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[ { "answer_id": 933, "body": "<p>You should consult a physician for treatment of hypertension if you fit into the categories below. </p>\n\n<p>When should you be alarmed? That's subjective. Physicians are alarmed when they see systolic blood pressure (SBP) is equal to or greater than 180 mm Hg, or where diastolic blood pressure (DBP) is equal to or greater than 120 mm Hg; HBP with any signs or symptoms (especially stroke symptoms, confusion, hallucinations, etc.) is an emergency. Patients should be alarmed long before physicians are - in other words, get treated before it becomes dangerous! </p>\n\n<p>The Eighth Joint National Committee on Hypertension (JNC 8) analyzed large studies of hypertension from 1966 through 2009 - with some consideration of studies up to 2013 - and made recommendations for adults age 18 and older with hypertension. The outcomes considered in making these recommendations, i.e. what will happen if one fails to lower blood pressure (BP) were, among others:</p>\n\n<ul>\n<li>overall mortality</li>\n<li>cardiovascular disease (CVD)-related mortality</li>\n<li>chronic kidney disease (CKD)-related mortality</li>\n<li>myocardial infarction, heart failure, hospitalization for heart failure, stroke</li>\n<li>need for coronary, carotid, renal, and lower extremity revascularization (bypass, etc.)</li>\n</ul>\n\n<p>They rated their recommendations on strength of evidence. Grades were assigned. </p>\n\n<p><strong>A</strong>: Strong - based on substantial (good) evidence (strongly recommended)<br>\n<strong>B</strong>: Moderate - the net benefit is moderate to substantial<br>\n<strong>C</strong>: Weak - moderate certainty that there is a small net benefit<br>\n<strong>D</strong>: Against -no net benefit or that risks/harms outweigh benefits.<br>\n<strong>E</strong>: Expert Opinion - <em>insufficient</em> evidence but the committee recommends (no great studies available) - further research recommended<br>\n<strong>N</strong>: No Recommendation for or against - insufficient/unclear/conflicting evidence; further research is recommended in this area.</p>\n\n<p><strong>Grade A</strong>: aged 60 years or older, treat to lower BP if systolic blood pressure (SBP) is equal to or greater than 150 mm Hg, or diastolic blood pressure (DBP) is equal to or greater than 90 mm Hg. Goal: SBP &lt; 150 mm Hg; DBP &lt; 90 mm Hg. (<strong>controversial</strong> for individuals 60 years or older who do not have diabetes or chronic kidney disease)</p>\n\n<p><strong>Grade A</strong>: ages 30 through 59 years, treat DBP of 90 mm Hg or higher; goal DBP &lt; 90 mm Hg. </p>\n\n<p><strong>Grade B</strong>: patients &lt; 60 years with hypertension (HTN): treat; goal: BP &lt; 140/90 mm Hg. </p>\n\n<p><strong>Grade E</strong>: ages 18 through 29 years, treat DBP of 90 mm Hg or higher; goal DBP &lt; 90 mm Hg.</p>\n\n<p>In patients with SBP between 130-150 mm Hg, there was no increase in risk in adverse effects.</p>\n\n<p>LOW BP: There are no JNC8 recommendations; the decision to treat is based on expert opinion only. Goal: decrease <em>symptoms</em>; treat underlying cause (if any) (I.e.: if you're active, have no problems, but your BP is 80/60 - well... that's great! No adverse outcome is known.</p>\n\n<p><strong>Please see references for other treatment groups and recommendation strength.</strong></p>\n\n<p>_{<a href=\"http://www.guideline.gov/content.aspx?id=48192\" rel=\"nofollow\">2014 evidence-based guideline for the management of high blood pressure in adults. Report from the panel members appointed to the Eighth Joint National Committee (JNC 8)</a>}<br>\n_{<a href=\"http://www.nhlbi.nih.gov/health/health-topics/topics/hyp/treatment\" rel=\"nofollow\">How Is Hypotension Treated?</a>}</p>\n", "score": 2 } ]

[ "blood-pressure" ]

[ { "answer_id": 881, "body": "<p>I cannot speak of all possible gas medicines. But there is a class of them which is indeed low risk and over the counter. These are silicones, and they work in a purely mechanical way, not getting absorbed by the body. </p>\n\n<p>These silicones are the same stuff which you get in hair conditioner. They are quite inert chemically, and all they do is to change the surface tension of the liquid it is dissolved in - it becomes slippery, and if gas is pumped into it, it cannot form a bubble. As a result, it does not foam. </p>\n\n<p>The bacteria in your intestine presumably continue to produce gas, but it quickly passes to its now-slippery contents, instead of being trapped and expanding them like the head of a poured beer. It does not exert painful, rumbling pressure anymore, and exits the intestine in small, less noticeable portions instead of creating mini-explosions. </p>\n\n<p>For a reference, you can see this patent describing the mechanism of action of simethicone tablets: <a href=\"http://www.google.com/patents/US5612054\">http://www.google.com/patents/US5612054</a>. </p>\n", "score": 7 } ]

[ "medications", "gastroenterology" ]

[ { "answer_id": 1075, "body": "<p>The mercury found in a thermometer is <strong>elemental mercury</strong>. It is poorly absorbed from the gastrointestinal tract. However, the greatest problem with it is that, apart from ingestion, there can be another route of exposure without noticing. <strong>Elemental mercury easily evaporates on room temperature, and these vapours can be inhaled.</strong> In this form Hg is liposoluble and is readily absorbed and passes the blood-brain barrier easily. Since main toxic effects of any form of mercury are neuro-toxic ones, this is a major concern. </p>\n\n<p>There is more information about toxicity of various forms of mercury in <a href=\"http://emedicine.medscape.com/article/1175560-overview#aw2aab6b2b4aa\" rel=\"noreferrer\">this Medscape article</a>.</p>\n\n<p>An EPA <a href=\"http://www.epa.gov/teach/chem_summ/mercury_elem_summary.pdf\" rel=\"noreferrer\">Toxicity and Exposure Assessment for Children's Health</a> Report on elemental mercury states that:</p>\n\n<blockquote>\n <p>Elevated levels of elemental mercury or mercury vapor in indoor air can occur as a result of accidental spills and can be lethal to children. Spills have occurred in home and school environments. Attempted clean-up using a vacuum cleaner disperses elemental mercury into the air, and is likely \n to increase exposure.</p>\n</blockquote>\n\n<p>So, yes: exposure to elemental mercury such as the one from a broken thermometer can cause poisoning. It can affect the nervous system, lungs, kidneys... \"Recovery is usually without sequela\" (without permanent consequences), but there have been cases with fatal outcomes. In pregnant women exposure has been associated with an increased rate of stillbirths. </p>\n", "score": 7 } ]

[ "side-effects", "poison" ]

[ { "answer_id": 27440, "body": "<p>Both retinoids and benzoyl peroxide must be absorbed by the skin to do their work. If you have make-up on or oily skin etc. this can be a barrier to absorption so must be cleaned off. The cleaner your skin, the more is absorbed and therefore the more effective it is.</p>\n<p>Tretinoin is a synthetic form of a retinoid used to treat acne however the mechanism of action is identical to all other retinoids so the information is applicable in general. Guidelines and further information for the use of 'tretinoin' which is a type of retinoid can be found below.</p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/2778128/\" rel=\"nofollow noreferrer\">https://pubmed.ncbi.nlm.nih.gov/2778128/</a></p>\n<p>Benzoyl peroxide is an anti-microbial also used to treat acne, in fact it has been used in combination with retinoids as evidence shows they are more effective together. You can find much more detail on that at the links below:</p>\n<p><a href=\"https://pubmed.ncbi.nlm.nih.gov/19588642/\" rel=\"nofollow noreferrer\">https://pubmed.ncbi.nlm.nih.gov/19588642/</a></p>\n<p><a href=\"https://www.mayoclinic.org/drugs-supplements/benzoyl-peroxide-topical-route/proper-use/drg-20062425\" rel=\"nofollow noreferrer\">https://www.mayoclinic.org/drugs-supplements/benzoyl-peroxide-topical-route/proper-use/drg-20062425</a></p>\n", "score": 1 } ]

[ "dermatology", "topical-cream-gel", "face", "benzoyl-peroxide" ]

[ { "answer_id": 1031, "body": "<p>Insulin resistance and obesity are both symptoms of type 2 diabetes, although they also occur at a prediabetic stage, before the diabetes diagnostic criteria are met. <a href=\"http://www.sciencedirect.com/science/article/pii/014067369292814V\" rel=\"noreferrer\">Insulin resistance is highly predictive of diabetes</a>. In the <a href=\"http://www.researchgate.net/profile/Giovanni_Targher/publication/13533291_Prevalence_of_insulin_resistance_in_metabolic_disorders_the_Bruneck_Study/links/00b4951dd5f59ca7d2000000.pdf\" rel=\"noreferrer\">Bruneck study</a>, less than 10% of the insulin resistant subjects had no other metabolic disorder. But still, the exact relationship between insulin resistance and obesity is unclear, as they could</p>\n\n<ul>\n<li>have a common cause, or </li>\n<li>one of them causes the other, or </li>\n<li>be coupled in a positive feedback cycle, or</li>\n<li>all of the above. But we know that they are highly correlated in untreated patients. </li>\n</ul>\n\n<p><img src=\"https://i.stack.imgur.com/JxrsV.gif\" alt=\"enter image description here\"></p>\n\n<p>This is the prevalence of insulin resistance in adolescents from <a href=\"http://care.diabetesjournals.org/content/29/11/2427.full#F1\" rel=\"noreferrer\">NHANES</a>, with white circles denoting normal weight adolescents, black squares denoting overweight adolescents and black circles denoting obese adolescents. </p>\n\n<p>For example, <a href=\"https://class.coursera.org/diabetes-003/\" rel=\"noreferrer\">one of the theories</a> for the progression to diabetes is that the capacity of the body's usual fat depots is overtaxed, leading to having too much fat where it does not belong (e.g. intraabdominal fat deposits), resulting in lipotoxicity and finally diabetes. This would be a potential argument for obesity leading to insulin resistance. A common cause could be searched e.g. in <a href=\"http://www.diapedia.org/metabolism/glp-1-defects-in-diabetes\" rel=\"noreferrer\">reduced incretin secretion</a> or <a href=\"http://www.researchgate.net/profile/Lufen_Chang/publication/11022576_A_central_role_for_JNK_in_obesity_and_insulin_resistance/links/5481cee20cf2941f830a02bd.pdf\" rel=\"noreferrer\">increased JNK activity</a>. But given the difficulty of finding a clear mechanism, and the complexity of the pathways involved, the connection is probably multifactorial. </p>\n\n<p>Weight loss is one of the goals in diabetes management. Exercise and dieting delay the progression of prediabetic stages to diabetes. They reduce both obesity and insulin resistance. So, to answer your question directly, <strong>if you had insulin resistance, and you managed to lose weight, it is very likely that your insulin sensitivity has increased.</strong> </p>\n\n<p>The above assumes that the patient is not taking any metabolic treatment. If he is taking diabetes medications, their effect on insulin sensitivity and weight will be independent. Some medication classes like <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19952301\" rel=\"noreferrer\">GLP 1 agonists</a> will reduce both obesity and insulin related effects, as will <a href=\"http://en.wikipedia.org/wiki/Gastric_bypass_surgery\" rel=\"noreferrer\">bariatric surgery</a>. <a href=\"http://en.wikipedia.org/wiki/Metformin\" rel=\"noreferrer\">Metformin</a> will improve insulin sensitivity without affecting weight much, while <a href=\"http://en.wikipedia.org/wiki/Thiazolidinedione\" rel=\"noreferrer\">the glitazones</a> reduce insulin resistance but lead to weight gain. </p>\n", "score": 7 }, { "answer_id": 9173, "body": "<p>People who have insulin resistance generally find it more difficult to attain and maintain a healthy weight.</p>\n\n<p>If the person with insulin resistance is overweight (which is often the case), and if s/he succeeds in losing even a small amount of weight, s/he will generally see some immediate improvement in their insulin sensitivity and a lessening of symptoms (such as headache, yucky feeling, foggy feeling).</p>\n\n<p>Reference: <a href=\"https://www.niddk.nih.gov/health-information/diabetes/types/prediabetes-insulin-resistance\" rel=\"nofollow\">https://www.niddk.nih.gov/health-information/diabetes/types/prediabetes-insulin-resistance</a></p>\n\n<p>A low-carb diet helped my insulin resistant son.</p>\n", "score": 0 } ]

[ "nutrition", "weight" ]

[ { "answer_id": 1141, "body": "<p><em>\"When the time came for her to give birth, there were twin boys in her womb. As she was giving birth, one of them put out his hand; so the midwife took a scarlet thread and tied it on his wrist and said, “This one came out first.” But when he drew back his hand, his brother came out, and she said, “So this is how you have broken out!” And he was named Perez. Then his brother, who had the scarlet thread on his wrist, came out. And he was named Zerah.\"</em> - Genesis 38: 27-30</p>\n\n<blockquote>\n <p>It is implied that before birth, they knew the mother had twins. </p>\n</blockquote>\n\n<p>Any good midwife can determine when a woman is carrying twins. The uterus will be bigger, and there will be excess everything: excess heads, excess rumps, excess backbones (these are things that can actually be felt and located on manual examination). Late in the pregnancy, if both twins are head down (the usual and most common presentation), there will be two rumps up top.</p>\n\n<blockquote>\n <p>The first thing to come out of the womb was one baby's arm... The arm goes back into the womb.</p>\n</blockquote>\n\n<p>In my medical experience delivering babies (I've delivered a significant number), this is fairly unlikely <em>if the story is told without including pauses</em>. For one thing, the waters would have had to have broken - at least one sac if they were dichorionic diamniotic twins, which is most common for non-identical twins (which they were). This usually occurs very close to the time of birth, when the pelvis would be already occupied by a head. There's not a lot of room for hands and arms to be swinging freely in there. </p>\n\n<p><img src=\"https://i.stack.imgur.com/tgBQd.gif\" alt=\"enter image description here\"></p>\n\n<blockquote>\n <p>The first thing to come out of the womb was one baby's arm (upon which the first thing the midwife does is tie a crimson thread to it).</p>\n</blockquote>\n\n<p>However, <strong>compound presentations</strong> may occur in a \"roomy\" pelvis, and are more likely to occur when the pelvis is not fully occupied by the fetus because of low birth weight, <strong>multiple gestation</strong>, polyhydramnios, or a large pelvis. They occur in singleton pregnancies about once in ~1500 births, and usually, the \"misplaced\" part is a hand or arm. <strong>In general, if left unattended, the <em>hand will retract</em> or <em>the arm will extend further</em> as labor progresses.</strong></p>\n\n<blockquote>\n <p>...unborn children have all their reflexes in utero, [therefore] unborn babies are fully capable, within the limitations of the space available, of reacting as they would as newborns. The simplest approach, therefore, may be to apply a benign noxious stimulus, such as a gentle pinch to a fingertip of the advancing hand. By applying a benign noxious stimulus (between contractions, of course), the hand may withdraw and never appear in the undesired position again.</p>\n</blockquote>\n\n<p>In Genesis, note that the hand alone came out, and since it usually retracts, this is possible. The tying of thread around the infant's arm might be enough noxious stimuli to cause it to retract.</p>\n\n<p>As I said, with twins there's less room, however</p>\n\n<blockquote>\n <p>Rupture of membranes when the presenting part is still high also increases the risk of compound presentation, cord prolapse, or both... In multiple gestations, a possible scenario involves the head of the first twin and an extremity of the second twin within the birth canal.</p>\n</blockquote>\n\n<p>Which would be the exact scenario described in Genesis.</p>\n\n<p>_{<a href=\"http://radiopaedia.org/articles/dichorionic-diamniotic-twin-pregnancy\" rel=\"nofollow noreferrer\">Dichorionic diamniotic twin pregnancy</a>}<br>\n_{Image from <a href=\"http://www.beaumont.edu/womens-health/obstetrics/during-pregnancy/multiple-babies/about-multiple-births/\" rel=\"nofollow noreferrer\">About Multiple Birth Pregnancy</a>}<br>\n_{<a href=\"http://emedicine.medscape.com/article/262444-overview\" rel=\"nofollow noreferrer\">Compound Presentations</a>}<br>\n_{<a href=\"http://www.uptodate.com/contents/management-of-the-fetus-with-compound-presentation\" rel=\"nofollow noreferrer\">Management of the fetus with compound presentation</a>} </p>\n", "score": 6 } ]

[ "obstetrics" ]

[ { "answer_id": 15933, "body": "<p>When ingesting sugar water, the body attempts to regulate movement of food from the stomach into the duodenum (first part of small intestine) to a rate of about <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/9838860\" rel=\"nofollow noreferrer\">2.1 kcal per minute</a>.</p>\n\n<p>Your drink that contains 24 grams of sugar will provide 96 kcal, and will likely be absorbed over a period of about 45 minutes.</p>\n\n<p>A normal healthy person will have around 80-110 mg/dl of glucose circulating in their blood plasma. An average person has about 50 dl of blood circulating in their veins, or about 5 grams of glucose total. If all 24 grams of sugar entered the blood stream instantly, that would cause the blood sugar level to rise by around 480 mg/dL, which would be well above the level defined as acute hyperglycemia and high enough to put a person into the emergency room or even cause death.</p>\n", "score": 1 } ]

[ "nutrition", "sugar" ]

[ { "answer_id": 1994, "body": "<p>Bones should be maximally immobilized. It is very painful and dangerous to move otherwise. </p>\n\n<p>It is possible to walk, using only one crutch (I know this by practice). </p>\n\n<p>Probably it is possible to use it on the side opposite to broken collar bone.</p>\n\n<p>Most probably, if we have complex fracture, it will be recommended to use carriage, especially on initial stages of recovery.</p>\n", "score": 1 }, { "answer_id": 1423, "body": "<p>Walking cast, if the leg break is amenable to same. Lots of examples if you search on that term.</p>\n\n<p><a href=\"https://duckduckgo.com/?q=walking+cast&amp;ia=products\" rel=\"nofollow\">https://duckduckgo.com/?q=walking+cast&amp;ia=products</a></p>\n\n<p>May need a cane to steady himself, so might matter if the breaks are ipsilateral or contralateral.</p>\n", "score": 0 } ]

[ "broken-bones", "musculoskeletal-system" ]

[ { "answer_id": 1576, "body": "<p>Humans are strange among mammals in making dairy products such a large proportion of their adult diet. It reminds me of this amusing quote by Henry David Thoreau:</p>\n\n<blockquote>\n <p>One farmer says to me, 'You cannot live on vegetable food solely, for\n it furnishes nothing to make bones with;' and so he religiously\n devotes a part of his day to supplying his system with the raw\n material of bones; walking all the while he talks behind his oxen,\n which, with vegetable-made bones, jerk him and his lumbering plow\n along in spite of every obstacle.</p>\n</blockquote>\n\n<p>Also, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24351141\" rel=\"nofollow\">this study</a> <em>seems</em> to be saying that vegetables can supply as much calcium as milk:</p>\n\n<blockquote>\n <p>Recent absorption studies in humans with low-oxalate and low-phytate\n vegetables and pulses also showed that contrary to common\n presuppositions, these vegetables with low calcium chelators do have a\n comparable calcium absorbability to milk.</p>\n</blockquote>\n\n<p>But the intake of calcium is just part of the equation - calcium is also lost by excretion, which is what makes oisteoporosis possible. Many studies, such as <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/9614169\" rel=\"nofollow\">this one</a> entitled \"Excess dietary protein can adversely affect bone\", report that high consumption of protein in the diet leads to increased excretion of calcium due to the acids formed in the metabolism of protein.</p>\n\n<p>Finally, an <a href=\"https://www.hsph.harvard.edu/nutritionsource/calcium-full-story/\" rel=\"nofollow\">article</a> published on Harvard's own website considers the 1,000-1,200 mg RDA for calcium recommended by the National Academy of Sciences, which were based on short-term studies, and raises them to question based on long-term studies:</p>\n\n<blockquote>\n <p>In particular, these [long term] studies suggest that high calcium\n intake doesn’t actually appear to lower a person’s risk for\n osteoporosis. For example, in the large Harvard studies of male health\n professionals and female nurses, individuals who drank one glass of\n milk (or less) per week were at no greater risk of breaking a hip or\n forearm than were those who drank two or more glasses per week.</p>\n</blockquote>\n\n<p>The article describes several more studies that found no benefit to bone strength from high milk consumption.</p>\n", "score": 4 }, { "answer_id": 1604, "body": "<p>According to <a href=\"http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S0004-27302006000400014\" rel=\"nofollow\">this review article</a>, adults need a bit more than 1 gram of calcium per day. However, it may be the case that the natural vitamin D levels for the human body should be a lot higher than what is currently the norm, see e.g. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22264449\" rel=\"nofollow\">here</a>. Calcium is absorbed from the gut by both passive and active mechanisms, the active mechanism is vitamin D dependent. If the level of calcium in the blood drops then calcium from bones will be released and simultaneously, the kidneys will produce more calcitriol which then turns on genes in the gut to produce enzymes that help to extract calcium from food.</p>\n\n<p>Besides the total intake per day, what is also relevant is the presence of big gaps in the intake of calcium. Such gaps will prompt the body to extract calcium from the bones and then you're dependent on processes that will eventually put calcium back into the bones. By spreading the intake of calcium over the day, you can prevent bone loss in the event that in your case this mechanism of putting the calcium back doesn't work as well as it should.</p>\n\n<p>Note that there are many sources of calcium that we tend to ignore. Water can contain calcium, e.g. where I live there is 60 mg per liter. That doesn't sound like a lot, but if you drink 3 liters a day, you'll get 180 mg. Bread only contains 10 mg per slice, but if you eat a lot like I do (I don't recommend doing that unless it fits into a well balanced diet for your case) like 15 slices per day, then that's 150 mg of calcium. So, the dry bread plus water alone is already 280 mg.</p>\n\n<p>Then if you eat 500 grams of broccoli at dinner like I did today, you'll get 235 mg of calcium. Potatoes contain 12 mg per 100 gram, I had 1 kg of potatoes for dinner, so I got 120 mg from the potatoes. This means that in total I got more than 600 mg of calcium from sources one normally doesn't bother to consider. However, it must be said that absorption of calcium from such sources isn't as efficient as from dairy products due to oxalates in vegetables, phytic acids in grains and the lack of phosphorous when you drink just plain water.</p>\n\n<p>So, you see that non dairy sources can give you a decent amount of calcium, but you then need to eat a lot (I eat about 4000 kcal per day, which is a lot more than average). The calorie intake of indigenous people who needed to jog for hours every day to chase prey was likely a lot higher than what it is today for the typical office worker, so they may actually have gotten their gram of calcium per day from only non dairy foods and their vitamin D levels were also likely a lot higher than that of the average office worker. </p>\n", "score": 3 } ]

[ "calcium", "minerals", "milk", "bones" ]

[ { "answer_id": 3941, "body": "<p>&quot;Normal&quot; eyelid twitching can possibly be caused or be made worse by lack of sleep, or too much caffeine or stress. That information can be found unsourced on <em>a lot</em> of websites, including with such qualifiers as &quot;many experts say&quot;. I couldn't find a single source - which doesn't mean it doesn't exist, or say that these things don't cause eyelid twitches.</p>\n<p>The Kellogg Eye Centre at the University of Michigan just says:</p>\n<blockquote>\n<p>The cause of minor eyelid twitch is unknown.</p>\n</blockquote>\n<p>And for treatment:</p>\n<blockquote>\n<p>Minor eyelid twitches require no treatment as they usually resolve spontaneously. Reducing stress, using warm soaks, correction of any refractive error, and lubrication of the eye with artificial tears may help. Some ophthalmologists recommend reducing caffeine usage</p>\n</blockquote>\n<p>The University of Maryland Medical Center mentions, just like a lot of sources, caffeine, sleep and stress</p>\n<blockquote>\n<p>The most common things that make the muscle in your eyelid twitch are fatigue, stress, and caffeine.</p>\n</blockquote>\n<p>And for treatment:</p>\n<blockquote>\n<p>Eyelid twitching most often goes away without treatment. In the meantime, the following steps may help:</p>\n<ul>\n<li>Get more sleep.</li>\n<li>Drink less caffeine.</li>\n<li>Lubricate your eyes with eye drops</li>\n</ul>\n<p>If twitching is severe or lasts a long time, small injections of botulinum toxin can control the spasms</p>\n</blockquote>\n<p>However, since you specifically mentioned <em>blepharospasm</em>, I am going to include some information on what's called <em>benign essential blepharospasm</em>. That's a condition that worsens with age, and often ends up including more face muscles than just the eyelids. It's probably caused at least in part by genetics, but the exact gene responsible for it remains unclear. Treatment for it includes medication, for example dopamine inhibitors, botox injections, and even surgery to remove the eyelid muscle.</p>\n<p>Interestingly, for benign essential blepharospasm, drinking coffee might actually <em>delay</em> onset of the disease.</p>\n<p><strong>Sources</strong></p>\n<p><a href=\"http://www.kellogg.umich.edu/patientcare/conditions/eyelid.spasms.html\" rel=\"nofollow noreferrer\">Kellogg Eye Center</a></p>\n<p><a href=\"https://umm.edu/health/medical/ency/articles/eyelid-twitch\" rel=\"nofollow noreferrer\">University of Maryland Medical Center</a></p>\n<p><a href=\"http://ghr.nlm.nih.gov/condition/benign-essential-blepharospasm\" rel=\"nofollow noreferrer\">Benign essential blepharospasm</a></p>\n<p><a href=\"https://rarediseases.org/rare-diseases/benign-essential-blepharospasm/\" rel=\"nofollow noreferrer\">Benign essential blepharospasm @ rarediseases.org</a></p>\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2676990/#__abstractid883428title\" rel=\"nofollow noreferrer\">Update on blepharospasm</a></p>\n", "score": 3 }, { "answer_id": 8997, "body": "<p>There are three core factors that contribute to eye twitching: <strong>caffeine consumption, stress, and fatigue.</strong></p>\n\n<p>If you’ve been noticing that your sleep has been disturbed or if you haven’t been getting enough of zzz time, you may expect daytime tiredness along with eye twitching. So if your eyelids have been bothering you lately, it may be wise to look at your sleep schedule.</p>\n\n<p><strong>Caffeine</strong> is a popular stimulant many of us drink to stay alert. But sometimes that surge of energy not only keeps you awake, but also causes your eyes to twitch. If you consume lots of coffee or even energy drinks on a daily basis, you may want to cut back in order to minimize eye twitching. Keep in mind that smoking and alcohol consumption can contribute to eye twitching, too.</p>\n\n<p><strong>Stress</strong> can play a large role in eye twitches, too. Stress-induced eye twitching can be more nerve-racking, as it may take place during important moments. For example, maybe you’re stressed out about putting a dinner party together. Well, now, not only are you trying to keep things under control, but your annoying eye twitch won’t stop either! All you can do here is handle stress at the best of your ability. And stop thinking about your eye twitch – otherwise, it will only add to the pressure of the moment. Relaxation techniques and other coping mechanisms should be utilized in order to lower stress, which in turn will reduce the eye twitch.</p>\n\n<p>Although these three factors are the most common causes for eyelid twitching, other causes include mineral deficiencies like lack of magnesium, dry eyes, eye strain from looking at a screen, incorrect eye glass prescription, allergies, alcohol consumption, smoking, an underlying eye problem, jaw clenching or teeth grinding. In some cases, eye twitching can be an early symptom of a serious medical condition including hypoglycemia, Parkinson’s disease, Tourette’s syndrome, and neurological dysfunction. If eye twitching worsens or is accompanied by other symptoms, you should see your doctor to determine the exact cause.</p>\n\n<p><strong>Treatment options for eyelid twitching</strong></p>\n\n<p>Treatment options for eyelid twitching depend on the underlying cause. For example, if excessive caffeine is causing your eyelids to twitch, you may need to cut back on your favorite drink. If fatigue or stress is the cause, then more rest or effective stress-reducing remedies are needed.</p>\n\n<p>You may have to work towards getting more sleep, start drinking less caffeine, apply cold compresses to your eyes, make it a point to look away from screens often, reduce stress, use artificial tears and other eye drops, and ensure you are getting adequate nutrition. These are just some ways to address eyelid twitching, but treatment may vary based on the cause.</p>\n\n<p>Proper treatment of eyelid twitches may also aid with prevention. For example, if you are sleeping more and, therefore, are well rested, you may be able to get rid of your existing eye twitching problem and avoid future occurrences.</p>\n\n<p><strong>Tips to manage your eye twitching</strong></p>\n\n<p>Apply hot and cold compresses to the eyelid\nTry acupuncture or massages to ease tension and reduce stress\nReduce stress as best as possible\nReduce your intake of caffeine\nGet more sleep\nTry a face steam</p>\n\n<p>Source: <a href=\"http://www.belmarrahealth.com/eye-twitching-causes-treatment-prevention/\" rel=\"nofollow\">Eyelid twitching causes, treatment, and prevention</a></p>\n", "score": 1 } ]

[ "cause-and-effect", "eyelids", "muscle-tremor-twitch" ]

