees him/her as well walking as standing - that should correct quite a bit of limping, when also the correct (!) amount of the heel lift is found (for example, I use layers of different thicknesses of tape to add - subtract, on contralateral side - some necessary bits - sometimes, a single layer). If all shoes are lifted (a patient could place a lift in a sock, if he or she wouldn't want to avoid being &quot;barefoot&quot;), I would not expect major caveats. There may be individual things only an experienced examiner finds. At the same time, if a patient just gives in to leg length difference and does nothing about it - just goes limping - this amounts to asymmetric load transfer and greater asymmetric joint use all over the body than necessary, most importantly the (lumbar) spine, <a href=\"https://www.oarsijournal.com/article/S1063-4584(08)00347-6/fulltext\" rel=\"nofollow noreferrer\">knees and (other) hip</a>. We always try to establish a somewhat symmetrical movement - within its borders, deviations are alright, but if you ask clinicians, the definition of &quot;deviation&quot; can differ quite a bit. My suggestion would be to prevent unilateralization for the lumbar spine and neighboring joints of the hip with the help of an experienced manual therapist or doctor of osteopathic medicine having specifically stated experiences with leg length differences.</p>\n<ul>\n<li>Question: Should i double check with another doctor?</li>\n</ul>\n<p>Most doctors would probably tell you that 5 mm is no big deal. If you read the survey responses gathered by Anthony McWilliams and his colleagues, some doctors think that double that amount is no big deal, and some think that even more is still acceptable. user8412 said that we deserve to be in control and provided appropriate information. Unfortunately the expertise about leg length differences has not yet enabled many clinicians to provide sufficient information, due to a rather growing evidence base. A physiotherapist with special training (there are orthopedic manual therapists, for example) or an informed osteopath might as well provide further help. Sometimes they work together with orthoticists. However, somebody should also entertain the difficult work to inform surgeons and orthopedists so that they might become sensitized for the fact that &quot;millimeters&quot; do matter - if, apparently, little - at least to stimulate new and open research questions. The patients and their therapy experiences may inform resarch - so patients theirselves, in their responses to and articulations of outcomes are most likely the very key for future patient experiences, also in the domain of leg length difference / inequality.</p>\n<ul>\n<li>Question: What are my options?</li>\n</ul>\n<p>Only if the options referred to until here seem to leave open an essential gap, it might be beneficial to actually write to some of the doctors conducting resarch for the topic, offering your participation in trials and on the way get adequate &quot;on the edge&quot; diagnosis - many doctors with a hunch for this specific topic, as it is seldom enough, actually treat real patients :) ... however, as, for example, spine symptoms - &quot;unspecific low back pain&quot; - can be a consequence of THR, asymptomatic patients in matters of pain might just be fine with a general screening of a physiotherapist, orthoticist and/or orthopedist. It could very well be, that a specialist can only point to what part of a problem is explicity <em>not</em> falling in his or her domain.</p>\n<p>While this can look like dry information, I hope it does not suck you into some mills of drifting into too much reflection but provide someone with a little hand of helping overview where needed.</p>\n", "score": 0 } ]

[ "orthopedics", "recovery", "post-surgical", "femur", "leg-length-discrepancy" ]

[ { "answer_id": 11386, "body": "<p>That approach works with some supplements and not others. Iron, for example, will be held in the small intestine until the blood level lowers enough for safe absorption by which time it might just be pushed out of the body. </p>\n\n<p>Zing is regulated by secretions in urine and sweat. Any you ingest, or breath in (unsafe welding practices), will be absorbed by the blood stream in a rather reckless fashion. Then the body will filter it down to normal levels. Before your body accomplishes this task you might be subjected to symptoms of zinc poisoning. \n<a href=\"https://en.wikipedia.org/wiki/Zinc_toxicity\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Zinc_toxicity</a></p>\n", "score": 3 } ]

[ "lasting-effects-duration", "risks", "supplement", "zinc", "missed-dose" ]

[ { "answer_id": 11439, "body": "<h2>Original Answer</h2>\n\n<p>This comes from my high-school chemistry book (in German): </p>\n\n<blockquote>\n <p>Hexanhexol (sorbitol) is common in apples, cherries and other fruits. The sweet taste comes from the OH-Groups within the molecule. […]<br>\n Sorbitol is half as sweet as sugar (glucose), but does not cause carries.<br>\n Furthermore, foods containing sorbitol feel cool in the mouth, as\n sorbitol is drawing energy from its surroundings in order to dissolve.<br>\n <strong>Pentanpentol (xylitol) has very similar properties [i.e. not causing carries], but is as sweet as glucose.</strong></p>\n</blockquote>\n\n<p><a href=\"https://i.stack.imgur.com/QjnBF.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/QjnBF.jpg\" alt=\"Extract from my chemistry book\"></a></p>\n\n<p>I think, if school books teach that xylitol prevents caries, this argument must be pretty solid. (School books are usually very conservative and only teach bullet-proof things, at least in Germany).</p>\n\n<p>I can't tell you exactly <strong>why</strong> xylitol and sorbitol prevent caries. It probably has something to do with the fact that neither we nor bacteria are able to process any source of energy other than carbohydrates, and so the cariogenic bacteria do not have enough \"food\". </p>\n\n<p>Following from this, your diet must consist of glucose (or polysaccharides which will be broken down into glucose), otherwise you would have starved to death! Therefore, <strong>if you do not brush your teeth regularly</strong> there will be enough \"food\" for caries because of polysaccharides in other foods that we eat.\nIf you brush your teeth regularly and have a good oral health, there will be almost no gains (apart from the diet/weight bit) by using a sugar substitute!</p>\n\n<hr>\n\n<h2>Edit</h2>\n\n<p>Some sources and studies about xylitol and dental health: </p>\n\n<ul>\n<li>This <a href=\"http://www.nature.com/bdj/journal/v194/n8/abs/4810022a.html\" rel=\"nofollow noreferrer\">Nature Article</a> discusses the benefit of xylitol compared to other polyols. </li>\n</ul>\n\n<blockquote>\n <p>Chewing xylitol gum is certainly effective at preventing caries\n development compared with chewing sugared gum or not chewing any gum.\n Xylitol gum appears to be more effective than sorbitol gum or\n combinations of xylitol and sorbitol.</p>\n</blockquote>\n\n<ul>\n<li>This <a href=\"https://academic.oup.com/jmicro/article-abstract/52/5/471/1044146/Remineralization-effects-of-xylitol-on?redirectedFrom=fulltext\" rel=\"nofollow noreferrer\">Study from the Japanese Microscopy Society</a> claims that xylitol remineralises tooth enamel. However, as <strong>@JohnP</strong> pointed out in the comments, there is a potential conflict of interest as the sponsor of the study is a manufacturing company which also produced products that include xylitol.</li>\n</ul>\n\n<blockquote>\n <p>We morphologically determined the effects of xylitol on the\n remineralization of artificially demineralized enamel. […] The MIP\n evaluation indicated that remineralization was more prominent in\n layers at depths of 50–60 µm in the xylitol samples than in the\n non‐xylitol samples.</p>\n</blockquote>\n\n<ul>\n<li>As Matías Fiedemraizer pointed out in the comments, the AASP <a href=\"http://www.aapd.org/media/policies_guidelines/g_xylitoluse.pdf\" rel=\"nofollow noreferrer\">recommends</a> Xylitol for patients with high risk of caries:</li>\n</ul>\n\n<blockquote>\n <p>The American Academy of Pediatric Dentistry (AAPD) recognizes the\n benefits of caries preventive strategies involving sugar substitutes,\n particularly xylitol, on the oral health of infants, children,\n adolescents, and persons with special health care needs. […]<br>\n Dosing frequency should be a minimum of two times a day, not to\n exceed eight grams per day.</p>\n</blockquote>\n\n<ul>\n<li>This <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007095.pub2/abstract;jsessionid=BC6106DDC9ACF5960C447362207A5021.f04t01\" rel=\"nofollow noreferrer\">article</a> shows that the risk of AOM is reduced for kids with xylitol intake.</li>\n</ul>\n\n<blockquote>\n <p>There is fair evidence that the prophylactic Administration of xylitol\n among healthy children attending day care centres reduces the\n occurrence of AOM by 25%. This meta-analysis is limited since the data\n arise from a small number of studies, mainly from the same research\n group.</p>\n</blockquote>\n\n<ul>\n<li>This is a <a href=\"http://www.cochrane.org/CD010743/ORAL_can-xylitol-used-in-products-like-sweets-candy-chewing-gum-and-toothpaste-help-prevent-tooth-decay-in-children-and-adult\" rel=\"nofollow noreferrer\">review</a> assessing whether xylitol can in fact prevent tooth decay. This is their conclusion:</li>\n</ul>\n\n<blockquote>\n <p>We found some low quality evidence to suggest that fluoride toothpaste\n containing xylitol may be more effective than fluoride-only toothpaste\n for preventing caries in the permanent teeth of children, and that\n there are no associated adverse-effects from such toothpastes. The\n effect estimate should be interpreted with caution due to high risk of\n bias and the fact that it results from two studies that were carried\n out by the same authors in the same population. The remaining evidence\n we found is of low to very low quality and is insufficient to\n determine whether any other xylitol-containing products can prevent\n caries in infants, older children, or adults.</p>\n</blockquote>\n\n<p><em>The abstracts and findings of all articles are available online, one has to purchase the whole article though to be able to read everything.</em></p>\n\n<h2>My conclusion</h2>\n\n<p>Judging from all the studies, I would just have a normal diet and brush my teeth regularly. For me, it is too much effort to change my eating habits, try to eat foods that only contain alcohol sugar when the benefits are not even clear.<br>\n<em>It is important to note</em> however that xylitol <strong>does</strong> prevent caries if used consequently as a sugar substitute and no other polysaccharides are consumed. <em>This is not recommended</em> (1). But fluoride tooth paste prevents caries it at least to a very similar extend.\nLastly, one has to consume xylitol at least twice a day to get a positive effect [AADP article], but only a maximum of 8g, as osmotic diarrhoea is a major possible side effect. </p>\n\n<hr>\n\n<p>(1): This was an understatement. Under no circumstances try to only consume xylitol and no other carbohydrates! </p>\n", "score": 6 } ]

[ "sugar", "oral-health", "clinical-study" ]

[ { "answer_id": 12956, "body": "<p>Generally these decisions are \"made\" by work groups of specialists in the field. Your question is very general. There are so many measurements that can be done from blood samples that there is no way I can provide you with information on exactly <em>who</em> decides what the reference value is.</p>\n\n<p>(\"Who decides\" makes it sound like it is arbritrary - <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556592/\" rel=\"nofollow noreferrer\">it is not</a>. \nDecisions are usually based on statistics - 2 standard deviations from the population mean, for example, are taken as a reference standard. This means that the reference range can be defined as: \"what is most prevalent in a reference group taken from the general population?\" Be aware: Values outside a reference range are not necessarily pathologic, and they are not necessarily abnormal in any sense other than statistically. On the other hand, values within the reference range can be pathologic even though they are \"normal\". This is why reference range is actually a better term than \"normal\" range.<br>\nSometimes, however, the reference value is based on what values have an optimal health effect. A problem with optimal health range is a lack of a standard method of estimating the ranges.)</p>\n", "score": 1 } ]

[ "blood", "blood-tests", "measurement", "different-national-health", "cbc-complete-blood-count" ]

[ { "answer_id": 16287, "body": "<blockquote>\n <p>Do US students take USMLE exams of the same content like IMG (foreign) doctors? </p>\n</blockquote>\n\n<p>Yes, they do.</p>\n\n<blockquote>\n <p>Is it true that American students take USMLE separated in subjects not a as a whole set of 300 questions on all topics?</p>\n</blockquote>\n\n<p>It is false. It's the same.</p>\n\n<ul>\n<li>USMLE Step 1 : single-day, composed of seven 40-question sections with a maximum 280 multiple-choice questions (<a href=\"http://www.usmle.org/step-1/\" rel=\"nofollow noreferrer\">Source: usmle.org</a>)</li>\n<li>USMLE Step 2 CK: 9-hour single-day computer-based test composed of eight question sets with no more than 40 questions per set (<a href=\"http://www.usmle.org/step-2-ck/\" rel=\"nofollow noreferrer\">Source: usmle.org</a>)</li>\n<li>USMLE Step 3: 2 days (9 hours and 8 hours) with the first day multiple choice questions, and second day multiple choice and computer-based (simulation-like) questions. It's broken into hour chunks like Step 2 CK.</li>\n</ul>\n", "score": 3 } ]

[ "health-education", "different-national-health" ]

[ { "answer_id": 12790, "body": "<p>The only way to know the the level of conversion is through bloodwork to measure it and even that can be problematic. From the CD site:</p>\n\n<blockquote>\n <p>Laboratory evidence of immunity or laboratory confirmation of disease</p>\n\n<pre><code>Commercial assays can be used to assess disease-induced immunity, but they lack sensitivity to always detect vaccine-induced immunity\n</code></pre>\n \n <p>(i.e., they may yield false-negative results).</p>\n</blockquote>\n\n<p>The issue there is that even the CDC knows that immunity can be undetectible (for what reason I do not know), and yet you are protected. If it's a vaccine induced infection, I think you'd be subject to the same risk of false negatives. </p>\n\n<p>The only way to measure is titer though. In fact, you cannot <em>actually</em> know the current vaccine schedule is leaving you protected. I have a sibling that has received a particular vaccine a number of times (3 times more than what is considered necessary) and regardless, if she has a titer pulled, it shows no immunity (not varicella, we had that as children). We don't typically titer all people because it isn't generally a good use of resources. You can though, request one to be done &amp; certainly after an outbreak of varicella, to simply see if another shot is warranted or not. </p>\n\n<p>The quote provided is about 1/4 of the way down on that link. </p>\n\n<p><a href=\"https://www.cdc.gov/vaccines/pubs/surv-manual/chpt17-varicella.html\" rel=\"nofollow noreferrer\">https://www.cdc.gov/vaccines/pubs/surv-manual/chpt17-varicella.html</a></p>\n", "score": 1 } ]

[ "immune-system", "vaccination", "chickenpox", "antibodies" ]

[ { "answer_id": 11589, "body": "<p>It is because rabies <a href=\"https://www.ccohs.ca/oshanswers/diseases/rabies.html#wb-auto-4\" rel=\"nofollow noreferrer\">take time to kill you</a> and vaccine that you <a href=\"https://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html\" rel=\"nofollow noreferrer\">are given is 'dead' virus</a> so it makes it easy to develop antibodies against and when you have antibodies you can fight actual virus</p>\n", "score": 1 } ]

[ "treatment", "vaccination", "rabies" ]

[ { "answer_id": 23470, "body": "<p>There are several reason actually, I will try to sum it for you:</p>\n\n<ol>\n<li>Doctors in USA is very careful when dealing with patient. They may require several test and check before make the decision about the treat that patient need to take.</li>\n<li>High administrative cost. Government in most of the developed countries play roles to rule the cost of medicare, but <a href=\"https://addresseek.com/category/12/hospital\" rel=\"nofollow noreferrer\">medical care in USA</a> is different due to <a href=\"https://www.investopedia.com/articles/personal-finance/080615/6-reasons-healthcare-so-expensive-us.asp\" rel=\"nofollow noreferrer\">lack of political support</a> for the government taking a larger role in controlling healthcare costs.</li>\n</ol>\n", "score": 1 } ]

[ "treatment", "surgery" ]

[ { "answer_id": 11652, "body": "<p>Yes, of course.</p>\n\n<p><strong>Helycobacter Pylorii</strong> is a gram- bacteria which live is acid envronment, like stomach or duodenum.</p>\n\n<p>Common thoughts are that since stomach is acid, HP should die during time. This is not true, because this bacteria has different \"weapons\" to survive:</p>\n\n<p>-<em>urease</em>: this enzyme uses urea in the stomach to produce ammonia and HCO3-(bicarbonate), that neutralize the acid of the stomach;</p>\n\n<p>-<em>motility</em>: this bacteria can move: this prevent acid to attack it;</p>\n\n<p>-specific proteins (<em>adhesins</em>): which allows the bacteria to attach to the side of the mucous membrane.</p>\n\n<p>Then, making other enzymes, like \"<em>vacA</em>\" and \"<em>cagA</em>\", can damage your stomach/duodenum wall and enter, causing the well known ulcers.</p>\n\n<p>This bacteria is also important in the genesis of <em>gastric cancer</em>, if it is not treat.</p>\n\n<p><strong>Diagnosis</strong> is really simple:</p>\n\n<p>-<em>invasive methods</em>: with an endoscopy, doctor take a \"bite\" of the mucous wall and make both histological research, culture or test with urea (if needed, I can explain better later)</p>\n\n<p>-<em>not invasive</em>: urea breath test, feces test, serology IgG anti HP</p>\n\n<p><strong>Therapy</strong> is simple as well:</p>\n\n<p>-proton pump inhibitors(PPI) + clarithromycin + metronidazole or amoxicillin for 2weeks</p>\n\n<p>-if clarithromycin resistance: PPI + tetracycline + bismuth + metronidazole </p>\n\n<p>This is called \"sequential therapy\"; there is also the triple therapy, but researches prove that sequential is effective.</p>\n\n<hr>\n\n<p>Ref.</p>\n\n<ul>\n<li><p><a href=\"http://accessmedicine.mhmedical.com/content.aspx?bookid=331&amp;sectionid=40726901\" rel=\"nofollow noreferrer\">Chapter 151 of the Harrison's principles of Internal Medicine</a></p></li>\n<li><p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2578890/\" rel=\"nofollow noreferrer\">Treatment of H. pylori infection: the reality.</a></p></li>\n</ul>\n", "score": 4 } ]

[ "lasting-effects-duration", "stomach", "bacteria", "ulcers", "h.-helycobacter-pylori" ]

