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[ { "answer_id": 30852, "body": "<p>The regulations define two phases of expanding definitions of what information must not be blocked.</p>\n<h4>Before October 6, 2022</h4>\n<p>The first phase is described in the Office of the National Coordinator for Health Information Technology (ONC) <a href=\"https://www.healthit.gov/curesrule/resources/information-blocking-faqs\" rel=\"nofollow noreferrer\">Information Blocking FAQs</a>:</p>\n<blockquote>\n<p>Before <strong>October 6, 2022</strong>, electronic health information (EHI) for the purposes of the information blocking definition is limited to the EHI identified by <strong>the data elements represented in the United States Core Data for Interoperability (USCDI) standard</strong>.</p>\n<p>From April 5, 2021 through October 5, 2022, the definition of information blocking is limited to the subset of EHI that is represented by data elements in the USCDI v1.</p>\n</blockquote>\n<p>The <a href=\"https://www.healthit.gov/isa/sites/isa/files/2020-10/USCDI-Version-1-July-2020-Errata-Final_0.pdf\" rel=\"nofollow noreferrer\">USCDI v1</a> provides this summary of the elements:</p>\n<p><a href=\"https://i.stack.imgur.com/oz1P3.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/oz1P3.png\" alt=\"Graphical summary of data elements including Allergies, Assessment and Plan of Treatment, Care Team Memebers, Goals, Health Concerns, Immunizations, Laboratory Results, Medications, Patient Demographics, Problems, Procedures, Provenance, Smoking Status, Unique Identifiers for Implants, and Vital Signs\" /></a></p>\n<h4>After October 5, 2022</h4>\n<p>After October 5, 2022, the information that must not be blocked is extended to the entire &quot;designated record set&quot; defined in the <a href=\"https://en.wikipedia.org/wiki/Health_Insurance_Portability_and_Accountability_Act\" rel=\"nofollow noreferrer\">Health Insurance Portability and Accountability Act</a></p>\n<blockquote>\n<p>On and after October 6, 2022, the definition of information blocking will apply to the full scope of EHI... EHI as defined for the purposes of information blocking is information that is consistent with the definitions of electronic protected health information (ePHI) and the <strong>designated record set (DRS)</strong></p>\n</blockquote>\n<p>The designated record set is basically any health information about an individual. <a href=\"https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html\" rel=\"nofollow noreferrer\">The Health and Human Services guidance materials</a> note the DRS comprises:</p>\n<blockquote>\n<ul>\n<li>Medical records and billing records about individuals maintained by or for a covered health care provider</li>\n<li>Enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan</li>\n<li>Other records that are used, in whole or in part, by or for the [healthcare] entity to make decisions about individuals.</li>\n</ul>\n<p>Thus, individuals have a right to a broad array of health information about themselves ... including: medical records; billing and payment records; insurance information; clinical laboratory test results; medical images, such as X-rays; wellness and disease management program files; and clinical case notes; among other information used to make decisions about individuals.</p>\n</blockquote>\n<h4>Conclusion</h4>\n<p>In short, after October 6, 2022, US healthcare providers must not block any health records they are technically capable of providing <em>immediately</em>.</p>\n<p>The <a href=\"https://www.healthit.gov/curesrule/resources/information-blocking-faqs\" rel=\"nofollow noreferrer\">ONC FAQ</a> notes:</p>\n<blockquote>\n<p>For health care providers, HHS must engage in future rulemaking to establish appropriate disincentives as directed by the 21st Century Cures Act.</p>\n</blockquote>\n<p>In other words, they haven't yet figured out what stick to use.</p>\n", "score": 3 } ]

[ "health-informatics", "united-states", "medical-records", "regulatory-agencies" ]

[ { "answer_id": 30920, "body": "<p>The October 2013 edition of Women's International Pharmacy newsletter (<a href=\"https://collierdrug.com/wp-content/uploads/2021/10/Insulin-Resistance-A-Weighty-Matter.pdf\" rel=\"nofollow noreferrer\">PDF</a>) points out that:</p>\n<blockquote>\n<p>Insulin is a hormone involved in the metabolic processes that convert food we eat into the fuel our bodies need to survive. As the maser fuel-supply hormone, insulin's main functions are to regulate the amount of blood sugar (glucose) that flows into our body's cells to create energy, and to communicate the need to refuel (that is, to eat or stop eating.</p>\n</blockquote>\n<p>As pointed out by the Glycaemic Index foundation (in your link), when you eat sugary foods, it elicits a spike in blood sugar — a sharp rise followed by a sharp fall. The greater the glycaemic index (GI) of a food or meal, the greater that spike will be.</p>\n<p>Because it knows that high levels of sugar in the blood is dangerous, the pancreas produces and then secretes insulin. The thing is, your cells must be “sensitive” (or responsive) to it. Eating a lot of high GI foods (sugary foods) makes your body used to the high levels of insulin in the body, leading to insulin resistance.</p>\n<p>Glucose then remains in your bloodstream as it cannot be stored in your muscles, liver, or fat cells, which means elevated blood sugar levels (diabetes). A low GI diet is associated with lower blood sugar levels — measured by <a href=\"https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/hba1c\" rel=\"nofollow noreferrer\">HbA1c levels</a> in blood tests (<a href=\"https://doi.org/10.1007/s00125-010-1927-1\" rel=\"nofollow noreferrer\">Jenkins, et al. 2011</a>).</p>\n<h2>References</h2>\n<p>Jenkins, D. J. A., Srichaikul, K., Kendall, C. W. C., Sievenpiper, J. L., Abdulnour, S., Mirrahimi, A., ... &amp; Leiter, L. A. (2011). The relation of low glycaemic index fruit consumption to glycaemic control and risk factors for coronary heart disease in type 2 diabetes. <em>Diabetologia, 54</em>(2), 271-279. <a href=\"https://doi.org/10.1007/s00125-010-1927-1\" rel=\"nofollow noreferrer\">https://doi.org/10.1007/s00125-010-1927-1</a></p>\n<p>Matter, A. W. (2013). Insulin resistance. <em>Women's International Pharmacy newsletter</em> <a href=\"https://collierdrug.com/wp-content/uploads/2021/10/Insulin-Resistance-A-Weighty-Matter.pdf\" rel=\"nofollow noreferrer\">https://collierdrug.com/wp-content/uploads/2021/10/Insulin-Resistance-A-Weighty-Matter.pdf</a></p>\n", "score": 2 } ]

[ "nutrition", "blood-sugar" ]

[ { "answer_id": 30959, "body": "<p>The reason the distinction if confusing, is because while both terms appear to be referring to inflammation of a particular anatomical / histologic structure, in reality, most clinicians use &quot;bronchiolitis&quot; to refer to a clinical <strong>syndrome</strong>.</p>\n<p>Here is an excerpt from <a href=\"https://www.uptodate.com/contents/bronchiolitis-in-infants-and-children-treatment-outcome-and-prevention\" rel=\"nofollow noreferrer\">UpToDate (sorry possible pay wall)</a>:</p>\n<blockquote>\n<p>Bronchiolitis is broadly defined as a <strong>clinical syndrome</strong> of respiratory distress that occurs in children &lt;2 years of age and is characterized by upper respiratory symptoms (eg, rhinorrhea) followed by lower respiratory (eg, small airway/bronchiole) infection with inflammation, which results in wheezing and or crackles (rales). Bronchiolitis typically occurs with primary infection or reinfection with a viral pathogen, but occasionally is caused by bacteria (eg, Mycoplasma pneumoniae). In young children, the clinical syndrome of bronchiolitis may overlap with recurrent virus-induced wheezing and acute viral-triggered asthma.</p>\n</blockquote>\n<p>Adults also experience bronchiolitis (the inflammation), but it is most often due to non-infectious etiologies. As Ryu and colleagues note (2020. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281671/\" rel=\"nofollow noreferrer\">7281671</a>):</p>\n<blockquote>\n<p>Respiratory bronchiolitis (RB) is likely the most common form of bronchiolitis and is usually related to cigarette smoking.</p>\n</blockquote>\n<p>Other non-infectious etiologies include constrictive (obliterative) bronchiolitis, follicular bronchiolitis, and diffuse aspiration bronchiolitis (Ryu <em>et al</em> 2020. PMCI <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7281671/\" rel=\"nofollow noreferrer\">7281671</a>).</p>\n<p>Even still, some adults also experience infectious acute bronchiolitis (akin to the pediatric syndrome). A review of 20 adult patients with infectious bronchiolitis by Ryu and colleagues in a different paper revealed mostly bacterial pathogens (2015. PMID <a href=\"https://pubmed.ncbi.nlm.nih.gov/26524622\" rel=\"nofollow noreferrer\">26524622</a>):</p>\n<blockquote>\n<p>Detected organisms included <em>Mycoplasma pneumoniae</em> in eight (40.0%) patients, influenza virus in two (10.0%), influenza virus and <em>Streptococcus pneumoniae</em> in two (10.0%), <em>Haemophilus influenzae</em> in three (15.0%), and respiratory syncytial virus and rhinovirus in one (5.0%) patient.</p>\n</blockquote>\n<p>Some authors have suggested that it is the relatively more mature innate immune system that is the underlying reason adults rarely experience primarily bronchiolar symptoms (Lambert and Culley 2017. PMCID <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694434/\" rel=\"nofollow noreferrer\">5694434</a>).</p>\n<p><img src=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694434/bin/fimmu-08-01570-g001.jpg\" alt=\"Figure of lung immunity in early life\" />\n^{Figure 1 from Lambert and Culley available <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694434/\" rel=\"nofollow noreferrer\">here</a>.}</p>\n<blockquote>\n<p>Innate immunity to infection in the lung in early life. Alveolar macrophages (AM) are the most numerous leukocyte in the lungs in early life. Reduced cytokine production and phagocytic ability in AM in early life compared to those of adults could underlie susceptibility to infection</p>\n</blockquote>\n", "score": 4 } ]

[ "epidemiology", "pathophysiology", "pneumonia", "bronchitis" ]

[ { "answer_id": 30978, "body": "<p>This is a pharmacokinetic question, as it refers to the effect of changes in the prescribed dosage regimen on the amount of drug in the body, which is usually related to the magnitude of effect the drug has (when the effect is said to be dose-dependent).</p>\n<p>Now, it should be noted that the limited pharmacodynamic information available about Paxlovid from the manufacturer only says that &quot;the increase in systemic exposure appears to be less than dose proportional up to 750 mg as a single dose and up to 500 mg twice daily as multiple doses&quot;. No quantitative information is available, but it seems this piece of information has no clinical significance in the following case.</p>\n<p>Under the assumption of first-order pharmacokinetics (as most drugs display), and of short and intravenous-like absorption to simplify (Tmax is ~3 hours, so it can be neglected for the purpose of demonstration), the amount of drug in the body can be plotted as a function of time, as it is dependent on the dose and the elimination half-life, which is provided (6 hours). Thus, the following plot is obtained:</p>\n<p><a href=\"https://i.stack.imgur.com/EeonR.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/EeonR.png\" alt=\"Paxlovid dosage regimen\" /></a></p>\n<p>The blue plot depicts the usual dosage regimen (300 mg twice daily for 5 days (120 hours)) and the red plot depicts the modified dosage regimen as described (alternating dosage intervals of 14.5 hours and 9.5 hours - time 0 is considered to be 4:30).</p>\n<p>It is evident from the figure that the trough level and the peak level of the modified dosage regimen are slightly lower at 19:00 compared to the usual dosage regimen, and are slightly higher at 4:30. This behavior is plausible, as the drug continues to be eliminated at the 12-hour point, so by the time of the next dose, the amount in the body is lower than in the usual dosage regimen. By the same token, shorter interval (9.5 hours) means less amount eliminated, which makes for higher amounts in the body following the next dose at 4:30.</p>\n<p>However, the difference between the troughs and the peaks seems negligible, and since the manufacturer states that the systemic exposure is 'less than dose proportional' it is safe to assume that these small differences in the amount of the drug in the body do not have any clinical significance.</p>\n<p>In addition, the fact sheet states the following:</p>\n<blockquote>\n<p>If the patient misses a dose of PAXLOVID within 8 hours of the time it is usually taken, the patient should take it as soon as possible and resume the normal dosing schedule. If the patient misses a dose by more than 8 hours, the patient should not take the missed dose and instead take the next dose at the regularly scheduled time.</p>\n</blockquote>\n<p>That is, potential extension of the dosage interval up to 8 hours more is not expected to have any clinical significance. A 2.5 hours shift in administration times is well within the allowed 8 hours, thus no clinical consequences are expected.</p>\n<p>Reference: <br>\n<a href=\"https://www.fda.gov/media/155050/download\" rel=\"nofollow noreferrer\">FACT SHEET FOR HEALTHCARE PROVIDERS: EMERGENCY USE AUTHORIZATION FOR PAXLOVID</a> and any basic pharmacokinetic textbook</p>\n", "score": 3 } ]

[ "covid-19", "medications", "drug-administration", "pharmacokinetics" ]

[ { "answer_id": 31070, "body": "<p>It turns out that I just needed to dig in deeper. Per <a href=\"https://escholarship.org/uc/item/08b9z9th\" rel=\"nofollow noreferrer\">https://escholarship.org/uc/item/08b9z9th</a>, &quot;Because of the short action of ethanol (beverage alcohol), withdrawal symptoms usually begin within 8 hours after blood alcohol levels decrease, peak at about 72 hours, and are markedly re-duced by day 5 through 7 of abstinence.&quot;</p>\n<p>So, the start of DT's can be as soon as 8 hours, which coincides with my friend going to sleep and waking up after 6 or more hours.</p>\n<p>But looks like they are in for a rough ride if the symptoms will increase and culminate after 3 full days.</p>\n", "score": 3 } ]

[ "alcohol", "alcohol-withdrawal" ]

[ { "answer_id": 31294, "body": "<p>Possibly, but &quot;can we&quot; is only really answerable once it's been done; there are lots of things that are within some plausible range of <em>possibility</em> (including those that seem within grasp and those closer to science fiction). It's often difficult to predict which of these goals will be achieved easily and which will turn out to be harder than expected.</p>\n<p>Here's one recent paper:</p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/34730109/\" rel=\"noreferrer\"><em>Persaud, S. P., Ritchey, J. K., Kim, S., Lim, S., Ruminski, P. G., Cooper, M. L., ... &amp; DiPersio, J. F. (2021). Antibody-drug conjugates plus Janus kinase inhibitors enable MHC-mismatched allogeneic hematopoietic stem cell transplantation. The Journal of clinical investigation, 131(24).</em></a></p>\n<p>They're testing in mice an alternative &quot;conditioning&quot; (the term for the pre-transplant elimination of HSCs) step using an antibody conjugated to highly toxic <a href=\"https://en.wikipedia.org/wiki/Saporin\" rel=\"noreferrer\">saporin</a>. The antibody is targeted to cell-surface markers expressed on the target cells. This is exactly the same family of methods used to target chemotherapy to cancer cells more generally as you describe.</p>\n<p>This isn't my field, and there may be many more papers out there, I have not attempted anything like a comprehensive literature review, this was just the first hit I got looking for recent papers with the search terms &quot;Hematopoietic stem cell transplantation conditioning&quot;. One paper that cites the one I mentioned is a review of antibody-based conditioning:</p>\n<p><em><a href=\"https://pubmed.ncbi.nlm.nih.gov/35590415/\" rel=\"noreferrer\">Griffin, J. M., Healy, F. M., Dahal, L. N., Floisand, Y., &amp; Woolley, J. F. (2022). Worked to the bone: antibody-based conditioning as the future of transplant biology. Journal of Hematology &amp; Oncology, 15(1), 1-21.</a></em></p>\n<p>so that's probably a good place to start. It looks like two are in phase 3 clinical trials and another 15 or so in earlier clinical trials. You may also wish to read about reduced-intensity conditioning approaches, for example:</p>\n<p><em><a href=\"https://pubmed.ncbi.nlm.nih.gov/19203728/\" rel=\"noreferrer\">Giralt, S., Ballen, K., Rizzo, D., Bacigalupo, A., Horowitz, M., Pasquini, M., &amp; Sandmaier, B. (2009). Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biology of Blood and Marrow Transplantation, 15(3), 367-369.</a></em></p>\n<p>Typically, the existing conditioning paradigms used are meant to be sparing of other tissues, and while they certainly aren't perfect, these antibody-based methods aren't going to be perfect either: there's no guarantee of no effects on other cells, and no guarantee that all target cells are killed. Importantly, these transplants are typically done for treatment of cancers, and this approach will only work if the cancerous cells express the target surface marker. Traditional chemotherapeutic approaches have the benefit that their effectiveness is biased against proliferative cells, giving them a more generalized efficacy against cancer cells.</p>\n", "score": 5 } ]

[ "cancer", "stem-cells", "chemotherapy" ]

[ { "answer_id": 31908, "body": "<p>No, please refer to the rest of the sentence:</p>\n<blockquote>\n<p>Among 3958 participants enrolled in the v-safe pregnancy registry, 827 had a completed pregnancy, <strong>of which 115 (13.9%) were pregnancy losses</strong> and 712 (86.1%) were live births</p>\n</blockquote>\n<p>To further clarify, the abstract of the article notes:</p>\n<blockquote>\n<p>From <strong>December 14, 2020, to February 28, 2021</strong>, we used data from the “v-safe\nafter vaccination health checker” surveillance system</p>\n</blockquote>\n<p>That is a total of 76 days.</p>\n<p>Median human gestation is approximately <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3777570/\" rel=\"noreferrer\">268 days</a>. Thus, less than a third of a human gestation was covered by the study period.</p>\n<p>Therefore it is perfectly reasonable that only 827 of 3958 (21%) participants completed their pregnancy during the study period. Presumably, some of the participants didn't fill out the survey that lets the staff know about the outcome.</p>\n<p>Of the 827 who did have their pregnancy complete, 115 (13.9%) ended in a loss. This is consistent with previous estimates of pregnancy loss in the United States (Wilcox et al 1988. PMID <a href=\"https://pubmed.ncbi.nlm.nih.gov/3393170/\" rel=\"noreferrer\">3393170</a>).</p>\n", "score": 8 } ]

[ "obstetrics", "safety", "vaccine", "covid" ]

[ { "answer_id": 31949, "body": "<p>Probably the easiest way to compare them is to look at their material safety data sheets (MSDS).</p>\n<p>The <a href=\"https://www.fishersci.com/msdsproxy%3FproductName%3DBP16910%26productDescription%3DUREA%2B10%2BKG%26catNo%3DBP169-10%26vendorId%3DVN00033897%26storeId%3D10652\" rel=\"nofollow noreferrer\">MSDS for urea</a> lists its LD50 as 8471 mg/kg, so it's not very toxic stuff. The US Occupational Safety and Health Administration (OSHA) does not consider it a hazardous material.</p>\n<p>The <a href=\"https://www.fishersci.com/content/dam/fishersci/en_US/documents/programs/education/regulatory-documents/sds/chemicals/chemicals-a/S25164.pdf\" rel=\"nofollow noreferrer\">MSDS for ammonia</a> lists its LD50 as 350 mg/kg, so it's about 24 times more toxic than urea. OSHA definitely considers it a hazardous material. It has inhalation, contact, and ingestion dangers.</p>\n<p>Note that the LD50 values were determined using rats, so they can only be taken as estimates in humans.</p>\n", "score": 3 } ]

[ "disease", "toxins", "urea" ]

[ { "answer_id": 36, "body": "<p>You should probably go to a physical therapist. Physicals therapists are more specialized in that they will treat the actual injury and its source. </p>\n\n<p>\"Occupational therapy (OT) addresses patients' impairments and functional limitations with the purpose of increasing their capability to complete activities of daily living (ADLs).\" Occupational therapy is more for helping people get on with their everyday life, usually when you have a permanent disabilities, such as an amputated limb. They help people do things such as bath and cook independently. </p>\n\n<p>\"Physical therapy (PT) is a health profession that focuses on the movement of the human body. Physical therapists (PTs) and physical therapy assistants (PTAs) treat patients of all ages with physical impairments and functional limitations as a result of a medical condition or injury.\" Physical therapy is more for injuries that can be fixed (not 100% of the time, but close to it). This fits what you need, so the better option would be to go to a physical therapist.</p>\n\n<hr>\n\n<p><a href=\"http://www.missouricollege.edu/student-life/blog/october-2014/difference-between-occupational-and-physical-therapy\" rel=\"nofollow\">^{The Difference Between Occupational and Physical Therapy}</a></p>\n", "score": 3 } ]

[ "tendinopathy" ]

[ { "answer_id": 402, "body": "<p>One study <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8894337\" rel=\"nofollow noreferrer\">published in 1996 in the Clinical Journal of Sport Medicince</a> said that there are insufficient published data to determine the comparative risks and benefits of corticosteroid injections. Most side effects are temporary, but skin atrophy and depigmentation can be permanent.</p>\n<p>In a further study <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/12512406\" rel=\"nofollow noreferrer\">published in 2002 in Foot and Ankle Clinics</a> we read:</p>\n<blockquote>\n<p>Intimidation with adverse effects of peritendinous corticosteroid injections is based on case reports only rather than convincing data from controlled clinical studies.</p>\n<p><strong>Although a complete tendon rupture with loading after steroid injection has been reported, no reliable proof exists of the deleterious effects of peritendinous injections</strong>; conclusions in literature are based mainly on uncontrolled case reports that fail under scientific scrutiny, whereas scientifically rigorous studies have not been performed.</p>\n<p>Although corticosteroid injections are one of the most commonly used treatment modalities for chronic tendon disorders, there is an obvious lack of good trials defining the indications for and efficacy of such injections, and subsequently, many of the recommendations for the use of local corticosteroid injections do not rely on sound scientific basis. Thus, <strong>there is an obvious need for high-quality basic science studies and controlled clinical trials in examining the effects corticosteroids on various tendon disorders</strong>.</p>\n</blockquote>\n<p>Based on above studies, the effect of local corticosteroid injection(s) for tendon disorders is unknown. The extent of the tendon problem, the duration of the symptoms, and the phase of healing at the time of injection are factors that may modify the efficacy and side effect profile of this procedure. More studies need to be conducted to determine how these factors influence outcomes.</p>\n<p><a href=\"http://www.nhs.uk/Conditions/Tendonitis/Pages/Treatment.aspx\" rel=\"nofollow noreferrer\">NHS</a> has provided the following advice about corticosteroid injections:</p>\n<blockquote>\n<p>Corticosteroids can be injected around injured tendons to reduce pain\nand inflammation.</p>\n<p>While these injections can help reduce pain, they aren't effective for\neveryone and the effect sometimes only lasts a few weeks.</p>\n<p>The injections can be repeated if they help, but a gap of at least six\nweeks between treatments, and a maximum of three injections into one\narea, is usually recommended because frequent injections can cause\nside effects. Possible side effects include the weakening of the\ntendon (which can increase the risk of rupturing or tearing), and\nthinning and lightening of the skin.</p>\n</blockquote>\n", "score": 5 }, { "answer_id": 217, "body": "<p>Effects of cortisone ie. glucocorticoids (GCs) are very variable.</p>\n\n<p>One effect of GC is the inhibition of collagen formation. Collagen is the main ingredient of tendons. Collagen units form the backbone for tendons and makes them as strong as they are. As every tissue in human reproduces all the time so do tendons by forming new collagen as the old molecules deteriorate. If collagen formation is blocked this naturally leads to possible rupture of tendon.</p>\n\n<p>It is also important to note that GCs should never be injected IN tendon. Instead injection should be put as peritendinous to avoid imminent rupture. Of course in long run repeated peritendinous injections may lead to rupture.</p>\n\n<hr>\n\n<p>peritendinous = surrounding the tendon.</p>\n", "score": 3 } ]

[ "tendinitis", "steroids", "injections" ]

[ { "answer_id": 326, "body": "<p>From the picture and the symptoms you mentioned, especially the itchiness, it seems that you are right about it being that being eczema. Also, eczema is common behind the knees. From that picture though, it does not seem like that eczema is very bad. There are a lot of <a href=\"http://www.webmd.com/skin-problems-and-treatments/eczema/eczema-causes\" rel=\"nofollow noreferrer\">worse cases</a>. Though there is still some dispute in the medical world, one study<a href=\"http://nationaleczema.org/study-reveals-eczema/\" rel=\"nofollow noreferrer\">¹</a> says that the cause of eczema is a bacteria that lives on the skin. This bacteria blocks the sweat ducts, which causes a reaction in the immune system that causes irritation, itchiness, and rashes.</p>\n<p>WebMD<a href=\"http://www.webmd.com/skin-problems-and-treatments/eczema/eczema-causes\" rel=\"nofollow noreferrer\">²</a> says that it is likely that the immune system causes the reaction, but they also provide some other possible causes, such as genetics (eczema is usually common in families), certains environments you may be, and skin irritants like chlorine, makeup, and even some soaps and cleansers. It is likely that these skin irritants cause the bacteria mentioned above to react, which in turn cause the immune system to create rashes and irritation on certain parts of the skin.</p>\n<p><strong>Tips for treating eczema</strong></p>\n<p>Other than drugs that can be prescribed by your doctor, there are a few things you can do to help treat eczema.</p>\n<ul>\n<li><p>Use more mild soap - some soaps can cause dry skin; these are the types of soap that tend to irritate eczema; try to get soaps that won't make your skin dry (usually your doctor can recommend a brand)</p>\n</li>\n<li><p>Showering - taking long, hot showers can also cause your skin to dry up; instead take shorter, <strong>warm</strong> (not hot) showers</p>\n</li>\n<li><p>Reduce stress - stress can be a factor for an irritation in your body; just relax sometimes; also, try to get more sleep</p>\n</li>\n<li><p>Petroleum jelly - using petroleum jelly on the spot of the eczema can help relieve the need to scratch</p>\n</li>\n<li><p>Moisturize your skin - dry skin is a side effect of eczema, so moisturizing your skin is important</p>\n</li>\n</ul>\n<hr />\n<p>^{[<a href=\"http://nationaleczema.org/study-reveals-eczema/\" rel=\"nofollow noreferrer\">1</a>] <a href=\"http://nationaleczema.org/study-reveals-eczema/\" rel=\"nofollow noreferrer\">National Eczema Association - Study Reveals the Cause of Eczema</a>}</p>\n<p>^{[<a href=\"http://www.webmd.com/skin-problems-and-treatments/eczema/eczema-causes\" rel=\"nofollow noreferrer\">2</a>] <a href=\"http://www.webmd.com/skin-problems-and-treatments/eczema/eczema-causes\" rel=\"nofollow noreferrer\">WebMD - Eczema Health Center</a>}</p>\n", "score": 6 }, { "answer_id": 8736, "body": "<p>I have had this behind only one knee since shortly after I had 4x CABG at the age of 48. The doctor said is could be caused from a reaction to the cardiac meds I take. I take 25mg Metoprolol, 25mg, of Losartan Potassium, and 40mg of Simvastatin.</p>\n\n<p>The doctor, though not a dermatologist said that is the likely cause. I can't really stop taking the drugs to see if it goes away.</p>\n\n<p>I use Cortaid 10% and if I use it regularly it keeps the itching down which causes all of the problems to begin with. Sometimes the itching is so intense I scratch until the little bumps bleed.</p>\n", "score": 1 } ]