[ { "answer_id": 1332, "body": "<p>You are right that there are conflicting viewpoints about whether or not Vaseline and other types of petroleum jelly, also known as petrolatum, are comedogenic (can cause or worsen acne). There are medical professionals who will say that petroleum jelly will cause acne, while others might argue the opposite. The same also goes for research, though most research points to petroleum jelly being non-comedogenic. </p>\n\n<p>Why might petroleum jelly be comedogenic? Petroleum jelly is very greasy. This greasiness could cause petroleum jelly to be comedogenic. Research has also shown this may be the case, but there is also some more reliable research that suggests that this is false. Because people have wondered if petroleum jelly is comedogenic for a long time, most studies on this topic are a little bit older (pre-2000). Also, most studies that suggest the petroleum jelly might cause acne were done on rabbits, who are much more sensitive to cosmetics than humans are. </p>\n\n<p>A 1972 article that introduced acne cosmetica,^{<a href=\"http://archderm.jamanetwork.com/article.aspx?articleid=532944\" rel=\"nofollow\">1</a>} acne caused by cosmetic products, tested many different cosmetic creams on rabbit ear canals, and found that many of them, including petroleum jelly, were mildly comedogenic. The research also found that using petroleum jelly or other cosmetic substances can cause mild acne breakouts in some woman. This research wasn't extremely convincing that petroleum jelly is comedogenic as rabbits aren't the perfect model for seeing what the effect would be on human skin. Also, the research done on petroleum jelly's effect on actual human skin showed that it caused comedonal reactions, but only in some women.</p>\n\n<p>The most reliable study testing if petroleum jelly is comedogenic is probably a 1996 study by the same man who did the previous study I mentioned.^{<a href=\"http://journal.scconline.org/pdf/cc1996/cc047n01/p00041-p00048.pdf\" rel=\"nofollow\">2</a>} The results, after testing different products that use petroleum jelly on different groups of patients, were that there wasn't any comedogenic potential in petroleum jelly. Petroleum jelly also didn't worsen acne at all.</p>\n\n<p>It is most likely that petroleum jelly is not comedogenic. Some studies point to it being comedogenic as a possibility, but rabbit ears are much more sensitive than human skin, so it is impossible to get definitive information from those studies. If you are worried about getting acne from using a product like Vaseline, you should be fine. Odds are, the Vaseline would be helping you more than hurting.</p>\n\n<hr>\n\n<p>^{<a href=\"http://archderm.jamanetwork.com/article.aspx?articleid=532944\" rel=\"nofollow\">1: \"Acne Cosmetica\"</a>}</p>\n\n<p>^{<a href=\"http://journal.scconline.org/pdf/cc1996/cc047n01/p00041-p00048.pdf\" rel=\"nofollow\">2: Petrolalum is not comedogenic in rabbits or humans: A critical reappraisal of the rabbit ear assay and the concept of \"acne cosmetica\" </a>}</p>\n", "score": 6 } ]

[ "dermatology", "acne" ]

[ { "answer_id": 1551, "body": "<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20188393\" rel=\"nofollow\">Less bad</a> than benzene itself.</p>\n\n<p>The reason for this is that the alkyl groups on toluene, ethyl benzene and xylene can all be metabolized to carboxylic acids by the liver rather than oxidizing the ring directly, which creates a phenol. Metabolism of benzene to phenol increases its toxicity (to the liver).</p>\n\n<p>Of the cases listed I would expect cooking with the water to cause the least exposure to the dissolved hydrocarbons. The reason for this is that they are volatile with steam, so that boiling the water would cause the listed hydrocarbons to be quickly removed in the steam. By the same token, bathing with the water may cause significant exposure to the hydrocarbon as it evaporates into the air in the shower.</p>\n", "score": 3 } ]

[ "water" ]

[ { "answer_id": 5563, "body": "<p>We were taught in physiology that the way to know if you need salt supplementation is whether the salt tastes good or not. The potassium chloride in salt will taste bitter if you don't need it. I have not seen studies to support this - but it fits a general medical principle we observe in other medical conditions.</p>\n\n<p>This general principle falls into the category of <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25122650\" rel=\"nofollow\">syndromes like pica which is commonly seen in pregnant patients who eat dirt or clay because they have an iron deficiency</a>. Patients crave clay or dirt or other substances because of their deficiency. Patients are often too embarrassed to tell their doctor. In one case, we had a pregnant patient who the clinician noticed she seemed to want to mention something but wasn't. On further questioning, eventually she confessed. She was sneaking out at night to eat a cup of black dirt from her backyard every night. She didn't know why. The doctor said, \"oh, you have pica\", put her on iron pills and the craving went away. </p>\n\n<p>In general, the body craves what it needs - and what it needs tastes good. </p>\n", "score": 2 } ]

[ "nutrition", "exercise" ]

[ { "answer_id": 5109, "body": "<p>After a literature search on Pubmed, Google Scholar, and consulting UpToDate, the answer to your question is <strong>we do not know</strong>.</p>\n\n<p>It appears that there are many expert recommendations (see <a href=\"http://www.canjurol.com/html/free-articles/V23I1S1F-08_DrBarkin.pdf\" rel=\"nofollow\">#1</a> and <a href=\"http://www.jhasim.com/files/articlefiles/pdf/XASIM_Issue_6_1A_p8_19.pdf\" rel=\"nofollow\">#2</a>) in articles that recommend leg elevation but there appears to be no real supporting trials or other literature evidence that leg elevation will help in general with people with nocturia. Also, sometimes the recommendation is specific to whether or not you have leg edema as elevation during the day may reduce the volume in your body at night. The recommendations are likely based on physiology and likely taking into account the low risk of leg elevation.</p>\n", "score": 1 } ]

[ "sleep", "position", "legs", "nocturia", "elevating-elevation" ]

[ { "answer_id": 3438, "body": "<p>Diagnosis of Alzheimer's Disease is something only a medical professional can do. However, the symptoms are often first observed by friends and family, and here is what the physician will look for:</p>\n<blockquote>\n<p>Significant memory problems in immediate recall, short-term, or long-term memory.</p>\n<p>Significant thinking deficits in at least one of four areas: expressing or comprehending language; identifying familiar objects through the senses; poor coordination, gait, or muscle function; and the executive functions of planning, ordering, and making judgments.</p>\n<p>Decline severe enough to interfere with relationships and/or work performance.</p>\n<p>Symptoms that appear gradually and become steadily worse over time.</p>\n</blockquote>\n<p><a href=\"http://www.helpguide.org/articles/alzheimers-dementia/alzheimers-disease.htm\" rel=\"nofollow noreferrer\">source: helpguide.org</a>, which has a questionnaire and more information on symptoms</p>\n<p>Alzheimer's disease is categorized into 5 stages : <a href=\"http://www.mayoclinic.org/diseases-conditions/alzheimers-disease/in-depth/alzheimers-stages/art-20048448\" rel=\"nofollow noreferrer\">preclinical Alzheimer's disease, mild cognitive impairment, mild dementia due to Alzheimer's, moderate dementia due to Alzheimer's and severe dementia due to Alzheimer's</a>. Alzheimer's is usually not diagnosed until the third or fourth stage, when it can be differentiated from mild cognitive impairment that is common in old age.</p>\n<p>To aid with diagnosis, it is very helpful if friends/family/caregivers document the type and frequency of symptoms, so the severity and progression can be seen. occasionally forgetting where your keys are is normal - suddenly forgetting that you have been putting your keys next to the door for the last twenty years can be a symptom of Alzheimer's disease.</p>\n", "score": 3 } ]

[ "neurology", "diagnosis", "alzheimers" ]

[ { "answer_id": 1351, "body": "<p>Frankly, medical terminology isn't necessary and might even lead to increased confusion, especially after being translated. All medical terminology is <em>not</em> universal. </p>\n\n<p>Just state your complaint in plain language as clearly as you can using layman's terms. I doubt that a Japanese doctor needs much more guidance from you than simply understanding your complaint. For example, you might say (in Japanese), \"Doctor, I can't hear as well as I used to and I think it may be due to an injury to my ear canal some time ago. Can you please have a look?\"</p>\n\n<p>I would expect the doctor to examine both ear canals. If your theory is correct, the doctor won't need further explanation. She will see it with her own eyes and know what to do about it. She will probably also want to test your hearing in both ears. I would not be terribly surprised to find that the cause is something other than what you suspect. </p>\n\n<p>Assuming that you don't speak fluent Japanese and he/she doesn't speak fluent English, you might consider bringing a translator along with you since the doctor will no doubt have questions and perhaps need to explain things to you. It's the sort of situation where language barriers can be troublesome and you don't want to risk misunderstandings.</p>\n", "score": 12 } ]

[ "dermatology", "terminology" ]

[ { "answer_id": 1430, "body": "<p>Provided that you are healthy, not suffering from a cold, disease state or other suppression of the immune system, moderate exercise during fasting periods should not impact your health. For submaximal efforts, you may notice earlier fatigue, and there will be definite performance impacts the closer you get to maximal efforts.</p>\n\n<p>Caveat: You are still introducing an artificial state (fasted), which may have health complications. I would schedule a consult with a physician and explain your plans, and have them give you a checkup with that in mind before starting this.</p>\n\n<p>However, there will be some impact on the effective level of the exercise, and how well you are able to perform the exercise during the later parts of the fasting period. These changes include depression in max VO2 (Although this value is more of a performance predictor, not really a measurement metric), higher levels of free fatty acids (FFA's) in the blood, as well as a somewhat suppressed gluconeogenesis as well as a concurrent rise in fat based oxidation for energy.</p>\n\n<p>What this means, is that your body will (mostly) use up all muscle and hepatic (liver) glycogen storage, and will turn to fax oxidation (ketone bodies) for fuel. There is not that much difference in the lactate/pyruvate levels during this time, suggesting that the switch is adequate to fuel performing muscles. There are other short term changes in several hormone and substrate (glycogen, pyruvate, lactate, etc) levels, but these are returned to normal after resuming normal dietary intake.</p>\n\n<p>While not an ideal state to pursue, intermittent periods of short fasting ( &lt; 12 hours) or even up to a few days shouldn't have any health impacts, although you may notice some performance impairment.</p>\n\n<p><a href=\"http://ajpendo.physiology.org/content/238/4/E322\" rel=\"noreferrer\">This study</a> I was able to obtain, only the first page is freely available. This took 5 obese subjects, and in a clinical setting (hospital), underwent a 3-5 week fast, with only water and vitamin supplements for health. They showed the changes described above in hormone and substrates, with a drop in VO2 max levels at the 2 and 4 week exercise marks. There was also substantial weight loss, but that is to be expected. They showed no other adverse health effects during the prolonged fast, but to emphasize, they had adequate water intake and daily vitamin and potassium supplementation.</p>\n\n<p>Another paper <a href=\"http://www.dartmouthsports.com/pdf9/2318985.pdf?DB_OEM_ID=11600\" rel=\"noreferrer\">available through Dartmouth Sports</a> looked at 12 hour fasting for Ramadan and the effect on athletic performance, and found that even in the limited fasting state, there is some performance impact. One passage stands out in the paper:</p>\n\n<blockquote>\n <p>An extensive review of the older literature on the effects of \n fasting on endurance performance was published by Aragón-\n Vargas.(21)\n The conclusion of this review was that a short period \n (24 h to 4 days) of fasting in humans resulted in a decreased \n capacity to perform endurance exercise. In spite of a rather \n consistent effect of fasting, however, there was no clear evi-\n dence as to the mechanism responsible for the earlier onset of \n fatigue.</p>\n</blockquote>\n\n<p>That is corroborated by other sections in the paper, one detailing performance impacts on cycling at 100% VO2 max level after 24 hours fast, and impacts on high intensity events such as the 100m and 800m runs. Interestingly, one section shows no difference in muscle glycogen stores in the absence of exercise during fasting.</p>\n\n<blockquote>\n <p>There may be some effect of a reduction in the muscle \n glycogen store on the maximal rates of muscle glycogenol-\n ysis with a consequent loss of exercise performance dur-\n ing high-intensity exercise, but a few days of fasting in \n the absence of exercise has little effect on muscle glycogen \n content.(18)</p>\n</blockquote>\n\n<p>They do postulate that because of the metabolic acidosis that starts rising with prolonged fast is part of the reason for early fatigue in exercise, which is interesting.</p>\n\n<p>The second paper also has 57 cited studies relating to exercise in a fasted state.</p>\n", "score": 7 } ]

[ "diet", "exercise" ]

[ { "answer_id": 1446, "body": "<p>The general consensus on the internet and among various physical trainers is that static stretching in 20-30 second segments is sufficient to increase range of motion (ROM) in a muscle. This is corroborated by two studies (Very similar in nature, conducted by the same people), where <a href=\"https://pubmed.ncbi.nlm.nih.gov/9327823/\" rel=\"nofollow noreferrer\">one study</a> showed that there was no difference when time was increased from 30 to 60 seconds and performed multiple times per day, and <a href=\"https://pubmed.ncbi.nlm.nih.gov/8066111/\" rel=\"nofollow noreferrer\">another that showed</a> no gains when solely increasing from 30-60 seconds per stretch.</p>\n<p>However, if your goal is to increase flexibility, then you may want to also look at adding proprioceptive neuromuscular facilitation (PNF) type stretching once or twice a week. The most basic form of this is to get into a stretch, and then isometrically contract (joint/muscle stay static, rather than moving) against the stretch. This is, however, an advanced stretching technique and should only be done after proper instruction. <a href=\"http://journals.lww.com/nsca-jscr/Abstract/2011/11000/The_Acute_Effects_of_Different_Stretching.8.aspx\" rel=\"nofollow noreferrer\">This study</a> showed that PNF stretching also was the only one that produced performance enhancement.</p>\n<p>Ballistic stretching (lean and bounce) type stretching has been much maligned, and is still contraindicated because of the tendency towards producing injury. (It tends to activate the <a href=\"https://en.wikipedia.org/wiki/Stretch_reflex\" rel=\"nofollow noreferrer\">stretch reflex</a> in muscles and produce tears/strains). However, <a href=\"http://journals.lww.com/nsca-jscr/Abstract/2006/11000/Ballistic_Stretching_Increases_Flexibility_and.12.aspx\" rel=\"nofollow noreferrer\">there is some indication</a> that it may aid in jumping type performances.</p>\n<p>TL;DR</p>\n<p>Dynamic stretching before workouts (active movement that mimics the motions of the sport), and static stretching after (30 seconds, and I personally do a stretch and hold, relax, repeat even deeper type of cycle for each muscle) produce some of your best gains for the typical everyday person. PNF can get even greater gains if needed. However, it has not been proven yet (Despite claims) that any type of stretching produces better injury prevention or reduces muscle soreness after workouts. Also, static stretching before performance has been shown to negatively impact performance.</p>\n", "score": 7 } ]

[ "exercise", "sports", "muscle" ]

[ { "answer_id": 1468, "body": "<p>You are seeing phosphenes.</p>\n\n<p>These have been described in medical notes for thousands of years</p>\n\n<p>They are assumed to be caused by random firing of optic nerves due to stray electrical stimulation in the brain, or pressure on the eye</p>\n\n<p>Other causes are; sudden changes in air pressure, moving from bright light outside into a dark room, violent body motions (like coughing or sneezing), over stimulation (sexual, drugs, grief), diabetic shock, violent sports (boxing, rugby etc); all these may cause pressure on the eye, or over stimulation of the bodies electrical system</p>\n\n<p>If you are getting increased phosphenes, bright flashes of light, or fixed objects appearing with your eyes closed, these may be a sign of eye nerve damage, and a trip to the doctor may be a good idea</p>\n\n<p>Interestingly, this is similar to the CCD device in a camera chip. They are very susceptible to stray electrical charge, and this causes a low level background noise in the picture, even in a totally dark room</p>\n\n<hr>\n\n<p>^{<a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2189731/\" rel=\"nofollow\">Cellular mechanisms underlying the pharmacological induction of phosphenes</a>}</p>\n\n<p>^{<a href=\"http://medical-dictionary.thefreedictionary.com/Phosphenes\" rel=\"nofollow\">Phosphenes</a>}</p>\n\n<p>^{<a href=\"https://en.wikipedia.org/wiki/Phosphene\" rel=\"nofollow\">Wikipedia - Phosphene</a>}</p>\n", "score": 6 } ]

[ "cognitive-science", "scientific-method" ]

[ { "answer_id": 1489, "body": "<p>Your blood sugar, as well as other blood markers, are in equilibrium most of the time. </p>\n\n<p>A meal will create a rise in glucose, but this will only last about 2 hours, so that you will have raised glucose only 6 hours out of 24. So this is one reason why the fasting glucose is the glucose to which your body is exposed most of the time. </p>\n\n<p>But more important, the doctors don't care for your peak glucose levels, they care for the equilibrium level of your glucose homeostasis, and that's 5 mmol or somewhere very close to it. If it is not there, then the mechanism for achieving it is broken, no matter what your postprandial glucose levels are. So both of your assumptions are incorrect. </p>\n\n<p>And if you are on a diet which has your blood glucose levels constantly elevated, that's a very calorie dense diet and you are probably indeed in trouble. But even then, measuring your fasting glucose is important, because the doctor cannot make any conclusions from the raised levels. </p>\n\n<p>By the way, there is also another test for blood sugar which gives you an estimation of not the current blood sugar, but of the average blood sugar over the last few weeks. Both an elevated fasting glucose and an elevated hgb 1ac levels are diagnostic criteria for diabetes, so if you somehow managed to keep your fasting glucose low but your average glucose unreasonably high, this could be discovered and you will be diagnosed with diabetes or warned that you are in a prediabetic condition, depending on the current diagnose guidelines used in your country. But if you suspect this, you should probably inform your physician, as I don't think hgb a1c is measured in routine blood tests. </p>\n\n<p>Source: a Coursera course on diabetes I can't link because it's no longer open, sorry. Maybe somebody else has a linkable source and can edit it in. </p>\n", "score": 4 }, { "answer_id": 1508, "body": "<p>The main reason is because your body conditions change rapidly after a meal. These changes are also meal dependent (I work in a lab and we recently found a way to estimate a person's citrus fruit consumption fairly reliably based on changes in urine). </p>\n\n<p>By instructing you to fast, healthcare providers are attempting to check you when your wildly fluctuating lab results are as stable as possible by minimizing factors like the timing and composition of your meal. That way any results they draw are more likely to reflect something actually wrong with your heath rather than what you last ate.</p>\n", "score": 0 } ]

[ "blood-tests" ]

[ { "answer_id": 1505, "body": "<p>No. Nexium is the trade name of a generic drug called <a href=\"https://www.purplepill.com/home.html\" rel=\"nofollow\">esomeprazole</a>, a <a href=\"http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000381.htm\" rel=\"nofollow\">proton pump inhibitor</a> used to treat <a href=\"http://www.uptodate.com/contents/acid-reflux-gastroesophageal-reflux-disease-in-adults-beyond-the-basics?source=see_link\" rel=\"nofollow\">gastro-esophageal acid reflux</a>. “Nitrates for chest pain” refers to the class of cardiac drugs that share a similar biochemical structure structure and pharmacologic mechanism, which involves conversion to nitric oxide. In the U.S., the available nitrates are: </p>\n\n<ul>\n<li>nitroglycerin </li>\n<li>isosorbide mononitrate</li>\n<li>isosorbide dinitrate</li>\n</ul>\n\n<p>These are vasodilators, used for <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/3934954\" rel=\"nofollow\">anginal chest pain</a>, usually in combination with beta blockers. They work by dilating the arteries around the heart and improving blood flow.</p>\n\n<p>A google search reveals that <a href=\"https://www.cellucor.com/c4-mass\" rel=\"nofollow\">C4 is a dietary supplement</a> that contains caffeine. I suspect that the warning about nitrates has to do more with identifying people who have cardiac problems (which could be exacerbated by caffeine) than any specific drug interaction. </p>\n\n<p>I have no idea why your chest was on fire, and this site is not a good place to try to find out. You should certainly discuss this with your doctor if you’re concerned. </p>\n", "score": 3 } ]

[ "medications" ]

[ { "answer_id": 1563, "body": "<p>Perforated eardrums (or ruptured tympanic membranes) are a problem older than mankind. The majority of cases (reported/observed, ~80%) heal spontaneously with little residual hearing loss or other problems, usually in a few weeks.</p>\n\n<p>It is acceptable practice, therefore, to only observe traumatic TM perforations for healing.</p>\n\n<p>If you are still experiencing hearing loss, however, you should see an ear specialist (ear, nose and throat if in the US). They will determine if your hearing loss is due to a chronic perforation (one that has not healed itself), or middle-ear bone damage (or another possible cause) which occurred during the traumatic event. In most cases, there are surgical treatments. If the perforation is still present, a simple patch may be all that's needed. If a bone was injured, the surgery (bone repair or replacement) is more involved. Other injuries are treated dependent on case.</p>\n\n<p>Edited to add: During healing, care should be taken to keep water out of the ear (no swimming; baths or showers with protection from water in ear), and, though I have not seen a study on it, I would recommend against headphones except at a very low volume. The healing membrane isn't as tough as the original. </p>\n\n<p>_{<a href=\"http://europepmc.org/abstract/med/2676466\" rel=\"nofollow\">Traumatic tympanic membrane perforations: complications and management.</a>}<br>\n_{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22032447\" rel=\"nofollow\">A prospective study evaluating spontaneous healing of aetiology, size and type-different groups of traumatic tympanic membrane perforation.</a>}<br>\n _{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/24822331\" rel=\"nofollow\">Tympanic membrane perforation</a>}<br>\n _{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/25377961\" rel=\"nofollow\">Early paper patching versus observation in patients with traumatic eardrum perforations: comparisons of anatomical and functional outcomes.</a>}<br>\n _{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22868290\" rel=\"nofollow\">Spontaneous healing of traumatic eardrum perforation: outward epithelial cell migration and clinical outcome.\nLou ZC1.</a>}</p>\n", "score": 7 } ]

[ "hearing", "otolaryngology", "ear" ]

[ { "answer_id": 3945, "body": "<p><em>Note: Part of this answer comes from personal experience. Judge as you wish.</em></p>\n\n<p>I have a condition similar to epilepsy, that has caused me to experience a number of seizures over time (ranging from simple partial seizures to full convulsive tonic-clonic seizures, also called \"grand mal\" seizures). This means that over the past few years, I have taken numerous tests, including EEGs.</p>\n\n<p>The basic principles of an <a href=\"https://en.wikipedia.org/wiki/Electroencephalography\" rel=\"nofollow\">electroencephalograph (EEG) test</a> (also sometimes called an electroencephalogram) are well-known and can be looked up with ease. However, they do have specific parts designed to test specific potential triggers - you don't simply lie down in a darkened room for half an hour with wires strapped to your head.</p>\n\n<p>One of these trigger tests involves a strobe light. The patient, lying in a darkened room, is instructed to close their eyes, if they have not already been doing so as per the instructions of the doctor, nurse, or technician in charge. A small light - sometimes jokingly referred to as a \"bug light\" - is then placed over the patient's eyes, at a distance of about one foot. It is a compound device, consisting of many small LEDs.</p>\n\n<p>The person in charge then begins the test, which goes like so:</p>\n\n<ul>\n<li>The light flashes on and off for about ten seconds fairly quickly.</li>\n<li>There is a ten second pause.</li>\n<li>The light flashes again for ten seconds, at a quicker speed.</li>\n<li>There is a ten second pause.</li>\n</ul>\n\n<p>This pattern repeats for some time, with the flashing getting quicker and quicker. It doesn't take long until it is impossible for the patient to tell whether the light is blinking or continuously shining, and even through closed eyelids, it is extremely bright. I've been told to not open my eyes during the test, as it could blind me. I don't know whether or not this is true, but I'm not keen to test it out any time soon.</p>\n\n<p>In someone with photosensitive epilepsy, this light might trigger some sort of seizure - of any strength - or at least increased brain activity. While this has never happened to me, it does happen to people.</p>\n\n<p>I wouldn't compare the experience to looking at bicycle lights like the ones you name, and for a few reasons:</p>\n\n<ol>\n<li>The bicycle lights are nowhere near as bright as the \"bug light\".</li>\n<li><p>The bicycle lights do not flash as quickly as the EEG light does. <a href=\"http://www.epilepsysociety.org.uk/photosensitive-epilepsy#.VmDDfGcgnIU\" rel=\"nofollow\">The Epilepsy Society</a> notes that</p>\n\n<blockquote>\n <p>Between 3-30 hertz (flashes per second) are the common rates to trigger seizures but this varies from person to person. While some people are sensitive at frequencies up to 60 hertz, sensitivity under 3 hertz is not common.</p>\n</blockquote>\n\n<p><a href=\"http://www.nhs.uk/ipgmedia/national/epilepsy%20action/assets/photosensitiveepilepsy.pdf\" rel=\"nofollow\">This Epilepsy Action pamphlet</a> gives slightly different ranges.</p></li>\n<li>The EEG light takes up a much larger portion of a person's field of vision than do bicycle lights, because . . .</li>\n<li><p>. . . the bicycle lights are typically much farther away that one foot. If you're closer than one foot to a bicycle, you're probably too close. Again, the Epilepsy Society says that this could be a problem if the light completely dominates your field of vision:</p>\n\n<blockquote>\n <p>Flashing bicycle lights or other LED lights [could cause a seizure], if this creates a high enough flash rate against a dark background, and if the effect fills your vision.</p>\n</blockquote>\n\n<p>The Epilepsy Action pamphlet confirms this - if you're too close.</p></li>\n</ol>\n\n<p>However, people with photosensitive epilepsy can have seizures when faced with lights less intense than the strobe lights I've been confronted with during EEGs (see the links). Those of us without photosensitive epilepsy should be fine; those with it might not.</p>\n\n<p>The bottom line? Yes, it's possible - under certain conditions. There have been some outcries over this - see <a href=\"http://road.cc/content/news/13526-epileptic-seizure-warning-over-flashing-bike-lights\" rel=\"nofollow\">this article</a>, for example - which has led to some changes. However, these cases occur when the lights are flashing pretty quickly - I haven't been able to find out average rates for bike lights, so any information there would be awesome - and when the person with epilepsy is relatively close to the lights. You don't necessarily have to be one foot away, but being a sensible distance from the bike would reduce the risk.</p>\n", "score": 3 } ]

[ "eye", "seizure" ]

[ { "answer_id": 1571, "body": "<p>No, not in a normal human (non surgical intervention) simply because of the mechanism of how the blood is pushed through the body.</p>\n\n<p>It isn't like a faucet, where you have constant pressure and regulate by opening or closing a valve in varying degrees. The heart has 4 chambers that alternately relax and fill, then squeeze and empty.</p>\n\n<p>The arterial pulse is from the left side of the heart. Oxygenated blood enters into the left atrium, and from there it is pushed into the left ventricle. When this portion of the heart contracts, this is what pushed blood out through the arteries to deliver oxygen to various systems (organs, muscles, skin, etc.) This surge is what you feel when you articulate a pulse.</p>\n\n<p>However, Yes it is possible in a surgical intervention which has been pointed out. There are LVAD's (Left Ventricular Assist Device) which will produce a pulseless human. When reading up on it, I did find an interesting study that suggests <a href=\"http://www.sciencedirect.com/science/article/pii/S0735109714075822\">LVAD use may stimulate heart regeneration</a>.</p>\n", "score": 5 } ]

[ "blood-pressure", "cardiology" ]

[ { "answer_id": 3230, "body": "<p>Some new pacemakers are <a href=\"http://dx.doi.org/10.1111/pace.12061\" rel=\"nofollow\">MRI compatible</a> ([<a href=\"http://dx.doi.org/10.1111/pace.12061\" rel=\"nofollow\">1</a>]). Of those, some have an exclusion zone where the body may not be scanned. I wouldn't be surprised if, in a few years, all new pacemakers and ICDs will be MRI compatible. Older pacemakers still won't be, however. The following quote from [<a href=\"http://dx.doi.org/10.1111/pace.12061\" rel=\"nofollow\">1</a>], lists problems MRI fields may cause with pacemakers:</p>\n\n<ul>\n<li>Heating at the lead tip and at the lead tissue interface</li>\n<li>Force and torque on devices</li>\n<li>Image distortion</li>\n<li>Alteration of programming with potential damage to\nthe pacemaker circuitry</li>\n<li>Rapid atrial pacing</li>\n<li>Pacing at multiples of the radiofrequency pulse and\nassociated rapid ventricular pacing </li>\n<li>Reed switch malfunction</li>\n<li>Asynchronous pacing</li>\n<li>Inhibition of pacing output</li>\n<li>Induction of ventricular fibrillation</li>\n<li>Electrical reset</li>\n<li>Component damage</li>\n<li>Death</li>\n</ul>\n\n<p>To be certified as MRI compatible by the FDA, T&Uuml;V, etc., each pacemaker system (device and leads) must be tested for MRI compatibility by the manufacturer.</p>\n\n<p>In the interest of full disclosure, I work for one of the one of the device manufacturers listed in the paper[<a href=\"http://dx.doi.org/10.1111/pace.12061\" rel=\"nofollow\">1</a>].</p>\n", "score": 7 } ]

[ "cardiology", "mri" ]