[ { "answer_id": 11712, "body": "<p>Welcome to Health SE!</p>\n\n<h1>Astrophobia</h1>\n\n<p>I did a Google search for [ <code>fear of space</code> ] and looked at what appeared. I think that your phobia is called \"astrophobia\". See, for example, <a href=\"https://en.wiktionary.org/wiki/astrophobia\" rel=\"nofollow noreferrer\">this Wiktionary definition</a>.</p>\n\n<h1>Causes</h1>\n\n<p>You can try a Google search, and look at some of the results, to learn <a href=\"https://www.google.com/search?q=why+phobias+develop\" rel=\"nofollow noreferrer\">why phobias develop</a>.</p>\n\n<h1>Treatment</h1>\n\n<p>Like all phobias, and like all other anxiety disorders, your fear is treatable. See <a href=\"http://www.mayoclinic.org/diseases-conditions/specific-phobias/diagnosis-treatment/treatment/txc-20253354\" rel=\"nofollow noreferrer\">here</a>.</p>\n\n<p>If it's only a tiny problem, maybe you can treat yourself; post a new question asking how. Or you can pay a psychologist the full hourly rate to do the treatment.</p>\n\n<p>If it's a bigger problem (e.g. if you're a primary-school teacher who's just been asked to teach an astronomy unit to your students), your medical insurance will likely cover the treatment. See your doctor.</p>\n\n<h1>Disclaimer</h1>\n\n<p>P.S. I'm an IT consultant, not a doctor, so this answer may be full of mistakes.</p>\n", "score": 4 } ]

[ "mental-health", "terminology", "anxiety-disorders", "psychologist-psychology" ]

[ { "answer_id": 11772, "body": "<h1>Are ibuprofen side effects something to worry about?</h1>\n\n<p><strong>Short answer</strong>: maybe.</p>\n\n<p><strong>Longer answer</strong>: As with a lot of health questions, it depends on how they are being taken. If, for example, you hurt yourself playing a sport and want to take a painkiller for some short-term relief, ibuprofen <em>probably</em> won't do you much harm in the short term.</p>\n\n<p>On the other hand, if you are in chronic pain (or inflammation, as another answer notes) the situation is a little different. If you are taking an <a href=\"http://www.nhs.uk/Conditions/Anti-inflammatories-non-steroidal/Pages/Introduction.aspx\" rel=\"noreferrer\">NSAID</a> - ibuprofen is one of several in this class of drug - on a regular basis it's worthwhile watching out for some side effects. One mentioned in the article you linked are <a href=\"http://www.nhs.uk/conditions/Peptic-ulcer/Pages/Introduction.aspx\" rel=\"noreferrer\">stomach ulcers</a> as NSAIDs can have an effect on the protective lining of the stomach. Usually some form of '<em>gastroprotection</em>' is offered to offset this, such as a PPI (proton pump inhibitor, such as omeprazole).</p>\n\n<p>As another example, if you are taking ibuprofen for recurrect headaches (eg migraines), you can counter-intuitively end up getting another kind of headache, called a [medication overuse headache(<a href=\"https://www.migrainetrust.org/about-migraine/types-of-migraine/other-headache-disorders/medication-overuse-headache/\" rel=\"noreferrer\">https://www.migrainetrust.org/about-migraine/types-of-migraine/other-headache-disorders/medication-overuse-headache/</a>) (MOH). </p>\n\n<p>The bottom line is that any long-term use should be discussed with a medical professional; who can assess relative risks and check for interactions with any other regular medications.</p>\n\n<h2>But ibuprofen/NSAIDs can't be safe! Vioxx was taken off the market...</h2>\n\n<p>Quite true. From <a href=\"https://qz.com/944231/ibuprofen-has-some-nasty-side-effects-that-doctors-have-known-about-for-a-while/\" rel=\"noreferrer\">the article you quoted</a>:</p>\n\n<blockquote>\n <p>In the early 2000s, a number of large studies found a significant association of negative heart events, such as heart attack and stroke, with the use of selective COX-2 inhibitors. This resulted in two of these drugs, Valdecoxib and Rofecoxib or Vioxx, being withdrawn from the market.</p>\n</blockquote>\n\n<p>The Vioxx controversy was a pretty big deal, and resulted in compensatory payouts and fines. The <a href=\"http://www.nejm.org/doi/full/10.1056/NEJM200011233432103#t=article\" rel=\"noreferrer\">VIGOR study</a> demonstrated a 4-fold increase in heart attack risk on rofecoxib (Vioxx) versus naproxen. This was attributed to the 'cardioprotective' effect of naproxen. This was incorrect, and another trial (<a href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa050493\" rel=\"noreferrer\">APPROVe</a> was stopped early because selective COX-2 inhibitors demonstrated adverse cardiovascular events. There was a <a href=\"https://en.wikipedia.org/wiki/Rofecoxib#Litigation\" rel=\"noreferrer\">raft of litigation</a> relating to the sale of Vioxx, with payouts and fines in the billions of dollars.</p>\n\n<p>If you are interested, the Vioxx controversy created lots of discussion ongoing to this day- from editorials, to book sections, entire books themselves and arguments relating to tort reform. It is clearly beyond the scope of this question! </p>\n\n<p>That said, not all NSAIDs are Vioxx; and as noted above, it is possible to take them (even ibuprofen) relatively safely.</p>\n\n<h2>What are the alternatives to ibuprofen?</h2>\n\n<p>As another answer comments, it depends on what you are taking ibuprofen for. As mentioned above, you may be fine continuing to take ibuprofen, depending on circumstances.</p>\n\n<p>Alternatives include:</p>\n\n<ul>\n<li>naproxen (another NSAID, but with <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019238/\" rel=\"noreferrer\">lesser risk / may be protective</a>)</li>\n<li>paracetamol / acetaminophen (ie Tylenol, as you say)</li>\n<li>NSAID cream / gel, eg for joint pain</li>\n<li>tramadol may help for some kinds of pain, but there are issues with addiction and constipation</li>\n<li>alternatives, such as exercise, acupuncture, meditation etc can all potentially reduce pain</li>\n</ul>\n\n<hr>\n\n<h2>Further Reading</h2>\n\n<ul>\n<li><a href=\"http://www.nhs.uk/Conditions/Anti-inflammatories-non-steroidal/Pages/Introduction.aspx\" rel=\"noreferrer\">NHS page on NSAIDs</a></li>\n<li><a href=\"http://www.nejm.org/doi/full/10.1056/NEJM200011233432103#t=article\" rel=\"noreferrer\">VIGOR</a>, for reference</li>\n<li><a href=\"http://www.nejm.org/doi/full/10.1056/NEJMoa050493\" rel=\"noreferrer\">APPROVe</a>, also for reference</li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3019238/\" rel=\"noreferrer\">Cardiovascular safety of non-steroidal anti-inflammatory drugs: network meta-analysis</a></li>\n<li><a href=\"http://www.health.harvard.edu/heart-health/heart-safer-nsaid-alternatives\" rel=\"noreferrer\">Heart-safer NSAID alternatives</a></li>\n</ul>\n", "score": 6 }, { "answer_id": 11776, "body": "<p>I understand that you are bothered and anxious over the fact the ibuprofen might have side effects.</p>\n\n<p>Every drug has side effects without exception. But that does not mean everybody will have those side effects. The probability of anybody getting one or more side effects is usually very low. </p>\n\n<p>You should talk to your physician who can help you choose the safest drug for you and help you with information that will allow you to make choices. </p>\n\n<p>If you are considering to take Ibuprofen as an anti-inflammatory drug, you can consider Acetaminophen (Paracetamol) as an Alternative. The safety profile of Acetaminophen is slightly better than Ibuprofen at normal dosages. </p>\n", "score": 3 } ]

[ "medications" ]

[ { "answer_id": 19442, "body": "<p>Flatulence, which is likely associated with abdominal distention and thus some discomfort, can disturb sleep.</p>\n\n<p>Sources:</p>\n\n<ul>\n<li>Functional Abdominal Bloating with Distention (<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388350/\" rel=\"nofollow noreferrer\">ISRN Obstetrics and Gynecology, 2012</a>) </li>\n<li>Tips for a Quiet Tummy, Restful Sleep (<a href=\"https://www.webmd.com/digestive-disorders/indigestion-sleep#1\" rel=\"nofollow noreferrer\">WebMD</a>)</li>\n</ul>\n", "score": 3 } ]

[ "sleep-deprivation", "cause-and-effect", "flatulence-gas-fart", "insomnia", "drowsy" ]

[ { "answer_id": 21027, "body": "<p>Google \"alcohol content of bread\" and you'll see:</p>\n\n<blockquote>\n <p>1.9%<br>\n Alcohol. However, during the baking process, most of the alcohol in the dough evaporates into the atmosphere. This is basically the same thing that happens to much of the water in the dough as well. And it has long been known that bread contains residual alcohol, up to 1.9% of it. Aug 3, 2017 </p>\n \n <p>www.forbes.com › sites › quora › 2017/08/03 › why-isnt-bread-alcoholic<br>\n <a href=\"https://www.forbes.com/sites/quora/2017/08/03/why-isnt-bread-alcoholic/#6d91940d318a\" rel=\"nofollow noreferrer\">Why Isn't Bread Alcoholic? - Forbes</a></p>\n</blockquote>\n\n<p>The next time you feed your child a PB&amp;J sandwich, be aware that the bread will contain up to 2% alcohol.</p>\n\n<p>But also know that one would have to eat a <em>lot</em> of bread to get enough alcohol to have any significant symptoms of drunkenness.</p>\n\n<p>And even then it simply wouldn't happen.\nEating bread before drinking is a traditional way of avoiding drunkenness, or at least reducing the peak level of blood alcohol.\nThe alcohol is absorbed by the bread and rather than directly entering the bloodstream (as it would on an empty stomach), it is released slowly over a period of several hours.</p>\n\n<p>Children have been eating bread for thousands of years without any recorded bad effects from its alcohol content.</p>\n\n<p>But consider other food products.\nVanilla extract for example is required to have at least 35% alcohol, and it can be much higher than that.\nEven so, no one worries about feeding vanilla flavoured desserts to children.</p>\n\n<p>That the concentration within that one ingredient is very high doesn't matter.\nIt's the <em>total</em> amount of alcohol in the final product that counts, and no one is ever going to add so much vanilla extract that it would make a significant contribution.</p>\n\n<p>Similarly with things like marzipan and miso paste.\nIt would be almost impossible for a child to eat sufficiently huge quantities of these products that the total alcohol consumed would be significant.</p>\n", "score": 1 } ]

[ "food-safety", "alcohol", "measurement", "children-kids" ]

[ { "answer_id": 12036, "body": "<p>The older the animal, the greater the amount of vitamin D stored in the liver. While liver is a <em>somewhat</em> good source of vitamin D, it's also <strong>very</strong> high in vitamin A. A person eating liver more often than once or twice a week could possibly overload on vitamin A. Especially in the amount youd need to correct a vitamin D deficiency. Vitamin A is toxic in larger amounts.</p>\n\n<p>Just one serving of 100 grams of beef liver contains 26,000 IU of vitamin A. 100 grams is roughly the size of a woman's palm. The US Institute of Medicine gives an upper limit of 3,000 IU of vitamin A per day. Vitamin D content in beef liver, however, is only 49 IU. The USDA Nutrient Database doesn't even list vitamin D in chicken or lamb liver.</p>\n\n<p>Why not take vitamin D tablets? They're available as D3 (cholecalciferol) and it's converted to calcitriol, the active metabolive used in the body. It's inexpensive and the dose can be better controlled than by eating liver. Your doctor would be best suggesting how much D to take. </p>\n", "score": 2 } ]

[ "nutrition", "healthy-cooking", "vitamin-d", "meat", "livestock" ]

[ { "answer_id": 12154, "body": "<p>No, that's not even a little bit plausible unless something else caused seizures or altered mental status that would deaden the normal airway protection reflexes. As you observed, inhaling water would cause an immediate and violent reaction even in someone who's sound asleep. </p>\n\n<p>For example, intoxicants, unrecognized injury, or hypothermia could explain it. In the story you mentioned, hypothermia would get my vote. Falling asleep with your body partially submerged in cold water could do that, and a soldier exhausted from days without sleep might be a ready victim. </p>\n\n<p><a href=\"http://www.nature.com/gimo/contents/pt1/full/gimo11.html\" rel=\"nofollow noreferrer\">http://www.nature.com/gimo/contents/pt1/full/gimo11.html</a></p>\n", "score": 1 } ]

[ "sleep", "death", "drowning" ]

[ { "answer_id": 12232, "body": "<p>When the rabies virus is spread to a new host, it first attacks muscle cells, which prevents the host's immune system from recognizing the invasion. Next, it binds to neurons at neuromuscular junction. Rabies virus is neurotropic, thus it binds preferentially to neurons, specifically the acetylcholine receptors on neurons. After binding the neuromuscular junction, it uses retrograde transport to travel up the neuron axon. When the virus reaches the neuron cell body, it rapidly spreads to the central nervous system, where it replicates in motor neurons and quickly reaches the brain. Next, it travels to the peripheral and autonomic nervous system and then finally reaches the salivary glands.</p>\n\n<p>So, why does the rabies virus cause hydrophobia? The virus is accumulated in the salivary glands of the host so that it can be transmitted to the next host, often through wounds inflicted by a bite. As the virus spreads through bites, drinking water or swallowing would decrease transmission (by reducing quantities of infected saliva present in the mouth). To prevent this, the rabies virus causes painful spasms in throat and larynx. This causes saliva production in the host to be greatly increased, and also means that drinking, or even thinking about drinking, causes painful spasms in the throat. Since the muscular movements that occur while drinking are involuntary, and the virus has already infected autonomic nervous system and motor neurons, this is what enables it to control the involuntary muscle movements of throat and larynx in the host. This association of swallowing with the excruciating pain, and an inability to swallow, leading to choking, is what leads to fear of water.</p>\n\n<p>Thus the term 'hydrophobia' in this case is somewhat misleading - bathing or a body of water might wouldn't trigger a hydrophobic response (unless ingestion of water was a possibility), as the fear is more specifically fear of choking on liquids due to impaired swallowing. </p>\n", "score": 2 } ]

[ "water", "swallow-swallowing", "rabies", "correlation" ]

[ { "answer_id": 13137, "body": "<p>The part of the ribs that articulates with the thoracic vertebrae (in your spine) is called the proximal end and the part that articulates with the costal-cartilage / sternum (in the centre of your chest) is called the distal end. The 11^th and the 12^th pair of ribs only articulates with the thoracic vertebrae (proximal). They are called as floating ribs.</p>\n\n<blockquote>\n <p>Ribs project from proximal articulating facets with thoracic vertebrae, slant forward, and depending on the rib pair under consideration, articulate at the distal end with either the sternum, hard cartilage or ‘float’ freely (Jurmain <em>et al</em> 2011).</p>\n</blockquote>\n\n<p>[<a href=\"https://thesebonesofmine.wordpress.com/category/rib-cage/\" rel=\"nofollow noreferrer\">Source</a>] </p>\n", "score": 3 } ]

[ "ribs-ribcage", "anatomy" ]

[ { "answer_id": 12207, "body": "<p>Currently no, but there is work in progress that will allow extremely premature babies to be grown in artificial uteri. It has so far worked well for baby goats.</p>\n\n<p><a href=\"https://www.theatlantic.com/health/archive/2017/04/preemies-floating-in-fluid-filled-bags/524181/\" rel=\"nofollow noreferrer\">https://www.theatlantic.com/health/archive/2017/04/preemies-floating-in-fluid-filled-bags/524181/</a></p>\n", "score": 4 }, { "answer_id": 12206, "body": "<p><strong><em>Taking a partly developed foetus out of the mother?</em></strong> This is currently not an available method.<br>\nHowever, there are methods out there for the problems you described:</p>\n\n<h2>Three-parent baby</h2>\n\n<p>One method <a href=\"http://www.bbc.com/news/health-31069173\" rel=\"nofollow noreferrer\">allowed in the UK</a> is called a \"<em>three-parent baby</em>\" and the following <a href=\"https://www.theguardian.com/science/2015/feb/02/three-parent-babies-explained\" rel=\"nofollow noreferrer\">guardian article</a> explains it fairly well:</p>\n\n<blockquote>\n <p>The procedure replaces a small amount of faulty DNA in a mother’s egg with healthy DNA from a second woman, so that the baby would inherit genes from two mothers and one father. The idea is to prevent certain genetic diseases being passed on to children. </p>\n</blockquote>\n\n<p><a href=\"https://i.stack.imgur.com/E09Di.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/E09Dim.png\" alt=\"BBC Graphic Method 1\"></a>\n<a href=\"https://i.stack.imgur.com/zAqeM.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/zAqeMm.jpg\" alt=\"BBC Graphic Method 2\"></a>\n[Image Credit: <a href=\"http://www.bbc.com/news/magazine-28986843\" rel=\"nofollow noreferrer\">BBC Article</a>] <em>Click Images for full resolution!</em></p>\n\n<h2>Gestational Surrogacy</h2>\n\n<blockquote>\n <p>Host (or gestational) surrogacy is when IVF (in-vitro fertilisation) is used, either with the eggs of the intended mother, or with donor eggs. The surrogate therefore does not use her own eggs, and is <strong>genetically unrelated to the baby</strong>. It is physically more complicated and considerably more expensive than straight surrogacy, (although many IPs can have some costs covered by the NHS) and always takes place in a fertility clinic.</p>\n</blockquote>\n\n<p>Further reading: </p>\n\n<ul>\n<li>HFEA UK about <a href=\"http://www.hfea.gov.uk/fertility-treatment-options-surrogacy.html\" rel=\"nofollow noreferrer\">Surrogacy</a></li>\n<li>PubMed Article about <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531011/\" rel=\"nofollow noreferrer\">legal and ethical aspects</a> </li>\n<li>Illinois Department of Health about <a href=\"http://dph.illinois.gov/topics-services/birth-death-other-records/birth-records/surrogacy\" rel=\"nofollow noreferrer\">Surrogacy</a> </li>\n</ul>\n", "score": 2 }, { "answer_id": 18541, "body": "<p>No, first you should go throw an <a href=\"https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716\" rel=\"nofollow noreferrer\">IVF process</a> (egg retrieval process and a fertilization by sperm in a lab). Once the embryos are created, after 3 or 5 days they can be transferred to a gestational carrier who will carry the baby until the birth. This process is called <a href=\"https://www.mysurrogatemom.com/what-is-surrogacy-meaning/\" rel=\"nofollow noreferrer\">gestational surrogacy</a>. In gestational surrogacy, the surrogate is not genetically linked to the baby, as the embryos are created using the intended mother eggs.</p>\n\n<p>There is a second type of surrogacy, it's called <a href=\"https://en.wikipedia.org/wiki/Surrogacy#Traditional_surrogacy\" rel=\"nofollow noreferrer\">traditional surrogacy</a>. In this surrogacy form, the surrogate mother provides her eggs and fertilization is done through a <a href=\"http://americanpregnancy.org/infertility/intrauterine-insemination\" rel=\"nofollow noreferrer\">Intrauterine insemination (IUI) process</a></p>\n", "score": 1 } ]