[ "dermatology", "eczema", "rash", "knee" ]

[ { "answer_id": 589, "body": "<p>Consumption of large quantities of sugar has been shown to cause a state of addiction^{<a href=\"https://en.wikipedia.org/wiki/Sugar_addiction\" rel=\"nofollow noreferrer\">wiki</a>}.</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12055324/\" rel=\"nofollow noreferrer\">Study from 2002</a> shown that excessive intake of sugar can cause signs of opioid dependence, because this kind of food stimulates our neural systems.</p>\n\n<blockquote>\n <p>Repeated, excessive intake of sugar created a state in which an opioid antagonist caused behavioral and neurochemical signs of opioid withdrawal. The indices of anxiety and DA/ACh imbalance were qualitatively similar to withdrawal from morphine or nicotine, suggesting that the rats had become sugar-dependent.</p>\n</blockquote>\n\n<p>This was confirmed by another study from <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17617461\" rel=\"nofollow noreferrer\">2008</a> that suggest sugar releases opioids and dopamine, therefore it might be expected to have addictive potential.</p>\n\n<p>This has been proven in animal model, so it may translate to some human conditions as well causing eating disorders and obesity.</p>\n\n<p>^{See also: <a href=\"https://health.stackexchange.com/q/584/114\">Does having too much sugary things cause headaches?</a>}</p>\n", "score": 5 }, { "answer_id": 1137, "body": "<p>Most of the studies study food addiction as a whole, because most of the biochemical mechanisms of food addiction are similar for the consumptions of sugar, refined flour, fats, caffeine and other substances. Also, addiction has been studied in relation of people's habit of eating food that is prepared with a combination of ingredients, as donuts or french fries, not separated ingredients. There are many studies that <strong>address the issue of excessive consumption of food as a real addiction</strong>, similar to that caused by drugs such as cocaine, heroin, alcohol and tobacco (Blumenthal &amp; Gold, 2010; Moreno &amp; Tandon, 2011).</p>\n\n<p>Dr. Ifland identifies the <strong>refined products (sweeteners, carbohydrates, fat, salt and caffeine) as the substances that have the greatest potential to cause addiction</strong>. Our body is programmed to recognize sugars and fatty substances as fundamental for life and health: they're energy reserves and address us toward the consumption of fruit, rich in fiber, vitamins and minerals. With the refining of foods we have an exaggerated concentration of sugars and fats, and this disrupts our evolutionary adaptation (Ifland et al., 2009).</p>\n\n<p>In the <strong>explanation of the mechanisms</strong> of addiction, there are at least three factors that contribute to the excessive consumption of foods. In the case of sugar and refined flour, part of the explanation goes through the concept of glycemic index: foods with <strong>high glycemic index</strong> - and load - cause a rise in blood sugar, which leads to an increase of insulinemia and subsequent hypoglycemia that is felt as hunger (Lennerz et al., 2013; Ludwig, 2002). Other explanations rely on the production of <strong>endogenous opioids</strong> caused by sugars that then would act as stimulants (Drewnowski, Krahn, Demitrack, Nairn, &amp; Gosnell, 1992, 1995), and the lower efficiency of <strong>dopamine receptors</strong>, which would lead to increased consumption of food to achieve the same satisfaction (Wang et al., 2001; Wang, Volkow, Thanos, &amp; Fowler, 2004). Lastly, a final interpretation refers to the fact that a high consumption of carbohydrates leads to increased levels of <strong>serotonin</strong>, which is perceived as a pleasant sensation (Wurtman, 1988).</p>\n\n<h2>References</h2>\n\n<p>Blumenthal, D. M., &amp; Gold, M. S. (2010). Neurobiology of food addiction. Current Opinion in Clinical Nutrition and Metabolic Care, 13(4), 359–65. doi:10.1097/MCO.0b013e32833ad4d4</p>\n\n<p>Drewnowski, A., Krahn, D., Demitrack, M., Nairn, K., &amp; Gosnell, B. (1992). Taste responses and preferences for sweet high-fat foods: Evidence for opioid involvement. Physiology &amp; Behavior, 51(2), 371–379. doi:10.1016/0031-9384(92)90155-U</p>\n\n<p>Drewnowski, A., Krahn, D., Demitrack, M., Nairn, K., &amp; Gosnell, B. (1995). Naloxone, an opiate blocker, reduces the consumption of sweet high-fat foods in obese and lean female binge eaters. Am J Clin Nutr, 61(6), 1206–1212. Retrieved from <a href=\"http://ajcn.nutrition.org/content/61/6/1206.short\" rel=\"nofollow\">http://ajcn.nutrition.org/content/61/6/1206.short</a></p>\n\n<p>Ifland, J. R., Preuss, H. G., Marcus, M. T., Rourke, K. M., Taylor, W. C., Burau, K., … Manso, G. (2009). Refined food addiction: a classic substance use disorder. Medical Hypotheses, 72(5), 518–26. doi:10.1016/j.mehy.2008.11.035</p>\n\n<p>Lennerz, B. S., Alsop, D. C., Holsen, L. M., Stern, E., Rojas, R., Ebbeling, C. B., … Ludwig, D. S. (2013). Effects of dietary glycemic index on brain regions related to reward and craving in men. The American Journal of Clinical Nutrition, 98(3), 641–7. doi:10.3945/ajcn.113.064113</p>\n\n<p>Ludwig, D. S. (2002). The Glycemic Index. JAMA, 287(18), 2414. doi:10.1001/jama.287.18.2414</p>\n\n<p>Moreno, C., &amp; Tandon, R. (2011). Should overeating and obesity be classified as an addictive disorder in DSM-5? Current Pharmaceutical Design, 17(12), 1128–31. Retrieved from <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21492085\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/21492085</a></p>\n\n<p>Wang, G.-J., Volkow, N. D., Logan, J., Pappas, N. R., Wong, C. T., Zhu, W., … Fowler, J. S. (2001). Brain dopamine and obesity. The Lancet, 357(9253), 354–357. doi:10.1016/S0140-6736(00)03643-6</p>\n\n<p>Wang, G.-J., Volkow, N. D., Thanos, P. K., &amp; Fowler, J. S. (2004). Similarity between obesity and drug addiction as assessed by neurofunctional imaging: a concept review. Journal of Addictive Diseases, 23(3), 39–53. doi:10.1300/J069v23n03_04</p>\n\n<p>Wurtman, J. J. (1988). Carbohydrate craving, mood changes, and obesity. The Journal of Clinical Psychiatry, 49 Suppl, 37–9. Retrieved from <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/3045110\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/3045110</a></p>\n", "score": 2 } ]

[ "nutrition", "sugar", "addiction", "food-addiction" ]

[ { "answer_id": 24501, "body": "<p>Glyphosphate is an organophosphate compound that is used a herbicide - it is generally aimed at inhibiting enzyme synthesis in plants.</p>\n<p>Generally, on oral intake from raw produce can produce toxicity, but the impact is low. [1]\nGlyphosphate formulations are usually mixed with additives that allow more rapid or easier transferral to the inside of plants, which can also increase acute toxicity in humans. [2]\nWith additives (which is how glyphosphate is usually in circulation) one of the more frequent problems is photocontact dermatitis due to preservatives used.</p>\n<p>[1] - <a href=\"https://doi.org/10.1016%2Fj.scitotenv.2017.10.309\" rel=\"nofollow noreferrer\">https://doi.org/10.1016%2Fj.scitotenv.2017.10.309</a></p>\n<p>[2] - <a href=\"https://www.fs.fed.us/r5/hfqlg/publications/herbicide_info/2003_glyphosate.pdf\" rel=\"nofollow noreferrer\">https://www.fs.fed.us/r5/hfqlg/publications/herbicide_info/2003_glyphosate.pdf</a></p>\n", "score": 1 } ]

[ "nutrition", "toxicity", "chemical", "carcinogens", "herbicide" ]

[ { "answer_id": 1138, "body": "<p>Most of the studies study food addiction as a whole, because most of the biochemical mechanisms of food addiction are similar for the consumptions of sugar, refined flour, fats, caffeine and other substances. Also, addiction has been studied in relation of people's habit of eating food that is prepared with a combination of ingredients, as donuts or french fries, not separated ingredients. There are many studies that <strong>address the issue of excessive consumption of food as a real addiction</strong>, similar to that caused by drugs such as cocaine, heroin, alcohol and tobacco (Blumenthal &amp; Gold, 2010; Moreno &amp; Tandon, 2011).</p>\n\n<p>Dr. Ifland identifies the <strong>refined products (sweeteners, carbohydrates, fat, salt and caffeine) as the substances that have the greatest potential to cause addiction</strong>. Our body is programmed to recognize sugars and fatty substances as fundamental for life and health: they're energy reserves and address us toward the consumption of fruit, rich in fiber, vitamins and minerals. With the refining of foods we have an exaggerated concentration of sugars and fats, and this disrupts our evolutionary adaptation (Ifland et al., 2009).</p>\n\n<p>In the <strong>explanation of the mechanisms</strong> of addiction, there are at least three factors that contribute to the excessive consumption of foods. In the case of sugar and refined flour, part of the explanation goes through the concept of glycemic index: foods with <strong>high glycemic index</strong> - and load - cause a rise in blood sugar, which leads to an increase of insulinemia and subsequent hypoglycemia that is felt as hunger (Lennerz et al., 2013; Ludwig, 2002). Other explanations rely on the production of <strong>endogenous opioids</strong> caused by sugars that then would act as stimulants (Drewnowski, Krahn, Demitrack, Nairn, &amp; Gosnell, 1992, 1995), and the lower efficiency of <strong>dopamine receptors</strong>, which would lead to increased consumption of food to achieve the same satisfaction (Wang et al., 2001; Wang, Volkow, Thanos, &amp; Fowler, 2004). Lastly, a final interpretation refers to the fact that a high consumption of carbohydrates leads to increased levels of <strong>serotonin</strong>, which is perceived as a pleasant sensation (Wurtman, 1988).</p>\n\n<h2>References</h2>\n\n<p>Blumenthal, D. M., &amp; Gold, M. S. (2010). Neurobiology of food addiction. Current Opinion in Clinical Nutrition and Metabolic Care, 13(4), 359–65. doi:10.1097/MCO.0b013e32833ad4d4</p>\n\n<p>Drewnowski, A., Krahn, D., Demitrack, M., Nairn, K., &amp; Gosnell, B. (1992). Taste responses and preferences for sweet high-fat foods: Evidence for opioid involvement. Physiology &amp; Behavior, 51(2), 371–379. doi:10.1016/0031-9384(92)90155-U</p>\n\n<p>Drewnowski, A., Krahn, D., Demitrack, M., Nairn, K., &amp; Gosnell, B. (1995). Naloxone, an opiate blocker, reduces the consumption of sweet high-fat foods in obese and lean female binge eaters. Am J Clin Nutr, 61(6), 1206–1212. Retrieved from <a href=\"http://ajcn.nutrition.org/content/61/6/1206.short\" rel=\"nofollow\">http://ajcn.nutrition.org/content/61/6/1206.short</a></p>\n\n<p>Ifland, J. R., Preuss, H. G., Marcus, M. T., Rourke, K. M., Taylor, W. C., Burau, K., … Manso, G. (2009). Refined food addiction: a classic substance use disorder. Medical Hypotheses, 72(5), 518–26. doi:10.1016/j.mehy.2008.11.035</p>\n\n<p>Lennerz, B. S., Alsop, D. C., Holsen, L. M., Stern, E., Rojas, R., Ebbeling, C. B., … Ludwig, D. S. (2013). Effects of dietary glycemic index on brain regions related to reward and craving in men. The American Journal of Clinical Nutrition, 98(3), 641–7. doi:10.3945/ajcn.113.064113</p>\n\n<p>Ludwig, D. S. (2002). The Glycemic Index. JAMA, 287(18), 2414. doi:10.1001/jama.287.18.2414</p>\n\n<p>Moreno, C., &amp; Tandon, R. (2011). Should overeating and obesity be classified as an addictive disorder in DSM-5? Current Pharmaceutical Design, 17(12), 1128–31. Retrieved from <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21492085\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/21492085</a></p>\n\n<p>Wang, G.-J., Volkow, N. D., Logan, J., Pappas, N. R., Wong, C. T., Zhu, W., … Fowler, J. S. (2001). Brain dopamine and obesity. The Lancet, 357(9253), 354–357. doi:10.1016/S0140-6736(00)03643-6</p>\n\n<p>Wang, G.-J., Volkow, N. D., Thanos, P. K., &amp; Fowler, J. S. (2004). Similarity between obesity and drug addiction as assessed by neurofunctional imaging: a concept review. Journal of Addictive Diseases, 23(3), 39–53. doi:10.1300/J069v23n03_04</p>\n\n<p>Wurtman, J. J. (1988). Carbohydrate craving, mood changes, and obesity. The Journal of Clinical Psychiatry, 49 Suppl, 37–9. Retrieved from <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/3045110\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/3045110</a></p>\n", "score": 1 } ]

[ "nutrition", "addiction", "refined-foods" ]

[ { "answer_id": 1135, "body": "<p>The most accurate data sets about nutrient intake of european population are linked to basically two sources:</p>\n\n<ol>\n<li><p>The <strong>EPIC</strong> cohort study, involving more than half a million participants recruited across 10 European countries and followed for almost 15 years. The homepage of the project is <a href=\"http://epic.iarc.fr\" rel=\"nofollow\">http://epic.iarc.fr</a> . There's not a unified table providing summarized statistics for all nutrients as I was asking in my question, but very reliable data can be extracted from individual studies that investigate singular nutrients; the list of these studies can be found here: <a href=\"http://www.nature.com/ejcn/journal/v63/n4s/index.html\" rel=\"nofollow\">http://www.nature.com/ejcn/journal/v63/n4s/index.html</a></p></li>\n<li><p>The <strong>European Nutrition and Health Report</strong>, 2009, showing similar statistics, togheter with other health and lifestyle indicators and major critical issues in each country. The report is here: <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20081327\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/20081327</a></p></li>\n</ol>\n", "score": 2 } ]

[ "nutrition", "micronutrients", "deficiency" ]

[ { "answer_id": 3861, "body": "<p>To the best of our knowledge, it just happens to some people and it's harmless. </p>\n\n<blockquote>\n <p>With aging, the tissues around your eyes, including some of the muscles supporting your eyelids, weaken. Normal fat that helps support the eyes can then move into the lower eyelids, causing the lids to appear puffy. Fluid also may accumulate in the space below your eyes, adding to the swelling.</p>\n</blockquote>\n\n<p>Unless there are additional symptoms, like itching or redness of the eye, there is no cause for concern. Some things can make it worse, like hot weather, and some things can make it look worse on some people, like people with very light skin. </p>\n\n<p>The medical expression is \"mild periorbital swelling\", by the way. Searching for it in medical databases will mostly lead to getting information on the rare cases where it was a symptom of a serious illness, though. </p>\n\n<p>Sources:</p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/bags-under-eyes/basics/definition/con-20034185\" rel=\"nofollow\">Mayo Clinic</a></p>\n", "score": 4 } ]

[ "eye" ]

[ { "answer_id": 850, "body": "<p>One might wonder why they gave an ambiguous and questionably relevant figure like \"reduces virus by 92%\" rather than saying \"people recovered more quickly\" or something like that. The answer is that in reference 1, which used real-world measures of cold severity and duration, the drug was a total failure. You can see this by looking on the results tab at the \"95% confidence interval.\" This is intended to represent a range of plausible values for the true effect of the drug, extrapolating from the sample of people that was studied (it gives a range of values because you can never know the exact value -- due to random chance, the people who were included in a study won't perfectly represent the entire population of people who might use the drug). By scientific convention, if the 95% confidence interval includes zero, the evidence isn't strong enough to say that the drug has an effect. </p>\n\n<p>The study looked at several outcomes, including patients' ratings of their symptoms, their impression of whether the drug worked, and the duration of their cold. For the first four outcomes, the confidence interval includes zero. For #5, duration of the cold, they don't report that kind of confidence interval, but they report a p-value which tells you the same thing (if p>.05, then by convention the evidence is not strong enough). For #6 they used a test where the critical value for the confidence interval is 1 and not 0. </p>\n\n<p>In other words, the clinical trial of this particular drug gives us little reason to believe that it works. That doesn't mean that it <em>doesn't</em> work, but they certainly haven't made a convincing case.</p>\n", "score": 2 } ]

[ "common-cold", "clinical-study" ]

[ { "answer_id": 869, "body": "<p>To be precise, one needs to know what \"normal\" means.</p>\n\n<p><em>Normal</em> is actually a function of two measurements (for example, hemoglobin level and number of people sampled with said hemoglobin level). This generates a bell-shaped curve. </p>\n\n<p>The graph of the normal distribution gives us both the mean and standard deviations from the mean. If the standard deviation is large, the curve is shorter and wider. If the standard deviation is small, the curve is taller and narrower. </p>\n\n<p>For example, if one measured 500 American males at 30 years of age who were 5'10 inches tall, your curve would look something like this:</p>\n\n<p><img src=\"https://i.stack.imgur.com/sqNgF.jpg\" alt=\"enter image description here\"></p>\n\n<p>where zero (the mean) might be 177 pounds. Including one standard deviation above and below the mean would represent ~68% of the population. Some will be thin, some will be heavy; they will fall outside this 68%.</p>\n\n<p>If the same measurements were taken in Africa, for instance, where there is a difference in diet and body habitus, then the mean might be 134 pounds. </p>\n\n<p>So, yes, it is possible to have different \"normals\" for different countries. However, that does not mean the same thing as \"healthy\" or \"optimum\".</p>\n\n<p>By and large, human beings are human beings, and what is regarded as healthy for an average person in Europe should be the same for an average person in India. </p>\n\n<p>There are exceptions, for example, sherpas in Nepal have a lower number of red blood cells compared to lowlanders who must accommodate themselves to lower oxygen in the highlands by making more red blood cells. This is a result of selection for a gene that regulates red blood cell production in the low oxygen of the highlands, with other compensatory mechanisms.</p>\n", "score": 2 } ]

[ "hematology" ]

[ { "answer_id": 889, "body": "<p>People tend to gain weight around the abdomen and hips because we generally have many more millions out fat cells in those areas and very few in the hands. It is possible to gain weight in your hands, but it is <em>not</em> possible to target weight gain in <em>only</em> your hands. Weight gain and weight loss happens systemically; that is, that your entire body gains and loses weight at the same time in proportion to the amount of fat cells in that part of your body. </p>\n\n<p>As for the disproportionate amount of fat cells in your abdominal region compared to your hands, I'm afraid you are just built that way.</p>\n", "score": 3 } ]

[ "weight", "hand", "stomach" ]

[ { "answer_id": 1577, "body": "<p>That <a href=\"https://en.wikipedia.org/wiki/Avocado#Toxicity_to_animals\" rel=\"nofollow\">wikipedia page</a> seems to blame the toxicity of some avacado parts to their content of persin. According to the <a href=\"https://en.wikipedia.org/wiki/Persin\" rel=\"nofollow\">page</a> on persin:</p>\n\n<blockquote>\n <p>Persin is a fungicidal toxin present in the avocado. It is generally\n harmless to humans, but when consumed by domestic animals in large\n quantities it is dangerous.</p>\n</blockquote>\n\n<p>Even in the case of animals, wikipedia suggests that it is the Guatemalan variety which is responsible for the reports of poisoning, not the Mexican variety. This is corroborated by <a href=\"http://www.gourmetsleuth.com/articles/detail/avocado-leaves\" rel=\"nofollow\">an article</a> which explains that the concern over the toxicity of avacado leaves originated with a 1984 study at the University of California at Davis. This study found that the consumption of very large amounts of avacado leaves was toxic to goats. However, an author of the atudy (Dr. Arthur Craigmill) clarified that the leaves in question were those of the Guatemalan avacado (<em>Persea american</em>), and that the toxic effects were not observed when goats were fed Mexican avacado leaves (<em>Persea dryminfolia</em>).</p>\n", "score": 4 } ]

[ "nutrition", "tea", "fruits" ]

[ { "answer_id": 5198, "body": "<ul>\n<li>It is usually only a problem in <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/002791.htm\" rel=\"nofollow noreferrer\">Ink poisoning</a>:</li>\n</ul>\n<blockquote>\n<p>Writing ink poisoning occurs when someone swallows ink found in\nwriting instruments (pens).</p>\n</blockquote>\n<p>And</p>\n<ul>\n<li><p><a href=\"http://www.livestrong.com/article/22877-ink-poisoning-symptoms/\" rel=\"nofollow noreferrer\">Allergies to skin:</a> Irritation to skin, burning or itching. Which are rare the main adverse effect is usually only staining do the dye in the ink.</p>\n</li>\n<li><p><a href=\"http://www.wisegeek.org/is-it-true-that-writing-on-skin-is-unhealthy-or-risky.htm\" rel=\"nofollow noreferrer\">Cuts in the skin and permanent ink can cause problems.</a></p>\n</li>\n</ul>\n<blockquote>\n<p>The primary concern with writing on skin with permanent ink is that\npermanent ink may contain xylene. Xylene is a toxic substance, though\ntoxicity is normally linked to inhalation.</p>\n<p>People can cause damage to their skin however, by cutting the skin and\nthen writing on skin with a permanent marker.</p>\n</blockquote>\n<ul>\n<li>I can find no evidence of a greater problem over time, unless you were referring to developing a allergy which is possible, but I found no evidence to support that statement.</li>\n</ul>\n<h2>Additional Info</h2>\n<ul>\n<li><p><a href=\"http://www.fda.gov/forconsumers/consumerupdates/ucm048919.htm\" rel=\"nofollow noreferrer\">FDA.gov</a> - About Tattoo ink</p>\n</li>\n<li><p>Skeptics SE - <a href=\"https://skeptics.stackexchange.com/questions/18586/can-you-get-ink-poisoning-from-drawing-or-writing-on-your-skin-with-pen\">Can you get ink poisoning from drawing or writing on your skin with pen?</a></p>\n</li>\n</ul>\n", "score": 2 } ]

[ "dermatology" ]

[ { "answer_id": 1054, "body": "<blockquote>\n <p>[I]s it logical/healthy to take in oral contraceptives on a regular basis even if one is not engaged in intercourse?</p>\n</blockquote>\n\n<p>There are several reasons to take oral contraceptive pills (OCPs) that have nothing to do with contraception. In that way, they can be considered medications to treat medical conditions, not contraceptives.</p>\n\n<p>In the case of women who bleed heavily during their periods, or those have their periods too frequently or irregularly, OCP's can reduce the amount of bleeding preventing anemia and can \"regulate\" cycles. </p>\n\n<p>When a woman has <a href=\"https://health.stackexchange.com/questions/975/\">excessive pain with menstruation</a>, OCPs can decrease the pain significantly. If women suffer from debilitating premenstrual dysphoric disorder symptoms (aka PMS), OCP help considerably.</p>\n\n<p>OCPs have been used to treat acne, hirsutism (excessive body hair, especially facial), and significant menstrual-related migraines.</p>\n\n<p>In women with premature menopause, OCP's can decrease the risk of endometrial and ovarian cancer.</p>\n\n<p>Interestingly, OCPs are not considered a good treatment of functional ovarian cysts, though intuitively one would think they were. </p>\n\n<blockquote>\n <p>Most patients are unaware of these health benefits and therapeutic uses of oral contraceptives, and they tend to overestimate their risk. Counseling and education are necessary to help women make well-informed health-care decisions ...</p>\n</blockquote>\n\n<p>As with any medication, discussion about the risks of OCP use should take place with the prescribing physician, and in the case of the benefits outweighing the risks, the choice to treat the condition with OCPs is quite logical. </p>\n\n<p>_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/11727171\" rel=\"nofollow noreferrer\">Noncontraceptive benefits and therapeutic uses of the oral contraceptive pill.</a>}<br>\n_{<a href=\"http://www.aafp.org/afp/2010/0801/p288.html\" rel=\"nofollow noreferrer\">ACOG Guidelines on Noncontraceptive Uses of Hormonal Contraceptives</a>}<br>\n_{<a href=\"http://europepmc.org/abstract/med/2226910\" rel=\"nofollow noreferrer\">Hormonal treatment of functional ovarian cysts: a randomized, prospective study.</a>}<br>\n_{<a href=\"http://www.sciencedirect.com/science/article/pii/S0015028207036618\" rel=\"nofollow noreferrer\">Consensus on infertility treatment related to polycystic ovary syndrome</a>}<br>\n_{<a href=\"http://press.endocrine.org/doi/abs/10.1210/jcem.85.8.6738\" rel=\"nofollow noreferrer\">Effect of Long-Term Treatment with Metformin Added to Hypocaloric Diet on Body Composition, Fat Distribution, and Androgen and Insulin Levels in Abdominally Obese Women with and without the Polycystic Ovary Syndrome</a>}</p>\n", "score": 7 } ]