[ { "answer_id": 8901, "body": "<p>From \"<a href=\"https://books.google.pl/books?id=C0sO1gNFWLAC&amp;lpg=PA210\" rel=\"nofollow\">Modern Food Microbiology</a>\" by James M. Jay, Martin J. Loessner and David A. Golde:</p>\n\n<blockquote>\n <p>The pH of non-carbonated water should be around neutrality, whereas that of carbonated water is typically between 3 and 4 - ideally at or below pH 3.5.</p>\n</blockquote>\n\n<p>Which means that drinking carbonated water lowers general pH in your mouth and when it gets lower than some critical value (estimated to be around 5.5 but which in fact <a href=\"http://www.cda-adc.ca/jcda/vol-69/issue-11/722.html\" rel=\"nofollow\">can be very individual</a>) tooth enamel begins to demineralize. Additionaly, low pH is a good environment for some species of bacteria which produce even <em>more</em> acid.</p>\n\n<p>Also, one may think that it is safe to hold carbonated water in mouth. After all isn't all water safe? Carbonated water is not safe because of its low pH and so proper drinking method should be used, see: \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/15560830\" rel=\"nofollow\">Influence of drinking method on tooth-surface pH in relation to dental erosion</a>\".</p>\n", "score": 2 }, { "answer_id": 13623, "body": "<p>If it is just sparkling water, not other acids –aka flavours– added, <a href=\"http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2842.2001.00795.x/abstract\" rel=\"nofollow noreferrer\">then it is <em>not</em> that bad for your teeth.</a> \nIt all depends on how acidic, how low the pH level for the actual drink is and for how long it comes into contact with your teeth.\nThe amount of time your teeth are in contact with it is typically low. Carbonic acid does not stick to your teeth. And this acid is very weak with minimal impact on teeth altogether.</p>\n\n<p>It is impossible to draw a general conclusion to all waters on the market.</p>\n\n<p>But for anyone still worried, there are two factors at play:</p>\n\n<ol>\n<li>Actual amount of CO2 added</li>\n<li>Presence of other minerals which can buffer the acidity</li>\n</ol>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Carbonated_water\" rel=\"nofollow noreferrer\">Wikipedia gives you for example a pH level of 3-4. Classifying it between apple and orange juice.</a> That sounds quite scary and very acidic.\n<a href=\"https://en.wikipedia.org/wiki/File:Rocks_El_Torcal_de_Antequera_karst_Andalusia_Spain.jpg\" rel=\"nofollow noreferrer\">Pictures</a> of <a href=\"https://en.wikipedia.org/wiki/Karst\" rel=\"nofollow noreferrer\">karst</a> erosion come to mind immediately.</p>\n\n<p>However, this is not necessarily the actual pH level of bottled sparkling water in every case. \nExcuse the ads, but for reference: several mineral waters on sale have much less acidity. Here is one with an actual <a href=\"http://highlandspring.com/natural-source/\" rel=\"nofollow noreferrer\">pH of between 4 and 5</a> and here is <a href=\"https://www.gerolsteiner.de/en/minerals/bicarbonate/\" rel=\"nofollow noreferrer\">one with pH of ~5.7</a> and one with <a href=\"http://www.finewaters.com/bottled-waters-of-the-world/france/badoit\" rel=\"nofollow noreferrer\">very low bubble count with a pH of 6</a>!</p>\n\n<p>Therefore you have to look for the actual product, ask the manufacturer or test the water in question yourself. In the case of homemade soda this the only option anyway.</p>\n", "score": 2 } ]

[ "dentistry", "water", "wisdom-teeth" ]

[ { "answer_id": 3240, "body": "<p>This is a diet produced by a group of researchers at USC led by a Dr. Longo that was used to try to avoid the effects of prolonged fasting (PF), by instead using a 5 day period once a month where nutrient intake was slashed by 34-54%.</p>\n\n<p><a href=\"http://www.sciencedirect.com/science/article/pii/S1550413115002247\">Here is the summary</a> from the publication in this June's \"Cell Metabolism\", that outlines the effects and benefits.</p>\n\n<p>It grew out of yeast studies, where they noticed that independent of the yeasts actual life cycle, fasting produced longer life spans. When they expanded it to mice and humans, they found that IGF-1 (Insulin Growth Factor 1) was reduced. T<a href=\"http://www.medicaldaily.com/diets-mimic-fasting-how-lose-belly-fat-improve-memory-and-increase-lifespan-safe-way-338908\">his is a hormone that helps promote aging, and is possibly linked to increased cancer susceptibility</a>.</p>\n\n<p>Since prolonged fasting (traditional, no food fasting) is hard for people to stick to, they came up with a reduced diet, with specific ratios of carbohydrates, proteins, fats and other nutrients.</p>\n\n<p>However, they did stress that it is not something that should just be done without intervention, and also that if you are at or below a normal body weight, it probably shouldn't be done.</p>\n\n<p>It's currently in review with the FDA to see if/how it can be introduced as a possible way to combat obesity, so I don't expect any books or other guidelines out on it any time soon.</p>\n\n<p>There are <a href=\"http://joshmitteldorf.scienceblog.com/2015/07/08/fasting-mimicking-diet-a-disclaimer/\">websites such as this one</a> that have created mimic plans, but they are not endorsed by, nor affiliated with Dr. Longo and the study group.</p>\n", "score": 9 } ]

[ "diet" ]

[ { "answer_id": 1654, "body": "<p>Yes, it counts.</p>\n\n<p>While the basic recommendation is to drink 2-3 liters (In the US, the recommendation is \"8x8\", or 8 8oz glasses of water per day), all fluids actually count towards that total. While making koolaid may not be as healthy as plain water, the water content remains the same, and will eventually be used in the body as such.</p>\n\n<p>This also includes fluid from food, such as apples, watermelon, tomatoes, etc. Anything that has a fluid component in it will count towards your daily fluid intake needs.</p>\n\n<p>Things that will impact this and require more fluid is exercise, pregnancy, illness, things like this. The <a href=\"http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256\" rel=\"nofollow\">Mayo Clinic</a> has a nice article on fluid intake and recommendations.</p>\n", "score": 3 }, { "answer_id": 1658, "body": "<p>Since there's more than one aspect to your question, I shall answer in two parts to your question:</p>\n\n<ul>\n<li>You will get <strong>3+3=6L of water, total</strong>, half of which is water with some added sugars and food colorant. Using information from the <em>Mayo Clinic</em>[1], \"an <strong>adequate intake</strong> (AI) for men is roughly about 13 cups (<strong>3 liters</strong>) of total beverages a day. The AI for women is about 9 cups (<strong>2.2 liters</strong>) of total beverages a day.\" This should change depending on the status of your health and physical activity. Now, I would say that you do have more than enough water, but take into account the following: </li>\n<li>Your daily <strong>intake doesn't need to depend on a fixed amount</strong>. Recently, in the <em>Clinical Journal of Sport Medicine</em>[2], it was said that \"<strong>Thirst should provide adequate stimulus for preventing excess dehydration</strong> [...] Physiologically-driven thirst has been defined as a “generalized, deep seated feeling of desire for water” and is an evolutionarily conserved, finely tuned, regulatory mechanism serving to protect both plasma osmolality and circulating plasma volume.\"</li>\n</ul>\n\n<p>Source(s):</p>\n\n<p>[1] The Mayo Clinic Website\n<a href=\"http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/water/art-20044256\" rel=\"nofollow\">http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/in-depth/water/art-20044256</a></p>\n\n<p>[2] Clinical Journal of Sport Medicine:\nJuly 2015 - Volume 25 - Issue 4 - p 303–320\ndoi: 10.1097/JSM.0000000000000221\n<a href=\"http://journals.lww.com/cjsportsmed/Fulltext/2015/07000/Statement_of_the_Third_International.2.aspx\" rel=\"nofollow\">http://journals.lww.com/cjsportsmed/Fulltext/2015/07000/Statement_of_the_Third_International.2.aspx</a></p>\n", "score": 3 } ]

[ "water" ]

[ { "answer_id": 1677, "body": "<p>Many substances that can be found in blood are distributed into saliva (but in different concentrations) so saliva as a biological material can be used for a wide range of tests. All of these have their advantages and disadvantages, and many are still not routinely used. The important thing to have in mind is that, in blood, substances are bound to plasma proteins to some extent, and only the free (unbound) fraction can pass into saliva, so the concentration in saliva is proportional to the concentration of free substance in blood. </p>\n\n<p>Let's have a look at some possible applications:</p>\n\n<h2>Pharmacokinetic studies</h2>\n\n<p>Monitoring the concentrations of certain medicines can be useful, and saliva is a good material for monitoring neutral substances, weak acids or weak bases. Saliva is often used in <a href=\"https://en.wikipedia.org/wiki/Therapeutic_drug_monitoring\" rel=\"nofollow noreferrer\">therapeutic drug monitoring</a>, metabolic phenotyping (determination of activity of metabolic enzymes in a patient), compliance monitoring and determining the free fraction of the medicine. These are all used in highly individalised approaches to treatment, and are not routinely used.</p>\n\n<h2>Diagnostic applications</h2>\n\n<p>These can be found if you visit the websites of some laboratories that do these tests, and see what they offer. Some of those that I have found include:</p>\n\n<ul>\n<li>steroid hormone testing (this is by far the most common one I found)</li>\n<li>peptide hormone testing</li>\n<li>antibody testing (for some infectious diseases, HIV e.g, and possibly allergies)</li>\n<li>there is a commercially available nitric saliva test</li>\n</ul>\n\n<p>(by testing I mean - detecting presence and determining the concentration).</p>\n\n<p>This procedure is definitely non-invasive, and as such it can be very convenient when multiple samples have to be drawn at certain time periods. This is often the case with steroid hormones, and this is why saliva can be preferred to blood - sampling saliva is less invasive than venipuncture. </p>\n\n<p>On the other hand there are some analytical limitations: saliva is a complex matrix and some substances in it interfere with analysis; the concentration of tested substances is usually low in saliva, so method sensitivity is an issue. These sensitive methods are often advanced and sophisticated, and may be quite costly. </p>\n\n<p>There are other options which are being used or studied (some are successful and entering diagnostic use, some require further research):</p>\n\n<ul>\n<li>Markers for systemic malignancies </li>\n<li>Biomarkers for oral diseases</li>\n<li>Biomarkers for some autoimmune diseases</li>\n<li>Forensic analysis samples</li>\n<li>Illicit drugs and their metabolites</li>\n</ul>\n\n<p>I take it that your question was out of curiosity. Clinical applications of these tests, whether they are necessary and cost-effective, and other clinical justification issues are up to a physician to determine in each individual case.</p>\n\n<hr>\n\n<p>An interesting aside:</p>\n\n<p>There are several collection methods. In some you don't actually have to spit into a tube - you chew a special swab and place it into a tube, and the saliva is obtained by centrifugation. Pretty neat, huh?\n<a href=\"https://i.stack.imgur.com/TI8lw.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/TI8lw.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>Image source: <a href=\"https://dafxbb5uxjcds.cloudfront.net/fileadmin/user_upload/99_Gebrauchsanweisungen/Englisch/666_haha_salivette_cortisol_GB_0314.pdf\" rel=\"nofollow noreferrer\">Salivette® instruction manual</a></p>\n\n<hr>\n\n<p>References:</p>\n\n<ol>\n<li><a href=\"http://rmalab.com/healthcare-professionals/our-tests\" rel=\"nofollow noreferrer\">Rocky Mountain Analytical - Our Tests</a> - commercial website, used as an example only</li>\n<li><a href=\"http://www.diagnostechs.com/Pages/WhySaliva.aspx\" rel=\"nofollow noreferrer\">Diagnos-Techs, Inc.™ - Why Saliva</a> - commercial website, used as an example only</li>\n<li><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1579286/\" rel=\"nofollow noreferrer\">Steroid Analysis in Saliva: An overview</a></li>\n<li><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3011946/\" rel=\"nofollow noreferrer\">Saliva as a Diagnostic Fluid</a></li>\n</ol>\n", "score": 5 } ]

[ "biological-parameter", "gastroenterology" ]

[ { "answer_id": 1707, "body": "<p>As stated <a href=\"http://www.cancer.org/cancer/cancercauses/radiationexposureandcancer/radiofrequency-radiation\" rel=\"nofollow noreferrer\">there</a>, </p>\n\n<blockquote>\n <p>Most animal and laboratory studies have found no evidence of an increased risk of cancer with exposure to RF radiation. A few studies have reported evidence of biological effects that could be linked to cancer.</p>\n</blockquote>\n\n<p>But</p>\n\n<blockquote>\n <p>Studies of people who may have been exposed to RF radiation at their jobs (such as people who work around or with radar equipment, those who service communication antennae, and radio operators) have found no clear increase in cancer risk.</p>\n</blockquote>\n\n<p>It also says it's not been possible yet to estabilish whether a link between cell phones and cancer exists at all.</p>\n\n<p>The worst effect it sure has is tissue heating due to the sub-ionizing frequencies' water-heating property.</p>\n\n<p>It also stated <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1469962/\" rel=\"nofollow noreferrer\">there</a>, at <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1469962/?page=3\" rel=\"nofollow noreferrer\">page 1567</a>, that</p>\n\n<blockquote>\n <p>There is no evidence for such a link (RF exposure and increased cancer incidency)</p>\n</blockquote>\n\n<p>Furthermore, <a href=\"http://www.cancer.gov/about-cancer/causes-prevention/risk/radiation/cell-phones-fact-sheet\" rel=\"nofollow noreferrer\">here is an article</a> which will clarify most of your doubts, it says:</p>\n\n<blockquote>\n <p>Although there have been some concerns that radiofrequency energy from cell phones held closely to the head may affect the brain and other tissues, to date there is no evidence from studies of cells, animals, or humans that radiofrequency energy can cause cancer.</p>\n</blockquote>\n\n<p>My personal conclusion are that it's mostly harmless to be around EMFs in the RF spectrum, though you should not abuse them, nor expose to any dangerous (ionizing) EMF without proper protection.</p>\n\n<p>Remember Paracelsus, </p>\n\n<blockquote>\n <p>Sola dosis facit venenum</p>\n</blockquote>\n\n<p>or</p>\n\n<blockquote>\n <p>The dose makes the poison</p>\n</blockquote>\n\n<p>Live long and prosper. Have a nice day</p>\n\n<p>EDIT: I had the time to check the study quoted, it says they found a link between RFR and Oxidative pathways' triggering, it only <strong>deduced</strong> it could cause</p>\n\n<blockquote>\n <p>Both cancer and non-cancer pathologies</p>\n</blockquote>\n\n<p>I think there is not a relation, at least in complex organisms, because we're talking about specialized tissues which can help shielding the inner organs (e.g. the skin protects us from most radiations, both high and low intensity ones)</p>\n\n<p>As before, Have a nice day</p>\n", "score": 5 } ]

[ "cancer" ]

[ { "answer_id": 1711, "body": "<p>First of all, just to be clear: IVF-associated twinning and “tripletting” are most commonly of the <strong>dizygotic</strong> (“fraternal”) variety. You appear to be asking about <strong>monozygotic</strong> (“identical”) twinning given the reference to “splitting the egg.” I will provide a brief overview of both.</p>\n\n<p><strong>Types of multiple conceptions and relationship to IVF</strong></p>\n\n<p><strong>Dizygotic</strong> (\"fraternal\") twins (and higher multiples) occur because more than one egg is fertilized. This is very common during the in vitro process because the ovaries are stimulated using medications, as opposed to the normal menstrual cycle where usually only one egg is release. Because multiple birth pregnancies have considerably higher rates of both maternal and fetal complications,¹ IVF centers and mothers together have to make a decision weighing the risk of multiple embryo transfer with the benefits of improved probability of successful live birth. In some countries, there are laws against transferring more than one embryo, but in the United States this varies by center, and overall about 35 percent of IVF pregnancies are twins, with 7-8 % being triplets.² </p>\n\n<p><strong>Monozygotic</strong> (\"identical\") twins occur because an early embryo divides after fertilization. This results in two embryos with identical DNA (hence the terminology and phenotype - “identical”). These have also been shown to be more common in IVF pregnancies, although the degree of over-representation is considerably less marked compared to the situation with dizygotes. The mechanism is also less clear. </p>\n\n<p><strong>Is this desirable?</strong><br>\nMonozygotic twins (and higher multiples) have markedly increased rates of every pattern of fetal and perinatal mortality, overall between four and seven times the rate compared to singletons.³ This may be in part due to the fact that the process of splitting is itself a “deformity” of sorts that tends to cluster with other deformities. It is also the case that monozygotic multiple births at times share, to varies degrees, portions of the placental sac (<em>mono-chorionic</em> and at times also <em>mono-amniotic</em>). Mono-amniotic are susceptible to umbilical cord entanglement, which can lead to serious complications. Those that do not share an amniotic sac (<em>mono-chorionic</em>, <em>di-amniotic</em>) are susceptible to something called Twin-twin Transfusion Syndrome wherein blood is shunted from one twin to the other via vascular connections between the placentas. This can lead to severe anemia of the “donor” twin and polycythemia (overload of red blood cells) in the “recipient”, both of which carry complications.³ </p>\n\n<p>You asked: </p>\n\n<blockquote>\n <p>can (we) ask the IVF clinic to split the eggs before insertion?</p>\n</blockquote>\n\n<p>Your goal appears to to increase the chance of monozygotic twinning. Although it has been shown³ that certain factors do increase this chance (advanced maternal age and some technical considerations during the fertilization step), because of the above considerations about complications during monozygotic multiple embryo pregnancies, this is considered an <em>undesirable</em> outcome during IVF. As such, IVF centers are unlikely to do anything likely to increase this chance.</p>\n\n<ol>\n<li><p>Seoud MA, Toner JP, Kruithoff C, Muasher SJ. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=1555695\" rel=\"nofollow noreferrer\">Outcome of twin, triplet, and quadruplet in vitro fertilization pregnancies: the Norfolk experience.</a> Fertil Steril. 1992 Apr;57(4):825-34.</p></li>\n<li><p><a href=\"http://www.yalescientific.org/2012/05/the-more-the-merrier-limiting-the-number-of-embryo-implantations/\" rel=\"nofollow noreferrer\">http://www.yalescientific.org/2012/05/the-more-the-merrier-limiting-the-number-of-embryo-implantations/</a></p></li>\n<li><p>Abusheikha N, Salha O, Sharma V, Brinsden P. Hum Reprod Update. <a href=\"http://humupd.oxfordjournals.org/content/6/4/396.full.pdf\" rel=\"nofollow noreferrer\">Monozygotic twinning and IVF/ICSI treatment: a report of 11 cases and review of literature.</a> 2000 Jul-Aug;6(4):396-403.</p></li>\n</ol>\n", "score": 8 } ]

[ "obstetrics", "sex" ]

[ { "answer_id": 1799, "body": "<p>There are many circumstances in which angioplasty would not be performed. First, let's look at when it <em>is</em> performed:</p>\n\n<blockquote>\n <p>Clinical indications for PCI [Percutaneous coronary intervention, or angioplasty] include the following:</p>\n\n<pre><code>Acute ST-elevation myocardial infarction (STEMI)\nNon–ST-elevation acute coronary syndrome (NSTE-ACS)\nUnstable angina\nStable angina\nAnginal equivalent (eg, dyspnea, arrhythmia, or dizziness or syncope)\nHigh risk stress test findings\n</code></pre>\n \n <p><a href=\"http://emedicine.medscape.com/article/161446-overview\" rel=\"nofollow\">http://emedicine.medscape.com/article/161446-overview</a></p>\n</blockquote>\n\n<p>A heart attack in the past isn't likely to meet any of those indications unless it's causing symptoms now such as angina or anginal equivalents. Generally, once ischemia (reduced blood flow) has killed heart tissue, reopening the artery with angioplasty won't accomplish anything. The tissue is dead and can't be revived. This last point is made in the same link as above. Emphasis is mine.</p>\n\n<blockquote>\n <p>In an asymptomatic or mildly symptomatic patient, objective evidence\n of a moderate to large area of <strong>viable myocardium</strong> or moderate to severe\n ischemia on noninvasive testing is an indication for PCI. Angiographic\n indications include hemodynamically significant lesions in vessels\n serving viable myocardium (vessel diameter >1.5 mm).</p>\n</blockquote>\n\n<p>Angioplasty also has a number of contraindications when it won't be performed even when the heart attack is ongoing. These include:</p>\n\n<blockquote>\n <p>Clinical contraindications for PCI include intolerance of long-term\n antiplatelet therapy or the presence of any significant comorbid\n conditions that severely limit the lifespan of the patient (this is a\n relative contraindication).</p>\n \n <p>Relative angiographic contraindications include the following:</p>\n\n<pre><code>Arteries &lt;1.5 mm in diameter\nDiffusely diseased saphenous vein grafts\nOther coronary anatomy not amenable to PCI\n</code></pre>\n \n <p>[ibid., <a href=\"http://emedicine.medscape.com/article/161446-overview]\" rel=\"nofollow\">http://emedicine.medscape.com/article/161446-overview]</a></p>\n</blockquote>\n\n<p>A lot of this is complicated language understood mainly only by cardiologists, but it boils down to saying that angioplasty will be performed only when it can save heart muscle from dying or when it can relieve chest pain or other symptoms, when the procedure is physically possible (eg, the arteries are large enough), and when it has a practical chance of extending the patient's life (eg, a terminal patient with days or weeks to live probably would not benefit from angioplasty).</p>\n", "score": 1 } ]

[ "heart-attack", "heart-disease" ]

[ { "answer_id": 4020, "body": "<p>This answer covers herpes, with both HSV1 (usually appearing and transmitted orally) and HSV2 (usually called genital herpes). </p>\n\n<p>So-called \"asymptomatic shedding\", when the virus can be transmitted despite the carrier not showing any sores, is unfortunately very common in both herpes types. </p>\n\n<p>An in my opinion good article is <a href=\"http://m.jid.oxfordjournals.org/content/198/8/1098.full\" rel=\"noreferrer\">Asymptomatic Shedding of Herpes Simplex Virus 1 and 2: Implications for Prevention of Transmission</a>. It given an overview over several studies, for example one where 144 heterosexual couples where only one partner was infected were tracked. </p>\n\n<blockquote>\n <p>Transmission occurred in 14 (9.7%) of the couples, including 13 in which diaries were maintained during the period when transmission occurred. Although 4 couples (31%) reported sexual contact during the prodrome (1 case) or within hours before lesions were first noted by the symptomatic partner (3 cases), in 9 cases (69%) transmission resulted from sexual contact when the source partner reported no symptoms or lesions</p>\n</blockquote>\n\n<p>PCR studies, looking for genetic material of the virus in the genital regions of infected but asymptomatic people confirmed that asymptomatic shedding is common:</p>\n\n<blockquote>\n <p>asymptomatic shedding from anogenital sites was documented in 80%–90% of seropositive men and women, was present on ~20% of days with daily sampling, and was present at even higher frequency during the first 3 months after acquisition of first-episode genital herpes</p>\n</blockquote>\n\n<p>The samples in these studies were daily swipes of the vulvar or penile region. Studies usually checked for lesions or open cuts. </p>\n\n<p>There are also studies were multiple samples were taken each day:</p>\n\n<blockquote>\n <p>Anogenital shedding was detected on 20% of 962 days, and the median duration was 13 h. Oral shedding was detected on 12% of 691 days during which all 4 samples were collected, and the median duration of shedding was 24 h.</p>\n</blockquote>\n\n<p>The <a href=\"http://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm\" rel=\"noreferrer\">CDC factsheet</a> on genital herpes basically agrees with this, saying:</p>\n\n<blockquote>\n <p>Transmission most commonly occurs from an infected partner who does not have visible sores and who may not know that he or she is infected. 4 In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10% of days, and on most of those days the person has no signs or symptoms</p>\n</blockquote>\n\n<p>As for your two specific questions:</p>\n\n<blockquote>\n <p>Possible transmitted diseases if saliva/semen/pre-cum/etc is swallowed?</p>\n</blockquote>\n\n<p>Herpes can be transmitted during oral sex, both from oral herpes being <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564751/\" rel=\"noreferrer\">transferred to the genitals</a>, and from <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/000857.htm\" rel=\"noreferrer\">genital herpes being transferred to the oral region</a>. </p>\n\n<blockquote>\n <p>Possible transmitted diseases if fluids (pre-cum/semen/saliva/etc) are spilled on the vagina, or the head of the penis?</p>\n</blockquote>\n\n<p>That's how herpes occurring in the genital region is usually transferred, even in the absence of sores (see above), so in that way herpes fits your criteria. </p>\n", "score": 5 } ]

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

[ { "answer_id": 3191, "body": "<blockquote>\n <p>what is the medically advised time between taking an antidepressant and coffee?</p>\n</blockquote>\n\n<p>There is no such time, and there cannot be. All we know is that there are negative consequences when you take them together. We know that there are must be spacing schedules when the consequences must be milder than with other schedules. But we have neither the data nor the mathematical models needed to make a prediction about which waiting time minimizes the negative consequences. </p>\n\n<p>The first problem is in the effect you were interested in initially: they are both psychoactive drugs, changing your mood and cognition. If you combine them, the effect can be stronger, or weaker, or you can experience changes which you wouldn't have experienced if you were taking only one of them. But this kind of thing is very, very hard to measure. A cursory search doesn't even find a study which seeks evidence for such interaction, much less trying to find consistent patterns in this interaction or investigating its time dimension. </p>\n\n<p>The second problem is that there is also a metabolic interaction, described in arkiaamu's <a href=\"https://health.stackexchange.com/a/1974/193\">answer</a>. This means that the metabolism rate of each drug (which already has a very wide spread between individuals) changes the metabolism rate of the other! Predicting how it develops in a given individual will take as much effort, computational time and data as predicting the weather for a given location. It's certainly not possible to derive some general rule. </p>\n\n<p>So, all we know that it will have some negative consequences. What you also asked is if there is a \"coffee must not be taken at all\" rule. If you were to just look at the interaction between coffee and antidepressants, then yes, you should stop drinking coffee at all, because you cannot avoid the interaction. </p>\n\n<p>But such a view would be very short sighted. Coffee has both positive effects such as <a href=\"http://www.sciencedirect.com/science/article/pii/S0308814608012454\" rel=\"nofollow noreferrer\">being a source of antioxidants</a> and <a href=\"http://link.springer.com/article/10.1007/BF02246055#page-1\" rel=\"nofollow noreferrer\">improving alertness</a> and negative effects, subsumed in one study as <a href=\"http://Indigestion,%20Palpitations,%20Tremor,%20Headache%20and%20Insomnia\" rel=\"nofollow noreferrer\">indigestion, palpitations, tremor, headache and insomnia</a>. None of these has some standard quantification so that one could say that medically, the risks are more than the benefits, or the other way round. Now, with the interaction with antidepressants, you are adding one more negative effect. Still, the situation is the same: we cannot measure whether it is better to take the caffeine or not take it. </p>\n\n<p>In the end, it is similar to all matters in nutrition. We know that what you choose to do will have some effect, but the effect is so complex that it is impossible to make a prediction of what it will be exactly, and derive specific advice based on that. </p>\n", "score": 5 }, { "answer_id": 1974, "body": "<p>Well it depends on what antidepressant you are taking.</p>\n\n<p>Caffeine works as a substrate and as an inhibitor for an enzyme called CYP1A2 (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10976659\" rel=\"nofollow\">1</a>). As so, metabolism of all other drugs which are processed by CYP1A2 enzyme are possibly influenced by administration of caffeine. </p>\n\n<p>Following antidepressants are processed by CYP1A2 (<a href=\"https://en.wikipedia.org/wiki/CYP1A2\" rel=\"nofollow\">2</a>):</p>\n\n<ul>\n<li>amitriptyline</li>\n<li>clomi- and imipramine</li>\n<li>agomelatine</li>\n<li>fluvoxamine</li>\n<li>mirtazapine (<a href=\"https://en.wikipedia.org/wiki/Mirtazapine\" rel=\"nofollow\">only partly</a>)</li>\n</ul>\n\n<p>The interaction between fluvoxamine and caffeine has been shown to exist in humans (<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16778712\" rel=\"nofollow\">3</a>). </p>\n\n<p>Interaction between caffeince and others antidepressants has not been investigated in humans but animals tests have shown significant interactions (<a href=\"http://www.if-pan.krakow.pl/pjp/pdf/2007/6_727.pdf\" rel=\"nofollow\">4</a><a href=\"http://www.if-pan.krakow.pl/pjp/pdf/2001/4_351.pdf\" rel=\"nofollow\">,5</a>). No reason to assume that these interaction would not exist in humans. </p>\n\n<p>It seems reasonable not take coffee and aforementioned antidepressants at the same time.</p>\n", "score": 4 } ]

[ "medications", "mental-health", "side-effects", "caffeine", "cognitive-science" ]

[ { "answer_id": 3050, "body": "<p>It's not really medically accurate, unless there are other drugs of abuse present, or some other disease etiology. The quote that you reference is correct, heroin addiction by itself <em>shouldn't</em> produce seizures as part of withdrawal symptoms. However, there can be other drugs present (Such as alcohol, which can definitely produce seizures during withdrawal) which could complicate the matter.</p>\n\n<p>Additionally, if the person is a long time heroin abuser, then withdrawal symptoms would most likely start much sooner than a couple of days, possibly even within hours of their last dose wearing off.</p>\n\n<p>The <a href=\"https://en.wikipedia.org/wiki/Opioid_addiction_and_dependence\" rel=\"nofollow\">wikipedia site</a> for opioid addiction gives a pretty detailed rundown of opiate addiction and other factors that can enhance or show predisposition to addiction. There are many other sites (Most of them rehabilitation facilities) that give fairly detailed rundowns of the withdrawal process and symptoms that can occur during that time.</p>\n", "score": 5 } ]

[ "seizure", "drug-withdrawal", "recreational-drugs" ]