[ "obstetrics", "fetus", "frozen-freeze", "surrogacy" ]

[ { "answer_id": 14370, "body": "<p>No one can be entirely certain, but most studies point in the direction of &quot;yes&quot;, <a href=\"https://www.medscape.com/viewarticle/460159\" rel=\"noreferrer\">for instance</a></p>\n<blockquote>\n<p>The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.</p>\n</blockquote>\n<p>For a more recent study of the same issue see <a href=\"https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1377417\" rel=\"noreferrer\">Cantrell et al.</a></p>\n<blockquote>\n<p>The Shelf-Life Extension Program (SLEP) checks long-term stability of federal drug stockpiles. Eighty-eight percent of 122 different drugs stored under ideal environmental conditions had their expiration dates extended more than 1 year, with an average extension of 66 months and a maximum extension of 278 months.</p>\n<p>In our data set, 12 of 14 medications retained full potency for at least 336 months, and 8 of these for at least 480 months. Given our inability to confirm ideal storage conditions for our samples, our results support the effectiveness of broadly extending expiration dates for many drugs, the efficacy of which has been demonstrated by SLEP in a more controlled fashion.</p>\n</blockquote>\n<p>One (exceptional) fact to note in the latter paper is that aspirin withstood really poorly the test of time: out of 226mg declared, only 1.5mg remained, but this was after a really long time; all drugs tested by Cantrell et al. had expired &quot;28 to 40 years prior to analysis&quot;. The first article I mentioned has a more optimistic take on recently expired aspirin:</p>\n<blockquote>\n<p>However, Chris Allen, a vice president at the Bayer unit that makes aspirin, said the dating is &quot;pretty conservative&quot;; when Bayer has tested 4-year-old aspirin, it remained 100% effective, he said. So why doesn't Bayer set a 4-year expiration date? Because the company often changes packaging, and it undertakes &quot;continuous improvement programs,&quot; Mr. Allen said. Each change triggers a need for more expiration-date testing, and testing each time for a 4-year life would be impractical. Bayer has never tested aspirin beyond 4 years, Mr. Allen said. But Jens Carstensen has. Dr. Carstensen, professor emeritus at the University of Wisconsin's pharmacy school, who wrote what is considered the main text on drug stability, said, &quot;I did a study of different aspirins, and after 5 years, Bayer was still excellent. Aspirin, if made correctly, is very stable.</p>\n</blockquote>\n", "score": 6 }, { "answer_id": 14375, "body": "<p>echoing what Fizz has stated. The shelf-life of medications depends on several competing factors. However, be advised that <em>nutritional supplements</em> are not approved by the FDA, so the aforementioned study does not apply to that class of pharmaceuticals</p>\n\n<p>FDA approval of Dietary Supplements\n<a href=\"https://www.fda.gov/AboutFDA/Transparency/Basics/ucm194344.htm\" rel=\"nofollow noreferrer\">https://www.fda.gov/AboutFDA/Transparency/Basics/ucm194344.htm</a></p>\n\n<p>Drug expiry\n<a href=\"https://sciencebasedmedicine.org/the-drug-expiry-date-a-necessary-safety-measure-or-yet-another-big-pharma-conspiracy/\" rel=\"nofollow noreferrer\">https://sciencebasedmedicine.org/the-drug-expiry-date-a-necessary-safety-measure-or-yet-another-big-pharma-conspiracy/</a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3429690/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3429690/</a></p>\n", "score": 1 } ]

[ "medications", "expiration-dates" ]

[ { "answer_id": 16778, "body": "<p>I think its time to update this question: now there are available a couple of options that do not require the calibrations of the CGM through the fingerstick. <br></p>\n\n<ul>\n<li>The <a href=\"https://www.dexcom.com/news/fda-authorizes-dexcom-g6\" rel=\"nofollow noreferrer\">Dexcom G6</a>, which it could be seen as the first \"real\" CGM \nthat does not require calibrations. Dexcom states: \n\n<blockquote>\n <p>As a factory-calibrated, real-time CGM system with exceptional\n accuracy, the Dexcom G6® will be transformative for people with\n diabetes, who will no longer be required to prick their fingers for\n diabetes management</p>\n</blockquote></li>\n<li>The <a href=\"https://www.fda.gov/newsevents/newsroom/pressannouncements/ucm577890.htm\" rel=\"nofollow noreferrer\">Freestyle Libre</a>, which since late 2017 has been officially approved by FDA.</li>\n</ul>\n", "score": 2 }, { "answer_id": 12537, "body": "<p>I am aware of only three available CGMs in the US today: The Dexcom G4, the Dexcom G5, and the Medtronic Enlite. There used to be one more, the Abbott Navigator, but it was withdrawn from the US market about 4 years ago.</p>\n\n<p>The Medtronic Enlite had a very rough start, with many complaints and worries about accuracy, but seems to have stabilized. The Dexcom G4 and G5 are strong and mature systems.</p>\n\n<p>The Enlite requires 3-4 calibrations per day. It can be a bit picky about how to redo a missed calibration. There are no communities of users that I know of where you can find great calibration recipes for the Enlite.</p>\n\n<p>The Dexcom G4 and G5 require 2-3 calibrations per day. Users have come up with fairly sophisticated routines to optimize them and ensure that the actual reading is close to reality -- a good forum to discuss that may be <a href=\"https://forum.FUDiabetes.org\" rel=\"nofollow noreferrer\">https://forum.FUDiabetes.org</a> . I can provide no proof for that, but I consider that almost all the calibration recipes you get there for the G4 and G5 would work for the Enlite as well - very little is specific to the Dexcom CGMs.</p>\n\n<p>The Freestyle Libre Pro is not a consumer CGM. Its function is really different: your doctor gives you the sensor, you wear it for 2 weeks without knowing what it measures, then your doctor downloads the results. It is a diagnostic tool, not a diabetes management tool.</p>\n\n<p>However, there is another Freestyle available that you may be aware of, the Freestyle Libre. The Freestyle Libre is actually a pretty cool idea, although not quite a consumer CGM either. Essentially, it is a sensor without a transmitter -- and, like the Freestyle Libre Pro, it dos not need calibration either! You need to manually pass a reader over it to read the result. So you can get a result anytime you want, but you do not get a track that you can view like you do with a Dexcom. The difference may seem small but is actually a giant one when trying to manage blood glucose. Nonetheless, the Freestyle Libre, with its much lower cost, is a great tool that fulfills a different need. </p>\n\n<p>Unfortunately, the Freestyle Libre is not available in the US yet.</p>\n\n<p>So, in the end -- there is no CGM that I know of which is present in the US but does not require calibration. If I had to pick:</p>\n\n<ul>\n<li>if I had good insurance I would pick a G5</li>\n<li>if I did not have good insurance I would pick a G4 (it is possible to pay a lot less for transmitters per year with the G4 -- but that is another story).</li>\n</ul>\n\n<p>Good luck!</p>\n", "score": 1 } ]

[ "blood-tests", "diabetes", "medical-device", "glucose" ]

[ { "answer_id": 12329, "body": "<p>Part of why some people get out of breath faster is due to an inefficiency in the lungs and in the muscles. Muscles use oxygen when they move, the more they move the more oxygen they use. However, muscles are able to adapt and become more efficient in someone who is consistently active. Also, the lungs are powered by intercostal muscles, which are a bunch of small muscles, and the diaphragm. Someone who is fit usually takes deep breaths to account for the increase in Oxygen needed for physical activity, and do this consistently with their exercise routine. Their diaphragm and other lung muscles get stronger with the regular deep breaths taken, making their lungs work more efficiently as well.<a href=\"http://www.active.com/articles/breathing-101-increase-your-efficiency-for-better-oxygen-uptake\" rel=\"nofollow noreferrer\">http://www.active.com/articles/breathing-101-increase-your-efficiency-for-better-oxygen-uptake</a></p>\n", "score": 2 } ]

[ "exercise", "weight" ]

[ { "answer_id": 12535, "body": "<h2>Findings</h2>\n<p>There is a strong link between the consumption of sugar-sweetened beverages (SSB), obesity, and Type 2 diabetes, recognized by multiple studies, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592517/\" rel=\"nofollow noreferrer\">for example this survey (1)</a>.</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144736/\" rel=\"nofollow noreferrer\">This article (2)</a> compares the consumption of SSBs with that of artificially sweetened beverages, and finds SSBs significantly worse. The study, however, is only a 10-week study.</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670679/\" rel=\"nofollow noreferrer\">This article (3)</a> shows that one dose of sucralose does not cause insulin production.</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/3714671\" rel=\"nofollow noreferrer\">This article (4)</a> tends to show that ongoing use of artificial sweeteners does not control weight, but it is not conclusive evidence that it causes an increase in weight (self-selection issue).</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660468/\" rel=\"nofollow noreferrer\">This article (5)</a>, however, discusses a cohort where higher consumption of diet soda is associated with a significant increase of the risk of metabolic syndrome and the development of T2 diabetes. It is not, however, a smoking gun, because it does not prove causality but association (there could be self-selection: people at risk for metabolic syndrome may tend to drink more diet soda).</p>\n<h2>Conclusion</h2>\n<p>I would say that there is weak evidence of an association between the consumption of artificial sweeteners and diabetes risk. There is also some evidence that using artificial sweeteners is better than SSBs. On the whole, it seems to me that evidence is mixed at this stage.</p>\n<p>For myself, I will continue -- carefully -- to use artificial sweeteners (sucralose in my case), but I will keep an eye on additional evidence when it comes up.</p>\n<hr />\n<h2>References</h2>\n<p>1: Malik, Vasanti S., and Frank B. Hu. &quot;<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592517/\" rel=\"nofollow noreferrer\">Fructose and cardiometabolic health: what the evidence from sugar-sweetened beverages tells us</a>.&quot; Journal of the American College of Cardiology 66.14 (2015): 1615-1624.</p>\n<p>2: Raben, Anne, et al. &quot;<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3144736/\" rel=\"nofollow noreferrer\">Increased postprandial glycaemia, insulinemia, and lipidemia after 10 weeks’ sucrose-rich diet compared to an artificially sweetened diet: a randomised controlled trial</a>.&quot; Food &amp; nutrition research 55.1 (2011): 5961.</p>\n<p>3: Ma, Jing, et al. &quot;<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670679/\" rel=\"nofollow noreferrer\">Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects</a>.&quot; American Journal of Physiology-Gastrointestinal and Liver Physiology 296.4 (2009): G735-G739.</p>\n<p>4: Stellman, Steven D., and Lawrence Garfinkel. &quot;<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/3714671\" rel=\"nofollow noreferrer\">Artificial sweetener use and one-year weight change among women</a>.&quot; Preventive medicine 15.2 (1986): 195-202.</p>\n<p>5: Nettleton, Jennifer A., et al. &quot;<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2660468/\" rel=\"nofollow noreferrer\">Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)</a>.&quot; Diabetes care 32.4 (2009): 688-694.</p>\n", "score": 6 } ]

[ "digestion", "diabetes", "sweeteners", "artificial-flavor" ]

[ { "answer_id": 12695, "body": "<p>We have all heard the saying that \"Laughter is the best medicine\" and some people in the medical community have been sceptical of the healing power of laughter, but that's changing. In fact, doctors have begun to support laughter therapy to complement traditional treatments for injuries and diseases like cancer. From research, it does seem like laughter <strong>is</strong> the best medicine (in compliment to other traditional medicine).</p>\n\n<p>Psychologists studying the science of happiness believe that practising certain positive behaviours like laughter can bring the pleasure, engagement and meaning that comprise happiness (<a href=\"http://www.latimes.com/la-he-happy8-2008sep08-story.html\" rel=\"nofollow noreferrer\">Jameson, 2008</a>)</p>\n\n<p>Some serving in the military are being trained to use genuine and forced laughter as stress relievers to help prevent and treat conditions like post-traumatic stress disorder (PTSD) that can result from harrowing experiences like combat duty (<a href=\"http://www.npr.org/templates/story/story.php?storyId=5165226\" rel=\"nofollow noreferrer\">Burbank, 2006</a>)</p>\n\n<p><a href=\"https://www.helpguide.org/articles/mental-health/laughter-is-the-best-medicine.htm\" rel=\"nofollow noreferrer\">According to helpguide.org</a>,</p>\n\n<blockquote>\n <p><strong>Laughter relaxes the whole body</strong>. A good, hearty laugh relieves physical tension and stress, leaving your muscles relaxed for up to 45 minutes after.</p>\n \n <p><strong>Laughter boosts the immune system</strong>. Laughter decreases stress hormones and increases immune cells and infection-fighting antibodies, thus improving your resistance to disease. (<a href=\"https://health.stackexchange.com/a/4526\">See also @JohnP's answer</a> in the Health Stack Exchange question <a href=\"https://health.stackexchange.com/questions/4477\">Does laughing improve immune system?</a>)</p>\n \n <p><strong>Laughter triggers the release of endorphins, the body’s natural feel-good chemicals</strong>. Endorphins promote an overall sense of well-being and can even temporarily relieve pain.</p>\n \n <p><strong>Laughter protects the heart</strong>. Laughter improves the function of blood vessels and increases blood flow, which can help protect you against a heart attack and other cardiovascular problems.</p>\n \n <p><strong>Laughter burns calories</strong>. OK, so it’s no replacement for going to the gym, but one study found that laughing for 10 to 15 minutes a day can burn about 40 calories—which could be enough to lose three or four pounds over the course of a year.</p>\n \n <p><strong>Laughter lightens anger’s heavy load</strong>. Nothing diffuses anger and conflict faster than a shared laugh. Looking at the funny side can put problems into perspective and enable you to move on from confrontations without holding onto bitterness or resentment.</p>\n \n <p><strong>Laughter may even help you to live longer</strong>. A study in Norway found that people with a strong sense of humor outlived those who don't laugh as much. The difference was particularly notable for those battling cancer.</p>\n</blockquote>\n\n<p>Paediatric hospitals also use therapeutic forms of entertainment like clown therapy to help children tolerate the pain, nausea and anxiety associated with chemotherapy and radiation treatment. The 1998 movie \"Patch Adams\" was based on the real-life story of a doctor who used humour to treat patients while he was still in medical school. Patch Adams and his colleagues at the Gesundheit Institute in Virginia use a combination of clowning, singing and dancing to treat patients through entertainment in conjunction with traditional medicine (<a href=\"http://www.patchadams.org/patch-adams/\" rel=\"nofollow noreferrer\">Gesundheit Institute</a>).</p>\n\n<p>Other internet sites including <a href=\"http://science.howstuffworks.com/life/inside-the-mind/emotions/laughter-cure-illness.htm\" rel=\"nofollow noreferrer\">How Stuff Works — Science</a> states</p>\n\n<blockquote>\n <p>Laughter sets off a chain reaction throughout the body that promotes physical and psychological health. Regular and frequent guffawing can both prevent illness and help you get well. Laughter lowers your body's hormone and cortisol levels. (Cortisol is a stress-induced chemical that can lead to heart disease, high blood pressure and excess belly fat.) Laughter also strengthens your immune system because it increases the production of antibodies in your saliva and in your bloodstream to stave off bacteria, viruses and parasites.</p>\n</blockquote>\n\n<p>Laughter also helps with skin conditions. People suffering from eczema noted improvement in their complexions after consistently watching funny movies. When allergy patients laugh regularly, it reportedly shrinks their welts (<a href=\"http://www.jpsychores.com/article/S0022-3999(08)00290-0/fulltext\" rel=\"nofollow noreferrer\">Kimata, 2009</a>).</p>\n\n<p>Some cancer treatment centres incorporate laughter therapy sessions into a patient's treatment plan to increase the positive thinking and happy feelings that support the healing process (<a href=\"http://www.cancercenter.com/treatments/laughter-therapy/\" rel=\"nofollow noreferrer\">CTCA, n.d.</a>)</p>\n\n<p>As for laughter curing diabetes, I don't know about curing diabetes, but as How Stuff Works — Science states that laughter reduces cortisol levels which can lead to excess belly fat <a href=\"http://www.health.com/health/condition-article/0,,20188164,00.html\" rel=\"nofollow noreferrer\">getting rid of belly fat may lower Type 2 diabetes risk</a>. So diabetes might not be able to be cured by laughter, but laughter <strong>can prevent</strong> Type 2 Diabetes.</p>\n\n<h2>References</h2>\n\n<p>Burbank, L. 2006. <em>The Growing Popularity of Laughter Therapy</em> NPR [Online]<br>\n(Transcript) <a href=\"http://www.npr.org/templates/story/story.php?storyId=5165226\" rel=\"nofollow noreferrer\">http://www.npr.org/templates/story/story.php?storyId=5165226</a><br>\n(MP3 Audio) <a href=\"https://ondemand.npr.org/anon.npr-mp3/npr/day/2006/01/20060120_day_11.mp3\" rel=\"nofollow noreferrer\">https://ondemand.npr.org/anon.npr-mp3/npr/day/2006/01/20060120_day_11.mp3</a></p>\n\n<p>CTCA, n.d. <em>Laughter therapy</em> Cancer Treatment Centers of America [Online]<br><a href=\"http://www.cancercenter.com/treatments/laughter-therapy\" rel=\"nofollow noreferrer\">http://www.cancercenter.com/treatments/laughter-therapy</a></p>\n\n<p>Jameson, M. 2008. <em>C'mon, get happy</em> Los Angeles Times [Online]<br>\n<a href=\"http://www.latimes.com/la-he-happy8-2008sep08-story.html\" rel=\"nofollow noreferrer\">http://www.latimes.com/la-he-happy8-2008sep08-story.html</a></p>\n\n<p>Kimata, H. 2009. <em>Viewing a humorous film decreases IgE production by seminal B cells from patients with atopic eczema</em> Journal of Psychosomatic Research 26(2): pp 173–175<br>\nDOI: <a href=\"https://doi.org/10.1016/j.jpsychores.2008.06.006\" rel=\"nofollow noreferrer\">10.1016/j.jpsychores.2008.06.006</a> PMID: <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/19154860\" rel=\"nofollow noreferrer\">19154860</a></p>\n", "score": 5 }, { "answer_id": 12701, "body": "<p>It's certainly beneficial and it has positive effects on our health. I see a lot of references on the answer above. But that's all to it. Otherwise we would be tickling patients day and night.</p>\n\n<p>There's absolutely no scientific evidence of laughter curing any diseases.</p>\n\n<p><strong>References:</strong></p>\n\n<ul>\n<li>Nothing came up on google, google scholar, pubmed, scopus, researchgate, mendeley. </li>\n<li><p>5 years of studying medicine so far and laughter cure hasn't come up </p></li>\n<li><p>I also asked other doctors for their opinions on the matter and they laughed at me. Oh the irony.</p></li>\n</ul>\n\n<p><strong>Conclusion:</strong> Laughter doesn't cure diseases.</p>\n\n<p>I propose a study to be done, where patients suffering from diabetes or other diseases get only to watch funny movies and take no medications. We'll get a definitive answer then.</p>\n", "score": 0 } ]