[ "medications", "contraception", "gynecology" ]

[ { "answer_id": 1613, "body": "<p>There are a few tricks which can make the cross-legged position comfortable:</p>\n\n<ol>\n<li>Sitting more \"crossy\" - if you are not flexible enough to align your heels one in front of another, cross your ankles or even cross your shins.</li>\n<li>Elevate the hips above your knees (by using a cushion, blanket or yoga-block)</li>\n<li>Support your knees (again using cushions or something similar).</li>\n</ol>\n\n<p>These \"tricks\" come from <a href=\"http://www.yogajournal.com/article/beginners/finding-a-comfortable-seated-cross-legged-position/\" rel=\"nofollow\">yoga practitioners</a>:</p>\n\n<blockquote>\n <p><em>If you choose to sit cross-legged, it is important to have your knees level with or below your hips. If you are having difficulty maintaining an erect spine while sitting cross-legged, begin by sitting on the edge of a cushion, bolster, or rolled blanket. For additional support, place rolled blankets or bolsters under your knees. (You may find that with the knees supported, the inner groins relax and that when you take the supports away, your knees drop further easily.)</em></p>\n</blockquote>\n\n<p>You can see <a href=\"https://www.youtube.com/watch?v=Q3CbdfbUcG0\" rel=\"nofollow\">this demonstration video</a></p>\n\n<p>Apart from this, when you feel physical strain, a good idea is to make a break and stand up for a few minutes. This doesn't apply just to sitting on the floor, by the way, because sitting for a long time (regardless of the position) is connected with <a href=\"http://www.nhs.uk/livewell/fitness/pages/sitting-and-sedentary-behaviour-are-bad-for-your-health.aspx\" rel=\"nofollow\">health risks</a> and some experts recommend a break from sitting every 30 minutes. </p>\n\n<hr>\n\n<p>I don't have references for this part: the pain you are feeling might be caused by low flexibility (especially in the hips), but also week abdominal and paravertebral muscles (both of which are important for a good, straight-back posture). Working on these issues over time might help, but, as with any exercise program, you need to be aware of your general health and whether you have any specific health issues, so that you can exercise safely.</p>\n", "score": 2 } ]

[ "ergonomics", "posture" ]

[ { "answer_id": 1085, "body": "<p>The simple answer is \"metabolic lactic acidosis\". </p>\n\n<blockquote>\n <p>According to <a href=\"http://en.wikipedia.org/wiki/Exercise-induced_nausea\" rel=\"nofollow noreferrer\">Wikipedia</a>, the duration of exercise and intensity (aerobic vs anaerobic) and prior food or drink consumption are the main factors contributing to this effect.</p>\n</blockquote>\n\n<p>Actually, the Wiki articles doesn't quite say that (?).</p>\n\n<p>Prior food/drink would determine the glucose and glycogen - the stored form of glucose - available. Also, hydration is important.</p>\n\n<p>The <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/11237347\" rel=\"nofollow noreferrer\">very, very, very small study</a> (12 volunteers) linked by Wikipedia concludes that </p>\n\n<blockquote>\n <p>nausea [was] greater during exercise at fasting state and immediately after eating [a hamburger patty] than those without exercise (p&lt;0.05 during low-intensity exercise, and p&lt;0.01 during high-intensity exercise). Immediately after eating, scores for nausea were greater during high-intensity exercise than during low-intensity exercise (p&lt;0.05). During high-intensity exercise, scores for nausea were greater immediately after eating than without eating (p&lt;0.05).</p>\n</blockquote>\n\n<p>Normally, muscles using glucose as an energy source produce a 3-carbon molecule called pyruvic acid (or pyruvate). In the presence of oxygen, the pyruvate is further metabolized into CO₂, which is carried by the blood and exhaled from the lungs. </p>\n\n<p>Exercising beyond a certain point causes muscles to burn glucose under anaerobic (no oxygen) conditions (the blood cannot deliver oxygen to the muscles quickly enough.) The result is that pyruvate is converted into lactate (lactic acid) instead of CO₂ which is released from the muscle cells into the bloodstream, where it accumulates over time. Since lactate is a relatively strong acid, it results in a decreased pH (an increase in free hydrogen ions, or H+) of the blood. This is called <a href=\"http://en.wikipedia.org/wiki/Lactic_acidosis\" rel=\"nofollow noreferrer\">lactic acidosis</a>.</p>\n\n<p>Normally, H+ in the blood is efficiently handled by a <a href=\"http://en.wikipedia.org/wiki/Buffer_solution\" rel=\"nofollow noreferrer\">buffer</a>, <a href=\"http://en.wikipedia.org/wiki/Bicarbonate_buffering_system\" rel=\"nofollow noreferrer\">bicarbonate</a>.</p>\n\n<p><img src=\"https://i.stack.imgur.com/rZy6Y.png\" alt=\"enter image description here\"></p>\n\n<p>The direction of the equation in the case of acidosis is driven to the left by the concentration of hydrogen ions. Normally, the CO₂ that is formed is simply exhaled by increasing the respiratory rate. This decreases the H* concentration and is called compensatory <a href=\"http://fitsweb.uchc.edu/student/selectives/TimurGraham/Introduction_to_Acid_Base_disorders.html\" rel=\"nofollow noreferrer\">respiratory alkalosis</a>.</p>\n\n<p>There is respiratory compensation whereby the body increases breathing to expel H+ in the form of CO2. </p>\n\n<p>In the presence of excess H+, the body tries to compensate metabolically by increasing HCO₃-, which takes time. With continued exercise, the body cannot 'make' enough HCO₃- to handle all the H+, and the blood's pH falls.</p>\n\n<p>This is the situation which results in nausea and vomiting if serious enough.</p>\n\n<p>_{<a href=\"http://fitsweb.uchc.edu/student/selectives/TimurGraham/Introduction_to_Acid_Base_disorders.html\" rel=\"nofollow noreferrer\">Introduction to Acid-Base Disorders</a> &lt;- click through} </p>\n", "score": 5 } ]

[ "exercise", "nausea" ]

[ { "answer_id": 1226, "body": "<p>For a one off experiment, a search of <a href=\"https://www.youtube.com/results?search_query=dog+shock+collar+on+man\" rel=\"nofollow\">YouTube </a> suggests that while uncomfortable, testing a dog shock collar on yourself is not particularly risky. That said, if you wish to avoid the discomfort, existing videos might get the point across.</p>\n", "score": 3 } ]

[ "burns" ]

[ { "answer_id": 1136, "body": "<p><strong>Oil-Pulling<br/></strong></p>\n\n<blockquote>\n <p>Oil pulling is an ancient Ayurvedic practice that essentially involves\n swishing around oil in the mouth. Similar to a mouthwash, the oil\n “pulls” bacteria and toxins out of the mouth and, over time, can leave\n your teeth whiter and your gums healthier. And while oil pulling may\n seem a little “woo woo” at first, many studies have proven that the\n practice can be extremely beneficial to oral health and hygiene.]<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21911944\" rel=\"nofollow\">1</a></p>\n</blockquote>\n\n<p>I wouldn't use \"never\" as it's an absolute that usually doesn't work, yet there are some indications that oils may have certain oral health benefits such as <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21911944\" rel=\"nofollow\">alleviating halitosis</a> (bad breath), and reducing <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19336860\" rel=\"nofollow\">gingivitis</a> (inflammation of the gums).</p>\n\n<p><strong>White Grease<br/></strong>\nWhite grease is basically inedible pig fat used as lubricant in mechanics. The studies mentioned test traditional Indian folk remedies that rely on sesame or sunflower oil, but there doesn't seem to be much indication if any about white grease.</p>\n\n<p>Decreasing the amount of bacteria in the mouth could contribute to less cavities, though there's no certainty of either effect in white grease.</p>\n\n<p>According to this <a href=\"http://www.panef.com/pdf/MSDS%20WGA-6.pdf\" rel=\"nofollow\">safety data sheet on White Lithium Grease</a>, </p>\n\n<blockquote>\n <p>\"INGESTION: Ingestion may cause slight stomach irritation and\n discomfort.\"</p>\n</blockquote>\n\n<p>If you're willing to bear the risks of accidental ingestion (which shouldn't happen anyways if you're using it like mouthwash), then maybe you could find out for yourself.</p>\n\n<p>Sources: <br/>\n<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21911944\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/21911944</a> <br/>\n<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19336860\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/19336860</a> <br/>\n<a href=\"http://www.panef.com/pdf/MSDS%20WGA-6.pdf\" rel=\"nofollow\">http://www.panef.com/pdf/MSDS%20WGA-6.pdf</a></p>\n", "score": 4 } ]

[ "dentistry", "traditional-medicine" ]

[ { "answer_id": 4132, "body": "<p>Just crunching the numbers, it at least seems unlikely. </p>\n\n<p>The lethal dose of nicotine is often stated to be around <a href=\"http://www.cdc.gov/niosh/idlh/54115.html\" rel=\"nofollow\">50 to 60 milligrams</a>, though <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880486/\" rel=\"nofollow\">it might be higher, with more recent data putting it closer to 500.</a> </p>\n\n<p>While a cigarette contains about <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3905555/\" rel=\"nofollow\">6 to 10 milligrams</a>, only about <a href=\"http://m.pharmrev.aspetjournals.org/content/57/1/79.long?view=long&amp;pmid=15734728\" rel=\"nofollow\">1 milligram of that is absorbed</a>. The average <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953858/\" rel=\"nofollow\">half-life of nicotine is about two hours</a>, meaning half is eliminated after two hours. </p>\n\n<p>Smoking a cigarette takes several minutes, let's say 3. The lowest lethal dose estimates I could find were 30 milligrams; smoking 30 cigarettes, for ingesting 30 milligrams of nicotine, would then take 90 minutes, at which point the body has already gotten rid of some of the nicotine. </p>\n\n<p>Even at the very conservative estimate of 30 milligrams as a lethal, or at least toxic, dose, smoking likely won't get you there, unless doing it competitively for hours. Even for smoking cigarettes at the same time as using nicotine patches (OCT NRT) <a href=\"http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm345087.htm\" rel=\"nofollow\">the FDA states</a> </p>\n\n<blockquote>\n <p>There are no significant safety concerns associated with using more than one OTC NRT at the same time, or using an OTC NRT at the same time as another nicotine-containing product—including a cigarette. </p>\n</blockquote>\n\n<p>Eating cigarettes or drinking e-cigarette liquid are different stories, though. That's usually the scenarios in which nicotine overdoses occur. </p>\n\n<p>As always, <em>this is not medical advice</em>. Please don't try to smoke 60 cigarettes an hour. It's not healthy either way. </p>\n", "score": 1 } ]

[ "smoking" ]

[ { "answer_id": 1210, "body": "<p>I am not sure about the leaf you are asking about. But in India we use <a href=\"http://en.wikipedia.org/wiki/Clove#Traditional_medicinal_uses\" rel=\"nofollow\">Cloves</a> since centuries to soothe toothache.</p>\n\n<p>It is a flower bud and very effective against toothaches.</p>\n", "score": 1 } ]

[ "dentistry", "natural-remedy" ]

[ { "answer_id": 1250, "body": "<p>Assuming that you are a person <em>in normal good health</em> who wants to lose weight, the best approach for you is to either decrease your intake, exercise to offset some of your intake, or both.</p>\n\n<p>You say you noticed the weight gain when all your sports ended. That does tell you something. Eating to maintain energy and strength during sports is physiological. Eating the same amount once you stop engaging in that sport is going to add weight.</p>\n\n<p>There are all kinds of diets out there which, usually for monetary reasons, claim superiority over one another. You don't need to read about or follow any one specific diet to lose weight. If you decrease caloric intake over a sufficient period of time, you will lose weight.</p>\n\n<blockquote>\n <p>Reduced-calorie diets result in clinically meaningful weight loss regardless of which macronutrients they emphasize.</p>\n</blockquote>\n\n<p>One approach you can take is to eat the same stuff you eat right now, but eat less of it. If you eat a Wendy's Baconator for lunch on Saturdays, leave some of it uneaten. Leave a third of your shake, a third of your fries, etc. At home, eat a smaller portion of everything equally. If you consume sweets, like soda or other nutritionally empty calories, cut them out or cut them back.</p>\n\n<p>Exercise. Take walks, take hikes, ride a bike. A male your age probably plays video games. Cut back on these, and do something which exercises your body instead (it doesn't matter what; listening to your summer reading list on audiotape while walking/bicycling/etc. will do the job.) Learn to swim if you don't already know, and keep in shape this summer by swimming regularly.</p>\n\n<p>If you have medical problems, have other symptoms of concern other than just weight gain (e.g. fatigue, constipation, a change in your voice/hoarseness, weakness, etc.), or any other symptoms of concern, see a doctor. If, after an <em>honest effort</em> was made to lose weight, you are unable to, you can see a doctor for more specialized help and to determine if you need testing.</p>\n\n<p>_{<a href=\"http://www.nejm.org/doi/full/10.1056/nejmoa0804748\" rel=\"nofollow\">Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates</a>}</p>\n", "score": 4 } ]

[ "weight" ]

[ { "answer_id": 1319, "body": "<p>I will answer your questions separately:</p>\n\n<p>1) <strong>Teeth can shift on their own</strong>, due to the fact that they are supported by the periodontal ligament (PDL) that holds the teeth by their roots in your mouth, while still allowing them to move slightly. Think of it as a shock absorber. </p>\n\n<p>Most movement of teeth happens due to pressure that is applied to your teeth (ex: biting when eating) but also when an orthodontist slowly moves the teeth into place by having the orthodontic wire push and pull your teeth in a certain way for a long time. </p>\n\n<p>Wearing a retainer is important, to prevent the teeth from returning to the way they were before wearing braces. The periodontal ligament has a certain memory and will tend to \"spring\" back to where it was before.</p>\n\n<p>2) <strong>Your orthodontist should tell you exactly how often and how long you should wear the retainer.</strong> Here is an example of what an orthodontist might tell you: \"Some retainers are used full-time for the first 6 months; after that, the retainers are worn only at night, for a few years. Other retainers are worn full-time for about a week, and solely at night thereafter. Fixed retainers are normally kept in place for 5 years\" [1]</p>\n\n<p>3) <strong>Yes, you may drink water with your retainer in your mouth.</strong> Avoid eating or drinking anything else when wearing your retainer.</p>\n\n<p>Some of my Sources:</p>\n\n<p>[1] <a href=\"http://www.ndcs.com.sg/ForPatientsAndVisitors/ConditionsAndTreatments/Glossary/Pages/Orthodontics-AfterBracesAlwaysRetainers.aspx\">http://www.ndcs.com.sg/ForPatientsAndVisitors/ConditionsAndTreatments/Glossary/Pages/Orthodontics-AfterBracesAlwaysRetainers.aspx</a></p>\n", "score": 6 } ]

[ "dentistry" ]

[ { "answer_id": 7320, "body": "<p>I have suffered from health anxiety for the last couple of years and let me share some of the things I find helpful.</p>\n\n<ol>\n<li><strong>Stay hydrated</strong>: Drinking loads of water instantly relieves the tightness in your throat and definitely helps alleviate anxiety. If you think you're about to have a panic attack start drinking till your stomach is full and think about the movement of water inside you. This will help you alleviate some of the anxiety.</li>\n<li><strong>Take Deep Breaths</strong>: When you get anxious, flight and fight hormones are released into your bloodstream that causes muscle tightness and increased metabolism, elevated heartbeat rate etc. You must start taking deep controlled breaths as soon as you feel anxious. Also by counting backwards from 10 to 1 as you breathe it will help your mind achieve relaxation more quickly</li>\n<li><strong>Hypnosis &amp; Meditation</strong>: This is the long term solution to attack the anxiety itself. There are youtubers like Michael Sealey and Jason Stephenson who have wonderful meditation/hypnosis video guides that will help you learn how to control your anxiety and have a more positive outlook. Don't try to meditate when you're having a panic attack as this may irritate you further. Make it a routine to meditate on a daily basis for at least 40-50 mins. While it may not cure your anxiety it will definitely help you and motivate you to practice more meditation and ease your anxiety.</li>\n</ol>\n\n<p>Remember if your anxiety has a psychological source such as some kind of pain or worry then it may be useful to address those issues first. Ask yourself questions like why am I anxious? Is there a specific reason? Identify the reason and act accordingly. If you have a generalized anxiety disorder then meditation on a daily basis should rid you of anxiety once and for all. </p>\n", "score": 3 }, { "answer_id": 15780, "body": "<p>For all those people that are suffering for the same cause as me, I would like to recommend them to start practicing yoga, it has been so beneficial for me. I didn't think it was going to help me but it did, I was so desperate about getting a solution that I gave it a try even though some friends were laughing at me for practicing it. It takes about 3 weeks of every day doing it. If you are doing it, make sure you are doing the postures that you need to do for anxiety, stress, insomnia, etc. I was doing other kind of postures and then it didn't help me, but a yoga teacher taught me the right ones and I have been feeling so much better. It has helped me even more than acupuncture and massages, since they are only temporary fixes. </p>\n\n<p>You can do whatever you want to do to improve your life but this is what worked for me and I was suffering from this for at least 5 years, and now finally I'm seeing an exit from this everlasting problem, I just felt I had to share this because it feels terrible and I don't wish this to anybody. </p>\n", "score": 0 } ]

[ "stress", "anxiety-disorders" ]

[ { "answer_id": 1310, "body": "<p><a href=\"https://healthunlocked.com/thyroiduk/posts/789489/t3-vs-t4-read-t3-five-times-strength-t4.-also-t3-ten-times-stronger.-which-is-it-penny\" rel=\"nofollow\">This</a> is the best answer I could find (from a page with more discussion):</p>\n\n<blockquote>\n <p>In a mythical \"normal\" human, around one third of the T4 is converted\n to T3. So you could argue that T3 is \"three times as strong as T4\". </p>\n \n <p>When taking tablets, for example, changing from T4 only to mixed T3\n and T4, it is common to estimate on the basis of T4 being one quarter\n the \"strength\" of T3. </p>\n \n <p>So, 100 mcg T4 (thyroxine) could be similar to 25 mcg of T3\n (liothyronine) OR 50 mcg of T4 plus 12.5 mcg of T3. </p>\n \n <p>This seems a reasonable basis for estimating doses but it is no better\n than an informed guess. </p>\n \n <p>BUT if you are NOT converting properly this falls down. Imagine if you\n are taking 100 mcg of thyroxine and NONE of it is converting. So you\n have NO T3. You then take just 10 mcg of T3 and that has an effect\n which the T4 NEVER had. So there really is no way you can think of one\n being stronger than the other. One does something; the other does not</p>\n</blockquote>\n", "score": 1 } ]

[ "medications", "drug-metabolism" ]

[ { "answer_id": 1334, "body": "<p>You may have answered your own question (\"However, these exotic fruits originate from countries with more dubious environmental or safety standards, or without any norms or oversight whatsoever\") if your goal is to eliminate toxic chemicals from your diet. The point of growing organic food is to minimize, if not eliminate, the presence of toxic chemicals (pesticides, fertilizers, etc.) in the food you consume. The following articles may help you make the decision:</p>\n\n<p>In the article, <a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/organic-food/art-20043880?pg=1\" rel=\"nofollow\">Organic foods: Are they safer? More nutritious?</a> The Mayo Clinic explains the rationale for \"going organic\", but they also provide some tips that may apply when an organic option is not available, as in the case you cite. </p>\n\n<p>In <a href=\"http://suppversity.blogspot.com/2012/09/conventional-vs-organic-its-not-about.html\" rel=\"nofollow\">Conventional vs. Organic: It's Not About Getting More, But Getting Less For Your Money. Less Pesticides, Dioxins &amp; Co</a>, a well documented article exploring the subject of organic vs. conventionally grown food by by Prof. Dr. Andro, Figure 1, near the top of the article shows a definite contrast in pesticide levels in organic exotic fruits vs conventionally grown exotic fruits. </p>\n", "score": 4 } ]

[ "fruits", "organic" ]

[ { "answer_id": 3231, "body": "<p>I've seen reports of the Fitbit HR being off by 25 BPM. I'm not familiar with the Dr. Coca pulse test, but the paper you link to mentions pulse rates that differ by only 10 BPM. <a href=\"https://www.youtube.com/watch?feature=player_embedded&amp;v=uWnaqsLSl8c\" rel=\"nofollow\">It appears that consumer Photoplethysmogram monitors work best when the patient is inactive.</a> I suspect the accuracy also depends on your physiology. I would recommend trying a wrist monitor such as the Fitbit HR, a chest strap monitor, and taking your pulse manually. Do this while you're inactive and compare the results. If the Fitbit HR is off from your manual measurement by 25 BPM, it sounds like it won't be useful for the Dr. Coca pulse test.</p>\n\n<p>There are other options for monitoring heart rate that are very accurate:</p>\n\n<ol>\n<li>A holter monitor. These are usually prescribed devices--the hospital or physician loans them to you (though it appears you can get them on eBay).</li>\n<li>An Implantable Cardiac Monitor (ICM) (also known as an Implantable Loop Recorder (ILR)). This is an implantable device similar to a pacemaker, however it only measures your heart activity--it doesn't provide therapy (electrical stimulus). Some examples are the <a href=\"http://www.biotronik.de/wps/wcm/connect/en_biomonitor/biotronik/home/biomonitor_home\" rel=\"nofollow\">Biotronik BioMonitor</a> and the <a href=\"http://www.medtronic.com/patients/fainting/device/our-insertable-cardiac-monitors/reveal-linq-icm/\" rel=\"nofollow\">Medtronik Reveal LINQ</a>.</li>\n<li>There are disposable holter monitor patches that are coming onto the market. Many of these are still in clinical trials, however. The advantage of these devices is that they don't have to be implanted and you don't have to wear a bulky unit on your belt.</li>\n</ol>\n\n<p>All three of the options above are used for diagnosing heart conditions by looking at ECG signals--they're probably overkill for your application, but they would work.</p>\n", "score": 0 } ]

[ "allergy" ]

[ { "answer_id": 7575, "body": "<p>Otitis media with effusion (OME) is most common in young children (under 2) making studying the effects on hearing difficult. While <a href=\"http://www.cdc.gov/features/newbornhearing/\" rel=\"nofollow\">newborn hearing screening</a> is common, it does not provide a full audiogram. Collecting an audiogram a a child who does not speak or understand direction and has limited attention is hard. Collecting an audiogram on a sick child is even harder. With a some serious caveat regarding sample size, <a href=\"http://www.sciencedirect.com/science/article/pii/S0163638397900308\" rel=\"nofollow\">Werner and Ward (1997)</a> provide the best study on this that I am aware of. They conclude that the effect of OME is 15-30 dB (while the child is sick).</p>\n", "score": 1 } ]

[ "hearing-impaired", "decibels", "middle-ear" ]

[ { "answer_id": 1460, "body": "<p>Your question is too big to be answered with a formal analysis. So here is a back of the envelope assessment:</p>\n\n<p>[A] We are worse off today (vs. 1900) because of:</p>\n\n<ul>\n<li>tobacco use</li>\n<li>obesity</li>\n<li>iPods (every adult will be deaf in 20 years)</li>\n<li>motor vehicle accidents, gun violence, immense wars</li>\n</ul>\n\n<p>[B] We are better off today (vs. 1900) because of:</p>\n\n<ul>\n<li>better nutrition (hunger was common in the USA even into the 1960s)</li>\n<li>public health improvements (e.g. clean water, shoes for all).</li>\n<li>refrigeration (stomach cancer was #1 in 1900, owing to widespread pickling of foods).</li>\n<li>safer work conditions.</li>\n</ul>\n\n<p>[C] Important medical developments since 1900:</p>\n\n<ul>\n<li>antibiotics</li>\n<li>anti-tuberculous medicines</li>\n<li>hypertension control</li>\n<li>vaccines</li>\n<li>infant mortality</li>\n<li>everything else is rounding error</li>\n</ul>\n\n<p>[D] Not a factor:</p>\n\n<ul>\n<li>genes</li>\n<li>alcohol (bad, but probably same vs. 1900)</li>\n</ul>\n\n<p>So, life in 2015 = C + B - A. Your question is whether B - A is better than life in 1900. </p>\n\n<p>Comparing survival curves, the biggest change in survival is the huge improvement in living to age 5.</p>\n\n<ul>\n<li>20% of people dead by age 5 (USA whites, 1900)</li>\n<li>8% of people dead by age 5 (USA whites, 1930)</li>\n<li>5% of people dead by age 5 (USA whites, 1940)</li>\n<li>40% of people dead by age 5 (British India, 1921-1930)</li>\n</ul>\n\n<p>If you look at the curves from 1900 vs. 1940, there is not that much difference once the initial large difference is subtracted. I was too lazy to go looking for more recent curves, but I doubt it would be much different. The median survival in 1940 was 70 years for USA whites.</p>\n\n<p>I do not think this early life difference can be explained by an improvement in medical care. It was public health, i.e. improved living conditions (including adequate food).</p>\n\n<p>You can find interesting historical survival curves in the book <em>Ageing: The Biology of Senescence</em>, 1964.</p>\n", "score": 1 } ]