[ { "answer_id": 3171, "body": "<p><a href=\"http://www.webmd.com/oral-health/guide/brushing-flossing-child-teeth\" rel=\"nofollow\">WebMD</a> recommends brushing children's teeth for 2 minutes (with different amounts of toothpaste for different age groups).</p>\n\n<p><a href=\"http://www.dentalhealth.ie/children/cleaning.html\" rel=\"nofollow\">Dental Health Foundation of Ireland</a> doesn't give recommendations on the length of brushing for children 0-2 years of age, and recommends brushing without toothpaste at that age. For children 2-7 years of age they recommend brushing with toothpaste, for 2-3 minutes. They also say that this is a length of a song, so they basically recommend a distraction technique you are already using. (There is a lack of consensus on-line what is the exact age limit for a child to be considered a toddler). </p>\n\n<p>An aside (more fit for parenting SE): I've browsed through You Tube for teeth-brushing songs and I found many, but honestly none of those would have motivated me to endure teeth brushing. So, perhaps another type of song and different song every night? Maybe one for every day of the week - Monday song (Twinkle twinkle?), Tuesday song... Or telling a story while brushing, such as <a href=\"http://freestoriesforkids.com/children/stories-and-tales/toothy-toad\" rel=\"nofollow\">this one</a> - if you find it age-appropriate. </p>\n", "score": 3 } ]

[ "dentistry", "pediatrics" ]

[ { "answer_id": 3444, "body": "<p>One of those prescriptions is written in plus cylinder form, the other in minus cylinder form. <a href=\"http://www.tedmontgomery.com/the_eye/glasses.html\" rel=\"nofollow\">This website describes how to convert between the two</a></p>\n\n<blockquote>\n <ol>\n <li>Add the sphere and cylinder powers together; this becomes the new sphere power.</li>\n <li>Change the sign of the cylinder power, from minus (–) to plus (+), or from plus (+) to minus (–).</li>\n <li>Change the axis value by 90°, remembering that the axis must be a number from 1 to 180.\n According to this, the two prescriptions you got are indeed the same.</li>\n </ol>\n</blockquote>\n\n<p>Going from the first to the second:</p>\n\n<blockquote>\n <p>-4.00 : +0.75 x 180°</p>\n</blockquote>\n\n<ol>\n<li><p>-4 + 0.75 = -3.25</p></li>\n<li><p>0.75 becomes - 0.75</p></li>\n<li><p>180 degrees becomes 90 degrees </p></li>\n</ol>\n\n<blockquote>\n <p>-3.25 : - 0.75 x 90°</p>\n</blockquote>\n", "score": 1 } ]

[ "eye", "prescription" ]

[ { "answer_id": 3113, "body": "<p>The FluMist vaccine contains (<a href=\"https://www.medimmune.com/docs/default-source/pdfs/flumist-us-pi-2015.pdf?sfvrsn=4\">source</a>):</p>\n\n<blockquote>\n <p>Each pre-filled refrigerated FluMist Quadrivalent sprayer contains a single 0.2 mL dose. Each 0.2 mL dose contains 106.5-7.5 FFU (fluorescent focus units) of live attenuated influenza virus reassortants of each of the four strains: A/Bolivia/559/2013 (H1N1) (an A/California/7/2009 (H1N1)pdm09-like virus), A/Switzerland/9715293/2013 (H3N2), B/Phuket/3073/2013 (B/Yamagata/16/88 lineage), and B/Brisbane/60/2008 (B/Victoria/2/87 lineage). Each 0.2 mL dose also contains 0.188 mg/dose monosodium glutamate, 2.00 mg/dose hydrolyzed porcine gelatin, 2.42 mg/dose arginine, 13.68 mg/dose sucrose, 2.26 mg/dose dibasic potassium phosphate, and 0.96 mg/dose monobasic potassium phosphate. Each dose contains residual amounts of ovalbumin (&lt; 0.24 mcg/dose), and may also contain residual amounts of gentamicin sulfate (&lt; 0.015 mcg/mL), and ethylenediaminetetraacetic acid (EDTA) (&lt; 0.37 mcg/dose). FluMist Quadrivalent contains no preservatives.</p>\n</blockquote>\n\n<p>So yes, there is at least one flu vaccine, the spray-based live-attenuated vaccine, that does not contain the adjuvant in question.</p>\n", "score": 7 }, { "answer_id": 3127, "body": "<p>When I searched for flu vaccines authorized in Germany, I got a list of 65 vaccines (at least I think so, because the information system is available only in German).</p>\n\n<p>The list is available at: <a href=\"http://www.pharmnet-bund.de/static/de/index.html\" rel=\"noreferrer\">http://www.pharmnet-bund.de/static/de/index.html</a> (but I don't think that there is any sense in linking the actual page with the list, because it expires after a while for some reason). You can go the the part of the website called \"Arzneimittel-Informationssystem\" and then search from there. Search criteria depends on your language skills in German, but at \"Recherche für Fachkreise\" (information for professionals) you can search by ATC code, which, for flu vaccines is: J07BB02 and you will get the list of many flu vaccines available or registered in Germany (I'm not sure which of those two).</p>\n\n<p>The catch - most of the information seems to be behind a pay wall. So the best I can do is find the vaccines from that list on the EMeA (European Medicines Agency) website. There are less vaccines listed there, and I have omitted those marked as \"withdrawn\". I also selected those that seemed to be polyvalent ones, since you are asking for the \"common flu\" I expect you are inquiring about the seasonal flu vaccine. <strong>Again, the final consultation about the sort of vaccine appropriate for this season, your organism and other factors, is to be done with your physician and your pharmacist (i.e. your healthcare team).</strong></p>\n\n<p>That being said, I dug up three vaccines that match the previously discussed criteria:</p>\n\n<p><a href=\"http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000758/WC500046957.pdf\" rel=\"noreferrer\">Optaflu</a>:</p>\n\n<blockquote>\n <p><code>A/California/7/2009 (H1N1)pdm09 - like strain used \n A/Brisbane/10/2010 wild type 15 micrograms HA** \n A/Texas/50/2012 (H3N2) - derived strain used \n (NYMC X-223A) 15 micrograms HA** \n B/Massachusetts/2/2012 15 micrograms HA** \n per 0.5 ml dose \n .............................................. \n *propagated in Madin Darby Canine Kidney (MDCK) cells \n ** haemagglutin</code></p>\n \n <p>List of excipients: \n 1. Sodium chloride, \n 2. Potassium chloride, \n 3. Magnesium chloride hexahydrate, \n 4. Disodium phosphate dihydrate, \n 5. Potassium dihydrogen phosphate, \n 6. Water for injections</p>\n</blockquote>\n\n<p><a href=\"http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000957/WC500033852.pdf\" rel=\"noreferrer\">INTANZA</a></p>\n\n<blockquote>\n <p><code>Influenza virus (inactivated, split) of the followi\n ng strains*: \n A/California/7/2009 (H1N1)pdm09-derived strain used\n (NYMC X-179A)....... 9 micrograms HA** \n A/Texas/50/2012 (H3N2)-derived strain used (NYMC X-\n 223A) ...................... 9 micrograms HA** \n B/Massachusetts/2/2012 ..... 9 micrograms HA** \n Per 0.1 ml dose \n *propagated in fertilised hens’ eggs from healthy chicken flocks \n **haemagglutinin</code></p>\n \n <p>List of excipients:\n 1. Sodium chloride \n 2. Potassium chloride \n 3. Disodium phosphate dihydrate \n 4. Potassium dihydrogen phosphate \n 5. Water for injections </p>\n</blockquote>\n\n<p><a href=\"http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000966/WC500031442.pdf\" rel=\"noreferrer\">IDflu</a></p>\n\n<blockquote>\n <p>List of excipients\n 1. Sodium chloride\n 2. Potassium chloride\n 3. Disodium phosphate dihydrate\n 4. Potassium dihydrogen phosphate\n 5. Water for injections</p>\n</blockquote>\n\n<p><a href=\"https://i.stack.imgur.com/yw7eP.jpg\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/yw7eP.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>The links for each vaccine are for the Summary of Product Characteristics for each one, where you can find more information on their composition, possible incompatibilities and precautions.</p>\n", "score": 5 } ]

[ "vaccination", "influenza" ]

[ { "answer_id": 9203, "body": "<p>Recently, I had the teeth in question removed.</p>\n\n<p>The dentist's assistant told me that the extractions would more or less be the same as those done on teeth with a more normal placement. The dentist told me that there was some chance of having to cut into the tissue if the teeth were too difficult to remove.</p>\n\n<p>The actual procedure was very straightforward: I was given an anaesthetic, which rendered everything afterwards painless, and the dentist then extracted the tooth. The dentist used something that looked like a knife on one occasion. I was told to avoid drinking, smoking, and hot foods, but did not have to make any major changes to my diet. The little pain there was was also very manageable.</p>\n", "score": 1 } ]

[ "dentistry" ]

[ { "answer_id": 3264, "body": "<p>I haven't found any studies that would directly link retching and the consumption of tea. However, this would be a rather narrow research, so the lack of it is no surprise. Your doctor told you that your acidity problems may be caused by tea and that this might be causing your gags, and they are correct.</p>\n\n<p>It has been proven that consumption of tea is directly related to increased secretion of gastric acid (1):</p>\n\n<blockquote>\n <p>The gastric acid response to a 200-ml cup of tea was measured [...] Tea resulted in an acid secretory response which was almost equal to that after a maximal dose (0.04 mg/kg) of histamine. The effect of tea was mainly due to its local chemical action on gastric mucosa. Tea without milk and sugar resulted in an acid response higher than that evoked by a maximal dose of histamine. The concentration of tea brew that had the greatest effect on gastric acid secretion was 15 g/200 ml, which was three times as much as that in a palatable cup of tea. Tea is a potent stimulant of gastric acid, and this can be reduced by adding milk and sugar.</p>\n</blockquote>\n\n<p>This effect of tea is most likely caused by caffeine, which was proven to increase gastric secretion in animals and humans. (2, 3)</p>\n\n<p>Therefore tea can have some adverse effects (4):</p>\n\n<blockquote>\n <p><em>Green tea and green tea extracts contain caffeine. Caffeine can cause insomnia, anxiety, irritability, upset stomach, nausea, diarrhea, or frequent urination in some people.</em></p>\n</blockquote>\n\n<hr>\n\n<p>*<a href=\"https://books.google.rs/books?id=pDa2QgAACAAJ&amp;dq=pdr+for+herbal+medicines+2000&amp;hl=en&amp;sa=X&amp;redir_esc=y\">Some sources</a> state that increased gastric secretion and possible irritation of gastric mucosa are caused by chlorogenic acid and tannins, which is why these effects are reduced by addition of milk. Other sources, however, state that both <a href=\"https://www.google.com/patents/US4865847\">chlorogenic acid</a> and <a href=\"http://pubs.acs.org/doi/abs/10.1021/np50082a022\">tannins</a> reduce gastric secretion.</p>\n\n<hr>\n\n<p>References:</p>\n\n<ol>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/6546540\">Effect of tea on gastric acid secretion</a></p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/1177987\">Gastric acid secretion and lower-esophageal-sphincter pressure in response to coffee and caffeine</a></p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2091237/pdf/brmedj03689-0007.pdf\">Caffeine and gastric secretion</a></p></li>\n<li><p><a href=\"https://nccih.nih.gov/health/greentea\">Green tea</a></p></li>\n<li><p><a href=\"http://abc.herbalgram.org/site/DocServer/Tea.pdf?docID=861\">ABC clinical Guide - Clinical overview: Tea, Black/Green</a></p></li>\n</ol>\n", "score": 6 } ]

[ "food-safety", "caffeine", "gastroenterology", "tea" ]

[ { "answer_id": 3606, "body": "<p>Roughly speaking, it appears that about 30-40% of patients in stage IV will survive for 5 years or more depending on where the cancer originated. <a href=\"http://www.cancer.org/cancer/laryngealandhypopharyngealcancer/detailedguide/laryngeal-and-hypopharyngeal-cancer-survival-rates\" rel=\"noreferrer\">This reference</a> provides details. </p>\n", "score": 4 }, { "answer_id": 24118, "body": "<p>There is a large difference in survival depending on whether the cancer was caused by HPV or ( probably) tobacco/alcohol. The HPV cancers have significantly higher survival rates. I am surprised the ACS information does not point out this difference. I was diagnosed with oral cancer about 9 years ago ( age 74), I had likely had it for a couple years before that, as initially 6 doctors missed the symptoms.Stage IV, chemo,radiation,surgery ( Oct '13) . MDAnderson quickly diagnosed HPV as the cause.</p>\n", "score": 1 } ]

[ "chemotherapy", "throat", "metastatic-cancer", "cancer" ]

[ { "answer_id": 3208, "body": "<p>I think you will find all the information you search for in <a href=\"http://tinyurl.com/p59wnjo\" rel=\"nofollow\">this book</a> (there are plenty out there on the subject).</p>\n\n<p>Anyway in brief terms <strong>inflammation is a reaction of the body to a deleterious event</strong> (eg too hot, too cold, dangerous chemicals, radiation, toxins etc) that could happen on a small (cellular level), or large scale (organ level) and in a little (a paper cut), or long time (chronic diseases) and provokes <strong>cellular damage</strong>. </p>\n\n<p>It involves a <strong>cellular</strong> and <strong>humoral</strong> response but it's really a big issue, difficult to solve in just a post.</p>\n\n<p>The invisible inflammation you mentioned falls in this field, but it depends on the specific subject since inflammation is involved in practically all the human diseases.</p>\n\n<p><a href=\"http://tinyurl.com/p2h2zjm\" rel=\"nofollow\">An example</a></p>\n\n<p>Hope it helps </p>\n\n<p>EDIT\ni changed the second link since it was not freely available to everyone. </p>\n", "score": 2 } ]

[ "infection", "inflammation" ]

[ { "answer_id": 3188, "body": "<p>The 2015 Advisory Committee on Immunization Practices (ACIP) does not express a preference for use of any particular product over another for persons for whom more than one type of vaccine is appropriate and available.</p>\n\n<p>The major recommendations concern age, state of health, allergies (some vaccines are specifically recommended for people allergic to eggs or to previous vaccines, pregnancy, etc.), fear of needles (there are multiple ways now to receive influenza vaccines including microneedle intradermal doses, intramuscular jet, and nasal, along with the routine IM injection), timing of the vaccine (especially in the elderly and young).</p>\n\n<p><em>A previous severe allergic reaction to influenza vaccine, regardless of the component suspected of being responsible for the reaction, is a contraindication to future receipt of the vaccine.</em></p>\n\n<p>Basically, if the vaccine (in the US) is FDA approved, it should be fine.</p>\n\n<blockquote>\n <p>What type of vaccine would be good for healthy lady in mid-30s[?]</p>\n</blockquote>\n\n<p>Assuming that you're <strong>not pregnant</strong>, in the absence of data (recent studies including the 2014 flu season) demonstrating consistent greater relative effectiveness of the current quadrivalent formulation of Live Attenuated Influenza Vaccine (LAIV), preference for LAIV over Inactivated Influenza Vaccine (IIV) is no longer recommended. </p>\n\n<p>In your age range and state of health, you should <em>avoid</em> the LAIV if</p>\n\n<blockquote>\n <ul>\n <li>you've experienced severe allergic reactions to the vaccine or any of its components, or to a previous dose of any influenza vaccine</li>\n <li>you have a history of egg allergy</li>\n <li>you've taken influenza antiviral medications within the previous 48 hours</li>\n <li>you care for severely immunosuppressed persons who require a protective environment </li>\n </ul>\n</blockquote>\n\n<p>If you live with someone with bad asthma, you might want to consult your doctor about which vaccine is better for you.</p>\n\n<blockquote>\n <p>What type of vaccine would be good for elderly who are somewhat active, doing stuff around the house, but suffer the regular aches and pains, who are early 70s?</p>\n</blockquote>\n\n<p>Well, they should avoid the LAIV. In addition, they should consult their doctor if they have any medical conditions, and for information about the timing of the vaccine (the optimal timing for those over 65 varies from continent to continent and even country to country.) </p>\n\n<p>Given all the above, I have only ever been asked, \"Are you allergic to eggs?\" before getting a flu shot!</p>\n\n<p>_{<a href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm\" rel=\"nofollow\">Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–16 Influenza Season</a>}</p>\n", "score": 4 } ]

[ "vaccination", "influenza" ]

[ { "answer_id": 19270, "body": "<p><strong>Is it possible for vegetarians who eat plenty of dairy food to have iron or protein deficiency?</strong></p>\n\n<p>Everyone who consumes too little iron can develop iron-deficiency anemia, but this is not necessary more common in vegetarians than in omnivores. </p>\n\n<blockquote>\n <p>An appropriately planned well-balanced vegetarian diet is compatible\n with an adequate iron status. Although the iron stores of vegetarians\n may be reduced, <em>the incidence of iron-deficiency anemia in vegetarians\n is not significantly different from that in omnivores</em> (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/8172127\" rel=\"nofollow noreferrer\">PubMed,\n 1994</a>).</p>\n</blockquote>\n\n<p>It is a blood test that can reveal the presence and severity of anemia. It may be unreliable to estimate anemia from symptoms.</p>\n\n<p>Dairy is not a good source of iron; an egg contains 0.88 mg, 50 g of most cheeses less than 0.30 mg, and a cup of milk (237 mL) only 0.15 mg (<a href=\"https://ndb.nal.usda.gov/ndb/nutrients/report?nutrient1=303&amp;nutrient2=&amp;nutrient3=&amp;fg=1&amp;max=25&amp;subset=1&amp;offset=0&amp;sort=c&amp;totCount=68&amp;measureby=m\" rel=\"nofollow noreferrer\">USDA.gov</a>). Calcium and phosphate from milk can significantly reduce the absorption of iron (<a href=\"https://academic.oup.com/ajcn/article-abstract/29/10/1142/4617100\" rel=\"nofollow noreferrer\">AJCN</a>). There are plant foods that contain much more iron, up to 6 mg per serving (<a href=\"http://www.nutrientsreview.com/minerals/iron.html\" rel=\"nofollow noreferrer\">Chart 2, NutrientsReview</a>).</p>\n\n<p>Protein deficiency in vegetarians who regularly eat protein-containing foods is very unlikely (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29786804\" rel=\"nofollow noreferrer\">PubMed, 2018</a>).</p>\n\n<blockquote>\n <p>There is a widespread myth that we have to be careful about what we\n eat so that we do not cause protein deficiency. We know today that it\n is virtually impossible to design a calorie-sufficient diet, whether\n it is based on meat, fish, eggs, various vegetarian diets or even\n unprocessed whole natural plant foods, which is lacking in protein and\n any of the amino acids.</p>\n</blockquote>\n\n<p><strong>Are there demonstrable health benefits from eating small amounts of shellfish? Or is there evidence it can be bad for health in the way red meat can be?</strong></p>\n\n<p>Certain shellfish contain 2-8 mg of iron per serving (<a href=\"https://ndb.nal.usda.gov/ndb/nutrients/report/nutrientsfrm?max=25&amp;offset=0&amp;totCount=0&amp;nutrient1=303&amp;fg=15&amp;subset=1&amp;sort=c&amp;measureby=m\" rel=\"nofollow noreferrer\">USDA.gov</a>). They also contain quite some protein, vitamin B12 and omega-3 fatty acids (<a href=\"https://ndb.nal.usda.gov/ndb/foods/show/15159?fgcd=&amp;manu=&amp;format=&amp;count=&amp;max=25&amp;offset=&amp;sort=default&amp;order=asc&amp;qlookup=mollusk&amp;ds=&amp;qt=&amp;qp=&amp;qa=&amp;qn=&amp;q=&amp;ing=\" rel=\"nofollow noreferrer\">USDA.gov</a>). It seems they contain less mercury than fish (<a href=\"https://www.fda.gov/food/metals/mercury-levels-commercial-fish-and-shellfish-1990-2012\" rel=\"nofollow noreferrer\">FDA.gov</a>). Rarely, shellfish poisoning can occur; this mainly depend on the location of their origin (<a href=\"http://www.inspection.gc.ca/food/information-for-consumers/fact-sheets-and-infographics/products-and-risks/fish-and-seafood/toxins-in-shellfish/eng/1332275144981/1332275222849\" rel=\"nofollow noreferrer\">Canadian Food Inspection Agency</a>). Shellfish are often considered a healthier food choice than red meat (<a href=\"https://health.gov/dietaryguidelines/2015/resources/2015-2020_dietary_guidelines.pdf\" rel=\"nofollow noreferrer\">Dietary Guidelines for Americans, 2015, p.24</a>); no food is healthy as such, though.</p>\n\n<p><strong>Is it still the case that there is little or no evidence that taking dietary supplements is an effective way of remedying iron or vitamin deficiency?</strong></p>\n\n<p>Supplements <em>are</em> an effective way to treat iron or other mineral or vitamin deficiencies. In a diagnosed deficiency, prescribed rather than commercially available supplements may be needed. <a href=\"https://lpi.oregonstate.edu/mic/minerals/iron\" rel=\"nofollow noreferrer\">Linus Pauling Institute</a> has a detailed article about iron, including iron supplements, anemia, foods high in iron, etc. <em>Individuals who are not at risk of iron deficiency should not take iron supplements without an appropriate medical evaluation to avoid iron overload.</em></p>\n\n<p>Healthy people without nutrient deficiencies will unlikely benefit from dietary supplements (<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309636/\" rel=\"nofollow noreferrer\">PubMed, 2012</a>).</p>\n", "score": 5 } ]

[ "diet", "vegetarianism", "supplement", "iron" ]

[ { "answer_id": 3319, "body": "<p>There seem to be a couple different issues under discussion. I will attempt to explain the relevant physiology and respond to the query in the title.</p>\n\n<ol>\n<li><p><strong>Hiccup interruption</strong>. Most physical techniques involve stimulating efferent vagal tone. <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/?term=25055206\" rel=\"nofollow noreferrer\">These are effective.</a>¹ Commonly used methods (similar to <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/7416025\" rel=\"nofollow noreferrer\">those used to abort supraventricular tachycardia</a>) include: </p>\n\n<ul>\n<li>cold stimulation of the nasopharynx (upside down with ice water in the mouth will do it), </li>\n<li>carotid sinus massage, and</li>\n<li><a href=\"https://en.wikipedia.org/wiki/Valsalva_maneuver\" rel=\"nofollow noreferrer\">Valsalva maneuver</a>.</li>\n</ul>\n\n<p>In theory, a sudden <em>increase</em> in <a href=\"https://en.wikipedia.org/wiki/Afterload\" rel=\"nofollow noreferrer\">afterload</a> could also stimulate vagal tone via baroreceptors. When you describe squatting and breath-holding maneuvers, this is reminiscent of techniques that affect afterload and preload,² namely: </p>\n\n<ul>\n<li><p>squatting (vs. standing) increases both preload and afterload; </p></li>\n<li><p>deep inspiration increases preload to the R heart but decreases venous return to the L heart and thus systemic (including carotid sinus) pressure.</p></li>\n</ul>\n\n<p>In theory, squatting and exhaling would be the combination that most effectively increases afterload and could theoretically trigger a vagal response. However, I’m not aware of any data suggesting that these are practically effective for termination of hiccups.</p></li>\n<li><p><strong>Orthostasis</strong>. You have outlined an effective method of temporarily depriving your brain of adequate blood flow and eliciting symptoms of orthostatic hypotension.³ This is due to decreased preload to the L heart, most marked upon inspiration occurring simultaneous with standing from the squatting position. This tends to trigger the <em>sympathetic</em> nervous system rather than the <em>parasympathetic</em>. It is the latter that is associated with vagal tone helpful for terminating hiccups. </p></li>\n</ol>\n\n<p><strong>In summary</strong>:\nYes, standing up while inhaling will cause systemic blood pressure to fall with resulting decreased cerebral perfusion. This is generally unpleasant and does not come highly recommended. This is unlikely to be effective for hiccups.</p>\n\n<hr>\n\n<p>_{<br>\n1. I have <a href=\"https://biology.stackexchange.com/q/21865/9268\">elsewhere outlined the physiology of hiccups</a> (=<em>singultus</em>), which provides some background on why such maneuvers are effective.\n} </p>\n\n<p>_{\n2. Techniques known to every med student from their application to <a href=\"http://www.learntheheart.com/cardiology-review/dynamic-auscultation/\" rel=\"nofollow noreferrer\">dynamic auscultation of heart murmurs</a>.\n} </p>\n\n<p>_{\n3. Apologies for the self-promotion, really, but I also <a href=\"https://biology.stackexchange.com/a/21526/9268\">answered a question</a> about the visual component of this syndrome, one of the lesser appreciated aspects.\n} </p>\n", "score": 3 } ]

[ "blood-pressure", "inhalation", "blood-circulation" ]

[ { "answer_id": 3878, "body": "<p>Risks appear to be low, if they are used as intended. </p>\n\n<blockquote>\n <p>There were no adverse events including skin changes, ulcerations, hypoesthesia or diminished rigidity.</p>\n</blockquote>\n\n<p><a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1743-6109.2008.00814.x/abstract\" rel=\"nofollow\">Penile Traction Therapy for Treatment of Peyronie's Disease: A Single-Center Pilot Study</a></p>\n\n<blockquote>\n <p>The application of such devices can be recommended in all patients regardless of the penile length, because of the low risk of complications</p>\n</blockquote>\n\n<p><a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2010.09647.x/full\" rel=\"nofollow\">Non-invasive methods of penile lengthening: fact or fiction?</a></p>\n\n<p>However, all studies on this I found had a really small sample size. So rare risks could just not have appeared. </p>\n", "score": 1 } ]

[ "penis" ]

[ { "answer_id": 3353, "body": "<p>It can be trusted as safe as much as the regulations that it comes under can be trusted to make it safe and producers following said regulations. </p>\n\n<blockquote>\n <p>Materials and articles that come into contact with food must comply with the rules laid down by European Regulation 1935/2004. The regulation requires that adhesives used in food packaging must not:<br>\n - affect the food<br>\n - make the food harmful<br>\n - change the nature, substance or quality of the food</p>\n</blockquote>\n\n<p><a href=\"https://www.nibusinessinfo.co.uk/content/using-adhesives-food-packaging\" rel=\"noreferrer\">https://www.nibusinessinfo.co.uk/content/using-adhesives-food-packaging</a></p>\n", "score": 7 } ]

[ "nutrition", "diet", "side-effects", "food-safety", "edible" ]

[ { "answer_id": 21020, "body": "<p>Whether specific foods are actually <em>healthier</em> is debatable, but when it comes to the abundance of nutrients such as lycopene, conclusive measurements can be made.</p>\n\n<blockquote>\n <p>Cooked sauce also had the effect of transforming the lycopene present in the tomato, which helped preserve its integrity through the digestive process, allowing more of this important antioxidant to be absorbed. Noted Heredia, \"[W]e found serving meals rich in probiotics with fried tomato sauce boosts its probiotic effect, as well as causing a progressive isomerization of the lycopene of the tomato, from form cis to trans throughout digestion, which positively results in an increased final bioaccessibility of this carotenoid.\"<br>\n — <a href=\"https://articles.mercola.com/sites/articles/archive/2018/06/04/cooked-tomatoes.aspx\" rel=\"nofollow noreferrer\">Cooking Tomatoes Increases Lycopene and Beneficial Bacteria</a></p>\n</blockquote>\n\n<p>Other studies have shown that <em>how</em> food is cooked also has a significant effect:</p>\n\n<blockquote>\n <p>We conclude that the addition of olive oil to diced tomatoes during cooking greatly increases the absorption of lycopene. The results highlight the importance of cuisine (i.e how a food is prepared and consumed) in determining the bioavailability of dietary carotenoids such as lycopene.<br>\n — <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/15927929#\" rel=\"nofollow noreferrer\">(Increases in plasma lycopene concentration after consumption of tomatoes cooked with olive oil — US National Library of Medicine, National Institutes of Health)</a></p>\n</blockquote>\n\n<p>I.e. cooking tomatoes helps to release greater quantities of lycopene into the food, and combining it with olive oil helps to increase the amount absorbed during digestion.</p>\n\n<p>So, if by \"healthier\" you mean <em>do cooked tomatoes provide more available lycopene (and other nutrients) than fresh tomatoes?</em>, the answer is yes.</p>\n", "score": 1 } ]

[ "nutrition" ]

[ { "answer_id": 31902, "body": "<p>Invisalign® works for many conditions but not all. E.g., see the 2018 systematic review {1}:</p>\n<blockquote>\n<p>There was substantial consistency among studies that the Invisalign® system is a viable alternative to conventional orthodontic therapy in the correction of mild to moderate malocclusions in non-growing patients that do not require extraction. Moreover, Invisalign® aligners can predictably level, tip, and derotate teeth (except for cuspids and premolars). On the other hand, limited efficacy was identified in arch expansion through bodily tooth movement, extraction space closure, corrections of occlusal contacts, and larger antero-posterior and vertical discrepancies.</p>\n</blockquote>\n<p>The 2007 paper {2} gives a list of clinical limitations of Invisalign:</p>\n<blockquote>\n<p>Joffe {3} suggested that the Invisalign appliance is most successful for treating mildly malaligned malocclusions (1 to 5 mm of crowding or spacing), deep overbite problems (e.g., Class II division 2 malocclusions) when the overbite can be reduced by intrusion or advancement of incisors, nonskeletally constricted arches that can be expanded with limited tipping of the teeth, and mild relapse after fixed-appliance therapy.</p>\n<p>Conditions that can be difficult to treat with an Invisalign appliance or are contra-indicated altogether include:</p>\n<ul>\n<li>crowding and spacing over 5 mm</li>\n<li>skeletal anterior-posterior discrepancies of more than 2 mm (as measured by discrepancies in cuspid relationships)</li>\n<li>centric-relation and centric-occlusion discrepancies</li>\n<li>severely rotated teeth (more than 20 degrees)</li>\n<li>open bites (anterior and posterior) that need to be closed</li>\n<li>extrusion of teeth</li>\n<li>severely tipped teeth (more than 45 degrees)</li>\n<li>teeth with short clinical crowns</li>\n<li>arches with multiple missing teeth</li>\n</ul>\n</blockquote>\n<hr />\n<p>References:</p>\n<ul>\n<li>{1} Papadimitriou, Aikaterini, Sophia Mousoulea, Nikolaos Gkantidis, and Dimitrios Kloukos. &quot;<a href=\"https://progressinorthodontics.springeropen.com/articles/10.1186/s40510-018-0235-z\" rel=\"nofollow noreferrer\">Clinical effectiveness of Invisalign® orthodontic treatment: a systematic review.</a>&quot; Progress in orthodontics 19, no. 1 (2018): 1-24.</li>\n<li>{2} Phan, Xiem, and Paul H. Ling. &quot;<a href=\"http://www.cda-adc.ca/jcda/vol-73/issue-3/263.pdf\" rel=\"nofollow noreferrer\">Clinical limitations of Invisalign.</a>&quot; Journal of the Canadian Dental Association 73, no. 3 (2007).</li>\n<li>{3} Joffe L. Invisalign: early experiences. J Orthod 2003; 30(4):348–52.</li>\n</ul>\n", "score": 3 } ]