[ "lifestyle", "benefits", "endorphins", "laugh-laughter-laughing" ]

[ { "answer_id": 12609, "body": "<p>The problem with treating &quot;the common cold&quot; is that it's really a large collection of similar illnesses caused by completely different strains of virus. The effects are similar, but the causes are different. Any treatment for one type would likely be ineffective against many of the others.</p>\n<p>Here are some stats from <a href=\"http://www.businessinsider.com/cure-for-common-cold-vaccine-2016-10\" rel=\"noreferrer\">a Business Insider article</a>:</p>\n<ul>\n<li>A &quot;cold&quot; can be caused by over 200 different viruses.</li>\n<li>20-30 types of <a href=\"https://en.wikipedia.org/wiki/Rhinovirus\" rel=\"noreferrer\"><em>rhinovirus</em></a> - the most common class of culprit - can be in a given area in a certain period.</li>\n<li>It's likely that a different set of viruses will be in that area the next year, meaning people would need to be vaccinated annually, at the least.</li>\n<li>It's impossible to predict what strains will pop up next.</li>\n</ul>\n<p>To have a completely effective vaccine, you'd need to have as many strains as possible in either a single vaccine or a series of them, and that's simply not easy. It could be impossible.</p>\n<p>That said, there are ongoing efforts, as always. A couple different paths have been taken; I've given an example for each.</p>\n<h2>The brute force approach</h2>\n<p>One technique is to simply stuff as many strains into a vaccine as possible. An attempt I've seen mentioned quite a lot is <a href=\"http://www.nature.com/articles/ncomms12838\" rel=\"noreferrer\"><strong>Lee et al. (2016)</strong></a>. They tested a vaccine on macaques (monkeys, not too different from humans) and found that certain antibodies were produced in response to types of human rhinovirus. They attempted to use 50 strains at once in the vaccine, which is quite impressive, and got good results for 49 out of those 50.</p>\n<h2>The alarm approach¹</h2>\n<p>There have also been other attempts in recent years. <a href=\"https://www.google.com/patents/WO2014122220A1?cl=en\" rel=\"noreferrer\">One group</a> went on a different path, using a specific protein found when viruses invade cells as a vaccination in mice. This has the advantage that it can be used to train the immune system against many different strains; one protein can serve as a vaccine against dozens of types of viruses.</p>\n<h2>The cell sacrifice approach</h2>\n<p>A few years back, a group at MIT (<a href=\"http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0022572\" rel=\"noreferrer\"><strong>Rider et al. (2011)</strong></a>) developed a technique called Double-stranded RNA [dsRNA] Activated Caspase\nOligomerizer (DRACO). DRACO essentially gets infected cells to shut themselves down - killing themselves - to stop the infection from spreading. After all, viruses need cells to reproduce. So far, DRACO has worked in mice, defeating over a dozen types of viruses.</p>\n<hr />\n<p>All of these approaches need testing! Human subjects have not yet been used; the closest any have gotten have been macaques, as well as isolated human cells. Additionally, no treatment has been tested against more than a fraction of rhinoviruses and other strains. There's absolutely no guarantee that any of this will work, but it's certainly steps in the right direction.</p>\n<hr />\n<p>¹ I've taken this from the &quot;home invasion alarm&quot; analogy used in <a href=\"https://www.statnews.com/2016/10/20/common-cold-vaccine/\" rel=\"noreferrer\">this explanatory article</a>.</p>\n", "score": 6 } ]

[ "common-cold", "vaccination" ]

[ { "answer_id": 12705, "body": "<p>Because when tobacco is smoked, nicotine causes <strong>physical</strong> and <strong>psychological dependency</strong>. You see, it acts on <strong>brain reward mechanisms</strong>, both indirectly (through endogenous opioid activity) and directly (through dopamine pathways). It actually extends the duration of positive effects of dopamine and increases the sensitivity of the brain's reward system to rewarding stimuli. <strong>It makes you to want more of it</strong>.</p>\n\n<p>It is suggested that it is even <strong>more addictive than cocaine!</strong></p>\n\n<p>In addition, nicotine is unusual in comparison to most drugs, as its profile changes from stimulant to sedative with increasing dosages. That explains why people smoke even more when they are under stress.</p>\n\n<p>I will not comment on why people start smoking in the first place. The reasons are numerous. Peer pressure is one of them.</p>\n\n<p><strong>References:</strong></p>\n\n<ol>\n<li>Easton, John (March 28, 2002). \"Nicotine extends duration of pleasant effects of dopamine\". The University of Chicago Chronicle. 21 (12).</li>\n<li>Kenny PJ, Markou A (Jun 2006). \"Nicotine self-administration acutely activates brain reward systems and induces a long-lasting increase in reward sensitivity\". Neuropsychopharmacology. 31 (6): 1203–11. </li>\n<li><p>Nesbitt P (1969). Smoking, physiological arousal, and emotional response. Unpublished doctoral dissertation, Columbia University.</p></li>\n<li><p>Parrott AC (January 1998). \"Nesbitt's Paradox resolved? Stress and arousal modulation during cigarette smoking\". Addiction. 93 (1): 27–39.</p></li>\n<li><p><a href=\"http://emedicine.medscape.com/article/287555-overview#a3\" rel=\"noreferrer\">http://emedicine.medscape.com/article/287555-overview#a3</a></p></li>\n<li><p><a href=\"https://en.wikipedia.org/wiki/Nicotine\" rel=\"noreferrer\">https://en.wikipedia.org/wiki/Nicotine</a></p></li>\n</ol>\n", "score": 5 } ]

[ "smoking" ]

[ { "answer_id": 15373, "body": "<p>A bit speculative as this seems to be, given current attitudes in most societies towards nudity, this would be a somewhat promising scenario.</p>\n<p>All human infesting lice species are parasites that depend not only on skin contact for nutrition but on certain types of fibres to dwell, to hide, to travel and to procreate. Eradicating this natural habitat on a large scale is very likely too destructive and radical for the lice to adapt quickly enough to such a new situation.</p>\n<p>But there is also a problem:</p>\n<blockquote>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687769/\" rel=\"nofollow noreferrer\"><strong>Apes, lice and prehistory</strong> (2009)</a><br />\nHead and body lice used to be designated Pediculus capitis and P. corporis but they are now known to belong to the same species, P. humanus x. Fifty years ago Levene and Dobzhansky showed that head lice could be trained or adapted to become the rather larger body lice by attaching them to the body in small pill boxes.\nMore extensive phylogenetic analyses [16,17] indicate that body lice evolved from head lice several times within the worldwide clade A, as they are found in many branches of the cladisitic tree. Multiple derivations of body lice from head lice had already been considered by Zinsser <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687769/\" rel=\"nofollow noreferrer\">1</a>, and it makes good sense if one considers that clothing was not a single invention. Wearing animal pelts fur-side next to the skin would have provided a suitable place for lice to breed before fabrics were developed with the inventions of spinning and weaving.</p>\n<p>In 17th and 18th century Europe, most of the aristocracy and gentry shaved their hair and wore wigs. Had this custom arisen to protect them from lice as Zinsser suggests? Not according to Samuel Pepys' diary, as he complained more than once about his wig being infested: &quot;Thence to my barbers, to have my periwig cleared of its nits.&quot; I wonder if they were head or body lice – is a wig hair or clothing?</p>\n<p><strong>Lice and nudity</strong>\nWhy naked apes are naked and when we 'lost' our hair has long been disputed, as discussed by Desmond Morris in The Naked Ape. Rantala suggested that nakedness could have had a selective advantage to rid the body of lice and other ectoparasites, a view also championed by Pagel and Bodmer, who added that being seen to be free of lice would be a fitness indicator and a good mating strategy.</p>\n</blockquote>\n<p>These little parasites are highly adaptable and while not that robust in general, the amount of fibre, fabric or hair they need to breed is really minimal.</p>\n<blockquote>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC558503/\" rel=\"nofollow noreferrer\"><strong>Shaving can be safer head lice treatment than insecticides</strong></a> (2005)<br />\nSladden and Johnson reviewed common skin infections in children.1 The life cycle of head lice (Pediculosis capitis) was well described and is similar to that of pubic lice. I worked in chronic emergencies in Somalia in 1993 and Sudan 1996-7 among internally displaced populations and in the nomadic Karimajong of Uganda in 1998-9, whose poor hygiene would have been a good breeding ground for head lice. However, head lice were never a clinical problem because these populations know how to interrupt its lifecycle: they shave off their hair, the only place where the eggs (nits) are anchored and glued close to the skin. Lice outside the hair are not transmissible and do not cause infestation.</p>\n</blockquote>\n<p>It is therefore likely that we might be able to not only reduce the lice problem, but to eradicate them completely. But only by going naked and <em>really</em>\nhairless.</p>\n<blockquote>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24825336?dopt=Abstract\" rel=\"nofollow noreferrer\"><strong>Pubic lice: an endangered species?</strong></a> (2014)<br />\nThe incidence of pubic lice infestations is estimated to be between 1.3% and 4.6%, with an average incidence of 2% worldwide. It is also estimated that 70% to 80% of adults now remove pubic hair in part or entirety, using a variety of methods. It is hypothesized that the destruction of this pubic hair habitat may account for the falling incidence of pubic lice and may possibly lead to its eradication or atypical presentation.<br />\n<strong>Aim:</strong> To report the changing incidence of pubic lice infestation from our unit over the last 10 years and assess its association, if any, with pubic hair removal of any kind.<br />\n<strong>Methods:</strong> Assessment of medical records and questionnaires were used to identify the incidence of hair removal and pubic lice infestation over a 10-year period. Data were anonymized and analyzed to identify any correlation.<br />\n<strong>Results:</strong> A significant and strong correlation between the falling incidence of pubic lice infections and increase in pubic hair removal was observed, with a Pearson correlation r value of 0.9686 (95% confidence intervals, 0.88-0.992). The P value is less than 0.0001.<br />\n<strong>Conclusions:</strong> The increased incidence of hair removal may lead to atypical patterns of pubic lice infestations or its complete eradication as the natural habitat of this parasite is destroyed.</p>\n</blockquote>\n<p>That seems to be the future. Well, a possible one. Prudes then need to find something else to get their pulses up.</p>\n", "score": 2 } ]

[ "parasites", "physical-health" ]

[ { "answer_id": 12826, "body": "<p>I assume by \"(added) sugar intake from solid foods\" you mean something like, \"Is higher-than-average sugar consumption from foods (separate from beverages) associated with increased risk of Type II diabetes?\" <em>- If that is not correct, please let me know.</em> </p>\n\n<h2>CONTEXT</h2>\n\n<p>Before listing citations to some relevant studies, some brief background information will provide important context for you and others reading this thread.</p>\n\n<p>As you know, the body breaks down carbohydrates (sugars, starches, fiber) into glucose. Consequently, health professionals encourage diabetic patients to not only monitor total carbohydrate intake, but also the <em>types</em> of carbohydrates consumed as well. </p>\n\n<p>One of the most common ways to gauge the impact of a carbohydrate on glucose levels is the <em>glycemic index</em> (GI), and its companion <em>glycemic load</em> (GL).</p>\n\n<p>I mention this fact because while sweet foods, e.g., candy bars, cake, ice cream, etc., tend to have a high glycemic index (GI) and glycemic load (GL), this is not always the case (e.g., watermelon is sweet, but has a low GL), and non-sweet foods high in starch can carry a high glycemic load. </p>\n\n<p><strong>MORE INFORMATION</strong></p>\n\n<p><a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/glycemic-index-diet/art-20048478\" rel=\"noreferrer\">Glycemic index diet: What's behind the claims</a> on the Mayo Clinic website.</p>\n\n<p>Atkinson, F. S., Foster-Powell, K., &amp; Brand-Miller, J. C. (2008). International tables of glycemic index and glycemic load values: 2008. <em>Diabetes Care, 31</em>(12), 2281–2283. <a href=\"https://doi.org/10.2337/dc08-1239\" rel=\"noreferrer\">https://doi.org/10.2337/dc08-1239</a></p>\n\n<p>The University of Sydney (Australia) - <a href=\"http://www.glycemicindex.com/index.php\" rel=\"noreferrer\">http://www.GlycemicIndex.com</a> - \n\"The Glycemic Index (GI) is a relative ranking of carbohydrate in foods according to how they affect blood glucose levels. Carbohydrates with a low GI value (55 or less) are more slowly digested, absorbed and metabolised and cause a lower and slower rise in blood glucose and, therefore insulin levels.\"</p>\n\n<p>You can look up many foods' GI and GL on the University of Sydney's <a href=\"http://www.glycemicindex.com/foodSearch.php\" rel=\"noreferrer\">glycemic index search engine</a>.</p>\n\n<h2>RESEARCH ARTICLES</h2>\n\n<p>Here are some articles published in peer-reviewed medical journals that directly address your question (the first two citations), or a related aspect of your inquiry:</p>\n\n<hr>\n\n<p>CITATION: AlEssa, H. B., Bhupathiraju, S. N., Malik, V. S., Wedick, N. M., Campos, H., Rosner, B., … Hu, F. B. (2015). Carbohydrate quality and quantity and risk of type 2 diabetes in US women. <em>American Journal of Clinical Nutrition, 102</em>(6), 1543–1553. <a href=\"https://doi.org/10.3945/ajcn.115.116558\" rel=\"noreferrer\">https://doi.org/10.3945/ajcn.115.116558</a></p>\n\n<p>QUOTE: \"Diets with high starch, low fiber, and a high starch-to-cereal fiber ratio were associated with a higher risk of T2D.\"</p>\n\n<hr>\n\n<p>CITATION: Tsilas, C. S., de Souza, R. J., Mejia, S. B., Mirrahimi, A., Cozma, A. I., Jayalath, V. H., … Sievenpiper, J. L. (2017). Relation of total sugars, fructose and sucrose with incident type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. <em>Canadian Medical Association Journal, 189</em>(20), E711–E720. <a href=\"https://doi.org/10.1503/cmaj.160706\" rel=\"noreferrer\">https://doi.org/10.1503/cmaj.160706</a></p>\n\n<ul>\n<li>ABSTRACT</li>\n</ul>\n\n<p>BACKGROUND: Sugar-sweetened beverages are associated with type 2 diabetes. To assess whether this association holds for the fructose-containing sugars they contain, we conducted a systematic review and meta-analysis of prospective cohort studies.</p>\n\n<p>METHODS: We searched MEDLINE, Embase, CINAHL and the Cochrane Library (through June 2016). We included prospective cohort studies that assessed the relation of fructose-containing sugars with incident type 2 diabetes. Two independent reviewers extracted relevant data and assessed risk of bias. We pooled risk ratios (RRs) using random effects meta-analyses. The overall quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.</p>\n\n<p>RESULTS: Fifteen prospective cohort studies (251 261 unique participants, 16 416 cases) met the eligibility criteria, comparing the highest intake (median 137, 35.2 and 78 g/d) with the lowest intake (median 65, 9.7 and 25.8 g/d) of total sugars, fructose and sucrose, respectively. Although there was no association of total sugars (RR 0.91, 95% confidence interval [CI] 0.76-1.09) or fructose (RR 1.04, 95% CI 0.84-1.29) with type 2 diabetes, sucrose was associated with a decreased risk of type 2 diabetes (RR 0.89, 95% CI 0.80-0.98). Our confidence in the estimates was limited by evidence of serious inconsistency between studies for total sugars and fructose, and serious imprecision in the pooled estimates for all 3 sugar categories.</p>\n\n<p>INTERPRETATION: Current evidence does not allow us to conclude that fructose-containing sugars independent of food form are associated with increased risk of type 2 diabetes. Further research is likely to affect our estimates.</p>\n\n<hr>\n\n<p>CITATION: Reeds, J., Mansuri, S., Mamakeesick, M., Harris, S. B., Zinman, B., Gittelsohn, J., … Hanley, A. (2016). Dietary patterns and type 2 diabetes mellitus in a First Nations community. <em>Canadian Journal of Diabetes, 40</em>(4), 304–310. <a href=\"https://doi.org/10.1016/j.jcjd.2016.05.001\" rel=\"noreferrer\">https://doi.org/10.1016/j.jcjd.2016.05.001</a></p>\n\n<p>QUOTE: \"At follow up, 86 participants had developed incident type 2 diabetes. FA [factor analysis] revealed 3 prominent dietary patterns: Balanced Market Foods, Beef and Processed Foods and Traditional Foods. After adjustment for age, sex, waist circumference, interleukin-6 and adiponectin, the Beef and Processed Foods pattern was associated with increased risk for incident type 2 diabetes (OR=1.38; 95% CI 1.02, 1.86). In contrast, the Balanced Market Foods and Traditional Foods Patterns were not significantly associated with type 2 diabetes.\"</p>\n\n<hr>\n\n<p>CITATION: Malik, V. S., Li, Y., Tobias, D. K., Pan, A., &amp; Hu, F. B. (2016). Dietary protein intake and risk of type 2 diabetes in US men and women. <em>American Journal of Epidemiology, 183</em>(8), 715–728. <a href=\"https://doi.org/10.1093/aje/kwv268\" rel=\"noreferrer\">https://doi.org/10.1093/aje/kwv268</a></p>\n\n<p>QUOTE: \"Substituting 5% of energy intake from vegetable protein for animal protein was associated with a 23% (95% CI: 16, 30) reduced risk of T2D [Type 2 Diabetes]. In conclusion, higher intake of animal protein was associated with an increased risk of T2D, while higher intake of vegetable protein was associated with a modestly reduced risk.\"</p>\n", "score": 5 } ]