[ "life-expectancy" ]

[ { "answer_id": 1502, "body": "<p>After some more google-research, I found this paper, published a couple of years after I received my BCG vaccination: <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1745564/\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1745564/</a></p>\n\n<p>The paper describes \"multipuncture\" as a method of delivering BCG as an alternative to the intradermal method, so apparently my memory was correct.</p>\n", "score": 3 } ]

[ "vaccination", "tuberculosis", "hypodermic" ]

[ { "answer_id": 1642, "body": "<p>First, congrats on actually being more comfortable sitting up-right. I've yet to master the talent.</p>\n\n<p>In short, I can't say the relation between old piano players in great health is directly related to or, is the result of a piano bank and an upright posture. </p>\n\n<p>That being said, a majority of the money spent on office chairs are for those ergonomic adjustable features for lazy sitters (myself included). If I can buy a chair that will posture me for me, count me in.</p>\n\n<p>Now, a backed chair I'm sure was purposed to keep people from falling off the back end but for today's office oriented purpose of keeping you upright, you're able to do without. </p>\n\n<p>Use whatever makes you comfortable and doesn't pull you out of the correct posture.</p>\n\n<p>Just out of curiosity though, does your as* ever start to hurt? That's the only concern I see from using a piano bank at my desk! </p>\n", "score": 1 } ]

[ "ergonomics", "posture" ]

[ { "answer_id": 3600, "body": "<p>Blood pressure that is lower in the morning than at noon or evening is perfectly normal. Variations on the level that you describe, which is 5 mm Hg systolic (the first number), are also completely normal. Blood pressure doesn't stay the same, it varies with activity, emotional state, etc. </p>\n\n<p>The first figure in the following paper illustrates normal blood pressure variations throughout a day: <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261916/#!po=10.4938\" rel=\"nofollow\">Prognostic Significance of the Morning Blood Pressure Surge in Clinical Practice: A Systematic Review</a>. The paper's topic is abnormal surges in blood pressure, which are surges before waking. </p>\n\n<p>A fluctuation of more than 14 mm Hg systolic as taken at the same time a day (without doing sports beforehand etc) should be checked out <a href=\"http://www.m.webmd.com/a-to-z-guides/news/20150727/big-swings-in-blood-pressure--could-spell-trouble\" rel=\"nofollow\">by a doctor</a></p>\n", "score": 2 } ]

[ "blood-pressure", "blood" ]

[ { "answer_id": 1679, "body": "<p>Yes, you should be looking into getting help.</p>\n\n<p>Nausea during chemotherapy is very common, and should be treated. But nausea in the morning 9 years after chemotherapy? That is not at all normal.</p>\n\n<p>There are a great many medical problems <a href=\"http://www.mayoclinic.org/symptoms/nausea/basics/causes/sym-20050736\" rel=\"noreferrer\">that can cause nausea</a>, including, unfortunately, a possible recurrence of her cancer. These should be ruled out by her doctor(s) as soon as possible.</p>\n\n<p>While you are waiting to see the doctor, you mentioned, ginger is a natural anti-emetic (anti-nausea). Ginger tea, ginger ale and even candied ginger can help. Eating 5-6 smaller meals, rather than 3 large meals, helps, as does keeping plain crackers by the bedside and eating some as soon as she wakes up (before rising), and rice or toast at night. </p>\n", "score": 5 } ]

[ "cancer", "prevention", "stomach", "chemotherapy", "anti-nausea" ]

[ { "answer_id": 1695, "body": "<p>Calculating from the numbers Wikipedia's articles on <a href=\"https://en.wikipedia.org/wiki/Bone_marrow\">bone marrow</a> and <a href=\"https://en.wikipedia.org/wiki/Red_blood_cell#Human_erythrocytes\">red blood cells</a>, the bone marrow in an adult human produces between 200 billion and 500 billion red blood cells a day, taking between 60 and 120 days to produce enough to replace the 20-30 trillion red blood cells in circulation. Under normal conditions, red blood cells wear out and are replaced on a 120-day cycle; presumably the faster production rate is for dealing with injuries or other abnormal loss of RBCs.</p>\n", "score": 8 } ]

[ "blood" ]

[ { "answer_id": 1719, "body": "<p>Many sleeping pills are addictive.\nMany non-addictive sleeping pills can be mentally addictive.</p>\n\n<p>If you do not mind using sleeping pills for the rest of your life, then that is a perfectly fine choice.</p>\n\n<p>Otherwise, you may want to consider other options first.</p>\n\n<p>Exercise will help. Use up your energy and your body will WANT sleep. Exercise is key to your body's cycles.<br>\nYour circadian rhythm (sleeping cycle) is largely affected by light. Particularly, artificial light gives off a lot of light in the frequency range that causes your body to think its NOT time to sleep and will screw up your cycles. When you know you have time to sleep, stay away from staring at computer screens as much as possible.<br>\nStay away from stimulants. i.e. caffeine or whatever else you may use throughout the day/night.</p>\n\n<p>The huge factor here is that you said you have no official known work hours and you go in whenever they ask you to. <br>If that means that you never know when you might have a good 6-8 hours of sleeping time, then there really is no way to \"fix your cycles\" since it is a constantly moving unknown. Sleeping pills <em>MAY</em> be the only realistic answer in that case. <br>However, if you are able to figure out times when you know you will be off work for a certain number of hours more often than not, then you have a good chance of trying to fix your sleeping cycle.</p>\n\n<p><a href=\"http://www.sciencedirect.com/science/article/pii/S0003687012001159\" rel=\"nofollow\">Light level and duration of exposure determine the impact of self-luminous tablets on melatonin suppression</a></p>\n\n<p><a href=\"http://www.pnas.org/content/112/4/1232.full.pdf\" rel=\"nofollow\">Evening use of light-emitting eReaders negatively\naffects sleep, circadian timing, and\nnext-morning alertness</a></p>\n\n<p><a href=\"http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=29249\" rel=\"nofollow\">The Sleep and Technology Use of Americans: Findings from the National Sleep Foundation's 2011 Sleep in America Poll</a></p>\n", "score": 3 } ]

[ "sleep", "sleep-cycles" ]

[ { "answer_id": 1741, "body": "<p>Dry cough is most often non-inflammatory. If you had a flu or influenza prior to the beginning of the symptoms, then you might suffer from something post-viral. It is usually self-limiting. <a href=\"https://en.wikipedia.org/wiki/Post-viral_cough\" rel=\"nofollow\">(Wikipedia)</a></p>\n\n<p>The fact that cold air provokes your symptoms might be indicative of <a href=\"http://asthma.ca/teamasthma/asthma_coldair_manage_eng.pdf\" rel=\"nofollow\">asthma</a>. As such, you may need to see a <strong>pulmonary specialist</strong>. Certainly he/she run some basic tests like a chest x-ray for a starter. <strong>Spirometry</strong> is also the routine test to be performed.</p>\n", "score": 3 } ]

[ "lungs", "cough" ]

[ { "answer_id": 1791, "body": "<p><em>You should thank your wife 1 million times for the cure that she suggested for you.</em></p>\n<p>The fact that the pain has gone, is probably related to the type of bacteria that caused the inflammation. Common salt is a mineral composed primarily of sodium chloride (NaCl), and there are some types of bacteria that cannot tolerate high concentrations of sodium chloride (NaCl) (These bacteria are called : Non-halophilic bacteria), hence, salt is the perfect way to get rid of non-halophilic bacteria.\nIn addition, I've been using salt-washing everytime I have toothache, and this works for me.</p>\n<blockquote>\n<p>And my answer is <strong>YES</strong>, salt-washing is a good cure for gum\ninflammation.</p>\n</blockquote>\n<p>These articles dealing with such pain (Gum pain, toothache..) remedies, include SALT as a remedy :</p>\n<blockquote>\n<p>1/ <a href=\"http://www.wikihow.com/Treat-Gum-Disease-With-Homemade-Remedies\" rel=\"nofollow noreferrer\">Treat Gum Disease With Homemade Remedies</a></p>\n<p>2/ <a href=\"http://www.livestrong.com/article/370884-how-to-reduce-pain-of-gum-disease/\" rel=\"nofollow noreferrer\">How to Reduce Pain of Gum Disease</a></p>\n</blockquote>\n", "score": 0 } ]

[ "dentistry", "home-remedies", "salt", "gums" ]

[ { "answer_id": 1824, "body": "<p>One big problem here is that it's difficult to do double blind studies. One is then forced to use more theoretical arguments, but because medical science is not a hard science like physics, such arguments are not very reliable. The best we can then do is argue from biological plausibility, in this case we should take serious the fact that Homo Sapiens evolved more than 200,000 years ago while people only started to take baths relatively recently. The adaptation via natural selection over hundreds of millions years since the first land animals evolved is thus still relevant for us. The human microbiome consisting of all the microbes that live on our skins, in our intestines is known to play non-trivial roles, but we don't know a lot about how this impacts our health (from rigorous randomly controlled trials) </p>\n\n<p>This means that the null hypothesis should assume that never washing, bathing or taking showers is beneficial for health over even occasionally doing so. You should need strong evidence to overturn this null hypothesis. Such strong evidence is lacking, what evidence there is there is consistent with this null hypothesis. E.g. we can <a href=\"http://www.bbc.com/news/health-28934415\">read here</a>:</p>\n\n<blockquote>\n <p>One hunter-gatherer community was found to not only have a higher diversity of bacteria, but only one in 1,500 suffered from an allergy - compared with one in three in the UK.</p>\n</blockquote>\n\n<p>Theoretical arguments can e.g. be <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518434/\">found here</a>.</p>\n", "score": 5 } ]

[ "dermatology", "hygiene", "oil-of-skin", "hair" ]

[ { "answer_id": 1839, "body": "<p>You should read the article carefully. In the Introduction section they give some insight for their study: </p>\n\n<blockquote>\n <p>The majority of AD cases are sporadic in nature. The small fraction of familial cases are caused primarily by mutations in three genes: amyloid precursor protein (APP), presenilin1 (PS1), and presenilin 2 (PS2).</p>\n</blockquote>\n\n<p>They clearly specify what they are investigating:</p>\n\n<blockquote>\n <p>Here we demonstrate that a WS extract reverses behavioral deficits and plaque pathology and reduces the Aβ burden in middle-aged and old APP/PS1 mice through up-regulation of liver LRP, leading to increased clearance of Aβ. </p>\n</blockquote>\n\n<p>So they are investigating the effects of this herb in mice which are \"diagnosed\" with familial Alzheimers disease (AD).</p>\n\n<p><strong>Less than 0.1% of all cases of AD are familial</strong> (<a href=\"http://Here%20we%20demonstrate%20that%20a%20WS%20extract%20reverses%20behavioral%20deficits%20and%20plaque%20pathology%20and%20reduces%20the%20A%CE%B2%20burden%20in%20middle-aged%20and%20old%20APP/PS1%20mice%20through%20up-regulation%20of%20liver%20LRP,%20leading%20to%20increased%20clearance%20of%20A%CE%B2.\" rel=\"nofollow\">Lancet</a>).</p>\n\n<p>The sad thing is that we have no possibility whatsoever to tell whether a patient have the familial type AD. Let´s make a wild assumption that this herb would actually reverse AD in 1% of patients with familial AD (This 1% we would be remarkable in this context). We need to treat 100,000 patients with AD to reverse it in one patient. That kind of \"treatment\" would not be feasible at all.</p>\n\n<p>Moreover, there are probably hundreds or thousands herbs and drugs which have shown promising results in animals. Unfortunately, >99% of these molecules and potential drugs fail to work in humans. This is due to facts that our fundamental understanding in disease processes are poor and the complexity of the diseases are so overwhelming that the proposed mechanism of recovery observed in the animal subjects with \"artificial\" diseases just don´t work similarly in human subjects.</p>\n", "score": 4 } ]

[ "neurology", "natural-remedy", "alzheimers" ]

[ { "answer_id": 3597, "body": "<p>Acne can be caused by several things, one of which is bacteria. The bacteria involved in acne are called <em>Propionibacterium acnes</em>. This bacteria species usually only colonizes the skin. Its main source of energy are the products of skin glands. In people with overactive glands, they grow to large numbers, and their byproducts lead to the inflammation known as acne. </p>\n\n<p>Dental abscesses are caused by a variety of anaerobic bacteria and the toxins they produce. <em>Propionibacterium acnes</em> would not get to the location of the dental abcess and would not outcompete the anaerobic bacteria in there because it is relatively slow growing while the bacteria causing the dental abscess are fast growing under the conditions present. </p>\n\n<p>Furthermore, there is no need for this anyway. <em>Propionibacterium acnes</em> is present on the skin of most healthy adults. </p>\n\n<p>There is, however, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10467506\" rel=\"nofollow\">one case report</a> from 1999 linking a case of dental abscess with the appearance of acne. The full case report is not accessible anymore and I can't find any paper citing it. That case report, however, also does not propose the mechanism you describe. </p>\n\n<blockquote>\n <p>We believe that the presence of our patient's dental infections provoked a follicular inflammatory response resulting in his recalcitrant acne.</p>\n</blockquote>\n\n<p>I interpret that as them saying that the immune response to the dental abcess might have triggered an immune response to the already present <em>Propionibacterium acnes</em></p>\n\n<p><strong>Sources and further reading</strong></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/books/NBK83685/\" rel=\"nofollow\">Scientific American : Does 1 Type of Bacteria Cause Acne? </a></p>\n\n<p><a href=\"http://www.scientificamerican.com/article/good-versus-bad-acne-bacteria/\" rel=\"nofollow\">PROPIONIBACTERIUM ACNES AND CHRONIC DISEASES</a></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/books/NBK83685/\" rel=\"nofollow\">The microbiology of the acute dental abscess</a></p>\n", "score": 3 } ]

[ "dentistry" ]

[ { "answer_id": 1945, "body": "<p>Restless Legs Syndrome (a.k.a. Willis-Ekbom Disease) is not rare! What it is is woefully under-diagnosed. Not that you asked, but, although estimates of prevalence vary widely depending on the criteria used, <a href=\"http://journal.publications.chestnet.org/article.aspx?articleid=1084803\" rel=\"nofollow\">5-8% of people in Europe/U.S</a> have clinically significant RLS/WED, with women affected about twice as often as men. </p>\n\n<p>Now to what you did ask: treatment of RLS/WED. In most situations, there is no <em>curative</em> treatment. However, there are excellent (mostly pharmacologic) treatments available to suppress symptoms. A few words about the various treatments by class:</p>\n\n<ol>\n<li><p><strong>Iron.</strong> For reasons that are not fully understood, even sub-clinical (i.e. otherwise non-problematic) iron deficiency is associated with an increased prevalence of RLS/WED, and <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25441748\" rel=\"nofollow\">treatment with iron has been repeatedly shown to be helpful in that population</a>. Recommendations vary, but most people would agree that iron supplementation should be provided to raise ferritin >20 μg/L, with some advocating cut-offs as high as 50 μg/L. Transferrin saturation should also be > 16% - 20%. Occasionally, RLS symptoms completely resolve with treatment of iron deficiency.</p></li>\n<li><p><strong>Dopaminergic agents.</strong> L-dopa (the therapeutic ingredient in Sinemet) has long been known to be effective treatment for RLS/WED. Unfortunately, it tends to promote <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24978636\" rel=\"nofollow\">“augmentation”</a>, where the drug ends up causing an iatrogenic worsening of symptoms over time, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26045290\" rel=\"nofollow\">necessitating a change in treatment</a> The newer dopamine agonists - pramipexole and ropinirole - have a lower (although still existent and commonly problematic during long-term treatment) incidence of augmentation. These are the medications most people start with for treating RLS. Nearly all patients who are correctly diagnosed will have at least partial improvement in RLS/WED symptoms with introduction of dopamine agonists. </p></li>\n<li><p><strong>Alpha-2-delta agents</strong>. This is a class of anti-epileptic drugs that has been increasingly used for treatment of RLS in recent years. The advantage of these drugs over dopaminergic agents is mostly that they are much less likely to cause augmentation. (Some would say that augmentation is <em>exclusively</em> a dopaminergic phenomenon, but this is debated.) The most commonly used drugs in the U.S. in this category are gabapentin and pregabalin. A <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24521108\" rel=\"nofollow\">landmark study in 2014</a> published in the New England Journal indicated that pregabalin is at least as effective as pramipexole, with a much lower incidence of augmentation. These drugs may become first-line agents in the future.</p></li>\n<li><p><strong>Opiods</strong>. You mentioned a family member on methadone for RLS/WED. This medication in particular <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21239226\" rel=\"nofollow\">is remarkably effective for RLS</a>. There was also a <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24140442\" rel=\"nofollow\">recent study demonstrating the efficacy of oxycodone</a>. Opioids have many side effects for long term usage (some of the more problematic: respiratory depression, potential for overdose, abuse potential, constipation). However, particularly for patients who have been suffering from RLS for many years and experienced augmentation with dopaminergic agents, opioids are at times appropriate and generally provide substantial relief. </p></li>\n</ol>\n\n<p>Please see <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22851801\" rel=\"nofollow\">the most recent practice parameters from the American Association of Sleep Medicine</a> and <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/23460396\" rel=\"nofollow\">a recent meta-analysis of treatment options</a> for further information. </p>\n", "score": 3 } ]

[ "treatment-options", "sleep-deprivation", "sleep-aids", "sedative-sedation" ]

[ { "answer_id": 1978, "body": "<p>Mild case of artistic license. </p>\n\n<p>The effects of epinephrine are rapid and can be dramatic, but <a href=\"http://www.rxlist.com/epipen-drug/consumer-uses.htm\">they're not long-lasting</a>. EpiPens are only intended as a delaying tactic to buy time for the patient to get to more definitive medical care. </p>\n\n<p>But how much that matters depends on the severity of the reaction. If someone had a relatively mild reaction and used an EpiPen, could they continue to function and recover without medical care? Yes, absolutely, especially if their exposure was limited. EpiPens didn't always exist, after all, and anaphylaxis has never been 100% fatal.</p>\n\n<p>But if the character was portrayed as having a severe, potentially lethal allergy to peanuts and was force-fed handfuls of them, I would expect her to spend days in the hospital, quite possibly in an ICU. She might manage to run or put up a fight for a while, but not for long.</p>\n\n<p>Portraying epinephrine as a magic potion was definitely artistic license.</p>\n", "score": 6 } ]

[ "treatment", "allergy", "drug-administration", "epi-pen-epinephrine", "nuts" ]

[ { "answer_id": 2004, "body": "<p>I am not sure about physiotherapists, but one solution that is over thousand years old is <a href=\"http://www.artofliving.org/yoga/yoga-poses/sun-salutation\" rel=\"nofollow noreferrer\">Surya Namaskar, or Sun Salutations</a>.</p>\n<p>One rep = two sets of yoga poses that give you a total body workout.</p>\n<p><a href=\"https://i.stack.imgur.com/BI3DG.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/BI3DG.jpg\" alt=\"enter image description here\" /></a></p>\n<p>If you are someone who doesn't like to exercise, or is short on time, Surya Namaskar is definitely for you.</p>\n<p>Recommended daily is 54 reps = 108 sets (according to Hindu numerology)</p>\n<p>Gradually build up your endurance and stamina. I am currently at 33 reps and I notice improved flexibility and strength.</p>\n<h3>Correction</h3>\n<p>One set is the 12 yoga poses that work both sides of the body.</p>\n<p>Aim for 108 sets of 12. As of Aug 2016 I am on 72 sets of 12.</p>\n", "score": 3 }, { "answer_id": 8743, "body": "<p>I used to only be able to touch my knees. Within 2-3 months I learned how to touch my feet. I did this by two simple stretching exercises, but I made sure to do them regularly. The main trick was to build it into my daily-routine:</p>\n\n<ul>\n<li>I started stretching in the shower, simply bending forward.</li>\n<li>I started stretching before going to sleep, doing this:\n<a href=\"https://www.youtube.com/watch?v=C-wiOqYcxoI\" rel=\"nofollow\">https://www.youtube.com/watch?v=C-wiOqYcxoI</a></li>\n</ul>\n\n<p>It only take me 2 minutes every day.</p>\n", "score": 0 } ]

[ "exercise", "feet", "stretching", "hips" ]

[ { "answer_id": 3088, "body": "<p>Omega-3 fatty acids are <strong>essential</strong> fatty acids i.e. the human body cannot synthesize them. They are absolutely essential for growth and maintenance of the body function and their deficiency can cause various problems. </p>\n\n<p>They are precursors for both inflammatory and anti-inflammatory molecules (<a href=\"http://www.wikiwand.com/en/Eicosanoid\" rel=\"nofollow\">prostaglandins, thromboxanes and leukotrienes</a>) but you should not assume that inflammation is always bad. It is how your immune system works to identify and destroy pathogens. </p>\n\n<p>PCB stands for <a href=\"http://www.wikiwand.com/en/Polychlorinated_biphenyl\" rel=\"nofollow\">polychlorinated biphenyls</a> which are aromatic molecules used for industrial applications are known environmental pollutants. Omega-3 fatty acids have no relationship with these molecules. PCB are much more oil-soluble (lipophilic) than water soluble (hydrophilic). When they are dumped in the environment and are taken up in the bodies of different organisms like fishes, they are effectively partitioned into the fatty compartments of the body (because of higher solubility). The fish oils, that are used as one of the primary sources of the omega-3 fatty acid supplements, therefore concentrate the PCBs that the fishes are exposed to, throughout their lives. </p>\n\n<hr>\n\n<p>NOTE: The terminologies good-cholesterol and bad-cholesterol are just utterly stupid because cholesterol is cholesterol and it has both good and bad effects depending on how much of it is present in the body. It is like saying good water and bad water. LDL or HDL are not really cholesterols; they are proteins that transport lipids. Read more about this <a href=\"http://www.ncbi.nlm.nih.gov/books/NBK351/\" rel=\"nofollow\">here</a>.</p>\n", "score": 4 }, { "answer_id": 3386, "body": "<p>Apparently omega-3 supplements do contain PCB. But I don't know what kind of container the supplement comes in (if it comes in capsules or not)</p>\n\n<blockquote>\n <p>The quality of fish oil / omega-3 supplements varies across brands...Analyses of 35 products...uncovered...: Trace levels of PCBs were found in every product...but two supplements exceeded contaminations limits for PCBs. The tested supplements include those with fish oil, krill oil, algal oil (from algae) and/or, calamari (squid) oil. </p>\n</blockquote>\n\n<p><a href=\"http://www.consumerlab.com/news/ReviewofFishOilandOmega-3SupplmentsbyConsumerLab.com/8_22_2012/\" rel=\"nofollow\">http://www.consumerlab.com/news/ReviewofFishOilandOmega-3SupplmentsbyConsumerLab.com/8_22_2012/</a></p>\n", "score": 1 } ]

[ "toxicity", "supplement" ]