[ "dentistry", "medical-device", "dental-braces" ]

[ { "answer_id": 3416, "body": "<p><a href=\"http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058483\" rel=\"noreferrer\">Yes, you can develop a food allergy as an adult.</a></p>\n<p>Apparently nobody really knows why but <a href=\"http://www.everydayhealth.com/allergies/understanding-adult-onset-allergies.aspx\" rel=\"noreferrer\">a couple of plausible theories</a>:</p>\n<blockquote>\n<ul>\n<li>being exposed to allergens when the immune system is weakened, such as during an illness or pregnancy</li>\n<li>not being exposed to a high enough level of the allergen as a child but reaching that threshold in adulthood</li>\n</ul>\n</blockquote>\n<p>From the Food Allergy Research &amp; Education (FARE) blog, <a href=\"http://blog.foodallergy.org/2014/10/20/new-findings-in-adult-onset-food-allergy/\" rel=\"noreferrer\">New Findings in Adult-Onset Food Allergy</a> (<a href=\"http://www.jaci-inpractice.org/article/S2213-2198(14)00301-8/fulltext\" rel=\"noreferrer\">the original study is here</a> but behind a paywall):</p>\n<blockquote>\n<p>At least 15 percent of people with food allergies develop the condition after the age of 18, a new study suggests.... The age of first reaction peaked during the early 30s, with patients’ ages ranging from 18-86 years. Another important finding was that an older age at the time of diagnosis was associated with higher risk for severe reactions. In addition:</p>\n<ul>\n<li>A higher percentage of the patients were female, which contrasts with the male dominance of food allergy in children.</li>\n<li>The five most common food allergies among this group were shellfish, tree nuts, fish, soy and peanut. Study participants also identified 14 other foods as allergic triggers.</li>\n<li>Approximately 16% of patients were allergic to more than one food.</li>\n</ul>\n</blockquote>\n<p>A slight aside: While it's really not known how allergies develop (either in children or adults), <a href=\"http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/allergy/food-allergy/#s0045\" rel=\"noreferrer\">one possibility is Oral Allergy Syndrome</a>, in which exposure (and allergy) to plant pollen can lead to an allergic reaction to food. That is a little different than anaphylactic shock though.</p>\n<p><strong>The chance of this happening to you:</strong> <a href=\"http://www.massgeneral.org/children/about/newsarticle.aspx?id=3518\" rel=\"noreferrer\">This Mass General Hospital article</a> states that &quot;an estimated 4% of the US adult population is food allergic – about 9 million of us&quot;. Of that 4%, 15% (1.35 million or <strong>0.6% of US adults</strong>) would develop that allergy after the age of 18.</p>\n<p>The public health question is really speculative. Obviously it would be very helpful for those people who are either allergic, or at risk of developing an allergy, since they wouldn't be exposed to the food trigger. However, many of these allergens are extremely prevalent in modern food production (peanuts, soy) meaning that food can be produced less expensively. It is probably more practical to emphasize allergens in ingredient lists (as is done in the US) to enable already-allergic or just-concerned adults to avoid ingredients of concern.</p>\n", "score": 6 } ]

[ "allergy" ]

[ { "answer_id": 3431, "body": "<p>Urine is not sterile, not while in the bladder and certainly not when it comes out. </p>\n\n<blockquote>\n <p>Contrary to dogma that urine is sterile in the absence of a clinical urinary tract infection (UTI); our research team and others have recently shown the existence of a urinary microbiota in individuals with and without lower urinary tract symptoms</p>\n</blockquote>\n\n<p>From <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16124436\">\"Bacteria isolated from blood, stool and urine of typhoid patients in a developing country\"</a> (note that while the paper itself is about people with \"Overactive Bladder syndrome\", the conclusion about urine not being sterile holds true for the control group in this study as well. </p>\n\n<p>However, it is very unlikely you could get or give someone else some kind of disease through the kind of hypothetical contact you are talking about in your question. The South Australian health ministry for example lists only one disease potentially spread through urine : Cytomegalovirus <a href=\"http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/health+topics/health+conditions+prevention+and+treatment/infectious+diseases/ways+infectious+diseases+spread\">[source]</a>. But while the test for this infection can be done through analysing urine, I could not find any evidence that there has ever been an infection that resulted from exposure to urine as opposed to saliva, semen or one of the other transmission routes. \nAnother disease found in urine is typhoid :</p>\n\n<blockquote>\n <p>Thirteen (14.1%) out of 92 urine samples were positive for bacterial growth</p>\n</blockquote>\n\n<p>From <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16124436\">[\"Bacteria isolated from blood, stool and urine of typhoid patients in a developing country\"]</a>. Whether the level in these samples would be enough to lead to infection even if ingested is unclear to me. \nNo substance in your urine is actively dangerous to you just by touching it. Even drinking it is generally considered to be safe, unless done too often (it does contain products your body is trying to get rid off). </p>\n\n<blockquote>\n <p> while urine’s purported healing properties have yet to be confirmed by rigorous research, drinking small amountsof your own urine is unlikely to produce serious harm if, for some reason, you are so inclined.<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16124436\">[source]</a></p>\n</blockquote>\n\n<p>Drying will possible reduce the amount of bacteria in the urine, just as it does for saliva. </p>\n\n<p>In summary, no, urine is not sterile, but it also doesn't seem to be a \"usual\" route of infection for many (or maybe any) diseases. Furthermore, having a spot of it dry on your clothes and a hypothetical person then touching it is bringing the infection risk down even more.</p>\n", "score": 6 } ]

[ "toxicity", "hygiene", "urinary-system", "disease-transmission", "urine" ]

[ { "answer_id": 3447, "body": "<p>This is very dependent on what one defines as a disease. There are people who only count acute conditions and/or infections as \"diseases\" though I wouldn't have expected a doctor to make this distinction. Under this definition, asthma would not be a disease, but a \"chronic condition\", for example. </p>\n\n<p>I found an interesting article <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1299105/\" rel=\"noreferrer\">What is a disease</a> which while mostly applicable to your question about asthma discusses the classification of osteoporosis</p>\n\n<blockquote>\n <p>One example is osteoporosis, which after being officially recognized as a disease by the WHO in 1994 switched from being an unavoidable part of normal ageing to a pathology </p>\n</blockquote>\n\n<p>So that used to be not counted as a disease to being called one. I recommend asking your doctor about it if you are curious about their reasoning - it might just be that they meant it isn't an infectious disease. If, however, they think asthma is really not a disease that needs to be managed, consider switching doctors - untreated asthma can <a href=\"http://www.m.webmd.com/a-to-z-guides/features/preventing-permanent-damage\" rel=\"noreferrer\">lead to serious problems</a>. </p>\n", "score": 5 } ]

[ "disease", "lungs", "asthma" ]

[ { "answer_id": 3482, "body": "<p>Sperm does not naturally exist in pre-cum since sperm is released at the point of ejaculation. However, both the articles you site are correct in that preexisting sperm already in the urethra could travel out with the pre-cum.</p>\n\n<p>A quote from Teen Clinic on <a href=\"http://teenclinic.org/about/get-answers/ask-us/if-my-boyfriend-and-i-had-unprotected-sex-but-he-pulled-out-far-before-he-could-ejaculate-can-you-still-get-pregnant-i-have-used-a-period-tracker-and-it-says-im-not-fertile-but-i-am-still-stressin/\" rel=\"noreferrer\" title=\"Teen Clinic\">pre-ejaculate</a></p>\n\n<blockquote>\n <p>Although pre-ejaculate does not contain sperm when it is produced, it can pick up leftover sperm in the urethra. This means that pre-ejaculate can contain sperm when it leaves the body, creating a risk for pregnancy. </p>\n</blockquote>\n\n<p><a href=\"http://americanpregnancy.org/getting-pregnant/can-you-get-pregnant-with-precum/\" rel=\"noreferrer\" title=\"American Pregnancy\">AmericanPregnancy.org</a> also mentions this same thing.</p>\n\n<p>One hygiene tip I've heard to help with this is for the man to urinate after sex to help clean out the urethra of both sperm and as a preventative measure against STDs.</p>\n\n<p>Core Physicians also mentions that</p>\n\n<blockquote>\n <p>You can help prevent UTIs if you: Urinate soon after sex.</p>\n</blockquote>\n", "score": 4 } ]

[ "sex" ]

[ { "answer_id": 5110, "body": "<p><strong>This is per my expert knowledge as a licensed MD.</strong> You can easily find the sources for recommendations/guidelines on chronic coronary artery disease (CAD), acute coronary syndrome (ACS), and prevention on the <a href=\"http://professional.heart.org/professional/GuidelinesStatements/searchresults.jsp?q=&amp;y=&amp;t=1001\" rel=\"nofollow\">ACC/AHA website</a>.</p>\n\n<p>You seem focused on angioplasty with the indication of angina (assuming refractory angina and a blockage in the heart arteries that would be causing it). After angioplasty is done, if a stent is used, you will have to be on a blood thinner for some mandatory time (up to a year...). This is to ensure that the stent does not immediately clot off causing a VERY BAD HEART ATTACK.</p>\n\n<p>You have to understand that there is a big <strong>difference</strong> between a heart attack blockage and a blockage that causes a stable angina. Stable angina is what a person has due to blockages that are chronic/slowly changing. ACS (acute coronary syndrome, <em>practically</em> a layman \"heart attack\") is when a fatty blockage suddenly is opened to the inside of a blood vessel, and an acute (fast, recent) clot develops, causing sudden worsening of angina or new angina. This is a \"heart attack\".</p>\n\n<p><strong>What is important to understand is that the small/unseen fatty blockages that will break open and cause a heart attack are just as likely (if not more likely) than those big chronic blockages to cause a heart attack.</strong> </p>\n\n<p>Simply ballooning open a fatty heart disease blockage in a vessel does NOT cure your \"coronary artery disease.\" If you have a large blockage causing chronic angina, you are surely to have many many many more blockages, from medium to small which can all cause a heart attack.</p>\n\n<p>So the answer to you question depends on whether the drugs are used to treat your angina or your heart disease itself. If you have a large blockage, then you CERTAINLY have a strong indication to continue medications that are targeted to prevent heart attacks and worsening blockages. Considering that, statins, aspirin, beta blockers (latter may also be for angina itself) and such drugs that target heart disease will almost always be continued. This includes drugs that treat underlying causes of heart disease/blockages which include high blood pressure, diabetes, smoking, etc.</p>\n\n<p>For the drugs you may be on for the anginal pain itself (sometimes beta blockers, calcium channel blockers, nitrates, etc)--- these medications may no longer be necessary if your pain subsides after the angioplasty.</p>\n", "score": 3 } ]

[ "heart-disease", "angioplasty" ]

[ { "answer_id": 3539, "body": "<p>Basically you're asking how to overcome a compulsion you feel about your mouth hygiene. That is no small feat, especially since you're already aware of the problems associated with over-brushing.</p>\n\n<p>In general, obsessive thoughts/compulsive behaviors are differentiated from simple worries by, among other things, being more frequent, distressing, associated with significant feelings (of guilt, unreasonableness, etc), resistance to the intrusive thought or behavior (you resist partially by limiting the number of times you brush), diminished perception of control over the obsession, being time-consuming, and having a significant interference in normal daily living.</p>\n\n<p>My advice for this is to read about coping with OCD and maybe see a therapist who specializes in treating it. It sounds like you can benefit from Cognitive Behavioral Therapy or some other treatment modality. You may well benefit from just a few sessions to help you develop specific coping strategies.</p>\n\n<p>_{Cognitive-behavioral Therapy for OCD By David A. Clark}</p>\n", "score": 5 } ]

[ "dentistry", "disorders", "behavior" ]

[ { "answer_id": 10069, "body": "<p>The question implies that breastfeeding is an unpleasant and inconvenient thing that should be put up with as long as possible to give a baby \"enough\" benefit, at which time the box can be ticked and everyone can stop. However most families that nurse past 6 months find it a convenient and pleasant thing, so there's no particular pressure to stop.</p>\n\n<p>The Canadian government, in conjunction with the medical association, <a href=\"http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/recom-6-24-months-6-24-mois-eng.php\" rel=\"nofollow noreferrer\">recommends</a> exclusively breastmilk for 6 months, and a mix of \"real food\" and breastmilk after that up to age 2 or longer. The \"or longer\" part is typically determined by how nursing is working for that particular family. </p>\n\n<p>Here is a whole paragraph of studies and sources from that page:</p>\n\n<blockquote>\n <p>Breastfeeding beyond six months has been associated with a number of positive infant and maternal health outcomes. Breastfeeding longer, in addition to a wide range of other determinants, may have a protective effect against overweight and obesity in childhood (Arenz, Rückerl, Koletzko, &amp; von Kries, 2004; Scott, Ng, &amp; Cobiac, 2012; von Kries et al., 1999). Limited evidence suggests breastfeeding continues to provide immune factors during the first and second years (Goldman, Goldblum, &amp; Garza, 1983; Goldman, Garza, Nichols, &amp; Goldblum, 1982). An observational study suggests breastfeeding to 12 months may protect against infectious illnesses, particularly gastrointestinal and respiratory infections (Fisk et al., 2011). Findings have consistently shown a decreased risk of maternal breast cancer with longer durations of breastfeeding (Collaborative Group on Hormonal Factors in Breast Cancer, 2002; Chang-Claude, Eby, Kiechle, Bastert, &amp; Becher, 2000; Brinton et al., 1995). Limited evidence also suggests a protective effect for the breastfeeding mother against ovarian cancer (Luan et al., 2013; Su, Pasalich, Lee, &amp; Binns, 2013; World Cancer Research Fund &amp; American Institute for Cancer Research, 2013). Mothers who breastfeed their older infants and young children also report experiencing an increased sensitivity and bonding with their child (Britton, Britton, &amp; Gronwaldt, 2006; Fergusson &amp; Woodward, 1999; Kendall-Tackett &amp; Sugarman, 1995).</p>\n</blockquote>\n\n<p>I recommend not trying to decide before birth how long the baby will nurse. After age 1 it's not only up to the mother, and it's possible a toddler will wean even though the family had planned to keep providing breastmilk for some time more. Committing to \"at least 6 months\" is probably the best strategy to start with.</p>\n", "score": 3 }, { "answer_id": 15005, "body": "<p>The evidence for a specific timeframe beyond six months is inconclusive. Therefore: When to wean is a personal choice that has to look at the health of both: mother and child. \"Individual infants must still be managed individually.\"</p>\n\n<p>Reference: <a href=\"http://ajcn.nutrition.org/content/85/2/635S.full\" rel=\"nofollow noreferrer\">Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations?</a> DOI:10.1093/ajcn/85.2.635S</p>\n", "score": 2 } ]

[ "nutrition", "pediatrics", "lasting-effects-duration", "breastfeeding", "who-world-health-org" ]

[ { "answer_id": 3611, "body": "<p>Currently there are no studies that prove the effectiveness of colloidal silver as a health supplement, despite many claims to the contrary. </p>\n\n<p>The FDA brands it as \"<a href=\"http://www.fda.gov/ohrms/dockets/98fr/081799a.txt\" rel=\"nofollow\">generally not recognized as safe</a>\", and that any claims that it has medical effectiveness are \"misbranded\", and could potentially result in litigation.</p>\n\n<p>A couple of other quick sources (soft science in nature) also reiterate the ineffectiveness in relation to the claims, and also outline some of the side effects (Such as buildup in major organs, and eventually possibly tinting the skin, eyes and other surfaces that does not dissipate with cessation of use).</p>\n\n<p>Additionally, there is some evidence that it blunts the effectiveness of certain medications, such as antibiotics.</p>\n\n<p><a href=\"http://www.webmd.com/vitamins-supplements/ingredientmono-779-colloidal%20silver.aspx?activeingredientid=779&amp;activeingredientname=colloidal%20silver\" rel=\"nofollow\">http://www.webmd.com/vitamins-supplements/ingredientmono-779-colloidal%20silver.aspx?activeingredientid=779&amp;activeingredientname=colloidal%20silver</a></p>\n\n<p><a href=\"http://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/colloidal-silver/faq-20058061\" rel=\"nofollow\">http://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/colloidal-silver/faq-20058061</a></p>\n\n<p>There will be many contrary claims, most of them herbal and homeopathic website related, but I personally would not consider it a safe supplement.</p>\n", "score": 4 }, { "answer_id": 4527, "body": "<p>Colloidal silver isn't directly harmful in the sense that it won't cause the body to stop functioning properly. As far as health goes, silver has little effect inside the human body for good or for ill.</p>\n\n<p>Some studies do suggest that silver may interact negatively with other medication. I would recommend researching this further if you think it may be a concern.</p>\n\n<p>The particle size isn't so important as the total amount of silver taken over time. No matter how small the particle size, silver will still accumulate in the body. If sufficient amounts of silver are taken into the body (usually this occurs over several months or years), it may cause a condition called <a href=\"https://en.wikipedia.org/wiki/Argyria\" rel=\"nofollow\">agyria</a>, which is characterized by a discoloration of skin. This condition is usually harmless although probably undesirable.</p>\n\n<p>The bottom line is this: <strong>the risks of using colloidal silver or other sources of silver for medical purposes outweigh the advantages</strong>. I recommend not using colloidal silver but rather opting for traditional modern medicine, which is not only safer but more effective.</p>\n\n<p>Sources:</p>\n\n<ol>\n<li><a href=\"http://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/colloidal-silver/faq-20058061\" rel=\"nofollow\">Mayoclinic</a></li>\n<li><a href=\"http://www.quackwatch.com/01QuackeryRelatedTopics/PhonyAds/silverad.html\" rel=\"nofollow\">Quackwatch</a></li>\n<li><a href=\"https://nccih.nih.gov/health/silver\" rel=\"nofollow\">National Institutes of Health</a></li>\n</ol>\n", "score": 4 }, { "answer_id": 19952, "body": "<p>Overdose of colloidal silver does happen and side effects do happen. </p>\n\n<p>This article about a 26 year old young woman who developed an ashen face, a typical symptom of argyria</p>\n\n<p><a href=\"https://www.thestar.com.my/lifestyle/health/2013/02/27/silver-no-solution-for-skin-ailments#HjvlJ8tst94BIzfb.99\" rel=\"nofollow noreferrer\">https://www.thestar.com.my/lifestyle/health/2013/02/27/silver-no-solution-for-skin-ailments#HjvlJ8tst94BIzfb.99</a></p>\n", "score": 0 } ]

[ "supplement", "toxicity", "metal" ]

[ { "answer_id": 3626, "body": "<p>Though most people do get surgery to reconstruct their torn ACL, it <em>is</em> possible to regain full ability of your knee without surgery. Just through rehabilitation, you can totally recover from a torn ACL. </p>\n\n<p>In a clinical trial done in 2010,^{<a href=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa0907797\" rel=\"nofollow\">1</a>} two different treatment strategies were given to 121 young, active adults (ages 18-35) who suffered acute ACL injuries. One strategy was rehabilitation with early ACL reconstruction surgery. Most people given this treatment strategy opted for the early surgery (61 out 62). The other strategy was rehabilitation with delayed ACL reconstruction surgery. Of the 59 people treated with this strategy, only 26 people opted to get surgery. The other 36 were healed with just rehabilitation. </p>\n\n<p>Though that trial was meant to find the most effective treatment of torn ACLs, it did display that with physical therapy and time, it is possible to completely recover from a major ACL injury. </p>\n\n<p>There are some situations in which rehabilitation without surgical reconstruction is not very effective for a torn ACL. If other parts of the knee, such as other ligaments, have also been injured, it is recommended that you get surgery. It is also recommended that you get surgery if you are still active, as running, jumping, pivoting, and other activities that give you a higher chance of reinjuring your ACL.</p>\n\n<hr>\n\n<p>^{<a href=\"http://www.nejm.org/doi/pdf/10.1056/NEJMoa0907797\" rel=\"nofollow\">1: A Randomized Trial of Treatment for Acute Anterior Cruciate Ligament Tears</a>}</p>\n\n<p>^{<a href=\"http://www.medicinenet.com/torn_acl/page5.htm#what_is_the_treatment_for_a_torn_acl\" rel=\"nofollow\">MedicineNet: What is the treatment for a torn ACL?</a>}</p>\n\n<p>^{<a href=\"http://www.sutterhealth.org/orthopedics/knee/acl-tear-reconstruction.html#nonsurg\" rel=\"nofollow\">Sutter Health: Nonsurgical Treatment for ACL Injuries</a>}</p>\n", "score": 1 }, { "answer_id": 3636, "body": "<p>Short answer, yes it is possible to have a full recovery without surgery. If the ligament is only torn, it may heal with a careful recovery plan. If it is torn, most of the strategies revolve around strengthening the muscles that also help stabilize the knee.</p>\n\n<p>Most of the links that I would use were already covered in michaelpri's answer, so I would just add a bit. The function of the ACL is to keep the distal (lower) end of the femur from \"sliding\" off the front of the tibia, and to provide rotational stability.</p>\n\n<p>Considering the position of skiing with the knees bent, and weight forward, and the rotation needed in the lower legs for turning (especially if you are a more advanced/mogul style skiier), I would highly recommend you explore the surgical option. In my opinion <a href=\"http://orthoinfo.aaos.org/topic.cfm?topic=a00297\" rel=\"nofollow\">(And that of the AAOS)</a>, that would give you the best chance to reurn to full activity. In addition, there may be other collateral damage to the meniscus and other structures that could be repaired with surgery.</p>\n\n<p>As an aside, I faced the same decision with a complete rupture of the achilles tendon, and opted for surgery. I'm back at full activity, with no after effects.</p>\n", "score": 0 } ]

[ "injury", "knee", "recovery", "tear-torn", "acl-ligament" ]

[ { "answer_id": 3643, "body": "<p>The answer at the moment seems to be a clear \"maybe\". </p>\n\n<p>There is a Cochrane review of this very topic. <a href=\"http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD003987.pub5\">Combination contraceptives: effects on weight</a>. </p>\n\n<p>A Cochrane review is a study where people collect a lot of other studies on the subject, determine whether the studies were well-designed, and, if they were, review those studies and draw a conclusion from that. These reviews get updated as new data becomes available. They are generally considered to be of high quality. </p>\n\n<p>The Cochrane review includes a section titled \"Plain language summary\", which is very helpful for those not familiar with scientific studies - also the review is quite long, so it's good to have a summary of the important points. I'll include a summary here nonetheless. </p>\n\n<p>In the Cochrane, the author looked at studies of women taking combination contraceptives for more than three months that included data on weight gain. The current conclusion of the review (last updated January 2014) is </p>\n\n<blockquote>\n <p>Available evidence was insufficient to determine the effect of combination contraceptives on weight, but no large effect was evident. Trials to evaluate the link between combination contraceptives and weight change require a placebo or non-hormonal group to control for other factors, including changes in weight over time</p>\n</blockquote>\n\n<p>This means that they found few studies that compared women taking combination contraceptives to women taking a placebo or nothing. This makes sense because contraception is usually taken for, well, contraception, and giving women a placebo instead is often unethical. Those four trials did not find a relationship between contraception use and weight gain. However, the four trials also only included five oral contraceptives and the skin patch, not a very wide variety of contraception.</p>\n\n<p>Most other studies compared oral combination contraceptives with other oral combination contraceptives or other methods of birth control (like the vaginal ring). </p>\n\n<blockquote>\n <p>Of the 79 weight change comparisons evaluating two combination contraceptives, seven showed a difference in the mean weight change or the proportion of women gaining or losing more than a set amount of weight. Even if no association existed between combination contraceptives and weight, one would expect several significant results (Type I errors) since numerous comparisons were made. Regardless of statistical significance, the clinical significance seems negligible. </p>\n</blockquote>\n\n<p>Basically, this means that the weight gains in these studies were so low that if a causation existed between taking contraceptives and gaining weight, the studies should have shown a more severe effect than they did. And even if <strong>no</strong> association existed, they would have expected more false positives than what was found. </p>\n\n<p>Unfortunately, ultimatively the quality of the available studies is just too low to give a definitive answer at the moment:</p>\n\n<blockquote>\n <p>More than 25% of the trials had high risk of bias due to lack of blinding or incomplete outcome data (Figure 1). The majority of studies had unclear risk of bias due to missing information on randomization sequence generation or allocation concealment. </p>\n</blockquote>\n\n<p>An interesting side note is that most studies only consider weight gain as anything over 2 kilograms or five pounds, which is a bit more than the weight gain described in the question. </p>\n", "score": 5 } ]

[ "medications", "weight", "endocrinology", "contraception", "reproduction" ]

[ { "answer_id": 3642, "body": "<p>Since you mention several of these episodes weeks apart, a few possible diagnosis come to my mind:</p>\n\n<p>One possible diagnosis for a person with these symptoms could be <strong>(rapid cycling) bipolar disorder</strong>. While bipolar disorder is often associated with people experiencing very noticeable episodes of mania, bipolar disorder can also present with \"hypomania\" a less severe form of mania where the patient feels good and productive. </p>\n\n<p>Bipolar disorder comes in several forms. One is rapid cycling bipolar disorder is characterized by more then 4 cycles of mania/hypomania and depression per year. Another is bipolar 2, which often presents with hypomania instead of mania. </p>\n\n<p>Another possible diagnosis is <strong>dysthymia</strong>, which is a mild, but chronic form of depression occurring for more than 2 years. Mild in this case does not mean that symptoms such as suicidal thoughts are not present, and the severity of symptoms can vary over the course of the disease, often with external influences. </p>\n\n<blockquote>\n <p>Dysthymia symptoms usually come and go over a period of years, and their intensity can change over time. But typically symptoms don't disappear for more than two months at a time</p>\n</blockquote>\n\n<p>Another possible diagnosis would be <strong>cyclothymia</strong>, a sort of \"mix\" between the two. </p>\n\n<p>In the end, only a therapist and/or a psychiatrist can make a useful diagnosis, but these are conditions that can show these symptoms and the therapist/psychiatrist would likely explore. (and as always with depressive episodes, excluding <a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/000353.htm\" rel=\"nofollow\">hypothyroidism</a> is important) </p>\n\n<p><strong>Sources and further reading</strong></p>\n\n<p><a href=\"http://www.nimh.nih.gov/health/publications/bipolar-disorder-in-adults/index.shtml\" rel=\"nofollow\">Bipolar disorder</a>, includes definitions for hypomania and rapid cycling bipolar disorder. </p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/dysthymia/basics/symptoms/con-20033879\" rel=\"nofollow\">Dysthymia</a> overview at the Mayo Clinic website </p>\n\n<p><a href=\"http://www.mayoclinic.org/diseases-conditions/cyclothymia/basics/definition/con-20028763\" rel=\"nofollow\">Cyclothymia</a></p>\n", "score": 4 } ]

[ "mental-health", "depression" ]

[ { "answer_id": 3750, "body": "<p>Probably the flu vaccine. \nThe first flu vaccine was developed in <em>1937</em>, it only protected against one strain of the virus (we now vaccinate against three or four), but by <em>1942</em>, another strain was added. The US Army even carried out the trials to test the vaccine and used it during WW2.</p>\n\n<p>Was it effective? Yep, at least in 1944. </p>\n\n<blockquote>\n <p>During the 1943–1944 season when the epidemic started in early November, the trial was repeated and 6,263 subjects were vaccinated.[10] This time the results showed that only 2.2% of the vaccinated subjects had clinically assessed influenza disease compared with 7.1% of those not vaccinated, an efficacy of 69%.</p>\n</blockquote>\n\n<p>That's a really good number for a flu vaccine. Better than we had the <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16004079\" rel=\"nofollow\">Achievements and challenges in antiviral drug discovery</a>, which varied between 10 and 60 percent - flu vaccine effectiveness varies wildly because what specific strains are vaccinated against need to be picked ahead of time and there's no guarantee that these are going to be the most widespread in the next season. </p>\n\n<p>1957 saw a flu pandemic of the Asian flu. </p>\n\n<blockquote>\n <p>The rapid development of avaccine against the H2N2 virus and the availability of antibiotics to treat secondary infections limited the spread and mortality of the pandemic</p>\n</blockquote>\n\n<p>It contrast, antivirals (against any virus) weren't discovered until the 50s and it was only in the late 60s that one effective against influenza started to be used. They are also used for treatment, not as mass prevention. </p>\n\n<p><em>Sources</em></p>\n\n<p><a href=\"http://www.medscape.com/viewarticle/812621\" rel=\"nofollow\">The Evolving History of Influenza Viruses and Influenza Vaccines</a></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16004079\" rel=\"nofollow\">Achievements and challenges in antiviral drug discovery</a> (full text PDF available) </p>\n\n<p><a href=\"http://www.britannica.com/event/Asian-flu-of-1957\" rel=\"nofollow\">Asian flu pandemic of 1957</a></p>\n", "score": 4 } ]