[ "nutrition", "sugar", "glucose", "type-2-diabetes", "glycemic-index" ]

[ { "answer_id": 13017, "body": "<p>It is impossible to answer these personal situations. In general, yes it is possible that no lymph nodes were removed during surgery. Whether that might be the case with your father, I simply cannot tell.</p>\n\n<p>Nx means \"cancer in nearby lymph nodes cannot (or has not (yet)) be measured\". Some lymph nodes <em>might</em> have been removed during surgery, but either for some reason they could not be tested, or they were not (yet) tested for traces of cancer. Or no lymph nodes were removed, and therefore the HPE can say nothing about lymph node status.<br>\nSimilarly, Mx means that \"metastatis cannot (or has not (yet)) been measured\".</p>\n\n<p>Again, we do not know your father's exact situation. It might be that the doctors think there is no reason to test for lymph nodes or metastasis (e.g. because the cancer was found in a very early stage), or HPE was simply insufficient and more testing is necessary in a later stage. If you're in doubt about this, please (advice your dad to) ask his doctors about it!</p>\n\n<p>Edit: I forgot to give this <a href=\"https://www.cancer.gov/about-cancer/diagnosis-staging/staging\" rel=\"nofollow noreferrer\">reference</a>.</p>\n", "score": 3 } ]

[ "terminology", "tumors", "cancer", "lymph-nodes" ]

[ { "answer_id": 12915, "body": "<h2>No!</h2>\n\n<p><strong>With brain injuries</strong>, it is <a href=\"https://www.brainline.org/author/jeffrey-bazarian/qa/it-true-you-should-keep-someone-awake-who-has-sustained-tbi\" rel=\"nofollow noreferrer\">not recommended anymore to keep patients awake</a> because</p>\n\n<blockquote>\n <p>people with a concussion need to sleep to recover. In the days before head CT scanning was widely available, the only way to know if someone had life-threatening brain bleeding (which occurs in less than 0.1 percent of those with concussion) was to observe him for a decrease in his level of alertness that resulted from the blood pressing on vital brain structures. This usually happened within six hours of injury. It was thought that if you could keep someone awake you could prevent him from lapsing into coma, which of course did not work.</p>\n</blockquote>\n\n<p><strong>While <a href=\"http://15answers.com/does-keeping-someone-awake-keep-them-from-dying-like-in-movies/\" rel=\"nofollow noreferrer\">some people on the internet</a> claim</strong> that someone awake with a higher blood pressure and a faster pulse will have better survival chances, (actually, this would mean that they bleed more, not less), there is no scientific evidence that this will indeed improve survival chances.</p>\n\n<p><strong>Emergency services</strong> usually check whether the patient is still able to stay awake to assess his situation <a href=\"https://www.cdc.gov/masstrauma/resources/gcs.pdf\" rel=\"nofollow noreferrer\">based on the Glasgow Coma Scale (GCS)</a>. Saying \"Stay with me, buddy\" will then be used to asses the verbal response.</p>\n\n<p><strong>However</strong>, this is only used to assess the current life-threatening dangers (for example in the <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564046/\" rel=\"nofollow noreferrer\">various Triage systems</a>). Keeping someone awake will not benefit their survival chances.</p>\n\n<p>Mostly, trying to keep someone awake only creates very dramatic scenes for movies.</p>\n", "score": 3 } ]

[ "bleeding", "alertness-level", "penetrate-trauma-wound", "unconsciousness", "exsanguination" ]

[ { "answer_id": 12972, "body": "<p>Chemically speaking, carbonated water is j<strong>ust plain water with carbon dioxide dissolved</strong> in it under high pressure. </p>\n\n<ul>\n<li>It hydrates just as well as normal water, because it still contains plain H2O. </li>\n<li>There are no additives.</li>\n<li>It might have a <a href=\"https://books.google.de/books?id=cIhPAwAAQBAJ&amp;pg=PT998&amp;redir_esc=y#v=onepage&amp;q=carbonated%20water&amp;f=false\" rel=\"noreferrer\">slightly larger effect on erosion of teeth than normal water</a> because it is <a href=\"http://www.thuisexperimenteren.nl/science/carbonaatkinetiek/Carbondioxide%20in%20water%20equilibrium.doc\" rel=\"noreferrer\">just a little bit acidic</a>.</li>\n<li>The effect on the gastro-oesophageal reflux disease <a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04232.x/abstract;jsessionid=8AF28D926E52FBD3DD7CEBED1003740E.f04t04\" rel=\"noreferrer\">is little to none</a>.</li>\n</ul>\n\n<hr>\n\n<p><strong>Sources</strong>:</p>\n\n<ol>\n<li>Joan Gandy, <em>Manuel of Dietary Practices</em>, <a href=\"https://books.google.de/books?id=cIhPAwAAQBAJ&amp;pg=PT998&amp;redir_esc=y#v=onepage&amp;q=carbonated%20water&amp;f=false\" rel=\"noreferrer\">Chapter on Dental Erosion</a></li>\n<li>T. Johnson et al., <em>Systematic review: the effects of carbonated beverages on gastro-oesophageal reflux disease</em>, <a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2010.04232.x/abstract;jsessionid=8AF28D926E52FBD3DD7CEBED1003740E.f04t04\" rel=\"noreferrer\">Wiley Online Library</a></li>\n</ol>\n\n<hr>\n\n<p><strong>Further Reading:</strong></p>\n\n<ol>\n<li><a href=\"http://www.livestrong.com/article/156879-health-effects-of-carbonated-water/\" rel=\"noreferrer\">Livestrong</a> </li>\n<li><a href=\"http://www.healthline.com/health/food-nutrition/is-carbonated-water-bad-for-you#1\" rel=\"noreferrer\">Healthline</a></li>\n<li><a href=\"http://www.nydailynews.com/life-style/health/sparkling-water-healthy-regular-water-article-1.1460179\" rel=\"noreferrer\">New York Daily News</a></li>\n</ol>\n", "score": 5 } ]

[ "nutrition", "water", "drinks" ]

[ { "answer_id": 12976, "body": "<p>Your interpretation is basically correct.</p>\n\n<p>The formal definition is:</p>\n\n<p><a href=\"https://prsinfo.clinicaltrials.gov/definitions.html#IntPurpose\" rel=\"nofollow noreferrer\">https://prsinfo.clinicaltrials.gov/definitions.html#IntPurpose</a></p>\n\n<blockquote>\n <p><strong>Primary Purpose</strong> <strong>*§</strong> Definition: The main objective of the\n intervention(s) being evaluated by the clinical trial. Select one.</p>\n \n <ul>\n <li>Treatment: One or more interventions are being evaluated for treating a disease, syndrome, or condition.</li>\n </ul>\n</blockquote>\n\n<p>The other choices are:</p>\n\n<blockquote>\n <ul>\n <li><p>Prevention: One or more interventions are being assessed for preventing the development of a specific disease or health condition.</p></li>\n <li><p>Diagnostic: One or more interventions are being evaluated for identifying a disease or health condition.</p></li>\n <li><p>Supportive Care: One or more interventions are evaluated for maximizing comfort, minimizing side effects, or mitigating against a\n decline in the participant's health or function.</p></li>\n <li><p>Screening: One or more interventions are assessed or examined for identifying a condition, or risk factors for a condition, in people\n who are not yet known to have the condition or risk factor.</p></li>\n <li><p>Health Services Research: One or more interventions for evaluating the delivery, processes, management, organization, or financing of\n healthcare.</p></li>\n <li><p>Basic Science: One or more interventions for examining the basic mechanism of action (for example, physiology or biomechanics of an\n intervention).</p></li>\n <li><p>Device Feasibility: An intervention of a device product is being evaluated in a small clinical trial (generally fewer than 10\n participants) to determine the feasibility of the product; or a\n clinical trial to test a prototype device for feasibility and not\n health outcomes. Such studies are conducted to confirm the design and\n operating specifications of a device before beginning a full clinical\n trial.</p></li>\n <li><p>Other: None of the other options applies.</p></li>\n </ul>\n</blockquote>\n", "score": 4 } ]

[ "research", "clinical-study" ]

[ { "answer_id": 15273, "body": "<p>Some vendors publish the pH values for the products they sell (<a href=\"https://health.stackexchange.com/a/13623/11231\">examples in this answer</a>). But that seems to be only the case if their product really stands out to the competition with high pH levels. Simple carbonated water (de-ionised) can have quite a low pH but other factors come into play for the acidity of the finished item. </p>\n\n<p>This brand's website has a section on this:</p>\n\n<blockquote>\n <p><a href=\"http://www.lacroixwater.com/nutritional-faqs/\" rel=\"noreferrer\"><strong>What is the PH balance of LaCroix waters?</strong></a></p>\n \n <p>_{The pH level of LaCroix varies by flavor and is less acidic than traditional soft drinks, 100% juice and juice drinks, and other typical beverages without the calories! If there are any concerns about your acidity consumption, please consult your physician.}</p>\n \n <p>_{Dr. Matthew Messina, a dentist and spokesperson for the American Dental Association, told MUNCHIES, a website and digital video channel, that “the health risks of sugarless, naturally carbonated waters like La Croix and Perrier are nowhere near those of sugary sodas, despite their textural similarities. There is no scientific evidence that sparkling waters are any more dangerous or damaging to the teeth than regular water.”}</p>\n</blockquote>\n\n<p>Real answer: \"What the hell, we won't tell!\"</p>\n\n<p>Of course, the real pH depends not only on the other salts in the water but on what exactly is used for flavouring it. If it is citric acid for example, and all too often it is, then chances for a drink low in acidity dwindle fast.</p>\n\n<blockquote>\n <p><a href=\"http://www.eatthis.com/la-croix-healthy/\" rel=\"noreferrer\"><strong>This Is Why You Should Stop Drinking LaCroix</strong></a> \n <a href=\"http://www.chicagotribune.com/lifestyles/health/ct-flavored-water-effects-on-teeth20170427-story.html\" rel=\"noreferrer\"><strong>Flavored waters — yes, including La Croix — are eroding your teeth</strong> (2017)</a></p>\n</blockquote>\n\n<p>It is really a pity and disgrace that \"sparkling water\" often refers to acidified flavoured sparkling water. Regarding dental health these are quite different.</p>\n\n<blockquote>\n <p><a href=\"http://www.leesimondds.com/dental-news-and-updates/why-flavored-waters-are-bad-for-your-teeth\" rel=\"noreferrer\">**Why flavored waters are bad for your teeth ** (2017)</a>\n Carbonating that (which is adding carbonic acid) lowers its pH to about 5. (Happily, that is well in the tooth-safe zone, so you can go ahead and drink your plain sparkling water without worry.) The trouble starts when flavors are added, and the citric acid commonly used in bottled flavored waters is considered especially insidious because besides lowering pH it also may remove calcium from the teeth. A 2016 report published in the Journal of the American Dental Association found that un-carbonated flavored waters such as grape, lemon or strawberry Dasani had a pH of 3, only somewhat better than RC Cola and Coca-Cola, which were among the most acidic tested, at 2.32 and 2.37 respectively (and which are close to the pH 2.25 of pure lemon juice). On its website, the brand Hint says the pH of its waters range from 3.5 to 4.</p>\n</blockquote>\n\n<p>Not only single expert opinions support this view. Some studies that support the </p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11556958\" rel=\"noreferrer\"><strong>Investigation of mineral waters and soft drinks in relation to dental erosion.</strong> (2001)</a></p>\n \n <p><a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1365-263X.2006.00784.x/abstract\" rel=\"noreferrer\"><strong>The erosive potential of flavoured sparkling water drinks</strong> (2007)</a>\n <strong>Conclusions:</strong>  Flavoured sparkling waters should be considered as potentially erosive, and preventive advice on their consumption should recognize them as potentially acidic drinks rather than water with flavouring.\n <a href=\"https://i.stack.imgur.com/u4NVL.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/u4NVL.png\" alt=\"Apaptite dissolution capacity\"></a>\n _{Mean hydroxyapatite dissolution and standard deviation, expressed as the theoretical mass of phosphate (μg) present in 1.5 mL of test solution, both after the immediate opening of the test liquid and after 30 min of exposure of the carbonated water to air. Each value is based on the average of 10 replicate samples.}</p>\n</blockquote>\n\n<p>That has to be put into perspective. Even citric acid is not the devil. The pH is not everything. Amount of drink you consume and exposure time to your teeth are much more meaningful and harder to measure but better controllable than this easy to measure but harder to control number that is pH. </p>\n\n<blockquote>\n <p><a href=\"http://jada.ada.org/article/S0002-8177(14)60548-1/fulltext\" rel=\"noreferrer\"><strong>The effects of beverages on plaque acidogenicity after a sugary challenge</strong> (2013)</a></p>\n</blockquote>\n\n<p>Companies adding needlessly such superfluous ingredients like citric or other acids to \"sparkling water\" should be held responsible for diluting the meaning of that term and sued if they continue to sell this with a misleading claim like \"healthy\", since all around these flavoured waters are apparently not tooth friendly. Not drinking them might be one sane option. </p>\n\n<p>Insisting to ingest might warrant the following precautionary measures: </p>\n\n<p>Copied from the Chicago Tribune article:</p>\n\n<blockquote>\n <ul>\n <li>Don't use it as your primary hydration </li>\n <li>Minimize time exposure</li>\n <li>Drink it with a meal or snack</li>\n <li>Don't be a swisher</li>\n </ul>\n</blockquote>\n\n<p>The company does not release pH levels for its products. Given the question's interest in lime, lemon it is quite reasonable to assume a significant amount of citric acid used or the \"flavour\". This will bring down the pH-level to significantly lower than real, unflavoured water. If it does not contain citric acid or similar compounds under the label of so-called \"flavour\" then another indicator is the fact that it does not contain any sodium. The less minerals such a water contains, the more pronounced the resulting pH from the added carbonic acid. Let me be bold and cast an educated guess: the pH level will be well below 4.</p>\n\n<p>For comparison some of these \"water\" drinks were classified as such:</p>\n\n<blockquote>\n <p><a href=\"http://jada.ada.org/article/S0002-8177(15)01050-8/pdf\" rel=\"noreferrer\"><strong>The pH of beverages in the United States</strong> (2015):</a><br>\n This comprehensive pH assessment of commercially available beverages in the United States found that most are potentially erosive to the dentition. </p>\n \n <p>Erosive ___________________________________ pH<br>\n Activ Water Power Strawberry Kiwi _____________ 3.38<br>\n Clear American (flavored water) Kiwi Strawberry __ 3.70<br>\n Skinny Water Acai Grape Blueberry ____________ 3.81<br>\n Sobe Life Water Acai Fruit Punch ______________ 3.22<br>\n Vitamin Water Connect Black Cherry-Lime _______ 2.96</p>\n</blockquote>\n\n<p>As long as the company decides to keep silent about the ingredients and the FDA continues to allow them this practice:</p>\n\n<blockquote>\n <p><a href=\"https://www.wired.com/2016/12/heres-lacroix-addictive/\" rel=\"noreferrer\">What's actually in this stuff? And why is it so incredibly addicting?</a></p>\n \n <p>Part of the problem is that there's actually no way to know for sure what gives this very subtly flavored drink its ambiguous \"essence.\" Look at a LaCroix can and you'll see it has no artificial sweeteners, no calories, no sodium, no nothing. The only two ingredients are carbonated water and natural flavor, which means almost nothing. Carbonated water is water with CO2 in it. Sure, it creates a little carbonic acid in the drink, which some folks have said could harm your teeth, but so long as you're healthy your saliva easily neutralizes those acids. It's the second ingredient—natural flavor—that holds the key to LaCroix's allure.</p>\n \n <p>According to the FDA, natural flavor can be anything that adds flavor to a product so long as it comes directly from a plant or animal source. That's a pretty wide range, but it's further muddled by the fact that natural flavors can be made up of more than one ingredient—including artificial ingredients that help preserve the flavor or help it mix well with the other ingredients. \"You see 'natural flavor' on a label and it's really a black box of secrecy in terms of what's being added to that product,\" says David Andrews, a chemist from the Environmental Working Group.</p>\n \n <p>Just like their artificial counterparts, natural flavors are complex chemical formulas invented by food companies and a small handful of flavor houses around the world. The FDA lets companies call these formulas natural even if they have synthetic solvents or preservatives because it classifies those filler ingredients as \"incidental additives,\" which usually come in trace amounts and get a pass from ingredient disclosure laws.</p>\n \n <p>Before you start panic-counting the gallons of LaCroix you've consumed in the last two days alone, know that National Beverage, the obscure Florida-based company that owns LaCroix, claims that it doesn't add anything artificial to its flavors. Instead, they use \"natural essence oils ... extracted from the named fruit used in each of our LaCroix flavors,\" a company spokeswoman said in an email.</p>\n \n <p><a href=\"http://www.dentistryiq.com/articles/2016/03/the-skinny-on-sparkling-water-does-it-erode-teeth.html\" rel=\"noreferrer\">The skinny on sparkling water: Does it erode teeth?</a><br>\n <a href=\"https://www.mcgill.ca/oss/article/health-and-nutrition-quackery/carbonated-water-bad-your-teeth\" rel=\"noreferrer\">Is Carbonated Water Bad for Your Teeth?</a> (Has some further measurements on pH levels.) </p>\n</blockquote>\n", "score": 5 }, { "answer_id": 20725, "body": "<p>This research article is maybe useful:</p>\n\n<p><strong>The pH of beverages available to the American consumer</strong>\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808596/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808596/</a></p>\n\n<p>Perrier is a 5.5 pH, albeit unflavored, and the article points out that anything over a 4.0 isn't bad for teeth. LaCroix didn't exist when it was written, so we dig farther. </p>\n\n<p><strong>Temperature</strong></p>\n\n<p>This one's also interesting, as it shows pH is much higher/less acidic... when carbonated beverages are warm:\n<a href=\"https://www.mcgill.ca/oss/article/health-and-nutrition-quackery/carbonated-water-bad-your-teeth\" rel=\"nofollow noreferrer\">https://www.mcgill.ca/oss/article/health-and-nutrition-quackery/carbonated-water-bad-your-teeth</a></p>\n\n<p><strong>Data</strong></p>\n\n<p>Here's someone directly testing LaCroix and getting a ~6 pH, which seems impossible... unless they add buffering agents to raise the pH, which is also possible.</p>\n\n<p><a href=\"https://www.reddit.com/r/lacroix/comments/be273e/i_ph_tested_my_lacroix/\" rel=\"nofollow noreferrer\">https://www.reddit.com/r/lacroix/comments/be273e/i_ph_tested_my_lacroix/</a></p>\n\n<p>Here's someone with a much more accurate test method... at 3.8, which makes more sense. They measured the grapefruit flavor, and I have bets about the temperature.</p>\n\n<p><a href=\"https://www.reddit.com/r/lacroix/comments/9jrrfm/i_got_a_ph_meter_so_i_measured_the_ph_of_my/\" rel=\"nofollow noreferrer\">https://www.reddit.com/r/lacroix/comments/9jrrfm/i_got_a_ph_meter_so_i_measured_the_ph_of_my/</a></p>\n\n<p><strong>TLDR</strong></p>\n\n<p>Yup, it's acidic. And delicious. As a combo of deliciousness and tooth protecting, you might drink it warm.</p>\n", "score": 3 } ]