[ { "answer_id": 3092, "body": "<p>I think you are having difficulty finding the answer because you are perhaps not asking the right question(s).</p>\n\n<blockquote>\n <p>...why are more efforts not made to improve their function?</p>\n</blockquote>\n\n<p>How would you support the assertion that more isn't being done to \"improve their function\"? The fact that you don't know about something doesn't mean it's not being investigated. </p>\n\n<blockquote>\n <p>...knowing that the body already has a tube designed to do the same thing without the risks why are more efforts not made to improve [e.g. by stenting] their function?</p>\n</blockquote>\n\n<p>You will not find any support for your proposal because stenting is not a benign procedure, and the risks of stenting the Eustachian tube far, far outweigh the benefits, as well as the risks of the alternatives. At least tympanostomy tubes have a physiological comparison in ruptured tympanic membranes. </p>\n\n<p>First, the Eustacian tube (ET) is normally <em>closed</em> in people of all ages. </p>\n\n<blockquote>\n <p>It was Toynbee, in 1853, who concluded from experiments on himself and from the tendency to swallow while descending in a diving bell that the eustachian tube is normally closed and opens only during swallowing.</p>\n</blockquote>\n\n<p>The ET also opens with yawning. Compare how much time is spent in the resting phase of ET function (all the seconds or minutes spent between swallows and yawns.) This normally non-patent state prevents the migration of bacteria-laden fluids from the posterior pharynx into the sterile middle ear.</p>\n\n<p>Eustachian tube function is a complex affair; it's not easily tampered with. The following details what occurs normally with swallowing (please keep in mind that the pharyngeal end of the ET is above where a bolus of food or saliva passes during swallowing):</p>\n\n<blockquote>\n <p>Normal ETs had four consistent sequential movements: (1) palatal elevation causing passive, then active, rotation of the medial cartilaginous lamina; (2) lateral excursion of the lateral pharyngeal wall; (3) dilation of the lumen, caused primarily by tensor veli palatini muscle movement beginning distally and inferiorly, then opening proximally and superiorly; and (4) opening of the tubal valve at the isthmus caused by dilator tubae muscle contraction. </p>\n</blockquote>\n\n<p>A chronically patent ET is pathological (it's called a Patulous ET or PET), and is quite uncomfortable, so much so that ENT's try <em>plugging</em> the tube shut:</p>\n\n<blockquote>\n <p>Trans-tympanic insertion of a new silicone plug seems to be useful for controlling the <em>distressing symptoms of patients with a chronic patulous Eustachian tube</em> (PET). </p>\n</blockquote>\n\n<p>It should be obvious that on a purely physiological basis, a stented ET is not a good idea. In addition to migration of bacteria-laden fluids into the middle ear, there is a problem with sound conduction, inappropriate air movement with even minor activities such as whistling, making certain consonant sounds, the difficulty of something as simple as swimming, etc. God help the kid who would start laughing with a mouth full of partially masticated food (have you ever been so caught off guard by something funny while eating or drinking that it comes out the nose?) Imagine the mess that would make if the ET were continuously patent. It's a recipe for disaster.</p>\n\n<p>Add to that the surgical complications, which would be considerably more substantial than with simple (yes, simple) myringotomy tube placement. Finally, those structures allowing ET function are delicate cartilagenous structures, and can easily be damaged by a foreign body (the reason even temporary, dissolvable ET stent use is not recommended). In the 80's, this was done in animal studies. Why you don't find papers of its use in humans is easy to deduce.^**</p>\n\n<p>Finally, you are mistaken that there are no attempts to treat (improve) ET dysfunction. There are surgical procedures available for those with severe ETD.</p>\n\n<p>For millions of years, ear infections either resolved on their own, killed the host, or resulted in tympanic membrane (TM, eardrum) perforation. It was very, very common when I was first practicing to look at an adult's TM and see a healed perforation. </p>\n\n<p>Yes, antibiotic resistance developed with overuse of antibiotics. But fewer cases of deafness, mastoiditis, and death from meningitis and brain abscesses occurred as well. We live and we learn.</p>\n\n<p>^{**Not to mention that mucous can - and did in animal studies in the 80's - block the stent, alone rendering it more harmful than doing nothing at all.}</p>\n\n<p>_{<a href=\"http://archotol.jamanetwork.com/article.aspx?articleid=563300\">THE EUSTACHIAN TUBE ABNORMAL PATENCY AND NORMAL PHYSIOLOGIC STATE</a>}<br>\n_{<a href=\"http://journals.lww.com/otology-neurotology/Abstract/2000/09000/Analysis_of_Eustachian_Tube_Function_by_Video.2.aspx\">Analysis of Eustachian Tube Function by Video Endoscopy</a>}<br>\n_{Ballenger's Otorhinolaryngology: Head and Neck Surgery, Volume 1, John Jacob Ballenger, James Byron Snow, Eustacian Tube Dysfunction, pp. 201-208}<br>\n_{<a href=\"http://journals.cambridge.org/action/displayAbstract?fromPage=online&amp;aid=399541&amp;fileId=S0022215100000281\">The complications of chronic otitis media: report of 93 cases</a>}</p>\n", "score": 7 } ]

[ "infection", "otolaryngology", "ear" ]

[ { "answer_id": 3815, "body": "<p>Predicting life expectancy of people currently alive, can, of course, only be speculation, but one based on statistics. If there is a nuclear war next year, the predicted life expectancy will not be accurate.</p>\n\n<p>For the United States, <a href=\"http://www.cdc.gov/nchs/data/hus/hus14.pdf#016\" rel=\"nofollow\">the CDC</a> estimated a life expectancy of about 80 for children born in 2013 (table 16). 71 is the estimated expected life span at birth by <a href=\"http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends/en/\" rel=\"nofollow\">the WHO</a> for children born in 2012. This includes all countries.</p>\n\n<p>However, these are medium values (often medians, meaning half of all people will reach a higher age), and people getting over 100 years is certainly not unheard of, even today. In 2012, there were over 300,000 people alive <a href=\"http://www.unfpa.org/sites/default/files/resource-pdf/UNFPA-Report-Chapter1.pdf\" rel=\"nofollow\">who are over 100</a>. The US <a href=\"https://www.ssa.gov/oact/STATS/table4c6.html\" rel=\"nofollow\">had over 7,000 of them alive in 2011</a> .</p>\n\n<p>As for predictions for over-100s: For the UK, <a href=\"http://www.ons.gov.uk/ons/rel/lifetables/historic-and-projected-data-from-the-period-and-cohort-life-tables/2012-based/sty-babies-living-to-100.html\" rel=\"nofollow\">one third of babies born in 2013 are expected to live to 100</a>.</p>\n", "score": 3 } ]

[ "life-expectancy" ]

[ { "answer_id": 3145, "body": "<p>Before the answer I owe you an apology - the Mint family is large, and aside from a large number of species, each has a number of varieties. Different varieties of the same species might have similar chemical composition and pharmacological effects, but look a bit different. The fact is, that I'm not 100% sure from your photo that it is <em>Mentha x piperita</em> that we are talking about (most of my sources state that it has pink flowers; leaves are a shaped a bit differently but this might be because the plant is young); still, it might be. Determining the species is tricky even for professionals in such plant families (I was hoping that you got the name of the plant when you purchased it/got it from someone to plant in your garden).</p>\n\n<p>Nonetheless, I'll try to answer the best I can:</p>\n\n<hr>\n\n<p>The only <strong>contraindications</strong> for using <em>Mentha x piperita</em> (Peppermint) leaves or <em>Mentha arvensis pipericans</em> (Japanese Mint) are <strong>gallstones, gallbladder obstruction or inflammation</strong> - because most members of Mint family have a cholagogic effect (stimulate bile production and excretion) so the patient might experience colic if they use mint leaves, and medical supervision of such use is advisable.</p>\n\n<p>For Peppermint the average daily dosage is 3-6 g/day (PDR) or 4.5 - 9g of the herbal substance, for preparation of herbal tea, divided in three doses (HMPC, EMeA).</p>\n\n<p>Another contraindication listed for Peppermint in monograph at EMeA is <strong>heartburn</strong> (gastro-oesophageal reflux) because the condition might worsen with the use of peppermint.</p>\n\n<p>Other from these, there are no known health risks associated with the use of these species, in recommended daily doses.</p>\n\n<p>For: <em>Mentha longifolia</em> (English horsemint), <em>Mentha spicata</em> (Spearmint), <em>Mentha aquatica</em> (Wild mint), PDR states:</p>\n\n<blockquote>\n <p>No health hazards or side effects are known in conjunction\n with the proper administration of designated therapeutic\n dosages.</p>\n</blockquote>\n\n<p>However, dosages are listed only for M. aquatica as one wineglass per day of infusion prepared from 30g of leaves and 500 ml of water.</p>\n\n<p><em>Mentha pulegium</em> (Pennyroyal) is associated with hepatotoxicity (prolonged use can damage the liver). However, the plant in your photo doesn't look like M. pulegium to me. </p>\n\n<hr>\n\n<p>I' recommend taking a sample of your herb to a local botanical garden if possible and asking for help with species determination there, just to be on the safe side. A somewhat less reliable option would be to post the photo of the plant on biology SE and see what they think of it (but determining the species of the plant from a photo is less reliable than with an actual sample).</p>\n\n<p>As for the quantity - I wasn't able to find a reliable source for the number of leaves used, so the safest method might be to measure the quantity you use and see if it fits the recommended doses (or to measure the maximal daily dose and try not to exceed it).</p>\n\n<hr>\n\n<p>References:</p>\n\n<ol>\n<li><a href=\"https://books.google.rs/books?id=pDa2QgAACAAJ&amp;dq=Pdr+for+herbal+medicines+2nd+edition&amp;hl=en&amp;sa=X&amp;redir_esc=y\" rel=\"nofollow\">PDR for Herbal Medicines</a></li>\n<li>European Medicines Agency Evaluation of Medicines for Human Use - COMMITTEE ON HERBAL MEDICINAL PRODUCTS (HMPC): <a href=\"http://www.ema.europa.eu/docs/en_GB/document_library/Herbal_-_Community_herbal_monograph/2010/01/WC500059393.pdf\" rel=\"nofollow\">COMMUNITY HERBAL MONOGRAPH ON MENTHA X PIPERITA L., FOLIUM</a></li>\n<li><a href=\"http://apps.who.int/medicinedocs/en/d/Js4927e/20.html#Js4927e.20\" rel=\"nofollow\">WHO Monographs on Selected Medicinal Plants Volume 2: Folium Menthae Piperitae</a> </li>\n</ol>\n", "score": 2 } ]

[ "nutrition", "diet" ]

[ { "answer_id": 3876, "body": "<p>Since it's unclear from the question what vaccination this was, I looked up two likely cases: the flu vaccine, and the DTaP booster, because these are vaccines regularly given to adults. </p>\n\n<p><strong>Influenza vaccine</strong></p>\n\n<p>The flu vaccine can cause soreness, redness, and swelling at the spot where the vaccination was given. If the pain is more than mild, or lasts longer than a day, ask your doctor. </p>\n\n<p><strong>DTaP, or Tdap</strong></p>\n\n<p>Pain at the injection site occurs in 2 out of 3 adult patients. Severe pain is rare, and should be discussed with a doctor. </p>\n\n<p>A rather comprehensive overview of vaccine side effects can be <a href=\"http://www.cdc.gov/vaccines/vac-gen/side-effects.htm#tdap\" rel=\"nofollow\">found at the CDC website</a>. Soreness and mild pain is a side effect of many, but anything severe or lasting more than 1 to 2 days should be discussed with a doctor. </p>\n", "score": 1 } ]

[ "pain", "vaccination" ]

[ { "answer_id": 3165, "body": "<p>What you have on your basil is a strain of <a href=\"https://en.wikipedia.org/wiki/Fusarium_oxysporum\" rel=\"nofollow\"><em>Fusarium oxysporum</em></a>, obviously a strain pathogenic to plants. </p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Fusarium#In_humans\" rel=\"nofollow\">Apparently</a>, other strains of <em>F. oxysporum</em> can cause <a href=\"https://en.wikipedia.org/wiki/Onychomycosis\" rel=\"nofollow\">onychomycosis</a> (nail infections) and <a href=\"https://en.wikipedia.org/wiki/Fungal_keratitis\" rel=\"nofollow\">keratomycosis</a> (corneal infections). And if you have a very low <a href=\"https://en.wikipedia.org/wiki/Neutrophil_granulocyte\" rel=\"nofollow\">neutrophils</a> count, it can cause aggressive infections throughout the entire body and bloodstream. </p>\n\n<p>Because these are different strains, you should be fine eating the basil, I've done it and suffered no ill effects, although it can alter the flavor. The plant strain of the species would have to mutate in order to affect humans, because the food source is drastically different, and a fungus that is adapted to one source will die if introduced to the other as a food source. The metabolization process is very different.</p>\n\n<p>In other words, be aware that there are some human pathogens in the species, but what you have isn't going to hurt you, unless you have an allergic reaction to the fungus (unlikely but possible), which I suppose you could test (by consuming a small quantity first) if you have known allergies to other fungi (such as penicillin, button mushrooms, etc).</p>\n\n<p><a href=\"http://www.umass.edu/comparativegenomics/Pdfs/ARM2013.pdf\" rel=\"nofollow\">Here</a> is a good paper on <em>Fusarium</em> Pathogenomics.</p>\n", "score": 3 } ]

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

[ { "answer_id": 3164, "body": "<p>From what I can gather after reading through several different sites in a search, it will depend somewhat on the type of alcohol (I am assuming schnapps) and the method used to turn it into alcohol.</p>\n\n<p>Archer appears to make liqueur type schnapps, which means that the fruit is steeped in the alcohol base, rather than distilled from the fruit itself. This means it will have a higher sugar content, and will go bad faster.</p>\n\n<p>As near as I can tell, there isn't any adverse health effects reported from drinking out of date alcohol, but the taste can vary wildly, and be anything from a \"flat\" taste, to very harsh and bitter as the sugars continue to break down. This is moderated by temperature and how much air is in the bottle.</p>\n\n<p>So there <em>shouldn't</em> be any health effects, other than possibly bad taste.</p>\n\n<p><a href=\"http://cocktails.about.com/od/stockyourbar/f/liquor_storage.htm\" rel=\"nofollow\">http://cocktails.about.com/od/stockyourbar/f/liquor_storage.htm</a></p>\n\n<p><a href=\"http://www.guntheranderson.com/liqueurs/storage.htm\" rel=\"nofollow\">http://www.guntheranderson.com/liqueurs/storage.htm</a></p>\n", "score": 2 } ]

[ "alcohol" ]

[ { "answer_id": 3973, "body": "<p>They appear to. </p>\n\n<p>In <a href=\"http://health.ucsd.edu/specialties/psych/clinic-based/eatingdisorders/neurobiology/Documents/KayeIJED1986CaloricConsumptionAN.pdf\" rel=\"nofollow\">Caloric consumption and activity levels after weight recovery in anorexia nervosa: a prolonged delay in normalization</a>, researchers looked at anorexia patients 2 to 6 weeks after what is called \"refeeding\", and patients 6 months after. </p>\n\n<blockquote>\n <p>Patients with anorexia nervosa, in the weeks after achieving target\n weight and terminating refeeding, have elevated levels of activity and\n caloric intake, compared to normal controls. In contrast, caloric intake\n and activity in anorectics who had maintained weight for months after\n weight recovery were similar to controls.</p>\n</blockquote>\n\n<p>So they were maintaining weight at the same amount of calories that people without a history of anorexia were also maintaining their weight at.</p>\n\n<p>The same was found in this study: <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/1098-108X(199407)16:1%3C45::AID-EAT2260160104%3E3.0.CO;2-Z/abstract\" rel=\"nofollow\">Resting metabolic rate and total energy expenditure in acute and weight recovered patients with anorexia nervosa and in healthy young women</a></p>\n\n<blockquote>\n <p>No significant differences were found between the weight-recovered anorectic women and the healthy controls in RMR (1,330 ± 131 kcal/day [weight-recovered]; 1,419 ± 197 [controls]) and in TEE (2,602 ± 637 kcal/day [weight-recovered]; 2,596 ± 493 kcal/day [controls]).</p>\n</blockquote>\n\n<p>RMR = Resting Metabolic Rate; TEE = Total Energy Expenditure </p>\n\n<p>Both studies had small sample sizes though. </p>\n\n<p>During recovery, patients recovering from anorexia need more calories than expected for weight gain, which is called <em>hypermetabolic</em>, but that period ends at around 4 to 6 months. </p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3829207/\" rel=\"nofollow\">Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment</a> (figure 2)</p>\n", "score": 3 } ]

[ "nutrition", "metabolism", "anorexia", "eating-disorder" ]

[ { "answer_id": 3292, "body": "<p>I can offer only partial answer to your question, and that is on how this shampoo works.</p>\n<p>From <a href=\"https://www.medicines.org.uk/emc/medicine/13755\" rel=\"nofollow noreferrer\">The Electronic Medicines Compendium</a>:</p>\n<blockquote>\n<p><strong>Mechanism of action</strong></p>\n<p>Coal tars suppress DNA synthesis in hyperplastic skin inhibiting mitotic activity protein synthesis and cell reproduction.</p>\n<p><strong>Coal tar</strong></p>\n<p>Coal tar decreases epidermal proliferation and dermal infiltration and thus promotes a return to normal keratinisation. Coal tar has anti-inflammatory, antibacterial, antipruritic, keratolytic, keratoplastic and vascoconstrictive effects.</p>\n</blockquote>\n<p>From the same source, on the correct use:</p>\n<blockquote>\n<p>The hair should be wetted and sufficient Alphosyl '2 in 1' Shampoo applied to produce an abundant lather. The scalp and adjacent areas should be vigorously massaged with the fingertips. The hair should be then thoroughly rinsed and the procedure repeated. Taking both of these shampoo applications into consideration, the total leave on time for the shampoo should be 3 – 5 minutes.</p>\n<p>Alphosyl '2 in 1' Shampoo should be used once or twice weekly for the treatment of scalp disorders</p>\n</blockquote>\n<p>Other <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945847/\" rel=\"nofollow noreferrer\">studies</a> support the claim of its efficacy.</p>\n<p><a href=\"http://www.nhshighland.scot.nhs.uk/Publications/Documents/Guidelines/Formulary/Highland%20Formulary.pdf\" rel=\"nofollow noreferrer\">Highland formulary</a> has some recommendations on how to use this shampoo in management of psoriasis (page 260):</p>\n<blockquote>\n<p>Scalp</p>\n<p>application of lukewarm olive oil to scalp, leave at least 30 minutes to soften scale and washout with tar-based shampoo (Alphosyl 2 in 1® or Capasal®).</p>\n</blockquote>\n<p>As for why it stopped working - I haven't found any studies on this. The SPC of Alphosyl, however, does state that it should be used for 4 weeks, and if the use is longer than that it should be supervised by a physician. So, if nobody else provides an answer, perhaps it would be best to talk to your physician about changing your routine or the treatment. It is often a matter of trial and error to determine what would work in an individual patient.</p>\n", "score": 4 } ]

[ "dermatology", "hair", "scalp", "shampoo", "dandruff" ]

[ { "answer_id": 3245, "body": "<p>First I should state I'm not in ortho, but have worked some on tissue engineering. The use of allogenic stem cells (cells from another person) brings a lot of <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26328017\" rel=\"nofollow\">practical concerns</a>, particularly in the need for <a href=\"https://bethematch.org/for-patients-and-families/finding-a-donor/hla-matching/\" rel=\"nofollow\">HLA matching</a>, but is the direction of a lot of interesting research.</p>\n\n<p>As may have noticed in the <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3149861/\" rel=\"nofollow\">review</a> you cited, much of the work on joint repair focuses on delivering the patient's own stem cells in a \"patch\" directly to the <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/17901396\" rel=\"nofollow\">injury site</a>. The main concerns in doing so are that the actual injury site gets repaired (as apposed to a ubiquitous smaller tissue growth) and that teratoma formations or other erroneous and harmful growths don't occur.</p>\n\n<p>On the other hand, the advantage of just being able to inject cells (+factors) would be the simplicity of the procedure. It has been done in one <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/18523506/\" rel=\"nofollow\">case patient</a> and <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/26365972\" rel=\"nofollow\">in rats</a>, but the more common procedure is to use <a href=\"http://thesteadmanclinic.com/bone-marrow-cell-concentrate-platelet-rich-plasma.asp\" rel=\"nofollow\">bone marrow cell concentrate (BMCC)</a>. </p>\n\n<p>BMCC's do not have the concentrations of stem cells that cultures specifically sorted/selected then expanded do. It is still exceedingly costly and difficult to culture a patient's mesenchymal stem cells (MSC's). You look at MSC's wrong and they differentiate. It is however, to the point where it can be reliably done.</p>\n\n<p>So why use bone marrow concentrate instead? It can be produced much faster and with equipment/techniques most hospitals already have on hand. And if we're going to move to an injection over surgical placement of a patch, then we have to make it significantly easier to justify not treating the damage directly.</p>\n", "score": 0 } ]

[ "surgery", "treatment-options", "orthopedics" ]

[ { "answer_id": 3249, "body": "<p>No, there is no evidence in reputable sources that any diet can restore a partially removed tooth to a full tooth again.</p>\n\n<p>Any source you do encounter which proposes such a possibility is highly likely to benefit from such a claim (i.e. there exists a conflict of interest between the claim and the truth.)</p>\n\n<p>There is, however, a large body of sound research on the repair of carious teeth via fillings, root canals, etc.</p>\n\n<p>_{<a href=\"http://www.sciencedirect.com/science/article/pii/S0300571205001417\" rel=\"nofollow\">Outcome of direct restorations placed within the general dental services in England and Wales (Part 1): Variation by type of restoration and re-intervention</a>}<br>\n_{<a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2591.2009.01671.x/abstract?userIsAuthenticated=false&amp;deniedAccessCustomisedMessage=\" rel=\"nofollow\">Tooth survival following non-surgical root canal treatment: a systematic review of the literature</a>}<br>\n_{<a href=\"http://www.researchgate.net/profile/Yupin_Songpaisan/publication/228553340_Manual_for_the_Atraumatic_Restaurative_Treatment_approach_to_control_dental_caries/links/02e7e51f0ef4f102d1000000.pdf\" rel=\"nofollow\">MANUAL FOR THE ATRAUMATIC RESTAURATIVE TREATMENT APPROACH TO CONTROL DENTAL CARIES</a>} </p>\n", "score": 4 } ]

[ "diet", "micronutrients", "cavity", "legumes" ]

[ { "answer_id": 3407, "body": "<p>I had a same situation due to allergic reaction. Hives and mouth ulcers. I mixed 50/50 Mylanta and Childrens Benedryl and swished. The Mylanta coated the mouth which allowed me to eat without the pain and burning, The Childrens Benedryl helped with the ulcers and hives. It's also okay to swallow. You didn't mention the cause or the remedies you have tried. This is one that helped me. Good Luck.</p>\n", "score": 2 }, { "answer_id": 3410, "body": "<p>Recurrent aphthous stomatitis (RAS; aphthae; canker sores) is not uncommon (>20% of the population of the UK) and can be very painful and disruptive. In addition to consulting a doctor, please consider asking your dentist (dentists deal with this a lot) or a specialist of the mouth (such as an oral surgeon). It may be as simple as your toothpaste choice, or as complex as an autoimmune disorder. In any case, they should help you treat it symptomatically, and may find an underlying cause.</p>\n\n<p>There are three \"kinds\" of RAS based on size and number of ulcers: minor, major, and herpetiform.</p>\n\n<p>In addition to treating any underlying disorder, common recommendations - among others - include maintaining good diet (with some attention to B₁₂), oral hygiene, avoiding toothpastes with SLS, and <em>possibly</em> using mouthwashes containing chlorhexidine or triclosan.</p>\n\n<p>For the occasional aphthous ulcer, there is a sticky paste you can apply to the ulcer called <em>Orabase</em>. It has a topical anesthetic and temporarily relieves pain, so that you can eat, sleep, etc. There is also a viscous lidocaine 2% solution which can be swished/spit. The downside of this is that you can't taste anything, as your tongue gets numbed as well. Alternatively, you can apply it to the lesions with a Q-tip.</p>\n\n<p>Under the supervision of a physician, topical corticosteroids can sometimes control symptoms that are incapacitating. There are corticosteroid preparations in <em>orabase</em>, gels, and other.</p>\n\n<p>There are prescription antibiotic oral preparations with which one can rinse and spit, usually containing a tetracycline derivative, or tetracycline plus nicotinamide which may provide relief and reduce ulcer duration and recurrence. If RAS fails to respond to these measures, oral immunomodulators may be required, again under specialist supervision.</p>\n\n<p>Complementary and Alternative Medicine recommendations include vitamin supplements, bee propolis, various herbs, and honey. </p>\n\n<p>_{<a href=\"http://www.nature.com/bdj/journal/v199/n5/full/4812649a.html\" rel=\"nofollow\">Oral medicine — Update for the dental practitioner Aphthous and other common ulcers</a>}<br>\n_{<a href=\"http://www.researchgate.net/profile/Robert_Barrons/publication/12137206_Treatment_strategies_for_recurrent_oral_aphthous_ulcers/links/0c96053be7aa3553bb000000.pdf\" rel=\"nofollow\">Treatment strategies for recurrent aphthous ulcers</a>}<br>\n_{<a href=\"http://www.biomedcentral.com/1471-2431/11/106/\" rel=\"nofollow\">A double blind, randomised placebo controlled trial of topical 2% viscous lidocaine in improving oral intake in children with painful infectious mouth conditions</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2943778/\" rel=\"nofollow\">Aphthous ulcers (recurrent)</a>}<br>\n_{<a href=\"http://journals.lww.com/amjmedsci/Abstract/2008/11000/Cyanocobalamin_May_be_Beneficial_in_the_Treatment.2.aspx\" rel=\"nofollow\">Cyanocobalamin May be Beneficial in the Treatment of Recurrent Aphthous Ulcers Even When Vitamin B12 Levels Are Normal.</a>}<br>\n_{<a href=\"http://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116570/all/Stomatitis\" rel=\"nofollow\">Stomatitis</a> &lt;- an <em>Unbound Medicine 5-minute Clinical Consult</em>}</p>\n", "score": 2 } ]

[ "pain", "treatment" ]