[ "vaccination", "influenza" ]

[ { "answer_id": 3770, "body": "<p>Steroids are used as treatment for acute attacks/flares in many diseases because they reduce inflammation. </p>\n\n<p>In multiple sclerosis, they are given to reduce inflammation of the nerves that occurs when the immune system attacks the nervous system. This inflammation may be one mechanism that causes the nerve damage in multiple sclerosis, although this seems to still be a subject of research.</p>\n\n<p>After treating the inflammation, symptoms are reduced and recovery takes less time. However, why, we don't really know yet. </p>\n\n<blockquote>\n <p>It's not fully understood how steroids speed up your recovery from a relapse, but they are thought to suppress your immune system so that it no longer attacks the myelin in your central nervous system. They may also help reduce the amount of fluid around any nerve fibre damage.</p>\n</blockquote>\n\n<p><a href=\"http://www.nhs.uk/Conditions/Multiple-sclerosis/Pages/Treatment.aspx\" rel=\"nofollow\">Multiple Sclerosis - Treatment</a> at the NHS website </p>\n\n<blockquote>\n <p>The way that steroids work in MS is not fully understood</p>\n</blockquote>\n\n<p><a href=\"https://www.mssociety.org.uk/what-is-ms/types-of-ms/relapsing-remitting-rrms/managing-relapses\" rel=\"nofollow\">Managing relapses</a></p>\n\n<p><em>Other sources</em></p>\n\n<p><a href=\"http://emedicine.medscape.com/article/1146199-treatment\" rel=\"nofollow\">Multiple Sclerosis treatment</a> (the section Treatment of Acute Relapses) </p>\n\n<p><a href=\"http://www.sciencedirect.com/science/article/pii/S0896627306007161\" rel=\"nofollow\">The Neurobiology of Multiple Sclerosis: Genes, Inflammation, and Neurodegeneration</a> (summary of research into inflammation and multiple sclerosis from 2006) </p>\n", "score": 5 } ]

[ "neurology", "immune-system", "autoimmune-disease", "steroids", "multiple-sclerosis" ]

[ { "answer_id": 20695, "body": "<p>You're right that sleep and general anesthesia are very different, and <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771087/\" rel=\"nofollow noreferrer\">general anesthesia in fact actively inhibits the glymphatic circulation</a> that clears waste products from the brain). Since most of are able to pull an all-nighter and except for problems with memory, focus etc, be OK after a couple of days' catch-up sleep, the sleep deprivation isn't an acute issue -- after all, folks after major surgery tend to sleep a lot anyway, as the body needs extra sleep during healing. </p>\n\n<p>As far as preventives, there is an ongoing study to see whether pre-operative cognitive training can reduce the odds of post-operative delirium, one of the ways in which temporary post-surgical cognitive dysfunction can be visible.</p>\n\n<p>More seriously, there may be long-term costs of surgery, with or without anesthesia, on cognitive reserve. This is well-known for cardiac surgeries, but may also be true for any surgeries, as a cross-sectional study found that even the <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/31370773\" rel=\"nofollow noreferrer\">lifetime number of non-cardiac surgeries one's had, correlates with reduced verbal learning and memory in one study of healthy older adults</a>. </p>\n\n<p>The general issue, called Post-Operative Cognitive Dysfunction (POCD) is an active area of investigation for older adult care. There seem to be multiple suspects - from inflammation to brain hypo-perfusion -- and each will suggest steps that can reduce the risk. A recent review is <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/31828240\" rel=\"nofollow noreferrer\">Current Perspectives on Postoperative Cognitive Dysfunction in the Ageing Population</a>. </p>\n", "score": 2 } ]

[ "surgery", "anesthesia" ]

[ { "answer_id": 3895, "body": "<blockquote>\n <p>Mosquitos transmit the pathogens that cause malaria, filariasis, dengue, yellow fever, West Nile fever, Rift Valley fever, and dozens of other infectious diseases of humans, domestic animals, and wildlife </p>\n</blockquote>\n\n<p><a href=\"http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1002588\">Ross, Macdonald, and a Theory for the Dynamics and Control of Mosquito-Transmitted Pathogens</a></p>\n\n<p>You already mentioned malaria and West Nile. The others mentioned are:</p>\n\n<p><em>Filariasis</em></p>\n\n<blockquote>\n <p>Lymphatic filariasis is infection with the filarial worms, <em>Wuchereria bancrofti</em>, <em>Brugia malayi</em> or <em>B. timori</em>. These parasites are transmitted to humans through the bite of an infected mosquito and develop into adult worms in the lymphatic vessels, causing severe damage and swelling (lymphoedema)</p>\n</blockquote>\n\n<p>According to the WHO, about 120 million people worldwide are currently infected. It causes pain and disfigurement. </p>\n\n<p>Filariasis can be cured if treated in time your can also be chronic and lead to lasting health problems. </p>\n\n<p><em>Dengue fever</em></p>\n\n<blockquote>\n <p>Dengue is a mosquito-borne viral disease that has rapidly spread in all regions of WHO in recent years. Dengue virus is transmitted by female mosquitoes mainly of the species <em>Aedes aegypti</em> and, to a lesser extent, <em>A. albopictus</em>. The disease is widespread throughout the tropics</p>\n</blockquote>\n\n<p>Estimates are that there's about 400 million infections a year, with about 100 million showing clinical symptoms. There is no specific treatment or vaccination, but it is not chronic. </p>\n\n<p>The number of infections is increasing and the WHO estimates that half of the world's population is at risk, with the disease being endemic in 100 countries. </p>\n\n<p><em>Yellow Fever</em></p>\n\n<blockquote>\n <p>The yellow fever virus is an arbovirus of the flavivirus genus, and the mosquito is the primary vector. It carries the virus from one host to another, primarily between monkeys, from monkeys to humans, and from person to person.</p>\n</blockquote>\n\n<p>Yellow fever can cause high fevers and jaundice. It's responsible for an estimated 30,000 deaths a year, out of 200,000 infections. Numbers are increasing, and about 900 million people live in countries where they are at risk. Yellow fever is not chronic. </p>\n\n<p><em>Rift Valley Fever</em></p>\n\n<p>Transmission through mosquitos isn't the primary source of infection for Rift Valley Fever - it is mostly transmitted through </p>\n\n<blockquote>\n <p>the handling of animal tissue during slaughtering or butchering, assisting with animal births, conducting veterinary procedures, or from the disposal of carcasses or fetuses</p>\n</blockquote>\n\n<p>There's a few more mentioned at the <a href=\"http://www.cdc.gov/ncidod/diseases/list_mosquitoborne.htm\">CDC list for mosquito-borne diseases</a>, for example:</p>\n\n<p><em>Japanese Encephalitis</em></p>\n\n<blockquote>\n <p>Japanese encephalitis (JE) is the most important cause of viral encephalitis in Asia. It is a mosquito-borne flavivirus, meaning it is related to dengue, yellow fever and West Nile viruses</p>\n</blockquote>\n\n<p>This affects 24 countries with about 70,000 cases being treated each year, up to 30 percent of which result in death. Japanese Encephalitis is not chronic. </p>\n\n<p><em>Chikungunya</em></p>\n\n<blockquote>\n <p>The virus is transmitted from human to human by the bites of infected female mosquitoes. Most commonly, the mosquitoes involved are Aedes aegypti and Aedes albopictus, two species which can also transmit other mosquito-borne viruses, including dengue.</p>\n</blockquote>\n\n<p>This disease had several large outbreaks in Africa within the last two decades. Since 2005, India, Indonesia, Maldives, Myanmar and Thailand have reported over 1.9 million cases. Some patients develop chronic joint pain. </p>\n\n<p><strong>Sources</strong></p>\n\n<p>All quotes are from the World Health Organization:</p>\n\n<p><a href=\"http://www.who.int/topics/filariasis/en/\">WHO Filariasis Overview</a></p>\n\n<p><a href=\"http://www.who.int/mediacentre/factsheets/fs102/en/\">WHO factsheet Filariasis</a></p>\n\n<p><a href=\"http://www.who.int/mediacentre/factsheets/fs117/en/\">WHO factsheet Dengue Fever</a></p>\n\n<p><a href=\"http://www.who.int/mediacentre/factsheets/fs100/en/\">WHO factsheet Yellow Fever</a></p>\n\n<p><a href=\"http://www.who.int/mediacentre/factsheets/fs207/en/\">WHO factsheet Rift Valley Fever</a></p>\n\n<p><a href=\"http://www.who.int/mediacentre/factsheets/fs386/en/\">WHO factsheet Japanese Encephalitis</a></p>\n\n<p><a href=\"http://www.who.int/mediacentre/factsheets/fs327/en/\">WHO factsheet Chikungunya</a></p>\n", "score": 5 } ]

[ "infectious-diseases", "mosquito", "insect-bites", "malaria" ]

[ { "answer_id": 3936, "body": "<p>Short: before the knowledge of blood typing transfusions were attempted and near all failed.</p>\n<p>Long: There were many attempted transfusions that were mostly fatal.\nThe first attempted (recorded) transfusions were practise by the Incas.\nSince 1616 when circulation was first detailed practitioners have been attempting to transfusion substances. These include beer urine and animal blood among many others. In the 1800's there were a few successful blood transfusions but fatalities occurred so this research was shut down until Karl discovered blood types. And the first successful transfusion using his know edge was completed in 1907. Blood borne diseases were still pretty much unknown.</p>\n<p>Support Material</p>\n<blockquote>\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738310/\" rel=\"nofollow noreferrer\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2738310/</a></p>\n<p><a href=\"http://www.madehow.com/Volume-5/Artificial-Blood.html\" rel=\"nofollow noreferrer\">http://www.madehow.com/Volume-5/Artificial-Blood.html</a></p>\n</blockquote>\n", "score": 2 }, { "answer_id": 3964, "body": "<p>The first recorded blood transfusion was done on dogs in 1665. Two years later, blood was successfully transferred from a sheep to a human. In 1818, James Blundell, an obstetrician, successfully treated a patient with postpartum hemorrhage with her husband's blood. </p>\n\n<blockquote>\n <p>The main problem that stood in the way of the development of blood transfusion was the tendency for the blood to clot and to block the tubes or apparatus connected to the recipient. In 1873, Sir Thomas Smith of St Bartholomew's Hospital, London, is reported to have successfully transfused blood from which the clot had been removed (ie defibrinated blood). Attempts by Dr James Braxton-Hicks at Guy’s Hospital in 1883–84 to overcome this problem using sodium phosphate mixed with the blood as an anticoagulant resulted in the deaths of the patients</p>\n</blockquote>\n\n<p>About half of the patients died:</p>\n\n<blockquote>\n <p>But in 1873, F. Gesellius, a Polish doctor, slowed the transfusion revival with a frightening discovery: More than half the transfusions performed had ended in death. Upon learning this, eminent physicians began denouncing the procedure. The popularity of transfusions once again waned.</p>\n</blockquote>\n\n<p>Franz Gesellius favored transfusions from animals over transfusions from human to human. But instead, milk and saline transfusions gained in popularity through this discovery. </p>\n\n<p>Even after the discovery of blood groups, it took years until first testing whether the donor and recipient blood matched became standard practice. Until then, transfusions were usually \"direct\" - from one person's vein directly to the recipient. </p>\n\n<blockquote>\n <p>Pretransfusion testing did not become normal practice until indirect transfusion became popularised by the use of sodium citrate anticoagulation and collection of donor blood, which occurred after 1915.</p>\n</blockquote>\n\n<p>Sources:</p>\n\n<p><a href=\"http://www.aabb.org/tm/Pages/highlights.aspx\" rel=\"nofollow\">Highlights of transfusion medicine history</a></p>\n\n<p><a href=\"https://www.ibms.org/go/nm:history-blood-transfusion\" rel=\"nofollow\">A brief history of blood transfusions</a> (includes references to the first successful blood transfusions) </p>\n\n<p><a href=\"http://wol.jw.org/en/wol/d/r1/lp-e/102000002#h=6\" rel=\"nofollow\">Blood transfusions - a long history of controversy</a></p>\n", "score": 1 } ]

[ "blood", "blood-donation", "hematology", "history" ]

[ { "answer_id": 7623, "body": "<p>To treat gastritis naturally there are some lifestyle changes you can do.\n 1. For starters, stop smoking and limit drinking.\n 2. Avoid trigger foods and eat smaller meals more frequently to avoid indigestion.\n 3. Control stress.\n 4. Limit the use of pain-relievers and anti-inflammatory medications.\n 5. Consume licorice prior to eating a meal. \n 6. Ginger has been shown to be quite beneficial for the stomach, so it may also help with gastritis.\n 7. Drink lots of water (at least eight glasses a day).\n 8. Marshmallow may help aid in fighting nausea and vomiting.</p>\n\n<p>Besides these you also want to follow a <a href=\"http://www.belmarrahealth.com/gastritis-diet-foods-to-eat-and-avoid-dietary-plan-and-recommendations/\" rel=\"nofollow\">gastritis-friendly diet</a> and also be aware of the foods that can worsen your condition. </p>\n\n<p>Foods you should limit or avoid.</p>\n\n<ul>\n<li>Hot cocoa and cola</li>\n<li>Whole milk and chocolate milk</li>\n<li>Peppermint and spearmint </li>\n<li>Tea Regular and decaf coffee </li>\n<li>Orange and grapefruit juices </li>\n<li>Black and red pepper</li>\n<li>Garlic powder</li>\n</ul>\n\n<p>The foods you should eat with gastritis are also the foods that should always be included in any healthy eating diet. These are whole foods that provide nutrients and can support overall health. Some foods you should eat with gastritis are leafy greens, low-fat proteins, foods containing flavonoids like brightly colored fruits and vegetables, and foods rich in fiber. </p>\n", "score": 2 } ]

[ "gastroenterology", "stomach", "lifestyle" ]

[ { "answer_id": 5143, "body": "<p>From your link:</p>\n\n<blockquote>\n <p>According to the linear no-threshold model, any exposure to ionizing radiation, even at doses too low to produce any symptoms of radiation sickness, can induce cancer due to cellular and genetic damage. Under this assumption survivors of acute radiation syndrome face an increased risk developing cancer later in life. The probability of developing cancer is a linear function with respect to the effective radiation dose</p>\n</blockquote>\n\n<p>Again, according to the linear no-threshold model, which is used for US and much international legislation.</p>\n\n<p>It is not possible to accurately know effective doses from only the ARS symptoms. The rough values are also mentioned in your link.</p>\n", "score": 1 } ]

[ "cancer", "statistics", "radioactivity" ]

[ { "answer_id": 4434, "body": "<p><strong>Gynecological effects</strong></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/23706279\" rel=\"nofollow\">Meczekalski et al. (2013)</a> found that, in addition to fertility problems and related, issues,</p>\n\n<blockquote>\n <p>Rates of birth complications and low birth weight may be higher in women with previous AN.</p>\n</blockquote>\n\n<p>Related gynecological effects were much more severe in women with the disease.</p>\n\n<p><a href=\"http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/\" rel=\"nofollow\">This article</a> also states that</p>\n\n<blockquote>\n <p>First-degree female relatives and monozygotic twin offspring of patients with anorexia nervosa have higher rates of anorexia nervosa and bulimia nervosa. Children of patients with anorexia nervosa have a lifetime risk for anorexia nervosa that is tenfold that of the general population (5%). Families of patients with bulimia nervosa have higher rates of substance abuse, particularly alcoholism, affective disorders, and obesity. Traits such as impulsivity, negative affect, perfectionism, and low self esteem are risk factors that may largely be genetically determined.</p>\n</blockquote>\n\n<p><strong>Neurological effects</strong></p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16139807\" rel=\"nofollow\">Wagner et al.</a> observed that by one year after recovery from anorexia, white matter, grey matter, and cerebrospinal fluid levels were back to normal, comparable with levels observed in a control group without a history of anorexia. In other words, this effect dissipated after recovery.</p>\n\n<p><a href=\"http://www.nature.com/npp/journal/v21/n4/full/1395377a.html\" rel=\"nofollow\">Kaye et al. (1999)</a> found that levels of a metabolite of dopamine continued to stay low one year after recovery. This could be responsible for mood swings associated with the disease before, during, and after recovery.</p>\n\n<p><strong>Bone effects</strong></p>\n\n<p><a href=\"http://www.jeatdisord.com/content/3/1/11\" rel=\"nofollow\">Mehler &amp; Brown (2015)</a> note that while bone mass loss effects are common in anorexia patients, these patients may never recover, especially if the disease strikes during adolescence. The chances of a fracture over the course of a lifetime are about 60% higher, as found by <a href=\"http://onlinelibrary.wiley.com/doi/10.1002/eat.22248/abstract\" rel=\"nofollow\">Faje et al. (2014)</a>, which studied 310 adolescent (ages 12-22) females with anorexia and 108 without. Specifically, they found that the control group had about a 20% chance of fracture, while the group with anorexia had about a 30% chance of fracture.</p>\n", "score": 4 } ]

[ "anorexia", "eating-disorder" ]

[ { "answer_id": 24357, "body": "<p>diclofenac by itself has a weak COX-2 selectivity and inhibition of COX-2 can cause or exacerbate hypertension and increase the likelihood of thrombotic events</p>\n<blockquote>\n<p>what is the most important information I should know about medicines called NSAIDs? new or worse high blood pressure; heart failure; liver problems including liver failure; kidney problems including kidney failure; low red blood cells (anemia); life-threatening skin reactions; life-threatening allergic reactions. <a href=\"https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021234s015lbl.pdf#page=21\" rel=\"nofollow noreferrer\">fda side effects</a></p>\n</blockquote>\n<p><a href=\"https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021234s015lbl.pdf\" rel=\"nofollow noreferrer\">fda info</a> regarding more specifically to your question it may represent an increased factor of hepatotoxicity</p>\n<blockquote>\n<p>Physicians should measure transaminases at baseline and periodically in patients receiving\nlong-term therapy with diclofenac, because severe hepatotoxicity may develop without a\nprodrome of distinguishing symptoms. [...] However, severe hepatic reactions can occur at any time during treatment\nwith diclofenac.</p>\n</blockquote>\n<p>also</p>\n<blockquote>\n<p>Long-term administration of NSAIDs has resulted in renal papillary necrosis and other renal\ninjury.</p>\n</blockquote>\n<p>and finally the GI tract</p>\n<blockquote>\n<p>NSAIDs, including diclofenac, cause serious gastrointestinal (GI) adverse events including\ninflammation, bleeding, ulceration, and perforation of the esophagus, stomach, small\nintestine, or large intestine, which can be fatal.</p>\n</blockquote>\n<p>in summary we could sum up all of this with</p>\n<blockquote>\n<p>Because serious GI bleeding, hepatotoxicity, and renal injury can occur without warning\nsymptoms or signs, consider monitoring patients on long-term NSAID treatment</p>\n</blockquote>\n", "score": 1 } ]

[ "medications", "lasting-effects-duration", "diclofenac", "humerus" ]

[ { "answer_id": 4082, "body": "<p>Not a lot, it seems, which reduces side effects, but of course also makes the effect more local instead of systemic. </p>\n\n<p>The pharmacological study \n<a href=\"http://onlinelibrary.wiley.com/doi/10.1177/0091270009336234/abstract\" rel=\"nofollow\">Systemic Bioavailability of Topical Diclofenac Sodium Gel 1% Versus Oral Diclofenac Sodium in Healthy Volunteers</a> concludes </p>\n\n<blockquote>\n <p>Systemic exposure with diclofenac sodium gel 1% was 5- to 17-fold lower than with oral diclofenac. Systemic effects with topical diclofenac were less pronounced.</p>\n</blockquote>\n\n<p>Which is conclusive with an earlier study <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/9794502\" rel=\"nofollow\">In vivo bioavailability and metabolism of topical diclofenac lotion in human volunteers</a>, which measured a systemic absorption of around 7 percent (around a 15-fold decrease). </p>\n\n<p>Most side effects from topical diclofenac affect the skin, gastrointestinal system are much lower than when a comparable oral dose is given. For example, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19648310\" rel=\"nofollow\">in a study on 200 elderly patients</a>, no gastrointestinal issues were reported. A <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21681001\" rel=\"nofollow\">meta analysis of 14 studies</a> concludes that it has a low incidence of gastrointestinal issues, with the main complaints being nausea. </p>\n\n<p>However, as the first referenced study also says, topical diclofenac </p>\n\n<blockquote>\n <p>inhibited COX-1 and COX-2 less than oral diclofenac</p>\n</blockquote>\n\n<p>And therefore </p>\n\n<blockquote>\n <p>Systemic effects with topical diclofenac were less pronounced</p>\n</blockquote>\n\n<p>So in terms of effect, topical application is not quite the same as taking it orally. </p>\n", "score": 2 } ]

[ "medications", "diclofenac" ]

[ { "answer_id": 4097, "body": "<p>What you are describing is most likely <a href=\"https://en.wikipedia.org/wiki/Hyperhidrosis\" rel=\"noreferrer\">hyperhidrosis</a>, a disorder that causes excessive sweating. It This sweating usually occurs on the underarms (axillary) or the palms of the hands and soles of the feet (palmoplantar). </p>\n\n<p>There is also another type of classification for hyperhidrosis. Primary hyperhidrosis (more common) is excessive sweating not related to another medical condition or medication, while secondary hyperhidrosis <em>is</em> related to a medication or medical condition. Some other differences are that sweating from primary hyperhidrosis does not typically occur while sleeping and that primary hyperhidrosis onsets earlier than secondary hyperhidrosis.^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21334095\" rel=\"noreferrer\">1</a>} If you don't have another medical condition or take any medications that may cause the sweating, then the condition you most likely have is primary palmoplantar hyperhidrosis.</p>\n\n<p>The cause of primary hyperhidrosis is mostly related to your genetics, rather than any external causes. Overactive sweat glands are the most common cause and hyperhidrosis is known to run in the family. What actually triggers the sweating to occur is much harder to pin down. Heat can be a trigger, as well as anxiety, but the sweating can occur randomly at nearly all times.</p>\n\n<p>Besides sweating, there are some other possible side effects of hyperhidrosis. One study^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19395123\" rel=\"noreferrer\">2</a>} concluded that patients with hyperhidrosis were at an increased risk of skin infection. This can be dealt with by treating your hyperhidrosis, though.</p>\n\n<p>Treating primary hyperhidrosis can be as easy as using prescription or even over-the-counter antipersperants. If those don't work, <a href=\"https://en.wikipedia.org/wiki/Iontophoresis\" rel=\"noreferrer\">iontophoresis</a> has been known to help, especially with palmoplantar hyperhidrosis, which would be especially useful in your case. In incredibly drastic circumstances, surgery is available as a last resort. This surgery would involve removing some of the sweat glands. The surgeries have been known to be safe and effective.^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/7601951\" rel=\"noreferrer\">3</a>}^,^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/9013011\" rel=\"noreferrer\">4</a>}</p>\n\n<hr>\n\n<p>^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21334095\" rel=\"noreferrer\">1: Clinical differentiation of primary from secondary hyperhidrosis.</a>}</p>\n\n<p>^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/19395123\" rel=\"noreferrer\">2: Primary hyperhidrosis increases the risk of cutaneous infection: a case-control study of 387 patients.</a>}</p>\n\n<p>^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/7601951\" rel=\"noreferrer\">3: Endoscopic transthoracic sympathectomy: an efficient and safe method for the treatment of hyperhidrosis.</a>}</p>\n\n<p>^{<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/9013011\" rel=\"noreferrer\">4: Hyperhidrosis treated by thoracoscopic sympathicotomy.</a>}</p>\n\n<p>^{<a href=\"https://www.nlm.nih.gov/medlineplus/ency/article/007259.htm\" rel=\"noreferrer\">MedlinePlus - Excessive sweating - overview</a>}</p>\n\n<p>^{<a href=\"http://www.webmd.com/skin-problems-and-treatments/hyperhidrosis2\" rel=\"noreferrer\">WebMD - Excessive Sweating (Hyperhidrosis)</a>}</p>\n\n<p>^{<a href=\"http://emedicine.medscape.com/article/1073359-overview\" rel=\"noreferrer\">Medscape - Hyperhidrosis</a>}</p>\n", "score": 5 } ]

[ "treatment", "diagnosis", "sweat" ]

[ { "answer_id": 5084, "body": "<p>Your question can basically be extended to all studies related to statistics. In simple terms you are generally looking for a relationship (e.g. between an increased number of deaths and air pollution levels). Of course finding such a relationship ALONE doesn't tell you anything about cause and effect. Even if you are only looking at deaths from diseases known to be linked to air pollution, you have to come up with a way to show that these factors depend on each other - that they are correlated.</p>\n\n<p>Usually, you look at some sort of control group that will have almost all the exact same characteristics as the test group, except obviously for the one you actually care about. The more similar the two groups are, the better of course - ideally if you could find two identical cities, with identical people - with the only difference being the air pollution, then you could show a cause and effect easily. Since this will be very difficult to achieve, you instead have to use some <strike>sophisticated</strike> statistical methods to study correlation of your variables. You can start reading about those methods here: <a href=\"https://en.m.wikipedia.org/wiki/Correlation_and_dependence\" rel=\"nofollow\">https://en.m.wikipedia.org/wiki/Correlation_and_dependence</a></p>\n\n<p>So, as long as those studies you refer to follow common statistical procedures, which I will assume they did, then yes, you could staticstically show a relationship and argue that X-many more people died from an increased in air pollution.</p>\n\n<p><strong>[EXTENSION]</strong></p>\n\n<p>One of the studies in the link you provided is referring to a Research Letter in Nature (one of the most highly regarded scientific journals out there): <a href=\"http://www.nature.com/nature/journal/v525/n7569/full/nature15371.html\" rel=\"nofollow\">http://www.nature.com/nature/journal/v525/n7569/full/nature15371.html</a></p>\n\n<p>[Lelieveld et.al] are using a: </p>\n\n<blockquote>\n <p>global atmospheric chemistry model to investigate the link between\n premature mortality and seven emission source categories</p>\n</blockquote>\n\n<p>They are using a </p>\n\n<blockquote>\n <p>sensitivity study that accounts for differential toxicity</p>\n</blockquote>\n\n<p>They are focusing on</p>\n\n<blockquote>\n <p>mortality related to PM_2.5 and O₃</p>\n</blockquote>\n\n<p>and</p>\n\n<blockquote>\n <p>estimate of overall health impact depending on assumptions regarding particle toxicity</p>\n</blockquote>\n\n<p>So, basically, they build a global model that will be able to correlate higher particle toxicity values with the number of deaths in different regions. They also talk about a sensitivity study, which will test if any change of specific variables may have extreme effects on their model.</p>\n\n<blockquote>\n <p>Our calculations of air pollution related mortality are based on the method of the global burden of disease [...] applying improved exposure response functions that more realistically account for health effects at very high PM_2.5</p>\n</blockquote>\n\n<p>Of course it is just a <strong>model</strong> and not the reality, so the accuracy of their results will depend on the accuracy of this model, which is explained in more detail here: <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/23245609\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/23245609</a></p>\n\n<p>Overall, this actually isn't so much of a direct study with X number of participants. Nobody actually collected health information from participants, but they are using previously generated information (from the World Health Organisation) on toxicity response the effects of air pollution onto a global level. I assume the WHO has collected thousands of samples and analysed clinical trial that do what I mentioned earlier - they study the effect of a particular change in your environment onto your health. So, by now knowing that O₃ is actually actually reducing your life expectancy by X percent, they can make the aforementioned conclusions.</p>\n", "score": 1 } ]

[ "statistics", "air-quality", "asthma", "autopsy", "coroner" ]

[ { "answer_id": 16485, "body": "<p>During birth, the pelvic floor is stretched significantly, and the stretch is probable to never get back to the way it was exactly before.</p>\n<p><a href=\"https://www.nhs.uk/live-well/sexual-health/vagina-changes-after-childbirth/\" rel=\"nofollow noreferrer\">The NHS states it</a> takes a few days for <em>the swelling and openness [...] to reduce [...] after your baby is born</em>. An interview on the independent says that it should at most take 6 weeks for the vagina to get roughly back to before:</p>\n<blockquote>\n<p>The vagina is an extremely forgiving part of the body, it can be very swollen and can look quite distressing to some people but after six weeks when the healing has happened it can go back to looking quite normal. If you have had a normal delivery it is common, for some degree, to have bruising on the vagina but this and the swelling <strong>should all go within six weeks</strong>.</p>\n<p>^{<em>Source</em>: The Independent: <strong><a href=\"https://www.independent.co.uk/life-style/health-and-families/womens-body-childbirth-impact-changes-obstetrician-reveals-pelvic-floor-bruising-bleeding-a7595031.html\" rel=\"nofollow noreferrer\">What Happens to the Vagina after Childbirth? Obstetrician reveals it all</a></strong>, 2017.}</p>\n</blockquote>\n<p>It is strongly <a href=\"https://www.webmd.com/parenting/baby/recovery-vaginal-delivery#3\" rel=\"nofollow noreferrer\">recommended to visit a doctor 6 weeks after the birth</a> (<a href=\"https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/postpartum-care/art-20047233\" rel=\"nofollow noreferrer\">other sources say prior to 12 weeks</a>) so they'll check the vagina, cervix, and uterus. If one feels pain, if the vagina is bleeding more than usual, one should schedule an appointment before.</p>\n<hr />\n<p>^{For further reading, this is a good study regarding postpartum care:}</p>\n<p>^{Romano M, Cacciatore A, Giordano R, La Rosa B (April 2010). <strong><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279173/\" rel=\"nofollow noreferrer\">&quot;Postpartum period: three distinct but continuous phases&quot;</a></strong>. Journal of Prenatal Medicine.}</p>\n", "score": 1 } ]