[ "dentistry", "drinks", "ph-levels" ]

[ { "answer_id": 13043, "body": "<p>You actually need to ask this question? If rats are falling on your food in the restaurant then they're running amuck in the kitchen eating and crapping on your food. So the answer is:</p>\n\n<ol>\n<li>Find the manager</li>\n<li>Demand a refund</li>\n<li>Leave</li>\n<li>Report it to the health department</li>\n</ol>\n", "score": 4 } ]

[ "food-safety", "food-poisoning", "food-addiction" ]

[ { "answer_id": 13230, "body": "<p>The <a href=\"https://www.cdc.gov/mold/cleanup.htm\" rel=\"nofollow noreferrer\">CDC has a great website on cleanup after mold</a>. Also, this is a <a href=\"https://www.cdc.gov/disasters/hurricanes/pdf/flyer-get-rid-of-mold.pdf\" rel=\"nofollow noreferrer\">simple pamphlet</a>. The degree of decontamination needed <strong>depends on the item and the extent of the mold</strong>. Whether something needs to be thrown out depends on multiple factors. There is too long a list to give a full discussion here, but the fundamentals include:</p>\n\n<ul>\n<li>Bleach can kill spores. Some clothing can be bleached. Nonporous surfaces can be scrubbed with bleach. Carpets cannot, drywall cannot, generally furniture cannot.</li>\n<li>Not everything requires bleach, like clothing/sheets can generally be washed on heavy cycle with detergent in very hot water.</li>\n<li>If mold did not directly grow on an item, sometimes it can be cleaned in other ways, so read about the specific circumstances. E.g. furniture steam cleaning or shampooing can be successful, depending on degree of mold.</li>\n<li>When handling items contaminated with significant amounts of mold, or in a mold-damaged area of the house, wear a respirator mask capable of filtering mold spores (N95) and other protective equipment so that you don't contaminate other areas.</li>\n</ul>\n\n<p>Mold has known deleterious health effects, so especially if you have allergies to mold, make sure you do read the CDC recommendations if you've experienced mold problems. Spores can be transported to a new location and grow there if it encounters favorable circumstances (damp rooms, leaking roof, etc).</p>\n", "score": 4 }, { "answer_id": 13237, "body": "<p><em>Note: this is my personal experience, not a scientific opinion or anything like that. I hope it helps.</em></p>\n\n<p>I had a similar situation to you three years ago. We moved out of the damp apartment, full of black mould. We cleaned all of our furniture with ordinary upholstery shampoo, washed our clothes with normal detergent, etc.</p>\n\n<p>We then moved to a nice, dry apartment. No doubt some spores remained on the clothes, etc. However, they did not cause any health effects that we know of. We have moved several times since then and have never had symptoms of anything. The spores need moisture to grow into mould, or they'll die.</p>\n", "score": 1 } ]

[ "allergy", "environmental-conditions", "eczema", "toxicology" ]

[ { "answer_id": 18469, "body": "<p>It is true that infants receive <a href=\"https://en.m.wikipedia.org/wiki/Antibody\" rel=\"nofollow noreferrer\">antibodies</a> from the mother via the placenta in the final trimester of pregnancy and also in breastmilk.</p>\n\n<p><strong>Passive immunity</strong></p>\n\n<p>This is <a href=\"https://en.m.wikipedia.org/wiki/Passive_immunity\" rel=\"nofollow noreferrer\">passive immunity</a>, because the antibodies (usually IgA type) are passed on pre-formed. They can resist infection but do not form lasting immunity, which requires the body to encounter the infectious agent itself (specifically the <a href=\"https://en.m.wikipedia.org/wiki/Antigen\" rel=\"nofollow noreferrer\">antigens</a> on its surface). After several weeks or months, the infant will become vulnerable again. It is important to note that the mother must have had the infection in question.</p>\n\n<p><strong>Antibodies in breast milk</strong></p>\n\n<p><a href=\"https://biology.stackexchange.com/questions/55458/how-do-the-antibodies-in-colostrum-survive-the-infant-s-digestive-system\">This question</a> on the Biology Stack Exchange asks about how antibodies in breastmilk survive digestion in the stomach of the infant. I refer to it’s answers. The structure of IgA antibodies and also the fact that the environment in the stomach of an infant is very different from that of an adult (specifically much less acidic so less <a href=\"https://en.m.wikipedia.org/wiki/Protease\" rel=\"nofollow noreferrer\">protease</a> activity). Their intestine is also more permeable. Thus adults would not derive the same benefit from breastmilk as infants do!</p>\n\n<p><strong>Chickenpox</strong></p>\n\n<p>You mention that you have never had <a href=\"https://en.m.wikipedia.org/wiki/Chickenpox\" rel=\"nofollow noreferrer\">chickenpox</a>. This is a highly transmissible disease and hard to miss. Many adults who have never had chickenpox will actually have had <a href=\"https://en.m.wikipedia.org/wiki/Subclinical_infection\" rel=\"nofollow noreferrer\">subclinical infection</a> (infection with no symptoms) and will have developed immunity. <em>(Wallace et al.)</em></p>\n\n<hr>\n\n<p><strong>Additional sources</strong></p>\n\n<p>Wallace MR, Chamberlin CJ,Zerbini L, et al. Reliability of a history of previous varicella infection in adults. JAMA 1997; 278:1520-1522.</p>\n\n<p><a href=\"https://www.nhs.uk/common-health-questions/childrens-health/how-long-do-babies-carry-their-mothers-immunity/\" rel=\"nofollow noreferrer\">NHS - How long do babies carry their mother’s immunity</a></p>\n", "score": 2 } ]

[ "immune-system", "disease-transmission", "breastfeeding", "chickenpox" ]

[ { "answer_id": 13293, "body": "<p>Stress- relief techniques can help manage anxiety... specific ones to incorporate based on anxiety are... </p>\n\n<p>Mindful meditation as shown by the study in this article... <a href=\"http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.149.7.936\" rel=\"nofollow noreferrer\">http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.149.7.936</a> Meditation can be performed in the morning before the toddlers awake, or after they go to bed. Even 5 minutes consistently done on a daily basis can help you to focus and reduce anxiety throughout the day.</p>\n\n<p>Yoga may be effective based on this article, although I know it can be difficult to do with toddlers, but if you have the time before they wake up, or during nap time. <a href=\"http://www.biomedsearch.com/article/effects-yoga-anxiety-stress/286390903.html\" rel=\"nofollow noreferrer\">http://www.biomedsearch.com/article/effects-yoga-anxiety-stress/286390903.html</a></p>\n\n<p>Deep breathing can also reduce anxiety, during an episode of anxiety <a href=\"http://www.anxieties.com/57/panic-step4#.WY9xmlGGOUk\" rel=\"nofollow noreferrer\">http://www.anxieties.com/57/panic-step4#.WY9xmlGGOUk</a> Basically when someone is anxious their breathing and heart rate go up, which affects other things as well. By controlling your breathing, your heart rate can go down, and help regulate the other symptoms of anxiety. This can be done at any time anywhere.</p>\n\n<p>Also don't stress if you can't do the above consistently... Stressing over not using stress relief techniques in counter productive. Also, depending on your situation you could ask for help from family and friends. I think sometimes us Moms think we have to do everything ourselves, when we don't.</p>\n", "score": 2 }, { "answer_id": 13323, "body": "<p>I recommend seeing a counselor/therapist/psychologist ASAP to help you with this. <a href=\"https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy\" rel=\"nofollow noreferrer\">Cognitive Behavioral Therapy</a> is one of many approaches to anxiety. But a professional can help identify what you need to focus on. They are the branch of healthcare that manages mental health with behavioral interventions rather than medications (or in addition to medications from an MD in some cases, as they don't prescribe meds)</p>\n", "score": 1 }, { "answer_id": 13336, "body": "<p>If this level of anxiety kicked in after having children it may qualify as <a href=\"https://www.anxietybc.com/parents/new-moms/feeling-anxious/recognizing-post-partum-anxiety\" rel=\"nofollow noreferrer\">PPA - post partum anxiety</a>. People often think of depression, but anxiety is also incredibly common. There are varying degrees you can experience such things and <em>sometimes</em> it might be a good idea to consider medication <em>while</em> making lifestyle changes to assist you. </p>\n\n<p>As a mother to young kids myself, I know that I am prone to anxiety. What I didn't know initially was that I am also prone to developing something called post partum hyper-thyroiditis. So this was doubly awful. I was loosing weight like crazy, unable to sleep, and having all sorts of symptoms due to my thyroid which also increases anxiety for some, and having anxiety with the two together had me convinced for a while that I had to have cancer or some awful thing happening, because of all my strange symptoms (especially excess weight loss). I tell you that because pregnancy also puts a strain &amp; sometimes that means it can change our health. It is always advisable to <em>talk</em> to the doctor about any symptoms you are having, even anxiety, simply because there can be a biological component to it. I could have never yoga-d my way into a healthy thyroid. That wasn't going to work, right? So a check up &amp; talk with the doctor is seldom a bad idea. If they advise a medication you prefer not to take, you don't <em>have</em> to take it, but it's still worth looking at all options and ensuring you don't have anything else causing you to have more intense anxiety.</p>\n\n<p>That said, the rest of what I do. I have recently started a supplement called <a href=\"https://www.psychologytoday.com/blog/integrative-mental-health-care/201703/l-theanine-reduces-symptoms-anxiety\" rel=\"nofollow noreferrer\">L Theanine</a>. It's an extract found in tea. It simply helps me feel more calm &amp; focused. The strength <em>I</em> take is about what you get in 2 cups of tea, so not much, and it's not magical, but it helps a little. </p>\n\n<p>Avoiding caffeine helps me as well. That was one my doctor advised right off. I again, can't say it magic, but also better.</p>\n\n<p>CBT is one that is commonly used clinically. I was already versed in meditation, so for <em>me</em> I've just reapplied myself to that, which in many ways is not too terribly far removed from the techniques of CBT, such that now there is MCBT that is a marriage of the two. <a href=\"http://www.harleytherapy.co.uk/counselling/cbt-mbct-difference.htm\" rel=\"nofollow noreferrer\">http://www.harleytherapy.co.uk/counselling/cbt-mbct-difference.htm</a></p>\n", "score": 0 } ]

[ "mental-health", "depression", "anxiety-disorders", "parenting" ]

[ { "answer_id": 13463, "body": "<p>Yes they can. Co-occurring conditions like depression may also contribute to low libido.</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623530/\" rel=\"nofollow noreferrer\">This is a good article</a> that discusses the details.</p>\n\n<blockquote>\n <p>The mechanisms by which antipsychotic drugs may cause sexual\n dysfunction are as follows: </p>\n \n <ul>\n <li>histamine receptor antagonism, </li>\n <li>dopamine receptor antagonism, </li>\n <li>dopamine D2 receptor antagonism, </li>\n <li>cholinergic receptor antagonism, </li>\n <li>alpha-adrenergic alpha receptor antagonism</li>\n </ul>\n</blockquote>\n\n<p>A primary theory is that antipsychotics that have dopaminergic receptor antagonism</p>\n\n<blockquote>\n <p>\"may decrease the libido by inhibiting motivation and reward.\" </p>\n</blockquote>\n\n<p>Of those medications, haloperidol, risperidone, and amisulpride are also known to raise levels of prolactin, which inhibits testosterone production. This has a higher association with sexual dysfunction.</p>\n\n<p>Olanzapine, clozapine, quetiapine, and aripiprazole are less likely to do so.</p>\n\n<p>Bupropion inhibits reuptake (increases amount) of norepinephrine and dopamine. It is one of the antidepressants least likely to be associated with sexual dysfunction.</p>\n\n<p><strong>Doctors:</strong></p>\n\n<p>You should talk with your psychiatrist that prescribes you this combination of medications and seek his/her advice. These are common side effects.</p>\n\n<p>You should also talk with your primary care physician. They can do the endocrinology tests for prolactin and/or testosterone IF they feel they are appropriate. They will likely ask that you discuss your meds with your psychiatrist as well, as they are the experts.</p>\n\n<p>Another possibility is to talk with a urologist, who are the experts in male genitalia and everything about them. But a primary care doctor is generally better at putting the whole-person picture together, if you have additional medical issues that are not being addressed. </p>\n\n<p>A sexologist is not a medical doctor (at least in my understanding it is a branch of psychology) and as such is not going to be able to do those tests or prescribe anything like testosterone - if that is necessary. They are, however, extremely helpful in addressing all other contributing factors to low libido and erectile dysfunction!</p>\n\n<p><strong>An important point:</strong></p>\n\n<p>This is not medical advice; talk everything over with your physician before making changes, and for anything regarding your unique situation.</p>\n\n<p>But overall, managing schizophrenia is paramount to anything else, as uncontrolled symptoms affect ALL quality of life aspects not just sex. I sincerely applaud anyone who maintains their schizophrenia well managed on medications, as it is easy to think \"I feel fine maybe I don't need it\" and fall into relapse of symptoms. It can be a very difficult condition to treat because med adherence is so important. </p>\n\n<p>Libido can be adjusted with things like sexual therapy and possibly medications, but when a condition like schizophrenia is well managed, you don't want to mess with changing those meds unless it's under your psychiatrist's careful guidance!</p>\n", "score": 4 } ]

[ "medications", "sex", "depression", "libido" ]

[ { "answer_id": 13502, "body": "<p>Good question, and this is not a complete answer, as I cannot think specifically of a <em>free course</em>. I will update this if I find one. But a very good resource that I feel provides a great foundation for what balanced nutrition is, with a lot of good explanations (that you don't have to be a scientist to understand), is a Harvard public health website. One of the primary researchers involved did a Skype lecture with us, during which he presented the research behind their information, and we felt it was quite solid: \n<a href=\"https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/\" rel=\"nofollow noreferrer\">https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/</a> </p>\n", "score": 4 }, { "answer_id": 13515, "body": "<p>The best directory of online courses that I know of is class-central.com. It includes and compares edx.org and Coursera. The more general subject <a href=\"https://www.class-central.com/subject/nutrition-and-wellness?sort=rating-up\" rel=\"nofollow noreferrer\">\"Nutrition &amp; Wellness\"</a> lists 99 courses. Only a few will fit all of your requirements. I have not tried them but they are often university backed and from other subjects I know class-central's rating system is useful. </p>\n", "score": 1 }, { "answer_id": 13513, "body": "<p>There are several online learning platforms that offer free and/or paid courses (in some platforms the courses are usually free of charge, and you can pay to get an official completion certificate). Personally, I have used so far only <a href=\"https://www.khanacademy.org/\" rel=\"nofollow noreferrer\">Khan Academy</a> (which is completely free to use and does not offer graduation certificates) and <a href=\"https://www.coursera.org/\" rel=\"nofollow noreferrer\">Coursera</a> (which offers the material for free, but the certificate is paid), but I did not see that they offer such a course.</p>\n\n<p>However, <a href=\"https://www.edx.org/\" rel=\"nofollow noreferrer\">edx.org</a>, with which I have had no experience, seems to offer a course that might be suitable for your needs (free to use, pay for a certificate, according to the course webpage). Check it out <a href=\"https://www.edx.org/course/nutrition-health-micronutrients-wageningenx-nutr102x\" rel=\"nofollow noreferrer\">here</a>.</p>\n\n<p>There may be other online learning platforms as well. If you haven't done that already, browse through <a href=\"https://www.google.co.il/search?q=online%20nutrition%20courses&amp;oq=online%20nutrition%20courses&amp;gs_l=psy-ab.3...422479.423318.0.423558.0.0.0.0.0.0.0.0..0.0....0...1.1.64.psy-ab..0.0.0.Xf-Qg0urrpg\" rel=\"nofollow noreferrer\">this Google search</a>.</p>\n\n<p>Edit: come to think of it, <a href=\"https://www.coursera.org/learn/food-and-health\" rel=\"nofollow noreferrer\">this course</a> by Coursera may also be of use to you (see the syllabus for more details).</p>\n", "score": 0 } ]

[ "nutrition" ]