[ { "answer_id": 3436, "body": "<p>Besides changing the amount of calories you expend or consume there aren't many more options. You might attempt to reduce your stress level. The 1994 paper <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16353426\">Stress-induced cortisol response and fat distribution in women</a> and the 2000 paper <a href=\"http://journals.lww.com/psychosomaticmedicine/Abstract/2000/09000/Stress_and_Body_Shape__Stress_Induced_Cortisol.5.aspx\">Stress and Body Shape: Stress-Induced Cortisol Secretion Is Consistently Greater Among Women With Central Fat</a> indicated a possible link between elevated cortisol (sometimes called the stress hormone, although that is far from the whole story) and increased abdominal fat distribution. Of course, you may find stress regulation as or even more difficult than finding time to exercise.</p>\n\n<p>However - diet and exercise remains the preferred method of weight loss. Particularly compared to the risks of medication or surgery. Any way you slice it, it takes behavioral changes to make physical changes. Exercise can be a great way to reduce stress, too.</p>\n", "score": 6 }, { "answer_id": 3572, "body": "<p>Losing weight via means of altering your diet will be safest choice, however, that doesn't mean it is your only option. In my opinion, <em>dieting</em> is an incredibly vague term. Ensuring you are eating a balanced diet and eating within your daily needs is better way to put it.</p>\n\n<p>When you consume an excess of calories that your body doesn't need it often stores this fat independently, for future use i.e. as an energy source. <a href=\"https://en.wikipedia.org/wiki/Saturated_fat\" rel=\"nofollow\">Fat</a>, despite the bad rep, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/6778757\" rel=\"nofollow\">is a very good energy source</a> and is essential in our diets - more specifically in times of (unintentional?) fasting. Is it healthy to use fat as a stable for your energy needs? No. It's all about maintaining a justified ratio of Carbohydrates; fats and proteins that build a stable foundation for a diet. </p>\n\n<p>Consider this when contemplating a weight loss diet: 'In 2005, the “American Journal of Clinical Nutrition” published the results of a study in which subjects who ate <a href=\"http://www.livestrong.com/article/303969-the-protein-fat-and-carbohydrate-ratio-for-losing-weight/\" rel=\"nofollow\">30% protein, 20% fats and 50% carbohydrates</a> felt fuller and ate an average of more than 400 fewer calories daily when compared to subjects who ate a diet of 15% protein, 35% fats and 50% carbohydrates. </p>\n\n<p>The most abundant method for weight loss that is clinically proven, would be obtaining a prescription for <a href=\"https://en.wikipedia.org/wiki/Orlistat\" rel=\"nofollow\"><em>Orlistat</em></a>, aka Alli. Additionally, you will only be able to obtain this medicine if you are truly overweight and if you are have \"fair\" reasoning etc.</p>\n\n<p><a href=\"http://www.webmd.boots.com/diet/guide/medicine-for-obesity\" rel=\"nofollow\">Orlistat</a> belongs to drug class called <em>Lipase inhibitors</em>. Lipase is the in situ enzyme that breaks down lipids (fats), so that they can effectively be absorbed by our body, and hence inhibiting this enzyme allows most of the fat we consume to pass through our digestive system, to be release via excretion in our fecal matter. It would be fair to say that this treatment is in favor of resisting storage/absorption some types of fat more than others. In this case it's <a href=\"https://en.wikipedia.org/wiki/Adipose_tissue#Obesity\" rel=\"nofollow\">visceral fat</a> - fat stored in the abdominal cavity and hence around our major organs. Knowing this, you should be able to comprehend how a physician may deem you suitable for a prescription. If he/she concludes that you are overweight and predisposed to risk of diseases such as cardiovascular disease, the decision will tilt in your favor.</p>\n\n<p>Edit: Orlistat is the generic name for the \"weight loss\" aid not sold over-the- counter. Alli, is <a href=\"http://www.webmd.boots.com/diet/guide/medicine-for-obesity\" rel=\"nofollow\">orlistat</a> at half its dosage and is sold over-the-counter.</p>\n", "score": 3 } ]

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

[ { "answer_id": 3433, "body": "<p>Without access to a doctor, a home pregnancy test is the most accurate way. It measures the amount of a hormone (hCG) in your urine (see for example <a href=\"http://www.m.webmd.com/baby/guide/pregnancy-tests\" rel=\"nofollow\">WebMD's site on pregnancy tests</a> for more information on how it works) .</p>\n\n<p>The other two reliable methods are a blood test for the same hormone and an ultrasound (usually conclusive starting from week 3 after conception), but these are not something that can be done at home. While you will find other methods on the internet, most of them are unproven and all of them will be less reliable than a home pregnancy test or a blood test. </p>\n\n<p>A study found that while urine tests are less accurate than blood tests, the difference in reliability is not that big:</p>\n\n<blockquote>\n <p>Overall, the whole blood pregnancy test was 95.8% sensitive (negative predictive value 97.9%), whereas the urine test was 95.3% sensitive (negative predictive value 97.6%); the specificity and positive predictive value of both tests was 100%.</p>\n</blockquote>\n\n<p>(from <a href=\"http://www.jem-journal.com/article/S0736-4679(11)00538-5/abstract\" rel=\"nofollow\">\" Substituting Whole Blood for Urine in a Bedside Pregnancy Test\" </a>) That means that urine tests have more false negative (not picking up pregnancy) , but there were no false positives in the study. </p>\n\n<p>From a Google search it looks like what you are referencing in your question is a standard home pregnancy test and thus your best available method. </p>\n", "score": 7 } ]

[ "obstetrics" ]

[ { "answer_id": 3435, "body": "<p>It has already been tested, <a href=\"http://www.theguardian.com/technology/2007/jan/18/guardianweeklytechnologysection4\" rel=\"nofollow\">see e.g. here</a>. The best thing to do is to accept that EMF interference does not cause health problems other than via the <a href=\"https://en.wikipedia.org/wiki/Nocebo\" rel=\"nofollow\">nocebo effect</a>. </p>\n", "score": 2 }, { "answer_id": 3527, "body": "<p>Yes, you can measure that. You can consider using EMF Meter Tester (Electromagnetic Radiation Dosimeter) which can detect electromagnetic radiation around the place of interest. The cheapest one which you can get can measure frequency range between low frequency: 50Hz-400KHz and high frequency: 30MHz-2000MHz which should be enough. It can be used in home electrical equipment, measurement of electromagnetic radiation such as: mobile phone, smart devices, computers, televisions, copiers, fax machines, air conditioners and other power sources of test analysis.</p>\n<p>I had similar issue where I had a lot of cables and power supplies next to my desk and I had slight headaches because of that. I've purchased EMF Meter (<a href=\"http://www.birikimelk.com/img/upload/DT1130.pdf\" rel=\"nofollow noreferrer\">DT-1130</a>, similar to <a href=\"http://www.electronicharassment.net/\" rel=\"nofollow noreferrer\">NJ-1130</a>) and it was showing very high reading around that area (up to 1m far away from the corner). So I think my multi socket extension was just faulty (or wrongly shielded) and the reading was perfectly fine (zero) when I've switched it off.</p>\n<p>So basically you should test the electric field radiation and if your equipment like computer connect power ground loop well, it would lead electric field radiation to the ground, to shield it, then the test would fail. Besides, metal will shield the radiation.</p>\n<p>Such EMF meters can be found <a href=\"https://www.google.co.uk/search?q=EMF%20Meter&amp;tbm=shop\" rel=\"nofollow noreferrer\">on-line</a>. For more details, refer to manual/instructions provided by manufacturer (e.g. <a href=\"http://www.mrclab.com/Media/Uploads/EMF819SPEC.pdf\" rel=\"nofollow noreferrer\">EMF819SPEC</a>, <a href=\"http://www.mrclab.com/Media/Uploads/EMF819SPEC(3).pdf\" rel=\"nofollow noreferrer\">EMF-819</a>) where it's stated:</p>\n<blockquote>\n<ul>\n<li>Persons with electromagnetic implant (e.g. cardiac-pacemaker) are subject to especial danger in some case.</li>\n<li>Claims by some scientists that long term exposure to electromagnetic field may be the cause of childhood leukemia &amp; other forms of cancer.</li>\n<li>Complete answers to any of these and related questions are not currently available. At the present time the most common practice is\nto avoid excess exposure over long period of time.</li>\n<li>Complete answers to any of these and related ”Prudent Avoidance“ as stated by the Environmental Protection Agency (EPA) USA is recommended.</li>\n</ul>\n</blockquote>\n<p>Related studies:</p>\n<ul>\n<li><p><a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2869.2011.00918.x/full\" rel=\"nofollow noreferrer\">Sleep EEG alterations: effects of different pulse-modulated radio frequency electromagnetic fields</a> - SCHMID – 2011 – Journal of Sleep Research – Wiley Online Library</p>\n<blockquote>\n<p>Consistent with previous findings, our results provide further evidence that pulse-modulated RF EMF alter brain physiology, although the time-course of the effect remains variable across studies.</p>\n</blockquote>\n</li>\n<li><p>Magda Havas, Ph.D., an eminent researcher in this domain, says:</p>\n<blockquote>\n<p>Symptoms of electrohypersensitivity have been demonstrated at exposures that are a fraction of U.S. exposure guidelines, in part because the guidelines themselves only take into consideration a 30-minute exposure, not chronic exposures.</p>\n<p>Symptoms people experience near cell phone antennas, within a 0.25 mile radius include: fatigue, headaches, difficulty concentrating, memory loss, irritability, dizziness, depression, visual disruptions, hearing disruptions and much more.</p>\n</blockquote>\n<p>^{Source: <a href=\"http://www.businesswire.com/news/home/20100426005523/en/Report-Recommends-FCC-Require-Minimum-1500-Feet\" rel=\"nofollow noreferrer\">New Report Recommends FCC Require Minimum 1,500 Feet Setbacks for Wireless Infrastructure near Schools</a> [2010]}</p>\n</li>\n</ul>\n<p>Related videos:</p>\n<ul>\n<li><p><a href=\"https://youtu.be/DwCs8DoehTU\" rel=\"nofollow noreferrer\">How to measure EMFs from your multi socket extension</a></p>\n<blockquote>\n<p>Even something as seemingly harmless as a multi socket extension lead can give off electrical and magnetic radiation. The danger is that such electrical devices can be held in close proximity to your body over long periods of time and over many years.</p>\n<p>Excessive fatigue, stomach complaints, irritability, sleep disturbances, headaches, visual problems, memory loss, dizziness, and cardiovascular disruptions are just some of the symptoms which have been linked to exposure to EMFs. The symptoms from long-term exposure can lead to syndromes such as tumors and cancer.</p>\n</blockquote>\n</li>\n<li><p><a href=\"https://www.youtube.com/watch?v=6sIeKRhclQI\" rel=\"nofollow noreferrer\">How to avoid EMF radiation risks from computers, microwaves, cell phones, and other household items</a></p>\n</li>\n<li><p><a href=\"https://www.youtube.com/watch?v=PCp4jiBZVvs\" rel=\"nofollow noreferrer\">Measuring Magnetic Fields EMF Pollution Under High Voltage Power Line</a></p>\n</li>\n</ul>\n", "score": 0 } ]

[ "sleep" ]

[ { "answer_id": 3486, "body": "<p>You're asking about <em>compounding</em> here, a complex subject to begin with. </p>\n\n<p>To compare formulations, you need to look at the label ingredients for both pills. I will compare two pills here, <a href=\"http://www.benadryl.ca/adult-allergy-medicine/benadryl-caplets\" rel=\"nofollow\">Benadryl brand caplets, 25 mg.</a> and Claritin Reditabs by MSD Consumer Care, Inc.</p>\n\n<p>Benadryl caplets:</p>\n\n<blockquote>\n <p>Medicinal ingredients: Diphenhydramine Hydrochloride, 25 mg\n Non-medicinal ingredients: Celluloses, Dicalcium phosphate, D&amp;C Red No. 27, Polyethylene glycol, Polysorbate, Starch, Stearic acid, Titanium dioxide, Wax, Zinc stearate</p>\n</blockquote>\n\n<p>Claritin Reditabs by MSD Consumer Care, Inc.:</p>\n\n<blockquote>\n <p>Active ingredient (in each tablet): Loratadine 5 mg\n Inactive ingredients: anhydrous citric acid, gelatin, mannitol, mint flavor</p>\n</blockquote>\n\n<p>Note that the difference in inactive ingredients (what used to be called <em>inert ingredients</em>) is mainly due to the first being a pill to swallow, while the second is a melt-in-your-mouth preparation.</p>\n\n<p>To compare ingredients, you must know the manufacturers and the exact pills you're comparing. You can do that right in the store by looking at the ingredients. That should tell you whether there is an ingredient in common between them.</p>\n\n<p>Diphenhydramine is an antihistamine of the <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/3100#section=Pharmacology-and-Biochemistry\" rel=\"nofollow\">ethanolamine class</a>. </p>\n\n<p>Loratadine is a <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/3957#section=Pharmacology-and-Biochemistry\" rel=\"nofollow\">piperidine</a> histamine H1-receptor antagonist.</p>\n\n<p>Piperidines are structurally related to the the ethanolamines. Because they both block the same receptor, they have a similar 3D structure. Whether you should take it depends partly on how severe an allergy you have to diphenhydramine; if you have a serious allergy, you should probably avoid taking loratadine. </p>\n\n<p>Ask your doctor or your pharmacist for a safe alternative to diphenhydramine.</p>\n", "score": 2 } ]

[ "allergy" ]

[ { "answer_id": 3541, "body": "<p>Please note that you have not gived a definition for your numbers. 15,000 platelets per µL? mL? L? It matters. 50,000/L is much different than 50,000/µL.</p>\n\n<p>Thrombocytopenia is not uncommon during pregnancy, and, as in non-pregnancy related cases, results from diverse causes. Without awareness of the cause(s) (i.e. knowing which tests she has undergone and the results), no one here can recommend the proper management of your sister's case. </p>\n\n<p>Some causes of thrombocytopenia are unique to pregnancy and may not be familiar to hematologists. </p>\n\n<blockquote>\n <p>Incidental thrombocytopenia of pregnancy, usually referred to as gestational thrombocytopenia, accounts for 70%-80% of cases. It occurs in the mid-second to third trimester, and its pathogenesis is unclear. It has been speculated that it may result from various mechanisms, including hemodilution and accelerated clearance. No confirmatory laboratory tests are available, and the diagnosis is one of exclusion. ...[However] we consider a diagnosis of gestational thrombocytopenia <em>unlikely if the platelet count is &lt; 50 × 10⁹/L, with very few cases having been described with counts 40-50 × 10⁹/L.</em> </p>\n</blockquote>\n\n<p>Also,</p>\n\n<blockquote>\n <p>ITP is not an indication for cesarean delivery. Mode of delivery in a pregnant patient with ITP is based on obstetric indications, with avoidance of procedures associated with increased hemorrhagic risk to the fetus (eg, forceps, vacuum extraction, and fetal scalp electrode/samples).</p>\n</blockquote>\n\n<p>Of interest:</p>\n\n<blockquote>\n <p>As a rule of thumb, developing a platelet count &lt; 100 × 10⁹/L early in pregnancy, with declining platelet counts as gestation progresses, is most consistent with ITP. ...Nevertheless, knowing the exact diagnosis at that stage of pregnancy changes the management very little, as will be discussed in the indications for treatment.</p>\n</blockquote>\n\n<p>And</p>\n\n<blockquote>\n <p>A rare inherited cause of thrombocytopenia is type IIB von Willebrand disease (VWD). Women with this condition may develop thrombocytopenia, for the first time, in pregnancy and be misdiagnosed with ITP. Platelet counts may occasionally fall to levels as low as 10-20 × 10⁹/L at term, typically with nadir value 1-3 days before delivery, but they rapidly improve after delivery.</p>\n</blockquote>\n\n<p>Below are three links to the American Society of Hematology journal, <em>blood</em>. There are linked references within the articles that can assist you in addressing your concerns with her doctors.</p>\n\n<p>Also, your hospital should have a medical library, where you might be able to access medical information with permission.</p>\n\n<p>_{<a href=\"http://www.bloodjournal.org/content/121/1/38.full?sso-checked=true\" rel=\"nofollow\">How I treat thrombocytopenia in pregnancy</a>}<br>\n_{<a href=\"http://www.bloodjournal.org/content/117/16/4190?ijkey=8498c96e5f8f042f204fca1ea5d707984a001135&amp;keytype2=tf_ipsecsha\" rel=\"nofollow\">The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia - note: this is for <em>immune</em> thrombocytopenia</a>}<br>\n_{<a href=\"http://www.bloodjournal.org/content/113/11/2386.short?sso-checked=true\" rel=\"nofollow\">Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group - note: this is for <em>immune</em> thrombocytopenia</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22000090\" rel=\"nofollow\">A rational approach to the diagnosis and management of thrombocytopenia in the hospitalized patient.</a>}<br>\n_{<a href=\"http://bestpractice.bmj.com/best-practice/monograph/795.html\" rel=\"nofollow\">Assessment of thrombocytopenia</a>}</p>\n", "score": 4 } ]

[ "obstetrics", "platelet-count", "birth", "c-section", "3rd-trimester" ]

[ { "answer_id": 3538, "body": "<p>You can continue to work as long as you take the usual common-sense precautions: wear clean clothes and wash your hands.</p>\n\n<p>While varicella is one of the most contagious viruses we know of, the primary route of spread is droplets expressed when an infected person coughs or sneezes. It can also be spread by touching virus from varicella lesions. The virus is believed to have a \"short\" survival time in the environment (pinning down exactly how short is harder, but this should still be comforting.)</p>\n\n<blockquote>\n <p>Labile outside host cell. It survives in the external environment for a few hours and occasionally for a day or two.¹ </p>\n</blockquote>\n\n<p>As regards your son,</p>\n\n<blockquote>\n <p>A person with varicella is contagious from 1-2 days before rash onset until the lesions have crusted.²</p>\n</blockquote>\n\n<p>Your son is no longer contagious, and if you've had chicken pox, you are not contagious unless you develop breakthrough varicella, which is not as rare as people might think.</p>\n\n<blockquote>\n <p>Approximately 15-20% of 1-dose vaccinated persons may develop varicella if exposed to VZV.³</p>\n</blockquote>\n\n<p>People with breakthrough varicella are contagious. Breakthrough varicella is usually milder than first infections, and the rash is usually maculopapular (little red bumps) rather than the typical blistery lesions. </p>\n\n<blockquote>\n <p>One study ...found that persons with mild breakthrough varicella (&lt; 50 lesions) were one third as contagious as unvaccinated persons with varicella. However, persons with breakthrough varicella with 50 or more lesions can be just as contagious as unvaccinated persons.³</p>\n</blockquote>\n\n<p>The take-home message here is you're fine as long as you don't have breakthrough varicella yourself, wash your hands before entering the building, and aren't rubbing your patients with your son's shirt.</p>\n\n<p>As an aside, most of your patients have already had chicken pox; that's why they can get shingles. If they were so immune-compromised that your son's illness could affect them, they would probably break out with shingles before you could carry it to them.</p>\n\n<p>_{1 <a href=\"http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/var-zo-eng.php\" rel=\"nofollow\">VARICELLA-ZOSTER VIRUS, Section IV</a>}<br>\n_{2 <a href=\"http://www.cdc.gov/chickenpox/hcp/clinical-overview.html\" rel=\"nofollow\">Chickenpox (Varicella)</a>}<br>\n_{3 <a href=\"http://www.cdc.gov/chickenpox/hcp/clinical-overview.html\" rel=\"nofollow\">Slide set: Overview of VZV Disease &amp; Vaccination for Healthcare Professionals available by clicking on link in 2</a>} </p>\n", "score": 2 } ]

[ "disease-transmission", "chickenpox" ]

[ { "answer_id": 3560, "body": "<p>Reduced oxygen saturation in blood is called hypoxia (though strictly that means reduced oxygen in the tissues). If there is marked reduction in oxygen saturation of blood, it may lead to bluish discoloration of skin and tongue, called cyanosis. </p>\n\n<p>Mildly reduced arterial oxygen saturation may be due to mild respiratory or cardiac diseases. A common lung condition is chronic obstructive airway disease (or chronic bronchitis, most commonly due to smoking). Congenital cyanotic heart diseases like Tetralogy of Fallot are generally discovered and treated in childhood. Arterio-venous malformations in lung is another cause of arterial oxygen desaturation which may be present in otherwise healthy persons. Persons staying at high altitudes have reduced blood oxygen saturation due to low atmospheric pressure leading to reduced partial pressure of oxygen in inhaled air. Sleep apnea syndrome often seen in obese persons may also lead to hypoxia. Other causes include neurological diseases leading to respiratory depression, respiratory conditions such as severe pneumonia, pulmonary embolism (clots in arteries supplying blood to the lungs), pulmonary edema (lung congestion), pulmonary fibrosis etc, but in all these the person is obviously ill. </p>\n\n<p>In an apparently healthy person, mild hypoxia is likely to be due to smoking or pollution related chronic obstructive airway (pulmonary) disease (COAD or COPD), pulmonary arteriovenous malformation or early pulmonary fibrosis.</p>\n\n<p>Mild hypoxia may not result in any symptoms. It may lead to increased hemoglobin level in the blood to compensate for reduced oxygen saturation, as commonly occurs in persons living at high altitudes. The main worry is that the underlying process may progress and hence the cause of desaturation should be investigated.</p>\n\n<p>References:</p>\n\n<p><a href=\"http://www.mayoclinic.org/symptoms/hypoxemia/basics/causes/sym-20050930\" rel=\"nofollow\">http://www.mayoclinic.org/symptoms/hypoxemia/basics/causes/sym-20050930</a></p>\n", "score": 1 } ]

[ "oxygenation", "pulmonology" ]

[ { "answer_id": 9467, "body": "<p>Only your healthcare provider can help diagnose and treat YOUR situation, so keep working with them on this. </p>\n\n<p>But what I can do is help <strong><em>reflect your own statements back to you.</em></strong> </p>\n\n<p>Regarding the recommendations that your doctor gave you:</p>\n\n<p>(1) You say you're not responding to weight loss - but that you are still 40 lbs overweight. </p>\n\n<ul>\n<li><p>You have reduced your weight, <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/23532991\" rel=\"nofollow\">but are still overweight/obese.</a> </p></li>\n<li><p><a href=\"http://www.mayoclinic.org/diseases-conditions/gerd/basics/lifestyle-home-remedies/con-20025201\" rel=\"nofollow\">Intra-abdominal pressure is associated with reflux. This also includes tight clothes, posture. </a></p></li>\n</ul>\n\n<p>(2) You say you're not responding to diet - but that it isn't perfect, just a lot better. </p>\n\n<ul>\n<li>You mentioned <a href=\"http://www.mayoclinic.org/diseases-conditions/gerd/basics/lifestyle-home-remedies/con-20025201\" rel=\"nofollow\">what you eat, but not how much you eat at once, what time of day, your posture</a>. </li>\n</ul>\n\n<p><strong>So, can you really say you aren't responding?</strong>\nThese things aren't easy, I completely understand that; <strong>however, sometimes you can't expect to see results unless you follow treatments all the way.</strong></p>\n\n<p>Yes, <a href=\"http://www.nature.com/gimo/contents/pt1/full/gimo21.html\" rel=\"nofollow\">possible factors include anatomic, neurologic, endocrine, infectious, inflammatory…</a> but it's only your healthcare provider that can lead you through a differential diagnosis for your situation. </p>\n\n<p>Your doctor <strong>has already evaluated you specifically</strong> and made <strong>recommendations tailored for you.</strong> Try your best to follow them all the way to see how you respond. And follow up with your provider along the way for guidance.</p>\n", "score": 2 }, { "answer_id": 11847, "body": "<p>I would first and foremost attempt to lose weight; nevertheless, Endoscopy is not really the the optimal test to diagnose hiatal hernia. You should do a double-contrast Esophagus-Stomach-Duodenal X-Ray.</p>\n\n<p>As for what Gene said re: PPIs, it makes no sense. Their mechanism of action is to inhibit the chemical mechanism that allows the gastric parietal cells to secrete acid (Proton -i.e. ionized hydrogen- Pump Inhibitor).</p>\n\n<p>Regardless, PPIs will never actually cure reflux, just by supressing the acid you prevent complications of ACID reflux (irritation of the esophagus, bruxism, etc).</p>\n\n<p><a href=\"https://radiopaedia.org/articles/barium-swallow\" rel=\"nofollow noreferrer\">Barium Swallow</a></p>\n\n<p><a href=\"http://www.uptodate.com/contents/acid-reflux-gastroesophageal-reflux-disease-in-adults-beyond-the-basics?source=search_result&amp;search=hiatal%20hernia&amp;selectedTitle=1%7E1\" rel=\"nofollow noreferrer\">Acid Reflux Patient Info</a></p>\n", "score": 1 } ]

[ "gastroenterology", "gerd-acid-reflux", "esophagus", "proton-pump-inhibitors" ]

[ { "answer_id": 5236, "body": "<p><a href=\"http://www.babycentre.co.uk/a3542/alcohol-during-pregnancy\" rel=\"nofollow\">First Trimester:</a></p>\n\n<blockquote>\n <p>It's especially important to steer clear of alcohol in the first\n trimester, because of the risk of miscarriage. Drinking at this time\n has also been associated with a higher rate of premature birth.</p>\n</blockquote>\n\n<p>The first trimester is <a href=\"http://www.webmd.com/baby/tc/pregnancy-your-first-trimester\" rel=\"nofollow\">week 1 to week 12.</a> </p>\n\n<p>...........</p>\n\n<blockquote>\n <p>Many women have a few drinks before realising they are pregnant.\n Babies have a habit of turning up when they're least expected, and\n many babies conceived around the time of a night out drinking have\n been fine.</p>\n</blockquote>\n\n<hr>\n\n<p>So some statements that can be made are:</p>\n\n<ul>\n<li><p>First Semester alcohol can lead to premature births mostly. </p></li>\n<li><p><a href=\"http://www.babycentre.co.uk/a3542/alcohol-during-pregnancy\" rel=\"nofollow\">Third Semester alcohol</a> can lead to the symptoms that you described. Especially, due to the fact that the brain is developing. </p></li>\n</ul>\n\n<p><a href=\"http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&amp;np=122&amp;id=1950\" rel=\"nofollow\">Is there a safe time to drink alcohol in pregnancy?</a></p>\n\n<blockquote>\n <p>No. There is no safe time in pregnancy to drink alcohol. The baby’s\n brain develops the whole way through pregnancy and can be effected by\n alcohol at any stage of its development.</p>\n</blockquote>\n\n<p><a href=\"http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&amp;np=122&amp;id=1950\" rel=\"nofollow\">Is there a safe amount of alcohol in pregnancy?</a></p>\n\n<blockquote>\n <p>No. There is no safe amount of alcohol to drink in pregnancy. Some\n babies can even be effected by a little bit of alcohol (1 or 2\n standard drinks once a week) Small occasional alcohol use in pregnancy\n = low risk to the developing baby Heavy frequent alcohol use in pregnancy = high risk to the developing baby No alcohol = no risk to\n the developing baby</p>\n</blockquote>\n\n<p><a href=\"http://www.webmd.com/baby/tc/alcohol-effects-on-a-fetus-topic-overview\" rel=\"nofollow\">What effect does alcohol have on a fetus?</a> - Any amount can harm a fetus, but more severe damage is related to heavy drinking. Heavy amounts depend on size of person and drink. </p>\n\n<p><strong><em>What can be done for drinking while pregnant:</em></strong></p>\n\n<ul>\n<li><p>Stop drinking if pregnant or trying to get pregnant.</p></li>\n<li><p>Contact healthcare provider if alcohol was consumed to know about the risks to your baby. </p></li>\n</ul>\n", "score": 1 } ]