[ "gynecology", "uterus", "vagina" ]

[ { "answer_id": 4223, "body": "<p>The bacteria that produce these foul smelling odors are anaerobic bacteria that live in the oxygen depleted film left on our teeth, tongue, and roof of our mouth if we don't brush. </p>\n\n<p>These bacteria can produce chemicals that cause malodor including:</p>\n\n<ul>\n<li>volatile sulphur compounds (VSCs), mainly methyl mercaptan, hydrogen sulphide, and dimethyl sulphide</li>\n<li>diamines (putrescine and cadaverine) and</li>\n<li>short chain fatty acids (butyric, valeric and propionic).</li>\n</ul>\n\n<p>It smells more outside because these smelly chemicals are normally diluted by saliva in your mouth but become concentrated when the saliva evaporates.</p>\n\n<p>Imagine your saliva as ocean water. Imagine the salt in the water is the smelly waste of bacteria, and your hand is like a dry shore. When the saliva evaporates on the hand, it leaves only the smelly salt (bacterial waste) behind.</p>\n\n<p><em>References:</em></p>\n\n<p><em><a href=\"http://cdn.intechopen.com/pdfs/29459.pdf\">Book Chapter by Suzuki et al., 2012</a></em></p>\n\n<p><em><a href=\"http://www.nature.com/bdj/journal/v199/n8/full/4812806a.html\">Review by Scully and Felix, 2005</a></em></p>\n", "score": 8 } ]

[ "dentistry" ]

[ { "answer_id": 4225, "body": "<p><em>The human immune system</em></p>\n\n<p>Basically, the human (and that includes all ages) immune system has two parts:</p>\n\n<ol>\n<li>The <a href=\"http://www.ncbi.nlm.nih.gov/books/NBK26846/\">innate immune system</a> is a very old part (which doesn't mean it's bad or superfluous, on the contrary) that is responsible for a nonspecific immune response when the body encounters a pathogen. This is a very quick response and includes inflammatory responses and fever. Since most bacteria grow better at a temperature of 37°C than at a slightly higher temperature, a fever is a normally beneficial response to any kind of pathogen and thus triggered often </li>\n<li>The <a href=\"http://www.ncbi.nlm.nih.gov/books/NBK10752/\">adaptive immune system, also called the humoral or specific immune response</a>. Evolutionary speaking, this is newer. The main components are B-cells and T-cells and it is pretty complex, but the basics are that this is what reacts to antigens to produce antibodies to specific pathogens. After the first encounter, this makes sure that the next time the same pathogen is encountered, the immune response is quicker and shorter. </li>\n</ol>\n\n<p><em>The immune response to vaccinations</em></p>\n\n<p>The infant's immune system really is capable of handling a lot more antigens than it is exposed to in a vaccine + its live environment at any one point in time. I suggest you read the review by Paul Offit, who is cited in the article you linked to, for more information on that, <a href=\"http://pediatrics.aappublications.org/content/109/1/124\">Addressing parents' concern: Do multiple vaccines overwhelm or weaken the infant's immune system</a>. Basically, the specific immune response mediated by B- and T-cells can handle a specific immune response for a large number of antigens at once. </p>\n\n<p>This number is largely <em>independent</em> of what you are seeing in the child. The number of antigens the immune system can handle says nothing about what symptoms the immune response will cause, because the effects you can see is largely the innate immune response. Small children get a fever pretty often because most pathogens are new to them and the innate immune system responds to that with a fever. Exposure to several pathogens at once does not cause a higher fever. </p>\n\n<p>With vaccines there is no actual risks of the child getting the disease. The vaccines contain <a href=\"http://www.historyofvaccines.org/content/articles/different-types-vaccines\">attenuated or dead viruses or no pathogens at all</a> (the <a href=\"http://www.cdc.gov/vaccines/vpd-vac/tetanus/\">tetanus one</a>, for example, is against the toxin, not the bacterium producing it). The adaptive immune system needs <a href=\"http://www.immunologyexplained.co.uk/HowItWorks.aspx\">days to weeks to produce the correct antibodies</a> in sufficient quantities, but it carries no risk of them suddenly developing measles or something like that. Unfortunately, we can't really tell the immune system we only need the antibodies, not the cytokines all the other parts that may let the child <em>appear</em> sick when it really isn't. So the innate immune response happens and may appear to weaken the child and leads to parents to jumping to the conclusion that this is too much for such a small child. Nobody is saying a fever is fun for the infant/baby of course, but in essence, vaccination is a risk/benefits calculation. </p>\n\n<p>One thing to keep in mind is that several of the vaccinations given in childhood are combination vaccines (MMR, DTP,..), and the immune response is still not in any way overwhelmed. And these are several vaccines for diseases that are actually dangerous (diphtheria, pertussis,...) given together. The resources don't get used up because different cells are doing different things and, even more, the B-cells that respond to the measles vaccines are not used for the immune response towards the rhinovirus the child is exposed to at the same time. </p>\n\n<p>The number of antigens is used for that reason - it's a metric to show that the humoral immune response is really capable of doing a lot of stuff at once. It's just that many people see the fever vaccinations can cause and then conclude that a child is actually sick after a vaccination and therefore their immune system must be \"weakened\" (which, outside of actually immunocompromised people is another ill-defined concept) by the vaccine and incapable of dealing with other things at the same time. It isn't. That fever is the body unspecifically reacting to anything that warrants an immune reaction, because the specific and unspecific parts of it didn't evolve to be independent. </p>\n\n<p>Also, nobody is saying anything about \"straining\" the immune system, because \"straining the immune system\" does not have a defined meaning. What they are saying is that a child's immune system is more than equipped to deal with several things at once. </p>\n\n<p><em>Delaying vaccinations</em></p>\n\n<p>That delaying vaccinations for fear of overwhelming the immune system is unnecessary can be seen by what happens in children who are already sick and receive a vaccine. The answer is \"not much out of the ordinary\". The innate immune response is launched already and the adaptive immune response can deal with everything at once. </p>\n\n<blockquote>\n <p>vaccine-specific antibody responses and rates of vaccine-associated adverse reactions of children with mild or moderate illnesses are comparable to those of healthy children. For example, the presence of upper respiratory tract infections, otitis media, fever, skin infections, or diarrhea do not affect the level of protective antibodies induced by immunization</p>\n</blockquote>\n\n<p>The recommendation to delay vaccines when the child has a serious illness is not based on the child's immune system not being able to \"handle\" both, but on trying not to \"mix\" symptoms and avoiding adverse vaccination reactions on top of an illness. </p>\n\n<blockquote>\n <p>Vaccination should be deferred for persons with a moderate or severe acute illness. This precaution avoids causing diagnostic confusion between manifestations of the underlying illness and possible adverse effects of vaccination or superimposing adverse effects of the vaccine on the underlying illness. </p>\n</blockquote>\n\n<p><a href=\"http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm\">General recommendations on Immunization by the CDC</a> - also a very good read. </p>\n\n<p>The actual study behind that WSJ article is <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/20498176\">On-time vaccine receipt in the first year does not adversely affect neuropsychological outcomes</a>, though that deals only with neurological outcomes and not infections. </p>\n\n<blockquote>\n <p>Timely vaccination during infancy has no adverse effect on neuropsychological outcomes 7 to 10 years later.</p>\n</blockquote>\n\n<p>As a general note on delayed schedules, there has been no evidence presented so far that delaying vaccines has any benefits whatsoever, for example less or less severe infections during childhood. Of course the vaccine schedule is not evidence-based down to the weeks where everything is given - of course parts of it could be delayed by two weeks, other parts could be given two weeks earlier, etc. Nobody is going to design 200 different schedules, enroll thousands of children in a study and test all possible schedules. </p>\n\n<p>But what we have is definitely not overwhelming the immune system and for most children, it ensures that by the time the body encounters the actually infectious pathogens in the wild, the specific immune response to it is already in place and parents will never even notice their child was exposed. </p>\n\n<p><em>Additional sources and further reading</em></p>\n\n<p><a href=\"http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/prinvac.pdf\">CDC - Principles of Vaccination</a></p>\n\n<p><a href=\"http://www.who.int/immunization/.../Elsevier_Vaccine_immunology.pdf\">WHO - Vaccine immunology</a></p>\n", "score": 9 } ]

[ "immune-system", "vaccination", "pediatrics" ]

[ { "answer_id": 4235, "body": "<p>I presume you're taking the teleological view that symptoms are \"good\" and have a beneficial (if not fully understood) purpose, and therefore should not be messed with. That is a <em>cognitive bias</em> (a belief based on a construct, not objective evidence). Taking your example, I would ask you, what beneficial purpose does a runny/stuffy nose serve? Does it facilitate viral removal? Is it necessary to full recovery from a cold? Is long-term immunity to a rhinovirus enhanced if no symptomatic treatment is rendered?</p>\n\n<p><em>Do you have any evidence that not treating symptoms is beneficial?</em></p>\n\n<blockquote>\n <p>...why do we take medicines to suppress our symptoms?</p>\n</blockquote>\n\n<p>First, let me clarify that symptoms are neither \"good\" nor \"bad\"; they merely <strong>inform</strong> (although one can argue that <em>the absence of symptoms</em> is a good thing.) Illness/disease/disorder is present. Thanks to them, now we know, and we can treat (or not treat) the underlying disorder. But the symptoms themselves are merely the body's reactions; they aren't necessarily <em>good</em>. Sometimes mild symptoms aren't treated, but the decision to treat is based on how disruptive (and/or dangerous) they are. </p>\n\n<p>Let's assume only 'relatively benign' symptoms, for example a runny nose, sore throat and cough that typically results from infection with a rhinovirus (the most common cause of the common cold). </p>\n\n<p>People treat a runny nose because it bothers them. It's hard to breathe easily with a runny nose, and the mere presence of nasal congestion causes a mild and very annoying feeling of air hunger in many people. Mouth-breathing dehydrates the oropharynx and upper airway, making a sore throat worse, worsens coughs, and makes sleep difficult, resulting in daytime drowsiness, irritability, etc. Overall, it's uncomfortable. The same applies to the sore throat: it makes eating, drinking, swallowing, and communication uncomfortable. Coughing (and sneezing) causes increased pain in sore throats, can keep people awake, spreads illness through aerosolized droplets (making for awkward social interactions), etc. The benefit of <em>not treating</em> these symptoms is largely unknown; <strong>the benefit</strong> of treating these symptoms (which supports the multi-billion dollar cold remedy industry) is that it just makes people feel better overall. They sleep better, cough less, feel less achey, swallow with less discomfort, etc. That's why people treat their cold symptoms. </p>\n\n<blockquote>\n <p>The morbidity associated with non–influenza-related VRTI is not trivial. ...the total economic impact [in the US] of non–influenza-related [Viral respiratory tract infection] approaches $40 billion annually (direct costs, $17 billion per year; and indirect costs, $22.5 billion per year).</p>\n</blockquote>\n\n<p>Some of the deleterious effects of rhinovirus infection are known (production of chemokines by epithelial cells resulting in influx of leukocytes into the airway leading to airway pathology; release of inflammatory cell products from neutrophils, cationic protein release from eosinophils, reactive oxygen species, etc., which can cause tissue damage.) However, <em>the benefit of not treating a rhinovirus infection</em> is unknown.</p>\n\n<p>This means that unless and until benefits are shown of <em>not treating</em> symptoms, the <a href=\"https://en.wikipedia.org/wiki/Risk%E2%80%93benefit_ratio\">risk to benefit ratio</a> of treatment of the common cold is incompletely known. In that event, the practice will favor treatment.</p>\n\n<p>My hope in answering this question is to shed light on the potential harm of teleological arguments, that they need to be discarded in favor of objective evidence. Things are not true because one believes them to be true; to quote Philip K. Dick, \"Reality is that which, when you stop believing in it, doesn't go away.\"</p>\n\n<p>_{This answer ignores obvious risks of treatment, such as decongestants in hypertensives, etc. which are present on information labels on OTC medications, and the risks of treatments without well-known benefit, e.g. Vitamin C supplements.}<br>\n_{<a href=\"http://www.sciencedirect.com/science/article/pii/S0140673603121629\">The common cold</a>}<br>\n_{<a href=\"http://archinte.jamanetwork.com/article.aspx?articleid=215118&amp;resultclick=1\">The Economic Burden of Non–Influenza-Related Viral Respiratory Tract Infection in the United States</a>}<br>\n_{<a href=\"http://journals.lww.com/pidj/Abstract/2005/11001/Role_of_Viral_Infections,_Atopy_and_Antiviral.11.aspx\">Role of Viral Infections, Atopy and Antiviral Immunity in the Etiology of Wheezing Exacerbations Among Children and Young Adults</a>}<br>\n_{<a href=\"http://journal.publications.chestnet.org/article.aspx?articleid=1084743\">How Viral Infections Cause Exacerbation of Airway Diseases</a>}</p>\n", "score": 7 } ]

[ "medications", "practice-of-medicine" ]

[ { "answer_id": 7145, "body": "<p><strong>I think it would help after the first few times, but lose effectivity as you become used to the less noise.</strong> I would think to put your alarm on extra early, and your alarm steadily getting louder would work. If you are in no rush to wake up, then as you get closer to natural wake up time, the alarm would be more likely to rouse you. The headaches probably are just caused by not enough sleep, erratic sleep patterns, and etc. Your best weapon would be to <a href=\"http://www.helpguide.org/articles/sleep/how-to-sleep-better.htm\" rel=\"nofollow\">sleep better</a>. </p>\n", "score": 1 }, { "answer_id": 7291, "body": "<p>How deep the sleep is depends on the sleep cycles. This overview from shows, that the deepest sleep stages 3 &amp; 4 only happen during the first half of the night. The second half is mainly REM sleep. However our brain is highly active during al these cycles. </p>\n\n<p><a href=\"https://i.stack.imgur.com/AknoT.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/AknoT.jpg\" alt=\"Sleep hyponogram from wikipedia\"></a>\nImage source: <a href=\"https://upload.wikimedia.org/wikipedia/commons/b/b7/HYPNOGRAM_created_by_Natasha_k.jpg\" rel=\"nofollow noreferrer\">wikipedia</a></p>\n\n<p>Because even at night there are noises and plently of stimulants for the brain, it needs a gatekeeper which decides which stimulant to get through. This is the job of the thalamus. So if you hear your alarm or if you don't depends wether the thalamus \"decides\" that it is an important noise and therfore should be recognized by the cortex (<a href=\"http://sleep.lovetoknow.com/Human_Thalamus\" rel=\"nofollow noreferrer\">2</a>,<a href=\"https://en.wikipedia.org/wiki/Thalamus#Function\" rel=\"nofollow noreferrer\">3</a>)\nOne example of that gatekeeper function are Mothers with newborn children. If their child does tiny noises they will wake up, no matter which sleep cycle they are in, because the thalamus recognizes the child as important. On the other hand cars which are passing by on the outside street, which are even louder that noises from the child will not wake up the mother. </p>\n\n<p>To answer the question: most likley your alarm will not be as important to you as your newborn child, but if it's important for you to wake up with your alarm, you will even with 30% less noise, no matter of your sleep stage. However disorientation and headaches will not get less. Probably you are in a deeper sleep cycle when your alarm goes of, to change that you should alter the time you go to bed. A roughly estimate is, that you need 90 minutes to get one full cycle of sleep. So try to get 6:00 or <strong>7:30</strong> or 9:00 hours of sleep. \nRead more about sleep hygiene <a href=\"https://sleepfoundation.org/ask-the-expert/sleep-hygiene\" rel=\"nofollow noreferrer\">here</a> or in the link of Adamawesome4.</p>\n", "score": 1 } ]

[ "sleep", "sleep-cycles" ]

[ { "answer_id": 4285, "body": "<p>Both these schedules, ie., 3 meals a day and 6 meals a day, can work well for different type of people.</p>\n\n<p>Let’s look at the benefits of eating 3 meals a day first</p>\n\n<p>This schedule often works well for most of us in the long term as we are used to the breakfast-lunch-dinner that we eat at home. Mostly, people do not want to eat immediately upon waking up (generally it’s a couple of hours after waking up). More often than not, most of us do not feel like eating after breakfast till it is lunchtime. Three-meal schedule allows you to eat bigger meals and this is where six meals a day theory becomes a problem for those who love to eat big and are trying to lose weight. Six small meals will never make you feel that you have eaten enough; you might feel like you are just snacking and it makes you crave for more. So, three-meal schedule teaches you to take control of your hunger better whereas eating six times a day tends to make you eat more, as you end up eating every 2-3 hours irrespective of the fact that you are hungry or not. </p>\n\n<p>Now, let’s look at the benefits of 6-meals-a-day schedule </p>\n\n<p>It could be an ideal plan when you are required to a lot of calories to gain weight or if you are a sports person who burns a lot of calories. Also, it’s something you want to follow if you are someone who needs to consume high amounts of protein as our body can only assimilate and absorb between 30-40 grams of quality protein per meal. Therefore, this schedule is ideal for people who want to limit protein intake to about 15-40 grams per meal. Another benefit of 6-meal-a-day plan is when you are required to consume large amounts of carbs. It can also help you to maintain your sugar levels. For some, especially diabetics, it could be a tough ask to go on for more than 3-4 hours without eating anything and smaller frequent servings would work well to maintain stable energy/sugar levels.</p>\n\n<p>Ref: <a href=\"http://www.medicaldaily.com/how-3-meals-day-became-rule-and-why-we-should-be-eating-whenever-we-get-hungry-324892\" rel=\"nofollow\">http://www.medicaldaily.com/how-3-meals-day-became-rule-and-why-we-should-be-eating-whenever-we-get-hungry-324892</a></p>\n\n<p><a href=\"http://www.barriespiritsoccer.com/carbohydrates.html\" rel=\"nofollow\">http://www.barriespiritsoccer.com/carbohydrates.html</a></p>\n", "score": 4 } ]

[ "nutrition", "diet" ]

[ { "answer_id": 20528, "body": "<p>It is now widely accepted that Alzheimer's disease is a form of cerebral amyloidosis (in fact the most common form of amyloidosis).</p>\n\n<p>The <a href=\"https://en.wikipedia.org/wiki/Amyloidosis\" rel=\"nofollow noreferrer\">amyloidoses</a> and <a href=\"https://en.wikipedia.org/wiki/Prion\" rel=\"nofollow noreferrer\">prionoses</a> are examples of protein misfloding diseases.</p>\n\n<p><strong>Amyloidosis</strong>: Abnormal proteins (amyloid fibrils) build up in tissues when they form incorrectly and are not completely broken down by protease enzymes. There are multiple types and they can be hereditary or acquired (e.g. due to inflammation, multiple myeloma and others).</p>\n\n<p><strong>Prionosis</strong>: An abnormally folded protein is able to transmit its abnormal folding to a normal version of the same protein. Examples include <a href=\"https://en.wikipedia.org/wiki/Kuru_(disease)\" rel=\"nofollow noreferrer\">kuru</a> and <a href=\"https://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease\" rel=\"nofollow noreferrer\">Creutzfeldt-Jacob Disease</a> (CJD).</p>\n\n<hr>\n\n<p><strong><a href=\"https://en.wikipedia.org/wiki/Alzheimer%27s_disease\" rel=\"nofollow noreferrer\">Alzheimer's Disease</a> (AD)</strong></p>\n\n<p>The type of amyloid protein found causing neuronal damage in Alzheimer's disease is known as amyloid beta / amyloid precursor protein.</p>\n\n<p>There are several hypotheses about the aetiology:</p>\n\n<ul>\n<li><p>Cholinergic hypothesis - This states that AD is due to reduction of the neurotransmitter acetylcholine. Most current drug therapies are based on this. The lack of efficacy of these treatments is one of the reasons why support for this hypothesis is falling.</p></li>\n<li><p>Amyloid hypothesis - First postulated in 1991 that extracellular amyloid beta deposits are the fundamental cause of the disease. Support for this postulate comes from the location of the gene for the amyloid precursor protein (APP) on chromosome 21, together with the fact that people with trisomy 21 (Down Syndrome) who have an extra gene copy almost universally exhibit at least the earliest symptoms of AD by 40 years of age. Also, a specific isoform of apolipoprotein, APOE4, is a major genetic risk factor for AD. While apolipoproteins enhance the breakdown of beta amyloid, some isoforms are not very effective at this task (such as APOE4), leading to excess amyloid buildup in the brain. A vaccination was developed and found to clear the amyloid plaques, but did not improve the dementia, leading researchers to believe that non-plaque oligomers of amyloid beta disrupt neuronal communication by binding to a receptor and altering the surface of the synapse.</p></li>\n<li><p>Tau hypothesis - This proposes that a hyperphosphorylated protein causes the neurofibrillary tangles.</p></li>\n<li><p>Inflammation hypothesis - This links AD to an inflammatory process, with links to chronic periodontal infection and problems with gut microbiome.</p></li>\n<li><p>Neurovascular hypothesis - AD due to problems with the blood-brain barrier.</p></li>\n<li><p>Other hypotheses - These suggest a role for smoking, air pollution and <a href=\"https://en.wikipedia.org/wiki/Oligodendrocyte\" rel=\"nofollow noreferrer\">oligodendrocyte</a> dysfunction.</p></li>\n</ul>\n\n<hr>\n\n<p>The amyloid plaques and neurofibrillary tangles can be seen clearly by microscopy at autopsy, so they are known to be present. My main source (noted below) summarises this complex disease process and goes into some detail on the pathogenesis. It seems likely that there is a combination of factors interacting, including both amyloid and tau proteins causing neuronal damage and the resulting dementia.</p>\n\n<hr>\n\n<p><strong>Sources</strong>:</p>\n\n<p><a href=\"https://doi.org/10.1016/S0169-409X(02)00149-7\" rel=\"nofollow noreferrer\">Ghiso et al. <strong>Amyloidosis and Alzheimer's disease.</strong> Advanced Drug Delivery Reviews, 2002.</a></p>\n", "score": 2 } ]

[ "neurology", "alzheimers" ]

[ { "answer_id": 4315, "body": "<p>First of all, the leaflet in question also states:</p>\n\n<blockquote>\n <p>Your doctor will tell you how much Daktarin \n oral gel to take and for how long you should \n take it.</p>\n</blockquote>\n\n<p><strong>It is essential that your therapy is supervised by a physician</strong>, primarily because infections of the stomach and the gut may be serious. The doctor can monitor how you respond to therapy in terms of both efficacy and safety (i.e. possible side effects).</p>\n\n<hr>\n\n<p>That being said, it is important that you understand the information provided in the leaflet, so here goes the explanation.</p>\n\n<p>20 mg is the dose of the active substance. This is a common practice because there may be preparations of different concentrations. </p>\n\n<p>There is an <a href=\"https://books.google.rs/books?id=NUnMZAb5NyAC&amp;pg=PA76&amp;lpg=PA76&amp;dq=how+is+the+dose+of+a+medication+expressed+per+body+mass&amp;source=bl&amp;ots=aNGqeDggxv&amp;sig=y8p4dLzOqECFdRdON1vZbCQh8Q4&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwi7mebzxZjKAhVD3iwKHS_iA3Q4ChDoAQgZMAA#v=onepage&amp;q=how%20is%20the%20dose%20of%20a%20medication%20expressed%20per%20body%20mass&amp;f=false\" rel=\"nofollow\">example of dose calculation based on body weight</a> in: Pharmacy Technician Certification Review and Practice Exam\n edited by Barbara Lacher.</p>\n\n<p>The other problem with you calculating the dose yourself is that the concentration is expressed as mass fraction, from which one can calculate the total mass of the preparation to be taken. On the other hand the measuring spoon provided (at least according to the attached leaflet) is scaled in milliliters and measures volume. To convert mass to volume you need the density of the preparation, which is not given in this document. This bit is probably known to your physician/health care team.</p>\n", "score": 3 } ]

[ "medications", "oral-health", "dosage" ]

[ { "answer_id": 8907, "body": "<p>First, some quote from British Fluoridation Society webpage (which text is based on some article authored by dr Levine, author of \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/1061590\" rel=\"noreferrer\">The action of fluoride in caries prevention. A review of current concepts</a>\"):</p>\n\n<blockquote>\n <p><strong>The relationship between fluoride and tooth decay is complex and probably not yet fully understood.</strong> However, it is known that fluoride interferes with the process of tooth decay in at least four ways: (1) If children ingest sufficient fluoride (...) up to 7 years of age the fluoride alters the structure of the developing enamel making it more resistant to acid attack. (2) (...) encourages remineralisation and ensures that the enamel crystals that are laid down are of improved quality. (...) low levels of fluoride in the mouth gradually improve the strength of the tooth enamel and its ability to resist acid attack. (3) (...) reducing the ability of the plaque bacteria to produce acid. <strong>This is a major factor in the prevention of tooth decay.</strong> (4) (...) if sufficient fluoride is ingested during childhood when the teeth are developing, it affects the depth of the fissures (grooves) on the biting surfaces of the teeth (...) thus reducing the ability of plaque to remain undisturbed.</p>\n</blockquote>\n\n<p>Now, let's analyze what is written above. Points (1) and (4) are important when you're a kid, they doesn't matter to you now. Point (2) is about improved self-repair and acid resistance. This is some very good property of fluoride, but it may not be so well understood and so effective as it is often presented. Quote from \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/10777135\" rel=\"noreferrer\">Current concepts on the theories of the mechanism of action of fluoride.</a>\" (1999):</p>\n\n<blockquote>\n <p>Comparative studies of fluoride efficacy have shown that higher concentrations in solution are needed in pH-cycling studies of dentine than in enamel to maintain the mineral balance or to induce remineralization. (...) future perspectives for fluoride applications should be found in the retention and slow release of fluoride after various combinations of fluoride treatment, the combination of fluoride and anti-microbial treatment, the individualization of caries prevention, and the combination of preventive schemes with new developments in caries diagnosis.</p>\n</blockquote>\n\n<p>(So this is not so simple just to have low levels of fluoride.)</p>\n\n<p>If you sincerely keep good dental habits which include also proper diet and mouth washing, then you could rely on your natural remineralization. Keeping/restoring proper pH level would be important here. \nPoint (3) is about bacteria and here things can get tricky. Bacteria evolve and it is not impossible that they will learn to deal with fluoride. Quote from \"<a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22327376\" rel=\"noreferrer\">New insight on the response of bacteria to fluoride.</a>\" (2012): </p>\n\n<blockquote>\n <p>However, the precise effects that fluoride has on bacteria and the mechanisms that bacteria use to overcome fluoride toxicity have largely remained unexplored. Recently, my laboratory reported the discovery of biological systems that bacteria use to sense fluoride and reduce fluoride toxicity. </p>\n</blockquote>\n\n<p>Actually, <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8704659\" rel=\"noreferrer\">some really bad-ass fluoride-resistant bacterias</a> are known to exist from a quite a long time now.</p>\n\n<p>If you're not to use fluoride then again a lot will depend on your dental habits. If proper pH levels are maintained then \"good\" and \"bad\" bacteries in your mouth will keep themselves in some form of balance (hopefully).</p>\n\n<p>Now, I think that it is important to explain what is the main function of toothpaste and general toothbrushing: it's <strong>mechanical surface abrasion</strong>. This is nicely summarized <a href=\"http://www.thefactsabout.co.uk/how-does-toothpaste-work/content/115\" rel=\"noreferrer\">here</a>:</p>\n\n<blockquote>\n <p>Toothpastes contain mild abrasives which physically scrub away the plaque and food debris without damaging the tooth enamel.</p>\n</blockquote>\n\n<p>This, in essence, has nothing to do with fluoride.</p>\n\n<p>So, in my opinion, you can use fluoride-free toothpaste. If you'll be careful with pH levels, do mouthwash, be careful what you eat, then your natural tooth decay prevention mechanisms should work. <strong>But I don't guarantee anything</strong>.</p>\n\n<p>Also, if I was to use fluoride-free toothpaste, I would like know if there exist some alternative chemical substance of similar properties. I haven't checked that and this is good material for another question.</p>\n", "score": 5 } ]

[ "dentistry", "oral-health" ]