[ { "answer_id": 13533, "body": "<h2>Conclusion</h2>\n\n<p>As your source points out, there are Health concerns with <em>some</em> acrylic mouthguards, if they contain BPA. However, the concerns are, according to the FDA, negligible and propose no danger to you. </p>\n\n<p><strong>Ask your dentist</strong> whether the mouthguard in question does contain BPA and act accordingly.**</p>\n\n<blockquote>\n <p>As required, the Schein MSDS for “Easy Flow Acrylic Powder” listed three hazardous ingredients: Dialkyl Phthalate (CAS# 84-66-2), Titanium Dioxide (CAS# 13453-67-7), and Mineral Pigments (CAS# 57453-37-5), but made no mention of <strong>BPA, the chemical of concern to the consumer.</strong></p>\n</blockquote>\n\n<h2>So what is BPA?</h2>\n\n<blockquote>\n <p>Bisphenol A (C₁₅H₁₆O2), commonly abbreviated as BPA, is an organic compound with two phenol functional groups. It is a difunctional building block of several important plastics and plastic additives. With an annual production of 2–3 million metric tonnes, it is an important monomer in the production of polycarbonate.\n <em>Source: <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/Bisphenol_A\" rel=\"nofollow noreferrer\">PubChem.gov</a></em></p>\n</blockquote>\n\n<p>BPA affects <a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/16904728/\" rel=\"nofollow noreferrer\">postnatal development of embryos</a>, and has many <a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/?term=BPA&amp;sort=[relevance]\" rel=\"nofollow noreferrer\">negative health effects on mice</a>. </p>\n\n<p>As always, <em>sola dosis facit venenum</em> (the dose makes the poison) and </p>\n\n<blockquote>\n <p>the Food and Drug Administration (FDA) has said that BPA is safe at the very low levels that occur in some foods. This assessment is based on review of hundreds of studies.<br>\n <em>Source: <a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/bpa/faq-20058331\" rel=\"nofollow noreferrer\">MayoClinic</a></em></p>\n</blockquote>\n", "score": 2 } ]

[ "dentistry", "oral-health" ]

[ { "answer_id": 13554, "body": "<p>VOCs are one of the most prevalent indoor air pollutants. They are released by many common materials, from foams to carpets to paints. House air circulation is not very conducive to adequate dispersion, and it is usually worse in the winter. There are known health effects from headaches to cancer. Effects experienced are usually limited to symptoms rather than more severe pathology, but it depends on air concentration and chemical.</p>\n\n<p>There are filtration systems for VOCs. This is not an exhaustive list. </p>\n\n<p>I have written a term paper on plant VOC filtration, and researched/spoken with an MD pulmonologist who is an Environmental Health professor, for my OWN home air quality questions. Sources below.</p>\n\n<h2>1. <a href=\"https://www.arb.ca.gov/research/indoor/aircleaners/air_cleaners_gas_leak.htm\" rel=\"nofollow noreferrer\">Activated charcoal and similar carbon filtration systems do filter VOCs</a>.</h2>\n\n<p>The issue is air circulation; check the square footage of units. I myself purchased a Vornado (not product placement, just an example) and there are numerous others. (Note: the ones that use electric fields to sanitize air produce potentially harmful molecules. That's another topic.)</p>\n\n<p>There are full-house HEPA filtration systems (HEPA filters can over-work your furnace) for particulates, but do note that putting a HEPA filter on a normal furnace can cause it to overwork and break. However for VOCs, I imagine there are installable carbon filters for even a normal house HVAC. <em>If you check into that, please add a comment or answer and I'll include it!</em></p>\n\n<blockquote>\n <p>Air filters with activated charcoal will remove benzene (and other\n volatile organic compounds) Source: </p>\n</blockquote>\n\n<h2>2. Individual respirators for chemicals do exist as well.</h2>\n\n<p>However it is not feasible to live in a gas mask...</p>\n\n<h2>3. Plants filter VOCs pretty well.</h2>\n\n<p>Some years ago there was a surge of large downtown office buildings across the world that installed numerous of the plants that have the highest filtration rate.</p>\n\n<p>I am going to quote my paper; references below. It's a text wall, but it thoroughly answers your question.</p>\n\n<blockquote>\n <p>Studies have shown that there are specific plants that are\n particularly excellent at removing VOCs from the air. Contrary to\n what one might expect, it is not the foliage nor flowers of the plants\n that are responsible for this filtration; it is the microorganisms\n unique to each plant that live on the root systems in the soil. They\n absorb the molecules and metabolism them for energy. (Wolverton,\n 1989). </p>\n \n <p>Regarding specific plants, Chrysanthemum morifolium, the florist’s\n mum, in multiple studies stood out as the best at removing overall\n VOCs in the indoor environment. Other plants have more “specialized”\n performances. For removal of formaldehyde, Chmaedorea seifrizii (the\n bamboo palm) outperforms all other plants. For benzene, Hedera helix\n (English Ivy) does the best at low concentrations, and Gerbera\n jamesonii (the Gerbara daisy) performs best at high concentrations. \n The Gerbara daisy also outperforms all others at high concentrations\n of TCE, but Spathiphyllum sp. (the Peace Lily) is better than the\n daisy at lower TCE concentrations. The common houseplants golden\n pothos and snakeplant are both also well-studied as being adept at\n removing VOCs (Wolverton, 1989).</p>\n \n <p>The number of houseplants that would be required in order to\n adequately filter an 1800 ft2 home is estimated at 15-18 of 6-8\"\n diameter plants per person (Wolverton, 1997). Aeration of the soil\n is critical in order for airborne VOCs to reach these microbes. There\n have been several designs of aerated planters utilizing hydroculture\n with charcoal filtration that have aimed to take advantage of this\n army of chemical-cleansing microbes, such as the Plant Air Purifier\n designed by Wolverton himself, but studies on efficacy are currently\n sparse.</p>\n</blockquote>\n\n<p>Sources:</p>\n\n<ul>\n<li>NASA Clean Air Study and Wolverton Research \n\n<ul>\n<li><a href=\"http://www.wolvertonenvironmental.com/air.htm\" rel=\"nofollow noreferrer\">http://www.wolvertonenvironmental.com/air.htm</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/NASA_Clean_Air_Study\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/NASA_Clean_Air_Study</a> </li>\n<li><a href=\"https://iaqscience.lbl.gov/voc-cancer\" rel=\"nofollow noreferrer\">https://iaqscience.lbl.gov/voc-cancer</a></li>\n<li><a href=\"http://www.health.state.mn.us/divs/eh/indoorair/voc/\" rel=\"nofollow noreferrer\">http://www.health.state.mn.us/divs/eh/indoorair/voc/</a></li>\n<li><a href=\"http://www.sciencedirect.com/science/article/pii/S0360132311002101\" rel=\"nofollow noreferrer\">http://www.sciencedirect.com/science/article/pii/S0360132311002101</a></li>\n<li>Environmental Health and Occupational Medicine courses</li>\n<li>[like 30 other references for term paper]</li>\n</ul></li>\n</ul>\n", "score": 5 } ]

[ "cancer", "air-quality", "environmental-conditions", "carcinogens" ]

[ { "answer_id": 13641, "body": "<p>If you want to adjust diet to identify an allergen, there are two approaches.</p>\n\n<ol>\n<li><p>Remove the thing you suspect (in this case, fish) and wait a certain amount of time. (<a href=\"https://en.wikipedia.org/wiki/Elimination_diet\" rel=\"nofollow noreferrer\">Wikipedia</a> says two weeks to two months.) If the reaction clears up and doesn't come back, the thing you removed was the allergen. If it does not clear up, or clears up but then recurs, something else the person is still eating is the allergen. Choose a different thing to eliminate and start the process again. (Some people now restore the first food since it's been cleared of suspicion, others don't in case multiple allergies are in effect.)</p></li>\n<li><p>Remove everything that might be suspect (Say, everything the person ate that day, or in extreme cases, everything except one or two foods eg rice and lamb.) Wait until symptoms subside, then add foods back one at a time. If a reaction occurs with something, never eat it again.</p></li>\n</ol>\n\n<p>The first strategy can take a very long time if you don't know what the allergen is. It also has the issue of not being sure whether the reaction has just not died down yet, or is still happening because an allergen is still being eaten. The second is dangerous because the diet may be missing things you can't go without for even a few days, never mind for the weeks some reactions take to die down. You need the support of a doctor or nutritionist to consider it.</p>\n\n<p>There are quite a lot of studies in the reference section of that Wikipedia article that you may find useful.</p>\n", "score": 3 } ]

[ "dermatology", "allergy", "itching", "rash" ]

[ { "answer_id": 17452, "body": "<p>There really aren't any known harmful effects for an otherwise healthy person to eat directly after an exercise session. You may not have as much appetite, as the body will somewhat shut down the digestive system and redirect blood and other resources to more needed places in the body, but it is not actively harmful.</p>\n\n<p>In actuality, there are quite a few studies now showing that an immediate feeding after exercise can both help lessen some of the effects of the exercise and promote greater muscle growth and adaptation. It used to be known as the \"golden hour\". Endurance athletes benefit from a drink that is 3:1 ration of carbs to protein, while power/strength athletes do better with an immediate ingestion of protein, and then more protein spaced every 3-4 hours throughout the day.</p>\n\n<p>Here are a few supporting positions and studies:</p>\n\n<p><a href=\"https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0189-4\" rel=\"noreferrer\">International Society of Sports Nutrition</a> - Position paper.</p>\n\n<p><a href=\"https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/jphysiol.2012.244897%4010.1002/%28ISSN%291469-445X%28CAT%29VirtualIssues%28VI%29VirtualIssue2016\" rel=\"noreferrer\">Physiological Society</a> - Immediate ingestion of protein stimulates protein synthesis</p>\n\n<p><a href=\"https://www.jstage.jst.go.jp/article/jnsv1973/45/4/45_4_401/_article/-char/ja/\" rel=\"noreferrer\">Journal Nutritional Science/Vitaminology</a> - Immediate feeding promotes greater muscle mass and lower fat tissue in rats.</p>\n", "score": 6 } ]

[ "exercise" ]

[ { "answer_id": 13778, "body": "<p><strong><em>Sorry for the wait!</em></strong> </p>\n\n<hr>\n\n<p>To orient ourselves first trace the Ulnar Nerve distally to the hand from the Brachial Plexus <em>(BP)</em> and then review how Cubital Tunnel Syndrome ties in (it's neurological relation). </p>\n\n<p>Let me know if you have a more specific question (this is most commonly what is seen -- can go into other areas. <em>Sorry for so many abbreviations - these are old ortho notes.</em> </p>\n\n<hr>\n\n<h2>Nerve Entrapment - UE</h2>\n\n<p><strong><em>Ulnar Nerve (C7, C8, T1)</em></strong></p>\n\n<p>1.) Arises from medial cord of BP<br>\n2.) Travels down medial arm <em>(anterior compartment)</em><br>\n3.) Once it reaches the medial epicondyle run b/n brachalis and the medial head of the triceps.<br>\n4.) Crosses elbow on medial under ulnar groove.<br>\n5.) Right after it crosses the elbow It’s travels b/n the heads of the FCU (called the cubital tunnel) then it. Innervates FCU ulnar (humeral and ulnar) heads and FDP (Medial Part) (MOTOR) <br>\n6.) In the forearm it travels b/n FDS and FDP. <br>\n8.) Exits forearm medial to FDP tendons and just before it crosses wrist gives off a branch Dorsal Brach (SENSORY) <br> Dorsal side sensation to medial ½ 4th finger and 5th finger <br>\n9.) Travels through Guyon Tunnel (or Canal) at wrist above flexor retiaculum and gives off 2 branches: <br></p>\n\n<h2><a href=\"https://i.stack.imgur.com/qYU1G.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/qYU1G.jpg\" alt=\"enter image description here\"></a></h2>\n\n<p><strong>Deep Branch Supplies</strong> <em>(MOTOR)</em></p>\n\n<ul>\n<li>Oppones Digiti Minimi</li>\n<li>Adductor DM</li>\n<li>2 Lumbricals (on ulnar side)</li>\n<li>Dorsal and Palmar Interossi</li>\n<li>FPB</li>\n</ul>\n\n<p><strong>Superficial Branch</strong> <em>(SENSORY)</em></p>\n\n<ul>\n<li>Palmar side sensation to medial ½ 4th finger and 5th finger</li>\n</ul>\n\n<hr>\n\n<h2>Ulnar Nerve Compression Syndromes</h2>\n\n<p><strong>Cubital Tunnel Syndrome:</strong>\n<a href=\"https://i.stack.imgur.com/7zntp.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/7zntp.jpg\" alt=\"enter image description here\"></a></p>\n\n<hr>\n\n<p><strong>Compression Sites:</strong> </p>\n\n<ul>\n<li>Ulnar groove</li>\n<li>Cubital tunnel (where nerve passes b/n 2 heads of FCU)</li>\n<li>Medial head of triceps – seen as a result of hypertrophy of that\nmuscle </li>\n<li>If nerve is unstable in ulnar groove and it starts subluxing, can result in neuritis, but overtime with scaring can lead to compression.</li>\n</ul>\n\n<hr>\n\n<p><strong>Etiology:</strong><br>\nSyndrome associated with frequent elbow flexion (ulnar nerve on stretch).</p>\n\n<ul>\n<li>Weight lifting</li>\n<li>Constricting fascia bands (ligament of strutres)</li>\n<li>Masses (bone abnormalities, swelling and ulnar nerve subluxation)</li>\n</ul>\n\n<hr>\n\n<p><strong>Clinical Picture:</strong></p>\n\n<ul>\n<li>Will be medial elbow discomfort (similar to medial epicondyltis)</li>\n<li>Parastesis of the medial ½ of the ring finger and 5th finger</li>\n<li>Repetieve flex/ext activites may excepabte these symptoms</li>\n<li>Orthopedic Testing / (+) tinnel</li>\n<li>Atrophy of hypothenear group</li>\n<li>Decreased grip strength</li>\n</ul>\n\n<h2><a href=\"https://i.stack.imgur.com/LNkZi.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/LNkZi.jpg\" alt=\"enter image description here\"></a></h2>\n\n<p> \n<strong>Treatment:</strong> </p>\n\n<ul>\n<li><p>Night splints to help keep elbow extended <em>(to avoid stretching of\nthat nerve)</em></p>\n\n<p> </p></li>\n</ul>\n\n<hr>\n\n<p><strong>Surgically:</strong></p>\n\n<ul>\n<li>Decompression, medial epicondyleptimy or transposition ulnar nerve\nmore anteriorly. <em>(so flexion will not stretch nerve)</em></li>\n<li>Ulnar Nerve Transposition</li>\n</ul>\n\n<hr>\n\n<p>Images From: <a href=\"https://www.physio-pedia.com/\" rel=\"nofollow noreferrer\">https://www.physio-pedia.com/</a></p>\n", "score": 2 } ]

[ "neurology", "tendons", "tendinitis", "carpal-tunnel-syndrome", "ligament" ]

[ { "answer_id": 29126, "body": "<p>You can follow our most recent published work, titled as &quot;Introduction of Human-Centric AI Assistant to Aid Radiologists for Multimodal Breast Image Classification&quot; [3] and published in a top Human-Computer Interaction (HCI) journal. We also have similar works [1, 2] under the HCI topic that you might be interested.</p>\n<p>Furthermore, you can look at several of my posts where I do some literature review:</p>\n<ul>\n<li><p>&quot;<a href=\"https://medium.com/oppr/applying-new-paradigms-in-human-computer-interaction-to-health-informatics-86d6a7046130\" rel=\"nofollow noreferrer\">Applying New Paradigms in Human-Computer Interaction to Health Informatics</a>&quot;</p>\n</li>\n<li><p>&quot;<a href=\"https://medium.com/oppr/using-cornerstonejs-and-orthanc-to-support-deep-learning-projects-c9675819c33a\" rel=\"nofollow noreferrer\">Using CornerstoneJS and Orthanc to Support Deep Learning Projects</a>&quot;</p>\n</li>\n<li><p>&quot;<a href=\"https://medium.com/oppr/medical-imaging-downloader-for-cornerstonejs-and-orthanc-d08c3a508d9b\" rel=\"nofollow noreferrer\">Medical Imaging Downloader for CornerstoneJS and Orthanc</a>&quot;</p>\n</li>\n</ul>\n<h1>References</h1>\n<p>[1] Francisco M. Calisto, Alfredo Ferreira, Jacinto C. Nascimento, and Daniel Gonçalves. 2017. Towards Touch-Based Medical Image Diagnosis Annotation. In Proceedings of the 2017 ACM International Conference on Interactive Surfaces and Spaces (ISS '17). Association for Computing Machinery, New York, NY, USA, 390–395. DOI: <a href=\"https://doi.org/10.1145/3132272.3134111\" rel=\"nofollow noreferrer\">https://doi.org/10.1145/3132272.3134111</a></p>\n<p>[2] Francisco Maria Calisto, Nuno Nunes, and Jacinto C. Nascimento. 2020. BreastScreening: On the Use of Multi-Modality in Medical Imaging Diagnosis. In Proceedings of the International Conference on Advanced Visual Interfaces (AVI '20). Association for Computing Machinery, New York, NY, USA, Article 49, 1–5. DOI: <a href=\"https://doi.org/10.1145/3399715.3399744\" rel=\"nofollow noreferrer\">https://doi.org/10.1145/3399715.3399744</a></p>\n<p>[3] Francisco Maria Calisto, Carlos Santiago, Nuno Nunes, Jacinto C. Nascimento, Introduction of human-centric AI assistant to aid radiologists for multimodal breast image classification, International Journal of Human-Computer Studies, Volume 150, 2021, 102607, ISSN 1071-5819, DOI: <a href=\"https://doi.org/10.1016/j.ijhcs.2021.102607\" rel=\"nofollow noreferrer\">https://doi.org/10.1016/j.ijhcs.2021.102607</a></p>\n", "score": 2 } ]

[ "research" ]

[ { "answer_id": 13629, "body": "<p>No. </p>\n\n<p>This line of reasoning expects infectious bacteria to be immobile on their own and \"gums\" to be isolated from one another in a regularly closed and healthily salivated mouth.\nIf your practitioner would have put the probe into her own mouth before examining yours, then that would be a great way to spread whatever.</p>\n\n<p>Your own mouth is an ecosystem where one, local, inflamed, infection can easily spread to any other place within your mouth, no probes needed. The bacteria can move on their own and your saliva provides a very convenient way of transportation. Everything that might spread is already there.</p>\n", "score": 5 } ]