[ "obstetrics", "alcohol", "fetus", "1st-trimester", "placenta" ]

[ { "answer_id": 3716, "body": "<p>Even if the <a href=\"https://en.wikipedia.org/wiki/Rapid_urease_test\" rel=\"nofollow noreferrer\">CLO test</a> comes up negative on the biopsy, you could have your blood tested to see if you are <a href=\"http://www.medscape.com/viewarticle/465349\" rel=\"nofollow noreferrer\">sera positive</a> for <a href=\"https://en.wikipedia.org/wiki/Helicobacter_pylori\" rel=\"nofollow noreferrer\">H. pylori</a>. This would show if you've ever been exposed rather than have an ongoing infection in the <a href=\"https://en.wikipedia.org/wiki/Polyp_%28medicine%29\" rel=\"nofollow noreferrer\">polyp</a>. This may not be medically significant, however, because it would not show active infection and a need for antibiotics.</p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Hyperplastic\" rel=\"nofollow noreferrer\">Hyperplastic</a> polyps are <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19491866/\" rel=\"nofollow noreferrer\">common</a>, benign, and <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962745/\" rel=\"nofollow noreferrer\">often asymptomatic</a>. They can arise from <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085239/\" rel=\"nofollow noreferrer\">any insult</a> (injury) to the <a href=\"https://en.wikipedia.org/wiki/Epithelium\" rel=\"nofollow noreferrer\">epithelium</a> in the <a href=\"https://en.wikipedia.org/wiki/Gastrointestinal_wall\" rel=\"nofollow noreferrer\">intestine</a>. Your question then becomes what can cause insults the epithelium?</p>\n\n<p>The most obvious is <a href=\"https://en.wikipedia.org/wiki/Abdominal_trauma\" rel=\"nofollow noreferrer\">abdominal trauma</a> (car accidents, stabbings, gun shot wounds, etc), but in the West that is not the most common cause. As you mentioned, H. pylori and <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150032/\" rel=\"nofollow noreferrer\">auto-immune disorders</a> are often screened against first, because they are more medically significant and common causes.</p>\n\n<p>But plenty of things can damage your intestinal epithelium. Viruses and bacteria are common causes. One of my <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450971/\" rel=\"nofollow noreferrer\">favorite studies</a> took the biopsies from 15 different patents and conducted deep sequencing of of the genetic material contained in the polyps to look for viral and bacterial genetic markers.</p>\n\n<p>As you can see there are plenty of viruses:\n<a href=\"https://i.stack.imgur.com/TVE1z.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/TVE1z.jpg\" alt=\"Viral Family Count in colon polyps\"></a></p>\n\n<p>And plenty of bacteria:\n<a href=\"https://i.stack.imgur.com/wlAbp.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/wlAbp.jpg\" alt=\"Bacterial Family detection in colon polyps\"></a></p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Ulcer\" rel=\"nofollow noreferrer\">Ulcers</a> can be another cause, which could further implicate <a href=\"https://en.wikipedia.org/wiki/Stress_ulcer\" rel=\"nofollow noreferrer\">stress</a> as a cause.</p>\n", "score": 3 } ]

[ "gastroenterology", "endocrinology", "diabetes", "autoimmune-disease" ]

[ { "answer_id": 24314, "body": "<p>I'd like to preface with a brief summary of both techniques:</p>\n<p><strong>Bone marrow donation</strong> - The stem cells are removed from a large bone of the donor, typically the pelvis, through a large needle that reaches the center of the bone.</p>\n<p><strong>Peripheral blood stem cell transplantation</strong> - The stem cells may come from the blood of the patient or a donor. A peripheral blood stem cell transplant may be autologous (using a patient’s own stem cells that were collected and saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin).</p>\n<p>You are correct, each of these methods have been designed to replace damaged stem cells.</p>\n<p>Damaged stem cells may be caused from:</p>\n<ul>\n<li>Radiation</li>\n<li>High doses of drugs (Recreational or cancer)</li>\n<li>Diseases</li>\n</ul>\n<p>Factors that may present favorable or unfavorable conditions for each of these techniques include the following:</p>\n<ol>\n<li><em>Transplantation</em> <br>\nBoth of these methods require healthy living-donors.</li>\n</ol>\n<p><em>Related or unrelated donors</em> <br> Related against unrelated donors was in <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816375/\" rel=\"nofollow noreferrer\">this journal article</a> - which identifies the exact differences between these methods of stem cell transplantation.</p>\n<p>Related - Identical siblings accelerates engraftment, but increases the risk of graft-versus-host disease when <em>compared to Bone marrow donation</em>.</p>\n<p>Unrelated - No significant survival differences were found between Bone marrow donation vs Peripheral blood stem cell transplantation.</p>\n<ol start=\"2\">\n<li><p><em>Damage Tissue</em> <br> What is the tissue that has been damaged? E.g. If the patient is using immunosuppresents or if the transplantation is time-dependent (and includes wait-lists) the optimal technique may change.</p>\n</li>\n<li><p><em>Other</em> <br> The patients or donor existing complications. E.g. If the patient has kidney failure, it may be advised to move away from Peripheral blood stem cell transplantation.</p>\n</li>\n<li><p><em>Cost</em> <br> The treatment cost may be a valuable aspect to assess.</p>\n</li>\n</ol>\n<p>Often the conditions are situation dependent.</p>\n", "score": 1 } ]

[ "bone-marrow", "stem-cells" ]

[ { "answer_id": 3703, "body": "<p>A bit of paper towel won't have any effect on a urine sample.</p>\n\n<p>People try a great many things to adulterate urine specimens: dilution, adding bleach, taking diuretics, adding lye, you name it, it's probably been tried.</p>\n\n<p>If your friend had no illicit drug use before the drug test, there will not be a false positive result (paper doesn't contain drugs.)</p>\n\n<p><em>False positives</em> are a valid concern, therefore there is much attention paid to such results. Further tests are usually done on positive urine samples to insure that they're true positives, such as gas chromatography, etc. </p>\n\n<p>It's false negatives that recreational drug users are interested in producing. And the guidelines in place for that are pretty uniform: the urine must be within normal ranges for temperature, pH, specific gravity, etc.</p>\n\n<p>_{<a href=\"http://www.mayoclinicproceedings.org/article/S0025-6196%2811%2961120-8/abstract\" rel=\"nofollow\">Urine Drug Screening: Practical Guide for Clinicians</a>} </p>\n", "score": 2 } ]

[ "urine-test", "contaminate" ]

[ { "answer_id": 3781, "body": "<p>The hepatitis B virus has been found in semen, salivia, and vaginal secretions (as well as in blood, of course). The risk of transmission is lower for oral sex than it is for vaginal or anal sex, but it is not zero. </p>\n\n<p>For oral sex with an infected man on the receiving end, a condom is recommended. As for giving oral sex, a dental dam can be used. To reduce the risk even more, <a href=\"http://www.cdc.gov/vaccines/vpd-vac/hepb/\" rel=\"nofollow\">a vaccine for hepatitis B is available</a>. </p>\n\n<p><em>Sources</em></p>\n\n<p><a href=\"http://www.webmd.com/hepatitis/hepatitis-and-sex-frequently-asked-questions\" rel=\"nofollow\">Hepatitis and sex</a></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1744490/\" rel=\"nofollow\">Sexually acquired hepatitis</a></p>\n\n<p><a href=\"http://www.health.state.mn.us/divs/idepc/diseases/hepb/hepbstd.html\" rel=\"nofollow\">Minnesota Department of Health recommendations</a></p>\n", "score": 4 } ]

[ "sex", "disease-transmission", "hepatitis" ]

[ { "answer_id": 23080, "body": "<p><a href=\"https://www.medscape.com/viewarticle/902826\" rel=\"nofollow noreferrer\">In October 2018</a>, the FDA approved Sarecycline (trade name Seysara; development code WC-3035) for the treatment of moderate to severe acne vulgaris.[1]</p>\n\n<p>As of 30 August 2018, <a href=\"https://www.sciencealert.com/researchers-are-one-step-closer-to-an-acne-vaccine\" rel=\"nofollow noreferrer\">a potential acne vaccine just passed an important early test</a>.</p>\n\n<blockquote>\n <p>An acne vaccine sounds too good to be true. One jab, and no more aggressive pimples making your face look like a pizza and damaging your self esteem.</p>\n \n <p>But researchers just got one step closer to that goal, discovering that an inflammation-triggering toxin called CAMP can be decreased by applying very specific antibodies – in mice at least.</p>\n \n <p>Actually turning those antibodies into a human vaccine will be complicated, but at least now we have an idea of what could work.</p>\n</blockquote>\n", "score": 2 } ]

[ "medications", "dermatology", "acne", "benzoyl-peroxide", "accutane" ]

[ { "answer_id": 4039, "body": "<p>You are asking about the protocol for allowing euthanasia. Usually, you can just look this up in the text of the law. </p>\n\n<p><a href=\"http://www.ethical-perspectives.be/viewpic.php?LAN=E&amp;TABLE=EP&amp;ID=59\" rel=\"nofollow\">This is the text of the law from Belgium</a>, for example. </p>\n\n<p>The treating doctor must:</p>\n\n<ul>\n<li>inform the patient clearly about their condition and treatment options </li>\n<li>have several conversations with the patient, being certain of the patient's constant suffering </li>\n<li>consult another physician, who must review the patient's medical records and the patient themselves </li>\n<li>if the patient is not expected to die of their disease, a psychiatrist must be consulted </li>\n<li>the patient's request must be in writing </li>\n</ul>\n\n<p>And so on, those laws are way too long to summarize here. This will vary with country. Unless a doctor wants to be charged with some form of homicide, they need to comply with these laws. </p>\n", "score": 1 } ]

[ "treatment-options", "practice-of-medicine", "death", "euthanasia" ]

[ { "answer_id": 3855, "body": "<p>In essence, neurofibromatosis is a disorder that makes nerve cells grow out of control and develop tumors. These tumors can be anywhere nerve cells are, so in the brain, spine, etc. Tumors, to most people, mean cancer, but cancers are a special (malignant) form of tumors. The tumors in neurofibromatosis may or may not develop into cancer. However, even if neurofibromatosis doesn't develop into cancer, the tumors can cause pain and other symptoms (such as hearing loss) because they press on nerves. </p>\n\n<p>It's usually recognized in childhood or early adulthood. There are three forms:</p>\n\n<p><strong>Neurofibromatosis 1</strong>:</p>\n\n<p>The most common form, symptoms appear in children, some of them in young children (under 5)</p>\n\n<blockquote>\n <ul>\n <li>Flat, light brown spots on the skin</li>\n <li>Freckling in the armpits or groin area</li>\n <li>Soft bumps on or under the skin (neurofibromas)</li>\n <li>Tiny bumps on the iris of your eye </li>\n <li>Bone deformities</li>\n <li>Learning disabilities</li>\n <li>Larger than average head size</li>\n <li>Short stature</li>\n </ul>\n</blockquote>\n\n<p><strong>Neurofibromatosis 2</strong> </p>\n\n<p>Less common and usually appears in teenagers. Symptoms are: </p>\n\n<blockquote>\n <ul>\n <li>Gradual hearing loss</li>\n <li>Ringing in the ears</li>\n <li>Poor balance</li>\n <li>vision problems</li>\n <li>facial drop</li>\n <li>numbness and weakness in the arms or legs</li>\n <li>pain</li>\n </ul>\n</blockquote>\n\n<p><strong>Schwannomatosis</strong></p>\n\n<p>A rare form only recently discovered that usually doesn't get dicovered until people are over 20 or even 30. It causes painful tumors, but not in the nerves that are responsible for hearing, so it doesn't cause hearing loss</p>\n\n<p>Neurofibromatosis is a genetic disorder, that means it's inherited and not caused by anything environmental.</p>\n\n<p><strong>Sources:</strong></p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/neurofibromatosis/basics/definition/con-20027728\" rel=\"nofollow\">Mayo Clinic - general overview</a></p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/neurofibromatosis/basics/symptoms/con-20027728\" rel=\"nofollow\">Mayo Clinic - Symptoms</a> (source of the quotes, and more details on the symptoms)</p>\n\n<p><a href=\"http://www.ninds.nih.gov/disorders/neurofibromatosis/neurofibromatosis.htm\" rel=\"nofollow\">NINDS Neurofibromatosis Information Page</a></p>\n", "score": 2 } ]

[ "neurology", "tumors", "nerves", "age" ]

[ { "answer_id": 3898, "body": "<p>I'll be answering this question in the way @DaveL edited the post.</p>\n\n<p>The specialist you should go to is a neurologist. They are the ones who are most qualified when it comes to seizures.</p>\n\n<p>In the mean time (because you'll probably have to wait before you can get an appointment), you can go to your GP and explain the problem. The way you're describing it, the EEG is probably normal because it would only changes when you're asleep and feverish, but maybe they'll like to redo it to see if there's an evolution, or test other hypotheses. </p>\n\n<p>To these doctors, you'll have to describe the seizures precisely - when do they happen in the night? do you lose consciousness or not? is there abnormal body moves and if so, what kind? are you immediately able to think normally after they happen or are you slowed down for a while? did you bite your tongue? do you have witnesses of these seizures that could possibly notice something you didn't? did you take any medication that could have induced them or reduced them? </p>\n\n<p>If you can, keep a journal of your seizures with these informations and bring it to your appointments. The more information, the better in these cases.</p>\n\n<ul>\n<li><a href=\"http://www.neurology.org/content/69/21/1996.full.html\" rel=\"nofollow\">Guidelines</a> of the American Academy of Neurology</li>\n<li>Exemple of <a href=\"https://www.epilepsy.org.uk/sites/epilepsy/files/files/A4-online-seizure-diary.pdf\" rel=\"nofollow\">seizure journal</a></li>\n</ul>\n", "score": 4 } ]

[ "common-cold", "seizure" ]

[ { "answer_id": 9249, "body": "<h2>Here are the sources you can use:</h2>\n\n<p>The main issue is that due to government controls on substances like LSD, <em>very little</em> research ends up being conducted with/about them due to the difficulties and regulations involved. So information about substances like LSD comes from three main sources:</p>\n\n<ol>\n<li>The few peer-reviewed academic/pharmaceutical studies which make it past Institutional Review and government regulations to be published in a journal</li>\n<li>Content written by \"experts,\" but <em>not</em> peer-reviewed and <em>not</em> processed by an Institutional Review Board and <em>not</em> published in a journal</li>\n<li>Community knowledge and user reports</li>\n</ol>\n\n<p>On the first count, here's <a href=\"https://wiki.dmt-nexus.me/w/images/5/5c/psychedelic_adverse_effects.pdf\" rel=\"nofollow\">a link to a literature review article from 1984.</a></p>\n\n<p>On the second count, you can look into the work of Aldous Huxley, George Greer, Ann Shulgin, Myron Stolaroff, Athanasios Kafkalides, and Stanislav Grof.</p>\n\n<p>On the third count, you can check out community forums at reddit, erowid, and bluelight.</p>\n\n<h2>Here's what they generally say:</h2>\n\n<p>You cannot take a toxic dose of LSD, though large doses could put you in a state in which you're life is in danger (e.g. you might accidentally walk off a cliff).</p>\n\n<p>Most if not all reported effects of LSD (after the substance's primary effects have waned) are psychological, ranging from the mundane (e.g. self-discovery, introspection) to the phenomenal (e.g. PTSD, complete personality change). </p>\n\n<p>Some people report experiencing \"flashbacks,\" where they unexpectedly feel like their state of consciousness shifts momentarily back into a psychedelic state. While such reports are popular, they seem relatively rare and unlikely.</p>\n\n<p>Ultimately, not enough users provide a large enough amount of reliable, objective data to say anything definite about long-term effects.</p>\n", "score": 4 }, { "answer_id": 30780, "body": "<p>The 2022-02-10 study {1} didn't find any risks for LSD microdosing:</p>\n<blockquote>\n<p>We conclude that within the context of a controlled setting and a limited number of administrations, <strong>repeated low doses of LSD are safe</strong>, but produce negligible changes in mood or cognition in healthy volunteers.</p>\n</blockquote>\n<hr />\n<p>References:</p>\n<ul>\n<li>{1} de Wit, H, Molla, HM, Bershad, A, Bremmer, M, Lee, R. Repeated low doses of LSD in healthy adults: A placebo-controlled, dose–response study. <em>Addiction Biology</em>. 2022; 27 (2):e13143. doi:<a href=\"https://doi.org/10.1111/adb.13143\" rel=\"nofollow noreferrer\" title=\"Link to external resource: 10.1111/adb.13143\">10.1111/adb.13143</a></li>\n</ul>\n", "score": 2 } ]

[ "recreational-drugs", "productivity" ]

[ { "answer_id": 3954, "body": "<p>If you are concerned about your lungs you could try to use <a href=\"https://en.wikipedia.org/wiki/Cannabis_foods\" rel=\"nofollow\">edibles</a>. They will not have any effect on your lungs.</p>\n\n<p>However you should be careful because the onset of edibles takes longer (generally between 30 minutes and an hour) so it is harder to dose and generally lasts for a longer period (4-6 hours).</p>\n\n<p>Another way of consuming cannabis involves the use of a <a href=\"https://en.wikipedia.org/wiki/Vaporizer_(inhalation_device)\" rel=\"nofollow\">vaporizer</a>. Although this might still have some effect on your lungs. It uses <a href=\"https://en.wikipedia.org/wiki/Convection\" rel=\"nofollow\">convection</a> instead of <a href=\"https://en.wikipedia.org/wiki/Combustion\" rel=\"nofollow\">combustion</a> of the cannabis leaving any plant material that has a lower vaporization point than the used temperature on the vaporizer behind. The benefit of this method is that the onset is as fast as smoking because the uptake of the active compounds is similar to smoking it so it is easier to dose.</p>\n\n<p>I am not sure how long you have to wait after your treatment so you should consult your doctor about it but I have heard of people using it during chemotherapy already to help combat the nausea.</p>\n", "score": 2 } ]

[ "cancer", "lungs", "recreational-drugs", "chemotherapy" ]

[ { "answer_id": 4213, "body": "<p>The exact <a href=\"https://health.stackexchange.com/a/140/114\">cause of migraines</a> is unknown^{<a href=\"http://www.nhs.uk/Conditions/Migraine/Pages/Causes.aspx\" rel=\"nofollow noreferrer\">NHS</a>}, although they are thought to be the result of temporary changes, or abnormal brain activity which can affect nerve signals, chemicals and blood vessels in the brain.</p>\n\n<p>It could also relate to your health conditions (e.g. <a href=\"https://en.wikipedia.org/wiki/Management_of_chronic_headaches\" rel=\"nofollow noreferrer\">chronic headache</a>), vital energy or specific hormone balance at the given time. Such as levels of sodium^{<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1410848/\" rel=\"nofollow noreferrer\">2006</a>} or <a href=\"https://en.wikipedia.org/wiki/Blood_sugar#Low_blood_sugar\" rel=\"nofollow noreferrer\">blood sugar (glucose)</a>.</p>\n\n<p>Therefore it's not possible to indicate whether concentrating hard on a task can cause migraines or headaches, unless it's caused by emotional (anxiety, tension, stress, etc.) or physical trigger (tiredness, low blood sugar, etc.)^{<a href=\"http://www.nhs.uk/Conditions/Migraine/Pages/Causes.aspx\" rel=\"nofollow noreferrer\">NHS</a>}.</p>\n", "score": 3 } ]

[ "headache", "migraine", "mental-exhaustion" ]

[ { "answer_id": 7061, "body": "<p>As far as I know MRI scans are mainly used to assess the location and extent of crohn's disease manifestations and crohn's associated complications (strictures, fistulas, wall thinkening). MRI is usefull to determine the phenotype of someones crohn's (e.g. localized terminal ileitis, perianal disease). </p>\n\n<p>An MRI of course is not suitable as sole instrument to establish a crohn's disease diagnosis. In my case diagnosis was established by ileocolonoscopy, examination of the biopsies collected thereby by a phatologist, stool markers and full blood count. MRI was used as additional diagnosis instrument since ileoscopy raised the gastrologists strong suspicion of a crohn's, the phatologist examination of the biopsies was inconclusive. Blood count showed the typical crohn's associated malnutrition signs and all the signs of an immune system actively fighting an inflammation. In addition a bacterology of the stool sample showed no evidence of yersinia enteritis. </p>\n\n<p>The ecco guidelines thoroughly describe the establishment of a crohn's diagnosis\n[ecco guidelines part definition and diagnosis][1]. </p>\n\n<p>[1] <a href=\"http://ecco-jcc.oxfordjournals.org/content/early/2016/11/10/ecco-jcc.jjw168\" rel=\"nofollow noreferrer\">http://ecco-jcc.oxfordjournals.org/content/early/2016/11/10/ecco-jcc.jjw168</a></p>\n", "score": 2 } ]

[ "gastroenterology", "diagnostics", "mri", "crohns" ]

[ { "answer_id": 4201, "body": "<p>Any line, including a very faint line, is considered a positive result on home pregnancy tests. To be sure, you may want to wait a couple of days (2 or 3) and then take another test. If you are pregnant, then the line should become darker.</p>\n\n<p>One of the commons reasons for a faint line on a pregnancy test is because you could be very early in your pregnancy. Home pregnancy tests measure the amount of the hormone <a href=\"https://en.wikipedia.org/wiki/Human_chorionic_gonadotropin\">human chorionic gonadotropin</a> (hCG), which increases during the first few weeks of pregnancy, in the urine. It is possible that you are testing too early and the amount of hCG in your urine is not high enough to produce a full dark line. This can change in a matter of days, though. It is also possible that you have miscalculated when your period was due and tested too soon.</p>\n\n<p>The pregnancy test itself could also cause a faint line. If your test has a low sensitivity, it would not pick up as low levels of hCG, and would return a faint line, rather than a dark one. You can usually check how sensitive the test is by checking the side of the box (note: a lower number is better). Your test could also have expired, causing it to not give accurate results.</p>\n\n<p>Some medications do cause false positives on pregnancy tests, but you can rule this out yourself if you aren't taking any medications that raise hCG levels. It is also possible that you could have gone through a chemical pregnancy, a form of very early miscarriage, which would still cause a rise in hCG levels. Still, you should take another test in a few days, preferably with a more sensitive brand, and if you are still unsure about your results, you can consult your doctor.</p>\n\n<hr>\n\n<p>^{<a href=\"http://www.newkidscenter.com/Faint-Line-On-Pregnancy-Test.html\">Faint Line on Pregnancy Test</a>}</p>\n\n<p>^{<a href=\"http://www.babycenter.com/404_my-home-pregnancy-test-showed-a-faint-line-am-i-pregnant_7105.bc\">My home pregnancy test showed a faint line. Am I pregnant?</a>}</p>\n", "score": 6 } ]

[ "obstetrics" ]

[ { "answer_id": 4229, "body": "<p>Some of the oils in coffee (terpenes, in particular kahweol and cafestol) are believed to be the source of its effect on cholesterol.^{[<a href=\"http://www.nbcnews.com/id/6242467/ns/health-heart_health/t/coffee-cholesterol/\" rel=\"nofollow\">1</a>, <a href=\"http://www.drweil.com/drw/u/QAA401225/Does-Coffee-Raise-Cholesterol.html\" rel=\"nofollow\">2</a>, <a href=\"http://atvb.ahajournals.org/content/11/3/586.long\" rel=\"nofollow\">3</a>, <a href=\"http://www.nature.com/ejcn/journal/v57/n9/full/1601668a.html\" rel=\"nofollow\">4</a>]</p>\n\n<p>There are two ways to cut down on intake of cholesterol-influencing terpenes:</p>\n\n<ol>\n<li><p><strong>Switch to filtered coffee.</strong>} The terpenes are mostly retained in the paper filter instead of going into your drink. At the same time, cut down on the cream and sugar, as you already noted ;)</p></li>\n<li><p><strong>Quit drinking coffee completely.</strong> Even filtered coffee still has <em>some</em> terpenes present, and therefore can still impact cholesterol levels. Filtered coffee is a significant improvement — \"serum cholesterol raising effect of unfiltered coffee ... is reduced by about 80% in filtered coffee\"^{[<a href=\"http://www.nature.com/ejcn/journal/v57/n9/full/1601668a.html\" rel=\"nofollow\">4</a>]} — but if you're being very rigorous about watching your dietary cholesterol intake, it may be time to quit.</p></li>\n</ol>\n\n<hr>\n\n<p>For further reading, some sources are below. The fourth (Strandhagen and Thelle 2003) has a number of additional studies in its introduction.</p>\n\n<ol>\n<li><p><a href=\"http://www.nbcnews.com/id/6242467/ns/health-heart_health/t/coffee-cholesterol/\" rel=\"nofollow\">Coffee and Cholesterol: Does your daily morning jolt boost the risk of heart disease?</a> (NBC News)</p></li>\n<li><p><a href=\"http://www.drweil.com/drw/u/QAA401225/Does-Coffee-Raise-Cholesterol.html\" rel=\"nofollow\">Does Coffee Raise Cholesterol?</a> (Dr. Andrew Weil)</p></li>\n<li><p>van Dusseldorp et al. <a href=\"http://atvb.ahajournals.org/content/11/3/586.long\" rel=\"nofollow\">Cholesterol-raising factor from boiled coffee does not pass a paper filter.</a> <em>Arteriosclerosis, Thrombosis, and Vascular Biology.</em> 1991 May-Jun;11(3):586-93</p></li>\n<li><p>E Strandhagen and D S Thelle. <a href=\"http://www.nature.com/ejcn/journal/v57/n9/full/1601668a.html\" rel=\"nofollow\">Filtered coffee raises serum cholesterol: results from a controlled study.</a> <em>European Journal of Clinical Nutrition</em> (2003) 57, 1164–1168.</p></li>\n</ol>\n", "score": 4 } ]

[ "cholesterol" ]

[ { "answer_id": 4247, "body": "<p>Sounds like you are talking about trying to help a possible disc pathology in your lower back region because you referenced the abdominal area. For lower back discs most of the time it is due to a flexion intolerance, in my opinion, and from the work of Prof Stuart McGill &amp; Dr Craig Liebenson which you can see here <a href=\"http://chirocentre.co.uk/lower-back-bent-over-forward-flexion-intolerant-spine/\" rel=\"nofollow\">http://chirocentre.co.uk/lower-back-bent-over-forward-flexion-intolerant-spine/</a></p>\n\n<p>Lower back pain from a lumbar disc source of pain tends to get worse from poor controlled lumbar spine flexion. That's why the McKenzie exercises are recommended physical therapists and chiropractors. Abdominal hollowing is one train of thought however, I follow the thinking of the work coming out of the Prague School of Rehabilitation method more which recommends using abdominal breathing instead. So pushing your stomach out when you breath in and pulling it in when you breath out. They also have other exercises or postures they recommended to help out. I made a massive Youtube playlist for people to watch if they want <a href=\"https://www.youtube.com/playlist?list=PLlQpsUduPwnH4Umm3fKrBG3V_ZrtlXU--\" rel=\"nofollow\">https://www.youtube.com/playlist?list=PLlQpsUduPwnH4Umm3fKrBG3V_ZrtlXU--</a></p>\n", "score": 2 } ]

[ "diet", "exercise", "back", "inflammation" ]

[ { "answer_id": 4261, "body": "<p>tl;dr - No, not really. HIV is different. No, use what is best (or best assumption based upon symptoms, finding, etc.) for infection.<br><br>\nYou are asking several questions.<br>\nTB is a very tough bacteria to treat taking many months of therapy for two main reasons:<br>\n1. It replicates very slowly. Preventing replication is one major area where antibiotics are effective. Slow replications makes stopping this process take longer as it is difficult to completely break the chain to reproduction.<br>\n2. It has the ability to encapsulate itself against the environment making it more difficult to get antimicrobials to penetrate and fight the infection.<br>\nThis is the simple explanation for why \"hitting it\" at every angle is the best mode of attack, especially in a situation where you have multi-drug resistance and are forced to use what would normally be \"second line\" agents.<br><br>\nThat being said, Successful eradication should lead to minimal additional drug resistance as all bacterial containing genes that allow for drug resistance to be wiped out and preventing them from being passed along to develop further resistances.<br>\nHIV is treated with HAART (highly active antiretroviral therapy) to attack the virus at various modes of replication <em>and</em> entry into the cells. Another example of hitting it at every angle. One strategy utilized in HAART is to use medications <em>specifically</em> for their drug interactions. Retrovir is utilized to increase the drug levels of other agents which allows for utilization of lower dosages. Lower doses = reduced side effects (typically).<br>\nLastly, with a generic infection, overkill is simply overkill. Treatment with appropriate antibiotics is considered better utilization of every possible antibiotic available. More medications means more side effects, increased risk of drug-drug interactions, and cost. Medicine typically follows the path of empiric (best estimation of pathogen and course of treatment for it), followed by a culture to determine exact pathogen, then specific treatment of that pathogen.</p>\n", "score": 0 } ]

[ "infectious-diseases", "evolution" ]

[ { "answer_id": 13541, "body": "<h2>Stress and Urination</h2>\n\n<p>In some people stress can cause an increase in urination. The form of stress may be physical or emotional. Since the control of aldosterone is partly under the influence of the brain, any type of nervous stimulus or mental stress can affect its secretion. </p>\n\n<p>When an individual has physical stress, there is increased release of the stress hormones, such as epinephrine, norepinephrine, glucagon and cortisol, all of which can affect urination. </p>\n\n<hr>\n\n<h2>Catecholamines - Direct and Indirect Renal Effects</h2>\n\n<p>Two of these \"fight or flight hormones\" - epinephrine and norepinephrine have direct and indirect effects on urine production. When these hormones act directly on the kidneys and the mean arterial pressure (MAP) remains constant. \n The result is a decrease in urinary output. Conversely, the indirect effects of these hormones increase MAP, resulting in increased urine output. </p>\n\n<hr>\n\n<h2>Aldosterone</h2>\n\n<p>It’s role is to regulate blood pressure and sodium levels. Water, sodium and aldosterone levels are all directly related. When your body’s aldosterone levels are high – so are your levels of sodium and water. thus less is secreted. This reverse of this process also holds true.</p>\n\n<p>Since the control of aldosterone is partly under the influence of the brain, any type of nervous stimulus can affect its secretion. </p>\n\n<hr>\n\n<h2>Cortisol and ADH</h2>\n\n<p>Under chronic stress this works slightly differently. First cortisol levels will increase. This leads to decreased levels of antidiuretic hormone (ADH) which results in increased urination. As stress levels remain high cortisol levels eventually drop. Your adrenal gland becomes unable to produce sufficient levels of aldosterone – which once again causes an increase in urination. </p>\n\n<hr>\n\n<p><strong>Sources</strong><br>\n<a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/11116129/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/m/pubmed/11116129/</a>\n<a href=\"http://ajplegacy.physiology.org/content/192/1/131\" rel=\"nofollow noreferrer\">http://ajplegacy.physiology.org/content/192/1/131</a>\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190050/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190050/</a></p>\n", "score": 3 } ]

[ "urinary-system", "stress" ]

[ { "answer_id": 4333, "body": "<p>The most severe health risk from frequent alcohol consumption are liver damage and malnutrition. There are others, see my list of sources, but I'll focus on those two in my reply. </p>\n\n<p>The <em>malnutrition</em> is mostly vitamin deficiencies: folate, vitamin B6, thiamine, and vitamin A. I think it's rather obvious that obvious that consuming more water will not help with those. </p>\n\n<p>As for <em>liver damage</em>, that's caused by several things, among them:</p>\n\n<ul>\n<li>Breakdown of alcohol into <a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.1988.tb02552.x/abstract\" rel=\"nofollow\">acetaldehyde, which damages the liver</a></li>\n<li>Free radicals produced during alcohol metabolism leading to inflammation </li>\n<li>Production of cytokines from this inflammation </li>\n<li>Increase of the passage of toxins produced by bacteria into the liver </li>\n</ul>\n\n<p>These will not be significantly prevented by drinking more water. </p>\n\n<p>Water is good for preventing the short term effects of dehydration that often comes with alcohol intake. It is not enough to prevent the serious effects alcohol can have in the long term. </p>\n\n<p><em>Sources</em></p>\n\n<p><a href=\"http://pubs.niaaa.nih.gov/publications/aa42.htm\" rel=\"nofollow\">Alcohol and the liver</a></p>\n\n<p><a href=\"https://umm.edu/health/medical/altmed/condition/cirrhosis\" rel=\"nofollow\">Cirrhosis</a></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/3544907\" rel=\"nofollow\">Mechanisms of vitamin deficiencies in alcoholism</a></p>\n\n<p><a href=\"http://www.nhs.uk/conditions/alcohol-misuse/pages/risks.aspx\" rel=\"nofollow\">Risks of alcohol misuse</a></p>\n\n<p><a href=\"http://www.m.webmd.com/a-to-z-guides/features/12-health-risks-of-chronic-heavy-drinking\" rel=\"nofollow\">Health Risks of Alcohol</a></p>\n", "score": 3 } ]

[ "alcohol", "water" ]

[ { "answer_id": 4371, "body": "<p>Satiety is not, and never was, a measure of the calories you have eaten. You feel sated when a certain type of neurons fire in your brain. These neurons are triggered by 1) impulses incoming from the enteric nerve network (motor neurons which partake in peristalsis) and 2) a number of hormones, including GLP1, orexins, cholestokynin and the leptin/ghrelin pair. It is however not yet entirely clear if we know all hormones involved, and what mechanisms determine the release of these hormones. </p>\n\n<p>In two words, it is a very complex matter, and we don't know what exactly creates a feeling of hunger or satiety, but we know it's not something simple as the amount of calories, or the amount of food measured by weight, or the amount of food measured by volume. </p>\n\n<p>Source: Kandel \"Principles of neural science\", plus a Coursera course on diabetes</p>\n", "score": 6 } ]

[ "nutrition", "diet" ]

[ { "answer_id": 4418, "body": "<p>I did end up finding some recent studies with a bit more searching. </p>\n\n<p><a href=\"http://www.ajog.org/article/S0002-9378(07)00300-6/abstract\" rel=\"nofollow\">Miscarriage risk from amniocentesis performed for abnormal maternal serum screening</a> looked at 30.000 women with abnormal serum levels and divided them into two equally sized groups, one undergoing amniocentesis and one not. They found <strong>no significant difference</strong> in risk of miscarriage, the risk being around 0.5 percent for both groups. According to their abstract, the study size would have been large enough to detect a jump from that 0.5 percent to 0.75 percent, so an increase by 0.25, or 1 in 400. </p>\n\n<p>No statistically significant difference was also found in <a href=\"http://journals.lww.com/greenjournal/abstract/2006/11000/pregnancy_loss_rates_after_midtrimester.5.aspx\" rel=\"nofollow\">Loss Rates After Midtrimester Amniocentesis</a>, with a study group of 3.000 women and a control group of 30.000.</p>\n\n<p><a href=\"http://journals.lww.com/greenjournal/Fulltext/2008/03000/Revisiting_the_Fetal_Loss_Rate_After.3.aspx\" rel=\"nofollow\">Revisiting the Fetal Loss Rate After Second-Trimester Genetic Amniocentesis: A Single Center’s 16-Year Experience</a> looked at a single medical center's results from 1990 to 2006. That included 12.000 women undergoing the procedure and 50.000 who didn't. The control group has a miscarriage rate of 0.26%, the amniocentesis group one of 0.4%, the difference was statistically significant. That's an <strong>increase in 0.13%, or 1 in 769</strong>.</p>\n\n<p>At least from those studies, the risk of 1 in 200 seems overstated. </p>\n", "score": 2 } ]

[ "obstetrics", "research", "miscarriage" ]

[ { "answer_id": 5670, "body": "<p>Yes. It is used as a gel.</p>\n\n<p><a href=\"http://www.m.webmd.com/vitamins/ai/ingredientmono-607/aloe\" rel=\"nofollow\">WebMd.com</a></p>\n\n<blockquote>\n <p>Aloe seems to be able to speed wound healing by improving blood\n circulation through the area and preventing cell death around a wound.</p>\n \n <p>It also appears that aloe gel has properties that are harmful to\n certain types of bacteria and fungi.</p>\n</blockquote>\n\n<p>Aloe - <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025519/\" rel=\"nofollow\">ncbi.nlh.nih.gov</a>: </p>\n\n<ul>\n<li><p>anti-inflammatory </p></li>\n<li><p>skin soothing</p></li>\n</ul>\n\n<p>Aloe Vera has been shown effective on scars <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4257949/\" rel=\"nofollow\">here</a>.</p>\n", "score": 3 } ]

[ "dermatology", "topical-cream-gel", "acne", "scar-tissue-scars", "aloe-vera" ]

[ { "answer_id": 5469, "body": "<p>The skin permeation profile (particularly the lateral diffusion coefficient) of a diclofenac (DK) transdermal patch, and percutaneous absorption in general, are in question here. I include the medical terms, mostly because it may help finding further reading beyond what I suggest.</p>\n\n<p>An approachable introduction to percutaneous absorption is <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1947480/\" rel=\"nofollow\">a review</a> written by Dr. Paul Brisson (it was in fact, used a source text in my schooling).</p>\n\n<p>Lateral diffusion, how any drug spreads out from the application site as opposed to down through the skin, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25091375\" rel=\"nofollow\">varies on how the patch is actually made</a>. This is often measured as cm²/h, as the diffusion happens over time. It should be noted that even with the constant application of the patch, you are going to get reduced diffusion based on concentrations gradients which roughly follow <a href=\"https://en.wikipedia.org/wiki/Fick&#39;s_laws_of_diffusion\" rel=\"nofollow\">Flick's laws of diffusion</a>. </p>\n\n<p>A standard salt gel formulation of DK (which is a good baseline, as any modifications will be at best 100x change in ether direction) has a lateral diffusion coefficient of <a href=\"http://onlinelibrary.wiley.com/doi/10.1021/js960198e/abstract\" rel=\"nofollow\"><strong><code>9.65x10^-9</code></strong></a> cm²/h, and a rough saturation time of about <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25091375\" rel=\"nofollow\">3 hours</a>. Even if we assume 10 hours of diffusion, and a 100X increase in the coefficient (<code>9.65x10^-7</code>), that still only gives us <code>9.65x10^-7 cm²</code> lateral diffusion. Let's round that off to an even 97 square nanometers.</p>\n\n<p>That's smaller than the cross sectional area of many viral particles. So you are quite right, a patch is most directly treating the area that it is directly on top of. But this ignores another factor in patch dosing, which is that the drug is transferred to the plasma (blood), and then distributed systemically throughout the body. Thus a significant portion of the dose that a prescribing physician is intending you to recieve might be through delivery from the blood.</p>\n\n<p>So yes, you can sometimes cut a patch to deliver the drug better to a local area, but you should first check with your medical professional to be sure that the type of patch you are using can in fact be cut and still effective (some the nanogel suspensions can't be).</p>\n", "score": 3 } ]

[ "epicondylitis", "diclofenac" ]

[ { "answer_id": 4964, "body": "<p>There are many factors that play a role in not allowing you to fill all the refills at once.</p>\n<p>1- a typical insurance will pay for your medication and will not pay again until 2-3 days before you run out. (Insurance polices)</p>\n<p>2- pharmacy systems do not allow the pharmacist to fill a medication on a patient profile more than once a day even if you do not use your insurance. (Company polices and systems)</p>\n<p>3- to track your compliance with your medication and ensure that you are taking your medication correctly. (Pharmacist decision)</p>\n<p>4- refills exist to limit the number of tablets you can take in an amount of time. Otherwise, the doctor could have given you all pills at once. (Common sense!)</p>\n<p>5- other insurance policies such as, insurance want you to go on mail order after your first 30 days supply, insurance will only pay for 30 days supply at a time, you have exceeded the maximum dose for the medication per 30 days supply (Insurance policies)</p>\n<p>Sincerely,\nPharmacist intern with 3 years of experience</p>\n", "score": 2 }, { "answer_id": 9657, "body": "<p><a href=\"http://www.drugchannels.net/2015/06/the-90-day-at-retail-boom.html\" rel=\"nofollow noreferrer\">90-day supplies are dominated by mail order pharmacies</a>.</p>\n\n<p><a href=\"https://i.stack.imgur.com/TpIP3.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/TpIP3.png\" alt=\"90 day scripts 2010 vs 2014\"></a></p>\n\n<p><em>According to the <a href=\"http://reports.pbmi.com/report.php?id=10\" rel=\"nofollow noreferrer\">PBMI’s 2014-2015 Prescription Drug Benefit Cost and Plan Design Report</a>, 61% of employers allowed community pharmacies to fill 90-day prescriptions for maintenance medications.</em></p>\n\n<p><a href=\"https://i.stack.imgur.com/fir9N.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/fir9N.jpg\" alt=\"Page 12 from http://reports.pbmi.com/report.php?id=10\"></a></p>\n\n<p>This means that although the gap between retail and mail order is closing, there's still a restriction in being able to fill 90-day locally based on the employer's insurance policy.</p>\n", "score": 1 } ]

[ "prescription", "legal", "medications", "class-schedule-of-drugs" ]

[ { "answer_id": 4697, "body": "<p>The diet consists of 24 <a href=\"https://en.wikipedia.org/wiki/Orange_%28fruit%29\" rel=\"nofollow\">oranges</a> per day plus water. Nothing else. So let's see how much nutrition you're actually getting per day. Percentages are based on <a href=\"https://en.wikipedia.org/wiki/Reference_Daily_Intake\" rel=\"nofollow\">US Recommended Daily Intake</a> for an adult.</p>\n\n<pre><code>Calories: 1128 kcal (56%)\nSugar: 224 grams\nFiber: 58 grams (232%)\nFat: 2.9 grams (4%)\nProtein: 22 grams (44%)\n</code></pre>\n\n<p><strong>Vitamins</strong></p>\n\n<pre><code>Vitamin A: 24%\nThiamine: 192%\nRiboflavin (B2): 72% \nNiacin (B3): 48%\nPantothenic acid (B5): 120%\nVitamin B6: 120%\nFolate (B9): 192%\nCholine: 48%\nVitamin C: 1536%\nVitamin E: 24%\n</code></pre>\n\n<p><strong>Minerals</strong></p>\n\n<pre><code>Calcium: 96%\nIron: 24%\nMagnesium: 72%\nManganese: 24%\nPhosphorus: 48%\nPotassium: 96%\nZinc: 24%\n</code></pre>\n\n<p>In essence, this diet is the same as living on sugar water, fiber and vitamins for two weeks. Without doubt you will lose weight consuming only 56% of a normal daily caloric intake. Unfortunately, a significant portion of that weight loss will be muscle since the diet meets less than half of your daily protein needs. It's also virtually devoid of fat, so it's quite likely you'd actually absorb far less of the fat soluble vitamins than it provides. You might also find that it would lead to dry skin and dry hair.</p>\n\n<p>No, two weeks on this diet wouldn't significantly harm a healthy adult, but frankly it's a hideous diet that would result mainly in short-term fat loss and long-term muscle loss, which would make it all the more difficult to keep the fat off going forward.</p>\n", "score": 4 } ]

[ "lasting-effects-duration", "acidic", "fad-diet", "vitamin-c", "juice" ]

[ { "answer_id": 4795, "body": "<p>There has been some talk about this in the exercise world over the last few years, as there has been a push by supplement manufacturers to convince people that it is a needed item. The theory is that since it transports fatty acids to be broken down, more carnitine will transport more, thus driving increased fat utilization/breakdown.</p>\n\n<p>L-Carnitine is a <a href=\"https://ods.od.nih.gov/factsheets/Carnitine-HealthProfessional/\" rel=\"nofollow\">protein that is manufactured in the body</a>, from the amino acids lysine and methionine by the kidneys and the liver. It can also be consumed, and it is mostly stored in tissues such as skeletal and cardiac muscle. It plays a role in delivering long chain fatty acids to mitochondria for energy metabolism, as well as transporting out waste products. The body excretes excess carnitine to maintain stable blood levels, so unless you are deficient (Or have a condition where your body does not independently produce it), you are unlikely to benefit from extra carnitine consumption.</p>\n\n<p>I was able to find two different studies regarding the effect on weight loss. <a href=\"http://www.karger.com/Article/Abstract/65408\" rel=\"nofollow\">The first study</a> was performed using obese rats fed a low calorie (hypocaloric) diet. One group was not given a supplement, the other group had added carnitine. At the end of the study, while there was weight loss and favorable fat to protein ratio shifts for both groups, the carnitine group did not produce a greater loss of weight.</p>\n\n<p><a href=\"http://europepmc.org/abstract/med/10861338\" rel=\"nofollow\">The second study was similar</a>, except it was performed using moderately overweight women, divided into two groups. One group consumed a placebo, the other carnitine, and they all did the same exercise program. In the end, there was no statistical difference between the groups for weight loss and body composition. In addition, 5 of the 18 (28%) in the carnitine group had to drop out due to diarrhea and nausea.</p>\n", "score": 2 } ]

[ "medications", "side-effects", "weight-loss", "supplement" ]

[ { "answer_id": 4830, "body": "<p>Sites vary, but most mention a median range of between 30-40% humidity. </p>\n\n<p><a href=\"http://www.highqproducts.com/nosebleeds.php\" rel=\"nofollow\">40-50% Humidity</a></p>\n\n<blockquote>\n <p>During extremely cold weather, your home loses humidity to the\n outdoors and may drop as low as 5%. By comparison, typical humidity in\n the Sahara Desert is about 25%! Generally, one does not want to have a\n home humidity any lower than 30%. Optimal comfort is considered to be\n achieved at 40-55% humidity. Nosebleeds also occur in hot dry climates\n with low humidity, or when there is a change in the seasons.</p>\n</blockquote>\n\n<p><a href=\"https://en.m.wikipedia.org/wiki/Relative_humidity\" rel=\"nofollow\">Above 30%</a></p>\n\n<blockquote>\n <p>Indoor relative humidities should be kept above 30% to reduce the\n likelihood of the occupant’s nasal passages drying out,[7][8]\n Humans can be comfortable within a wide range of humidities depending\n on the temperature—from thirty to seventy percent[9]—but ideally\n between 50%[10] and 60%.[11] Very low humidity can create discomfort,\n respiratory problems, and aggravate allergies in some individuals. In\n the winter, it is advisable to maintain relative humidity at 30\n percent or above.[12] Extremely low (below 20%) relative humidities\n may also cause eye irritation.[13]</p>\n</blockquote>\n\n<p><a href=\"http://www.webmd.com/first-aid/tc/nosebleeds-prevention\" rel=\"nofollow\">WebMD</a></p>\n\n<blockquote>\n <p>Keep the heat low [60°F (16°C) to 64°F (18°C)] in sleeping areas</p>\n</blockquote>\n", "score": 2 } ]

[ "air-quality", "epistaxis--bloody-nose", "scratch-scratching", "humidifier" ]

[ { "answer_id": 4887, "body": "<p>It's possible the speakers you're using to test are not able to output frequencies that high, even if they claim they should be able to.</p>\n\n<p>Aside from that, I'm pretty sure by age 30 your hearing ability for higher frequencies has declined some - check out this chart <a href=\"http://jslhr.pubs.asha.org/data/Journals/JSLHR/934609/m_JSLHR_58_5_1592fig1.jpeg\" rel=\"nofollow\">http://jslhr.pubs.asha.org/data/Journals/JSLHR/934609/m_JSLHR_58_5_1592fig1.jpeg</a>. If you want to research it more, search for ISO 7029.</p>\n", "score": 1 } ]

[ "hearing" ]

[ { "answer_id": 4942, "body": "<p><strong><em>Edit:</em></strong></p>\n\n<p>If there's any obvious fracture, follow RICE - Rest, Ice, Compression, Elevation.</p>\n\n<p>Do not bear any weight until you can see a specialist and get a diagnosis, and a diagnosis you are happy with.</p>\n\n<p>Try to rest it as much as possible and keep the limb elevated above the heart as much as you can until you have professional medical advice.</p>\n\n<hr>\n\n<p>In my situation:</p>\n\n<p>I saw the orthopaedic specialist today. The conclusion from the x ray is that yes, it's fractured... But the \"good\" news is that I only have a fracture boot and can load bear on my heel as much as pain allows.</p>\n\n<p>The summary is that there's a lateral metatarsal ligament that binds the knuckles of the metatarsals together, and as long as only 1 of the central metatarsals is fractured, it is in effect supported in position by that ligament and the two either side act as splints.</p>\n\n<p>In that the bone is in the correct position, it'll not drop back (if more than one was fractured, the ligament would pull it back) and it'll be 3 -4 weeks before I can start to weight bear and 6 weeks should be back to <strong>ahem</strong> normal. No pins or plates required.</p>\n", "score": 1 } ]

[ "orthopedics", "broken-bones", "toe" ]

[ { "answer_id": 4915, "body": "<p>HSV1 and HSV2 are different strains of the <em>Herpes simplex</em> virus. They <em>both</em> can lead to <a href=\"https://www.aad.org/public/diseases/contagious-skin-diseases/herpes-simplex\" rel=\"nofollow noreferrer\">oral</a> or <a href=\"http://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm\" rel=\"nofollow noreferrer\">genital</a> infection. </p>\n\n<p>The reason they are usually known as oral (HSV1) and genital (HSV2) herpes are that the majority of genital herpes cases used to be from HSV2. However, this has been changing and now HSV1 is <a href=\"http://journals.lww.com/stdjournal/Fulltext/2003/10000/Is_Herpes_Simplex_Virus_Type_1__HSV_1__Now_More.13.aspx\" rel=\"nofollow noreferrer\">the more dominant genital infection at least in some regions</a>. Moreover, people <a href=\"http://m.jid.oxfordjournals.org/content/185/8/1019.full\" rel=\"nofollow noreferrer\">can be infected by both</a>, even in the same \"region\", though it's unlikely that most people even <em>know</em> whether they are infected by HSV1 or HSV2 because testing what strain someone is infected with not always done, from what I understand. So yes, someone with HSV1 can additionally acquire HSV2, both orally and genitally. </p>\n\n<p>In addition to that, even a genital infection with <a href=\"https://health.stackexchange.com/questions/4912/hsv-transmission-risk-from-oral-sex\">HSV2 may lead to shedding the virus from the oral region</a> - it is uncommon, though. </p>\n", "score": 4 } ]

[ "sex", "herpes", "sti" ]