[ "gums", "preventative-medicine", "periodontal-pathogen" ]

[ { "answer_id": 20057, "body": "<p>for now there is no specific immunotherapy for the treatment sepsis (defined as sepsis-3.0); the main treatment for severe sepsis is supportive in the intensive care unit. some medicine such as ulinastatin and thymosin α1 <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26517783\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/26517783</a> may be effective but with low level of evidence. </p>\n", "score": 1 } ]

[ "immune-system", "inflammation", "fungal-infection", "blood-clotting" ]

[ { "answer_id": 13691, "body": "<p>I would trust the professional organizations' websites and journals:</p>\n\n<ul>\n<li>American Academy of Dermatology <a href=\"http://www.AAD.org\" rel=\"nofollow noreferrer\">http://www.AAD.org</a></li>\n<li>American Osteopathic College of Dermatology <a href=\"http://www.aocd.org/\" rel=\"nofollow noreferrer\">http://www.aocd.org/</a></li>\n<li>American Journal of Clinical Dermatology <a href=\"https://link.springer.com/journal/40257\" rel=\"nofollow noreferrer\">https://link.springer.com/journal/40257</a></li>\n<li>Journal of the American Academy of Dermatology <a href=\"http://www.sciencedirect.com/science/journal/01909622?sdc=1\" rel=\"nofollow noreferrer\">http://www.sciencedirect.com/science/journal/01909622?sdc=1</a></li>\n</ul>\n\n<p>Or google your terms followed by site:aad.org or site:aocd.org etc</p>\n\n<p>Finding evidence for the newest procedures is harder; there's simply less of it. I find this to be the case myself. Dermatologists themselves differ in what they accept and practice from newer technologies.</p>\n\n<p>Any other major peer reviewed medical reference, like UpToDate, I would as well. </p>\n", "score": 4 } ]

[ "research", "home-remedies", "scientific-method", "cosmetics" ]

[ { "answer_id": 13816, "body": "<p>Tics occur very rarely (i.e.: 1 in 10,000) with lamotrigine. (1)</p>\n\n<p>I am not convinced that your symptoms meet the definition of a tic. Tics are are non-rhythmic and can be temporarily suppressed (2). From your description, the movements appear to be completely involuntary. A twitch (or myclonic jerk) may more accurately describe what you are experiencing. \nWhen you take into consideration that twitches occur more frequently than tics (are uncommon - 0.1%-1.0% of people) in individuals undergoing lamotrigine therapy (3), it is more likely that it is this that you are suffering from.</p>\n\n<p>Your cluster of symptoms is consistent with benign essential blepharospasm (a type of muscle twitch (2)), which involves (4):</p>\n\n<blockquote>\n <p>increased blink rate (77%), eyelid spasms (66%), eye irritation\n (55%), midfacial or lower facial spasm (59%), brow spasm (24%), and\n eyelid tic (22%).</p>\n</blockquote>\n\n<p>Although this is my non-medical opinion (I am not a doctor), and I urge you to visit your treating health care professional for proper diagnosis.</p>\n\n<h1>References</h1>\n\n<ol>\n<li>TGA PI Lamitical <a href=\"https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2013-PI-01024-1\" rel=\"nofollow noreferrer\">https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&amp;id=CP-2013-PI-01024-1</a></li>\n<li>Tic Disorders and Twitches <a href=\"http://www.webmd.com/brain/tic-disorders-and_twitches#1\" rel=\"nofollow noreferrer\">http://www.webmd.com/brain/tic-disorders-and_twitches#1</a></li>\n<li>Lamictal Side Effects <a href=\"https://www.drugs.com/sfx/lamictal-side-effects.html\" rel=\"nofollow noreferrer\">https://www.drugs.com/sfx/lamictal-side-effects.html</a></li>\n<li>Benign Essential Blepharospasm Clinical Presentation <a href=\"http://emedicine.medscape.com/article/1212176-clinical\" rel=\"nofollow noreferrer\">http://emedicine.medscape.com/article/1212176-clinical</a></li>\n</ol>\n", "score": 3 } ]

[ "medications", "side-effects" ]

[ { "answer_id": 21066, "body": "<p>The aim of taking two antibiotics at the same is to prevent an overgrowth of the <em>H. pylori</em> strains that could be resistant to a single antibiotic. The antibiotic choice depends on the individual sensitivity to antibiotics. </p>\n\n<p>Various treatment regimes have been proposed: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5748437/\" rel=\"nofollow noreferrer\">Helicobacter pylori treatment: antibiotics or probiotics (Applied microbiology and biotechnology, 2018)</a>.</p>\n\n<p>A standard treatment regime for the <em>H. pylori</em> infection of the stomach is a <strong>triple therapy</strong> for 10-14 days:</p>\n\n<ol>\n<li>a proton pump inhibitor, such as omeprazole (or ranitidine bismuth citrate)</li>\n<li>the antibiotic clarithromycin (or levofloxacin in case of resistance) </li>\n<li>the antibiotic amoxicillin (or metronidazole)</li>\n</ol>\n\n<p>Probiotics taken along with triple therapy can increase the eradication rate.</p>\n\n<p>In recent years, the effectiveness of the triple regime has fallen from 90% to &lt;70% due to resistance of <em>H. pylori</em> to multiple antibiotics. The reported prevalence of resistance to:</p>\n\n<ul>\n<li>metronidazole: ~10% in Japan, 17 to 44% in Europe and America, 50-100% in Africa</li>\n<li>clarithromycin: 16% in Japan, 1.7 to 23.4% in Europe, 10.6 to 25% in North America</li>\n</ul>\n\n<h2>Suggested new therapies</h2>\n\n<p><strong>Quadruple therapy</strong> (for areas with high incidence of clarithromycin resistance):</p>\n\n<ol>\n<li>a proton pump inhibitor</li>\n<li>bismuth citrate</li>\n<li>the antibiotic tetracycline</li>\n<li>the antibiotic metronidazole</li>\n</ol>\n\n<p>The efficacy of the quadruple therapy in <em>H. pylori</em> eradication is similar than in triple therapy (~77%).</p>\n\n<p><strong>Sequential therapy</strong> uses the same drugs as the triple therapy but not at the same time (more effective in patients with the single clarithromycin-resistant strain; eradication rates were 80.9% for sequential therapy and 40.7% for standard triple therapy):</p>\n\n<ul>\n<li>5 days with a proton pump inhibitor plus amoxicillin followed by</li>\n<li>5 days of a proton pump inhibitor plus clarithromycin and amoxicillin </li>\n</ul>\n", "score": 5 } ]

[ "medications", "infection", "gastroenterology", "bacteria", "antibiotics" ]

[ { "answer_id": 13823, "body": "<p>Sure, Alzheimer's is considered by some to be <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769828/\" rel=\"nofollow noreferrer\">type III diabetes</a> and the pathology induced is a combination of hypertension, hyperlipidaemia, and elevated glycation products.</p>\n", "score": 3 } ]

[ "diabetes", "heart-disease", "alzheimers" ]

[ { "answer_id": 13919, "body": "<p>Blood irritates the stomach and in sufficient quantity will cause nausea and vomiting, so that would make it harmful. </p>\n\n<p><a href=\"https://www.emedicinehealth.com/stopping_a_nosebleed-health/article_em.htm\" rel=\"nofollow noreferrer\">https://www.emedicinehealth.com/stopping_a_nosebleed-health/article_em.htm</a></p>\n\n<blockquote>\n <p>Do not tilt your head back. This may cause blood to run down the back\n of your throat, and you may swallow it. Swallowed blood can irritate\n your stomach and cause vomiting. And vomiting may make the bleeding\n worse or cause it to start again. Spit out any blood that gathers in\n your mouth and throat rather than swallowing it.</p>\n</blockquote>\n\n<p>The story behind the photo you posted may or may not be accurate, but clearly the patient in question was not well. Blood running down the trachea of a healthy, alert person would trigger an immediate cough reflex.</p>\n", "score": 2 } ]

[ "blood" ]

[ { "answer_id": 14012, "body": "<p><a href=\"https://en.wikipedia.org/wiki/Black_tea\" rel=\"noreferrer\">Black tea</a> <em>can</em> last <a href=\"https://en.wikipedia.org/wiki/Pu%27er_tea\" rel=\"noreferrer\">almost forever</a>.\n<a href=\"https://www.webmd.com/vitamins-and-supplements/black-tea-uses-and-risks#1\" rel=\"noreferrer\">Health related detriments are potentially</a> present already in fresh leaves.\nRisks added by storing tea for too long are first and foremost: taste deterioration. This is especially true if it was stored improperly, that is with spices and other material that emits odours that are then captured by the tea. That is of course all moot if it was stored somewhere moist. Molds growing on it should be of some concern. Since it is black tea that will be prepared with boiling water :this will kill most of the microorganisms present on the leaves, since they never had a chance to thrive on dry material. </p>\n\n<p>Trust your eyes, your nose and your taste buds. <br>\nIf you think it looks gross now, or tastes way off, don't drink it. Otherwise don't worry.</p>\n\n<p><a href=\"http://www.eatbydate.com/drinks/coffee-tea-shelf-life/tea-shelf-life-expiration-date/\" rel=\"noreferrer\">How long does tea last?</a>:</p>\n\n<blockquote>\n <p>How long does packaged tea last? Unopened, packaged tea can last a year beyond any \"best by\" date stamped on the package. Does tea expire? Tea will eventually lose flavor, but dry leaves will last a very long time. The shelf life of tea depends on a variety of factors, such as the best before date, the preparation method and how it was stored.</p>\n</blockquote>\n\n<p><a href=\"http://www.teavivre.com/info/shelf-life-of-tea/\" rel=\"noreferrer\">The Shelf Life of Black Tea</a>:</p>\n\n<blockquote>\n <p>Black tea is fully fermented, and it has a longer shelf life than green tea. Generally, the shelf life of black tea in bulk is about 18 months, while bagged tea is 24 months. Tins or aluminum foil bags for black tea can be stored for about 3 years, and paper bag is for 2 years.</p>\n</blockquote>\n\n<p><a href=\"http://www.stilltasty.com/fooditems/index/18486\" rel=\"noreferrer\">Food Storage - How Long Can You Keep...\nTea Bags, Commercially Packaged — Unopened Or Opened</a></p>\n\n<blockquote>\n <ul>\n <li><p>How long do tea bags last? The precise answer depends to a large extent on storage conditions — to maximize the shelf life of tea bags (including black, green, herbal and oolong), store in a cool, dark cupboard, away from direct heat or sunlight.</p></li>\n <li><p>How long do tea bags last at room temperature? Properly stored, tea bags will generally stay at best quality for about 18 to 24 months.\n To maximize the shelf life of tea bags, and to better retain flavor and potency, store in airtight containers.</p></li>\n <li><p>Are tea bags safe to use after the \"expiration\" date on the package? Yes, provided they are properly stored and the package is undamaged — commercially packaged tea bags will typically carry a \"Best By,\" \"Best if Used By,\" \"Best Before,\" or \"Best When Used By\" date but this is not a safety date, it is the manufacturer's estimate of how long the tea bags will remain at peak quality.</p></li>\n <li><p><strong>Do tea bags ever spoil? No, commercially packaged tea bags do not spoil, but will start to lose potency and flavor over time — the storage time shown is for best quality only.</strong></p></li>\n <li><p>Should you store tea bags in the refrigerator or freezer? Storing tea bags in the fridge or freezer is not recommended, since condensation can result, which will harm the taste and flavor of the tea.</p></li>\n <li><p>How can you tell if tea bags are still good? To test whether tea bags are still good, brew a cup of tea for at least 3 to 5 minutes - if the aroma is weak and the flavor is not obvious, the tea bags should be replaced.</p></li>\n </ul>\n</blockquote>\n\n<p><a href=\"http://now.tufts.edu/articles/tea-health-benefits-storage-time\" rel=\"noreferrer\">Does tea lose its health benefits if it’s been stored a long time? And is it better to use loose tea or tea bags?</a></p>\n\n<blockquote>\n <p>While fresh may be best for enjoying many types of teas, that’s not always the case. Some pu’er teas from China are considered to improve in taste with storage, much like a fine wine. In fact, the degradation and oxidation of catechins during storage of pu’er teas result in the formation of new phytochemicals, which have come to be highly valued by tea drinkers for their rich, earthy taste and probiotic health properties.</p>\n</blockquote>\n\n<p>Related on Cooking.SE (Seasoned Advice):\n<a href=\"https://cooking.stackexchange.com/q/9778/62255\">My tea bags are expired, can I still use them?</a></p>\n", "score": 9 } ]

[ "tea", "expiration-dates" ]

[ { "answer_id": 17533, "body": "<p>The only weight loss method I've heard that increases the risk of <em>kidney stones</em> is bariatric surgery (<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382441/\" rel=\"nofollow noreferrer\">PubMed, 2015</a>).</p>\n\n<p>Here's a recommendation to prevent <em>gallstones (<a href=\"https://www.niddk.nih.gov/-/media/Files/Weight-Management/DietingandGallstones2002.pdf\" rel=\"nofollow noreferrer\">NIDDK.gov, pdf</a>):</em></p>\n\n<blockquote>\n <p>Depending on your starting weight, experts recommend losing about\n <strong>1/2 to 2 pounds per week.</strong></p>\n</blockquote>\n", "score": 3 } ]

[ "weight-loss", "uric-acid", "length-of-time", "calculi-stones" ]

[ { "answer_id": 14072, "body": "<p>This is generally unhealthy, especially as sleep cannot be made up or paid back like financial debt. Try to get back to at least seven hours. As always, consult with a doctor.</p>\n\n<p>See: <a href=\"http://www.sciencedirect.com/science/article/pii/S2352721815000157\" rel=\"nofollow noreferrer\">National Sleep Foundation’s sleep time duration recommendations</a>.</p>\n", "score": 2 }, { "answer_id": 14883, "body": "<p>The way you are sleeping is <em>not necessarily unhealthy</em>, but this is easily debatable and you should probably look at what social and lifestyle factors may be affecting your sleep duration and consider some adjustments.</p>\n\n<p>To quote from an <a href=\"http://www.mindupdate.com/2007/04/the-mystery-of-sleep-and-the-lucky-few-who-dont-need-it/\" rel=\"nofollow noreferrer\">article</a> on the <a href=\"http://www.mindupdate.com/2007/04/the-mystery-of-sleep-and-the-lucky-few-who-dont-need-it/\" rel=\"nofollow noreferrer\">\"Mystery of Sleep and the Lucky Few Who Don't Need It\"</a></p>\n\n<blockquote>\n <p>Also interesting is how we perceive the amount of sleep we’ve gotten. A study by Dr. Allison Harvey, of Berkley, measured how much sleep a group of insomniacs actually got compared to their perception of it. It turns out that they only received 35 minute less than those who had no trouble sleeping, yet when asked how long they had slept, the insomniacs reported only 2-3 hours of actual sleep.</p>\n</blockquote>\n\n<p>Perhaps your perception is skewed? Or perhaps you are one of the lucky few who simply require less sleep? </p>\n", "score": 1 } ]

[ "sleep", "sleep-cycles", "sleep-aids" ]

[ { "answer_id": 14077, "body": "<p>Stomach acid helps to get iron absorbed from food. Calcium supplements in the form of calcium carbonate will lower stomach acid levels and thereby impede iron absorption. One can avoid that problem by using calcium citrate supplements. The calcium that's naturally present in foods is not in the form of calcium salts like calcium carbonate or calcium citrate. Instead, the calcium in vegetables sits inside an organic molecule, a so called molecular complex. In some cases this leads to poor absorption for calcium, e.g. in case of spinach the calcium is bound to oxalate and only 5% of the calcium is absorbed. The calcium in kale, in contrast, has a 50% bioavailability. The calcium in typical dairy products have about 30% biovailability.</p>\n\n<p>Another thing to keep in mind when you try to get your minerals like calcium and iron from vegetables instead of dairy and meat products, is to make sure you eat a lot of vegetables. While only a few slices of cheese and small piece of meat is sufficient to get to the RDA for calcium and iron, the volume of vegetables you need to eat to meet the RDA is huge by ordinary standards. The best way to go about this is to include vegetables in your lunch and even in your breakfast if you struggle to eat large volumes in single meals.</p>\n", "score": 3 }, { "answer_id": 14081, "body": "<p>There doesn't seem to be a problem when you look at iron status so there may be other mechanisms at play that compensate for the effect of calcium on iron absorption.</p>\n\n<blockquote>\n <p>Studies on human subjects have shown that calcium (Ca) can inhibit iron (Fe) absorption, regardless of whether it is given as Ca salts or in dairy products. This has caused concern as increased Ca intake commonly is recommended for children and women, the same populations that are at risk of Fe deficiency. However, a thorough review of studies on humans in which Ca intake was substantially increased for long periods shows no changes in hematological measures or indicators of iron status. Thus, the inhibitory effect may be of short duration and there also may be compensatory mechanisms. </p>\n</blockquote>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21462112\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/21462112</a></p>\n", "score": 2 } ]

[ "nutrition", "minerals", "iron", "calcium", "intestine" ]

[ { "answer_id": 14079, "body": "<p>The American Dental Association states that the overall exposure to all sources of radiation per year is estimated to be in the USA 6.2 mSv. And from an OPG which is probably similar to what you're having as 0.01 mSv.</p>\n\n<p>If you're a child, a young woman, or pregnant, you should ask for neck-shielding with a lead collar, or a lead apron to protect your thyroid and fetus.</p>\n\n<p>As for do you need yearly x-rays, then I suggest you discuss with your dentist. If you don't need fillings due to a lack of dental caries, you may get away with less frequent x-rays. And with the newer digital x-ray systems, there's a lower dose again.</p>\n\n<p><a href=\"https://i.stack.imgur.com/lVT1t.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/lVT1t.png\" alt=\"exposure table\"></a></p>\n\n<p><a href=\"http://www.ada.org/en/member-center/oral-health-topics/x-rays\" rel=\"nofollow noreferrer\">http://www.ada.org/en/member-center/oral-health-topics/x-rays</a></p>\n", "score": 4 } ]

[ "x-rays" ]