[ { "answer_id": 4375, "body": "<p>First, it is unlikely that the fecal matter was in fact pathogen-laden, but as a general statement should be treated as such. Further pathogens that would be in fecal mater are mostly transmitted through the <a href=\"https://en.wikipedia.org/wiki/Fecal-oral_route\" rel=\"nofollow\">fecal-oral route</a>. That's why on an individual case you have little to worry about without any symptoms, but as a general case we wouldn't recommend going around taking big sniffs of feces (I'm enjoying the ad campaign for this in my head). </p>\n\n<p>But you mention \"vomit, etc,\" and it's worth pointing out there are pathogens that can infect through the respiratory tract from infectious fluids. This is mostly limited to things that can infect both your GI tract and respiratory tract, and that's not a long list (<a href=\"https://en.wikipedia.org/wiki/Epstein-Barr_virus#Replication_cycle\" rel=\"nofollow\">EBV</a> is a good example). Further \"smelling something\" with an infectious respiratory virus (rhino, influenza, etc) can certainly cause an infection. I would highly discourage sniffing used tissues.</p>\n\n<p>A bigger concern are pathogens like <a href=\"https://en.wikipedia.org/wiki/Norovirus\" rel=\"nofollow\">norovirus</a> which are so infectious, possibly down to 10 virions to cause infection (instead of 1000s or more), that it could enter your oral tract without your even knowing it.</p>\n\n<p>Even if it was infectious, there's really nothing to be done until symptoms arise that can be treated. Do feel free to discourage sniffing feces if that doesn't seem to be a self-correcting behavior.</p>\n", "score": 4 }, { "answer_id": 4376, "body": "<p>Good question. The answer is <strong>no</strong>, not in this case. </p>\n\n<p>In order to understand why, it will help to talk about the different ways pathogens enter the body:</p>\n\n<ul>\n<li><p><a href=\"http://microbiology.mtsinai.on.ca/faq/transmission.shtml#two\" rel=\"nofollow\"><em>Direct contact</em></a> - touching an infected person</p></li>\n<li><p><a href=\"http://microbiology.mtsinai.on.ca/faq/transmission.shtml#three\" rel=\"nofollow\"><em>Indirect contact</em></a> - touching something an infected person touched</p></li>\n<li><p><a href=\"http://microbiology.mtsinai.on.ca/faq/transmission.shtml#four\" rel=\"nofollow\"><em>Droplet contact</em></a> - infected droplets touching mucosal surfaces of eye, nose, mouth</p></li>\n<li><p><a href=\"http://microbiology.mtsinai.on.ca/faq/transmission.shtml#five\" rel=\"nofollow\"><em>Airborne transmission</em></a> - contact with dust/air particles containing infectious agents</p></li>\n<li><p><a href=\"http://microbiology.mtsinai.on.ca/faq/transmission.shtml#six\" rel=\"nofollow\"><em>Fecal-oral transmission</em></a> - ingesting contaminated water or material</p></li>\n<li><p><a href=\"http://microbiology.mtsinai.on.ca/faq/transmission.shtml#seven\" rel=\"nofollow\"><em>Vector-borne transmission</em></a> - pathogens carried by a host animal, and transmitted through any of the above methods</p></li>\n</ul>\n\n<p>Picking up the fecal matter and smelling it raises concerns about direct contact, vector transmission and airborne transmission. As Atl LED mentions, the pathogens in feces are normally transmitted through the <a href=\"https://en.wikipedia.org/wiki/Fecal-oral_route\" rel=\"nofollow\">fecal-oral route</a>. The fecal-oral route requires that the pathogen enters the digestive tract, which won't happen by smelling. Nevertheless, it can be classified as risky behavior, and is not recommended.</p>\n", "score": 3 } ]

[ "infection", "immune-system", "disease-transmission" ]

[ { "answer_id": 4590, "body": "<p><strong>\"Snoring occurs during sleep when soft tissue in the upper airway vibrates as you breathe.\"</strong> (1) Typically, this will happen because the passage way for air narrows and the air rubs against the tissue in passing, similar to what happens to your lips when you blow a raspberry.</p>\n\n<p>It's actually common in men, but can also occur frequently in women, especially during pregnancy and after menopause. <strong>Obesity, age, nasal obstruction, sickness, alcohol, smoking, and even position possibly increase the risk of snoring, and may also contribute to the intensity of your snores.</strong></p>\n\n<p>One of the most important risk factors is obesity, and in particular having a lot of fatty tissue around the neck.</p>\n\n<p>The Sleep Foundation (2) notes: That the normal aging process leads to \"the relaxation of the throat muscles, thus resulting in snoring.\"</p>\n\n<p>Your personal anatomical shape could play a part too. Enlarged tonsils, nasal polyps, or deviated nasal septum could narrow the throat during sleep and also lead to snoring.</p>\n\n<p>Inflammation of the throat, due to a disease or otherwise, would also cause the throat to narrow, and may cause snoring.</p>\n\n<blockquote>\n <p>Sleep position, such as sleeping on your back, may lead to snoring in\n some people. Alcohol is a potent muscle relaxant and its ingestion in\n the evening will cause snoring. </p>\n \n <p>Muscle relaxants taken in the evening may lead to or worsen snoring in\n some individuals.</p>\n</blockquote>\n\n<p>Possibly any one of these or a combination of them may be contributing to the intensity of your snores, or it could be something else too, but these tend to be the most common causes of snores.</p>\n\n<ol>\n<li><p><a href=\"http://www.aadsm.org/snoring.aspx\" rel=\"nofollow\">http://www.aadsm.org/snoring.aspx</a></p></li>\n<li><p><a href=\"https://sleepfoundation.org/sleep-disorders-problems/other-sleep-disorders/snoring\" rel=\"nofollow\">https://sleepfoundation.org/sleep-disorders-problems/other-sleep-disorders/snoring</a></p></li>\n</ol>\n", "score": 6 }, { "answer_id": 5412, "body": "<p>Snoring is a common condition that can affect anyone. There are many factors, such as the anatomy of your mouth and sinuses, alcohol consumption, allergies, a cold, and your weight, can lead to snoring. Try these natural solutions and lifestyle changes, which may help you stop snoring- Change Your Sleep Position, Lose Weight, Limit alcohol consumption, Use anti-snoring sprays.</p>\n", "score": 0 } ]

[ "sleep" ]

[ { "answer_id": 5029, "body": "<p>BRCA1 and BRCA2 are the names of genes that every human has¹, located on chromosome 17. These genes code for proteins that <em>suppress</em> tumors. </p>\n\n<p>However, in some humans these genes carry mutations that mean that the tumor suppressing function doesn't work as well or at all. That's what people usually mean when they say that they \"have\" BRCA1/2, even though it's not the clearest way to phrase it. </p>\n\n<p>Because in those cases suppression of tumor development is not as good as in people with the wild type (not mutated) version, these people are more at risk for certain cancers, specifically breast and ovarian cancer. In total, the mutations are probably responsible for about 10 percent of all breast cancers and 15 percent of all ovarian cancers. </p>\n\n<p>For more information, the <a href=\"http://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet\" rel=\"nofollow\">National Cancer Institute's fact sheet</a> is a good resource. </p>\n\n<p>_{1) it is possible that there are people who actually don't have the gene - I couldn't find any reports on that, but that doesn't mean it hasn't happened. However, that in itself is a mutation (a gene deletion). In a whole genome analysis, I can only hope that a missing gene would be listed as a result.}</p>\n", "score": 2 } ]

[ "cancer", "test-results", "genetics", "brca-gene-test" ]

[ { "answer_id": 4489, "body": "<p>The site you found that on is the <a href=\"https://en.wikipedia.org/wiki/Centers_for_Disease_Control_and_Prevention\" rel=\"noreferrer\">Centers for Disease Control and Prevention</a>. It's generally considered an authoritative source. The site states the following:</p>\n\n<blockquote>\n <p>There are high rates of Hepatitis C in people born during 1945-1965. \n People born during 1945 through 1965 are 5 times more likely than\n other adults to be infected. In fact, 75% of adults with Hepatitis C\n were born in these years. The reasons why baby boomers have the\n highest rates of Hepatitis C are not completely understood.</p>\n</blockquote>\n\n<p>In support of that statement, they include a link to <a href=\"http://www.cdc.gov/knowmorehepatitis/Media/PDFs/FactSheet-Boomers.pdf\" rel=\"noreferrer\">further information (PDF)</a>. Note that in this document they mention possible reasons for the Baby Boomers to have such a high prevalence:</p>\n\n<blockquote>\n <p>Hepatitis C is primarily spread through contact with blood from an\n infected person. Many baby boomers could have gotten infected from\n contaminated blood and blood products before widespread screening of \n the blood supply in 1992 and universal precautions were adopted.\n Others may have become infected from injecting drugs, even if only\n once in the past. Still, many baby boomers do not know how or when \n they were infected.</p>\n</blockquote>\n", "score": 5 } ]

[ "health-informatics", "hepatitis" ]

[ { "answer_id": 4522, "body": "<p>One word: dehydration.</p>\n\n<p>You spent a day out in the sun, exerting yourself, and probably didn't maintain your normal level of hydration. Consequently, you're mildly dehydrated (or, more properly, <em>hypohydrated</em>).</p>\n\n<p>Dehydration means a lower blood volume, which in turn means your heart has to beat faster to move the same volume of blood. Consequently, your heart rate is mildly elevated until you restore your normal hydration levels. </p>\n\n<h2>Summary of Findings <a href=\"http://ksi.uconn.edu/wp-content/uploads/sites/1222/2015/04/Heart-Rate-and-Hydration-Template_New-Logo.pdf\" rel=\"nofollow\">1</a></h2>\n\n<ul>\n<li>Scientific Definitions: Hypohydration is the steady state condition of decreased total body water. Dehydration is the process of losing body water (eg, during exercise).</li>\n<li>Body mass losses as small as 2% have been shown to result \nin an increase in cardiovascular strain and subsequently \ndecrease performance during exercise. Exercise in the heat \nfurther exacerbates cardiovascular strain, thus causing further\ndecrements in performance.</li>\n<li><strong>Results have shown that for every 1% decrease in body mass \nduring exercise in the heat there is an increase in heart \nrate of 3.29 beats/min. This equates to an increase in heart\nrate of 10 beats/min if an athlete is 3% dehydrated.</strong></li>\n<li>Exercise at a fixed and variable intensity has shown an \nincrease in heart rate of 3.55 and 1.39 beats/min respectively\nduring exercise in the heat.</li>\n</ul>\n", "score": 2 } ]

[ "cardiology", "injury", "cause-and-effect", "sun-burn", "forehead" ]

[ { "answer_id": 7378, "body": "<p>Treatment of Myoclonus</p>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899494/?tool=pmcentrez\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899494/?tool=pmcentrez</a></p>\n\n<p>Caviness JN. Treatment of Myoclonus. Neurotherapeutics. 2014;11(1):188-200. doi:10.1007/s13311-013-0216-3.</p>\n\n<p>This article offers a concise and fairly exhaustive approach to the treatment of Myoclonus of any cause. If you look at Figure 3 (the treatment algorithm), there is a specific pathway for the treatment of drug-induced (Symptomatic) Myoclonus. The actual treatment - and any drugs that might be used - depends on the classification:</p>\n\n<blockquote>\n <p>cortical;\n cortical–subcortical;\n subcortical–nonsegmental;\n segmental;\n peripheral.</p>\n</blockquote>\n\n<p>The ultimate treatment depends on this classification and is outlined in the article. The list of specific medications that may be used - anticonvulsants as well as other medications - is listed in the treatment algorithm.</p>\n\n<p>The medications include:</p>\n\n<blockquote>\n <p>Levetiracetam, Piracetam, and Related Compounds; Sodium Valproate; Clonazepam; Zonisamide, Primidone, and Miscellaneous Agents (these are not anti-seizure medications)</p>\n</blockquote>\n\n<p>Of these only a couple are specifically listed as add-on agents:</p>\n\n<blockquote>\n <p>Primidone and phenobarbital can be useful as add-on therapy </p>\n</blockquote>\n", "score": 3 } ]

[ "seizure" ]

[ { "answer_id": 9546, "body": "<p><em>There are several parts in your question.</em></p>\n\n<blockquote>\n <p>Does pain trigger epileptic seizure?</p>\n</blockquote>\n\n<p>To answer this question, it is essential to understand what is an epilepsy. <strong>An epilepsy arises when the normal pattern of neuronal activity is disturbed</strong> (ie the epileptogenic threshold is altered). This involves different cellular and molecular alterations: change in neuronal connections (lesions in the neuronal pathways), neuronal signalling (alteration in neurotransmitter availability or in neurotransmitter receptors), etc...</p>\n\n<p>In the literature, some describe <strong>internal factors</strong> (such as hormones, electrolytes, state of consciousness and body temperature) and <strong>external factors</strong> (sensory or electrical) that may reduce the epileptogenic threshold and hence trigger a seizure.</p>\n\n<p>One study, including more than 400 patients which were asked to describe the triggering factors of their last seizures, identified m<strong>issing medication (40.9%), emotional stress (31.3%), sleep deprivation (19.7%), fatigue (15.3%), missing meals (9.1%), fever (6.4%), and smoking (6.4%) as the most common triggering factors</strong>. However, <strong>pain was also reported as a possible triggering factors, altough less common compared to the above mentionned factors</strong>. Considering that pain is associated with different molecular (neurotransmitter concentration alteration) and cellular alterations in the brain, it is understandable that pain can be a trigger for seizure.</p>\n\n<p>Now to your second question</p>\n\n<blockquote>\n <p>I would not like to question if doctor on neurology ward was right\n that it was not epileptic seizure (I have not reason to don't believe\n her).</p>\n</blockquote>\n\n<p><strong>Loss of consciousness is not always due to a seizure.</strong> You could also have experienced a <strong>vasovagal syncope</strong> in response to the ongoing procedure (and the pain associated with it). Indeed, <strong>syncope is defined as a transient and self-terminating loss of consciousness (LOC) with rapid onset, short duration combined with spontaneous, prompt and complete recovery. Pain is a known triggering factor for vasovagal syncope (a subtype of reflex syncope).</strong> The fact that your EEG did not show any evidence for an epileptic seizure (and your CT did not find any structural anomaly which would trigger a seizure) further suggests a possible vasovagal syncope. <strong><em>Of course, this comment is only based on the description you provided and should not be taken for a \"final diagnosis\".</em></strong></p>\n\n<p><em>Sources:</em></p>\n\n<p>Epilepsy. Pubmed Health Library. <a href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023036/\" rel=\"nofollow\">https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0023036/</a></p>\n\n<p>Reflex Seizures and Reflex Epilepsies. Chapter 13. The Epilepsies: Seizures, Syndromes and Management. Panayiotopoulos CP.\nOxfordshire (UK): Bladon Medical Publishing; 2005.</p>\n\n<p>Balamurugan E et al. Perceived trigger factors of seizures in persons with epilepsy. Seizure. Volume 22, Issue 9, November 2013, Pages 743–747</p>\n\n<p>Aydin MA et al. Management and therapy of vasovagal syncope: A review. World Journal of Cardiology. 2010;2(10):308-315. doi:10.4330/wjc.v2.i10.308.</p>\n", "score": 4 } ]

[ "pain", "neurology", "seizure", "triggers", "epilepsy" ]

[ { "answer_id": 4625, "body": "<p>Blood vessels do pop or rupture at times, causing a nosebleed. </p>\n\n<p>So what exactly in the sick and stressed cause them to have more nosebleeds?</p>\n\n<p>In regards to the sick, <strong>medicines that cause you to bleed more easily, including aspirin and anticoagulants such as warfarin and heparin will tend to cause higher rates of nosebleeds.</strong> <a href=\"http://www.nhs.uk/Conditions/Nosebleed/Pages/Causes.aspx\" rel=\"nofollow\">(1)</a></p>\n\n<p>Now with regards to stress, there is debate <a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120295/\" rel=\"nofollow\">(2)</a>. A study published in 1977 found no correlation <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/339142\" rel=\"nofollow\">(3)</a>, but a more recent study in 2012 <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22694985\" rel=\"nofollow\">(4)</a> suggests that high blood pressure is associated with nosebleeds. If this is the case, <strong>researchers theorize that since high levels of stress cause high blood pressure and constrict blood vessels <a href=\"http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Stress-and-Blood-Pressure_UCM_301883_Article.jsp#.VrAi_XSxalx\" rel=\"nofollow\">(5)</a>, then it is possible for stress to cause these vessels in our nose to rupture.</strong></p>\n\n<p>These sources seem to indicate that both stress and certain medications can in some situations cause nosebleeds.</p>\n\n<p>Sources:</p>\n\n<ul>\n<li><p><a href=\"http://www.nhs.uk/Conditions/Nosebleed/Pages/Causes.aspx\" rel=\"nofollow\">http://www.nhs.uk/Conditions/Nosebleed/Pages/Causes.aspx</a> (1)</p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120295/\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1120295/</a> (2)</p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/339142\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/339142</a> (3)</p></li>\n<li><p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/22694985\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/22694985</a> (4)</p></li>\n<li><p><a href=\"http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Stress-and-Blood-Pressure_UCM_301883_Article.jsp#.VrAi_XSxalx\" rel=\"nofollow\">http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Stress-and-Blood-Pressure_UCM_301883_Article.jsp#.VrAi_XSxalx</a> (5)</p></li>\n</ul>\n", "score": 4 } ]

[ "blood", "lifestyle", "nose", "epistaxis--bloody-nose", "exertion" ]

[ { "answer_id": 5562, "body": "<p>We were taught in medical school that the single biggest contributor to hangovers is dehydration. The degree of dehydration is caused by the percent concentration of ETOH/ethanol which is a diuretic (i.e. it makes you take many trips to restroom.)</p>\n\n<p>Dehydration from drinking causes a drop in cerebral spinal fluid (CSF) pressure. This is why a hangover headache is worse when you sit up or stand up. Your brain has less fluid support and is almost \"dangling\" on its suspensory supports. (This is an overstatement.) </p>\n\n<p>Thus the effect of a hangover is almost purely correlated to the percent alcohol you are consuming rather than the class.</p>\n\n<p>At the risk of increasing drinking - this also suggests the number one way to <em>avoid</em> a hangover: fluid and salt. If you just drink water, your body cannot hold onto it. If you drink fluid with salt (i.e. gatorade, broth, or similar) - your headache will be substantially diminished because you will counteract the dehydration. </p>\n\n<p>That said - alcohol is also toxic to the brain and liver. That's why your liver can hurt after drinking. If we draw LFTs lab tests on you, your liver enzymes will actually be elevated! (Michael Crichton, the author of Jurassic Park actually did that when he was a medical student at Harvard. You can read about it in his book Travels.) The liver damage is why people get scarred cirrhotic livers. You actually lose brain neurons every time you drink. Unfortunately...that part of the damage is not reversed with Gatorade and may account for some of the headache.</p>\n", "score": 1 } ]

[ "alcohol", "liquids", "hangover-hungover", "drinks" ]

[ { "answer_id": 5379, "body": "<p>Scientists have found some perfumed products in the home can create unhealthy levels of <em>formaldehyde</em>, for example scented candles. In view of its widespread use, toxicity, and volatility, <em>formaldehyde</em> is a significant consideration for human health. </p>\n\n<p>In 2011, the US National Toxicology Program described <em>formaldehyde</em> as \"known to be a human carcinogen\".</p>\n\n<p><strong>An interesting article that talks a bit of it:</strong></p>\n\n<blockquote>\n <p>With the winter winds howling at the door, the thought of battening the hatches and lighting a scented candle is understandably appealing.</p>\n \n <p>But new research suggests scented candles could actually be far more harmful than previously thought, giving off potentially dangerous levels of the toxic substance <em>formaldehyde</em>.</p>\n \n <p>A study carried out by Professor Alastair Lewis of the National Centre for Atmospheric Science at the University of York found that an ingredient commonly used to give candles their scent mutates into <em>formaldehyde</em> upon contact with the air.</p>\n \n <p>The ingredient in question is limonene, which is used to give citric-scented candles their aroma. In its unaltered state limonene is considered so safe that it is used to flavour food, as well to give cleaning products and air fresheners a lemony scent.</p>\n \n <p>But limonene also reacts with naturally occurring ozone when released into the air, causing one in every two limonene molecules to mutate into formaldehyde.</p>\n \n <p>While it is already well known that limonene, which occurs naturally in plants, can degrade into formaldehyde, almost every test into its harmful impacts was carried out decades ago.</p>\n \n <p>Professor Lewis’ concerns are therefore two-fold. Firstly the concentrations of limonene he found in scented candles were up to 100 times higher than previously thought.</p>\n \n <p>Secondly homes now let so little energy and air escape that these high concentrations of formaldehyde linger longer and can cause long term harm.</p>\n \n <p>Speaking to the Telegraph he said: “The really surprising thing is just how high the concentrations of some fragrances are now in people’s homes…Fragrance chemicals now completely dominate the inside of most homes.”</p>\n \n <p>“The issue is we don’t really know what the consequences of long-term exposure to formaldehyde are. It is a chemical that is known to harm you long-term,” he added.</p>\n \n <p>Taken from <a href=\"http://www.telegraph.co.uk/news/health/news/12103003/Why-scented-candles-could-cause-cancer.html\" rel=\"nofollow\">Telegraph</a>.</p>\n</blockquote>\n", "score": 1 } ]

[ "cancer" ]

[ { "answer_id": 4760, "body": "<p>I'm going to approach this from a strictly physiological stance. With all of these diets available it can be very confusing. Ketogenic, Atkins, Paleo, etc.. The body uses glucose for energy. Many, many, many compounds we eat are complex and large. Our body utilizes each of these in a very efficient manner. </p>\n\n<p>Short Answer: YES! We have a \"starvation\" mode, but it's called gluconeogenesis. When we stop eating, we use glycogen (huge chains of linked glucose) for energy. When glycogen is depleted we begin to indiscriminately (situationally) using proteins and lipids for energy. There are many molecules that contain the secret ingredient (carbon) that can be manipulated by enzymes to create the ever-important six-ringed molecule we need to live. </p>\n\n<p>To be honest 1000-1500 is not really starving; depending on sex, activity level, BMR, etc. Depending on the makeup of those 1500 calories, the body will utilize the path of least resistance. If you take in ~600 calories from carbohydrates, you will use them. If you take in 100 calories from carbohydrates, you will use those and glycogen supplementation. </p>\n\n<p>There are signaling pathways in the body that are purposefully designed to ensure a constant, steady supply of glucose in our bloodstream. Our brain alone uses about ~120g of carbohydrate per day. As long as we have carbon molecules available, our body will take them and rearrange them to make \"fuel\". That's why you see people lose weight or muscle mass -- because the body will literally eat muscle tissue to survive. </p>\n", "score": 2 }, { "answer_id": 5420, "body": "<p>I found a pretty good article <a href=\"http://community.myfitnesspal.com/en/discussion/761810/the-starvation-mode-myth-again\" rel=\"nofollow\">here</a> that discusses starvation mode pretty intelligently and cites valid research. In short, yes, starvation mode exists, but it will not cause a person to gain weight, at least while being starved. However, once a person who has triggered their starvation reflex is allowed to eat normally and at will, they lose their sense of being satiated and not only gain their original weight back but put on much more. It takes several days of starvation (not just one or two) to trigger starvation mode. On average, people in the Minnesota study saw an average drop of metabolic rate of about 40%. This is why starvation diets are generally not recommended.</p>\n", "score": 1 }, { "answer_id": 5428, "body": "<p>Starvation/fasting does lead to physiological changes that recently are being investigated as an adjunct to chemotherapy for cancer control.</p>\n\n<blockquote>\n <p>The dietary recommendation for cancer patients receiving chemotherapy, as described by the American Cancer Society, is to increase calorie and protein intake. Yet, in simple organisms, mice, and humans, fasting--no calorie intake--induces a wide range of changes associated with cellular protection, which would be difficult to achieve even with a cocktail of potent drugs. In mammals, the protective effect of fasting is mediated, in part, by an over 50% reduction in glucose and insulin-like growth factor 1 (IGF-I) levels. Because proto-oncogenes function as key negative regulators of the protective changes induced by fasting, cells expressing oncogenes, and therefore the great majority of cancer cells, should not respond to the protective signals generated by fasting, promoting the differential protection (differential stress resistance) of normal and cancer cells. Preliminary reports indicate that fasting for up to 5 days followed by a normal diet, may also protect patients against chemotherapy without causing chronic weight loss. By contrast, the long-term 20 to 40% restriction in calorie intake (dietary restriction, DR), whose effects on cancer progression have been studied extensively for decades, requires weeks-months to be effective, causes much more modest changes in glucose and/or IGF-I levels, and promotes chronic weight loss in both rodents and humans. In this study, we review the basic as well as clinical studies on fasting, cellular protection and chemotherapy resistance, and compare them to those on DR and cancer treatment. Although additional pre-clinical and clinical studies are necessary, fasting has the potential to be translated into effective clinical interventions for the protection of patients and the improvement of therapeutic index.</p>\n</blockquote>\n\n<p><a href=\"http://www.ncbi.nlm.nih.gov/pubmed/21516129\" rel=\"nofollow\">http://www.ncbi.nlm.nih.gov/pubmed/21516129</a></p>\n", "score": 1 } ]

[ "nutrition", "fad-diet", "starvation", "malnutrition" ]

[ { "answer_id": 4770, "body": "<p>Motion sickness is a complicated process, and as you've noticed, different people are affected to different degrees.</p>\n\n<p>People can and do become habituated to vertigo-inducing motion, but it takes a long time. Similarly, the <em>potential</em> benefit you might gain from any exercises you do (they would be similar to those one does when experiencing benign paroxysmal positional vertigo) would take weeks to acquire.</p>\n\n<p>There is nothing you can do in this short time span to naturally decrease the probability of having a recurrence. Your best hope is in getting a good drug to prevent it.</p>\n\n<p>Astronauts often experience motion sickness, and the reference I used is from space aviation literature (it is available in full online but as a PDF), and is a pretty thorough treatment of the condition.</p>\n\n<p>There are a few things which (in addition to drugs) might help:</p>\n\n<blockquote>\n <ul>\n <li>Decrease the motion of your eyes as much as feasible (no reading, people watching, etc.) Instead, look at the horizon. This is because a disparity between brain signals from your eyes and those from your vestibular system often do not correlate well, which is one of the proposed mechanisms of motion sickness.</li>\n <li>If possible, stay outside, or at least where you're getting some fresh air.</li>\n <li>Try to find a spot mid-ship (where there is the least rolling/pitching) and sit, don't stand.</li>\n <li>Try to avoid heavy/greasy meals before travelling, and to avoid strong odors while traveling.</li>\n </ul>\n</blockquote>\n\n<p>Scopolamine is one of the most effective anti-motion sickness drugs available. Note that a transdermal scopolamine patch doesn't hit it's peak effect until 6-8 hours after it's been applied. Scopolamine isn't for everyone. Ask a pharmacist for drug information if it's available without a prescription where you are.</p>\n\n<p>If you opt for an antihistamine, dimenhydrinate, cyclizine, meclozine, and promethazine are the antihistamines most widely used for prophylaxis and treatment of motion sickness. Since you already tried the dimenhydrinate, you might try a different one. Please note, however, that they should be taken long before the voyage starts to be effective. This might be why yours didn't seem to last. One usually needs to build up to something a bit closer to a steady state.</p>\n\n<p>Cinnarizine is very popular in Europe but it is not available in the United States.</p>\n\n<p>A very small study found ginger (a natural anti-emetic) helpful, but this has been disputed.</p>\n\n<p>This is a presentation of some of the available literature. You need to discuss your specifics (age, medical conditions, etc.) with a doctor or pharmacist.</p>\n\n<p>Good luck.</p>\n\n<p>_{Shupak A, Gordon CR. Motion sickness: advances in pathogenesis, prediction, prevention, and treatment. Aviat Space Environ Med 2006; 77: 1213–1223}<br>\n_{<a href=\"http://ajpgi.physiology.org/content/284/3/G481.short\">Effects of ginger on motion sickness and gastric slow-wave dysrhythmias induced by circular vection</a>}<br>\n_{<a href=\"http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD002851.pub4/abstract\">Scopolamine (hyoscine) for preventing and treating motion sickness</a>}</p>\n", "score": 5 } ]

[ "prevention", "travel", "motion-sickness", "anti-nausea" ]

[ { "answer_id": 12964, "body": "<blockquote>\n <p>Does this mean my previous psychiatrist can share information with my current psychiatrist?</p>\n</blockquote>\n\n<p>Yes.^1,2 </p>\n\n<p>There is an exception for 'psychotherapy notes', a term with a very specific meaning³ under HIPAA:</p>\n\n<blockquote>\n <p><em>Psychotherapy notes</em> means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual's medical record. Psychotherapy notes <strong>excludes</strong> medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date. <em>(emphasis added)</em></p>\n</blockquote>\n\n<p>If you had psychotherapy sessions with your previous psychiatrist, <em>and</em> he or she kept psychotherapy notes of each session, which are stored separately from other treatment records, you would need to sign a consent form to permit your previous psychiatrist to send copies of those psychotherapy notes to your new psychiatrist. </p>\n\n<h3>Footnotes</h3>\n\n<ol>\n<li><p><a href=\"https://www.gpo.gov/fdsys/pkg/CFR-2003-title45-vol1/xml/CFR-2003-title45-vol1-sec164-506.xml\" rel=\"nofollow noreferrer\">Uses and disclosures to carry out treatment, payment, or health care operations, C.F.R. § 164.506 (2017)</a>.</p></li>\n<li><p>Office for Civil Rights, United States Department of Health and Human Services, <em>Does a physician need a patient's written authorization to send a copy of the patient's medical record to a specialist or other health care provider who will treat the patient?</em>, <a href=\"https://www.hhs.gov/hipaa/for-professionals/faq/271/does-a-physician-need-written-authorization-to-send-medical-records-to-a-specialist/index.html\" rel=\"nofollow noreferrer\">https://www.hhs.gov/hipaa/for-professionals/faq/271/does-a-physician-need-written-authorization-to-send-medical-records-to-a-specialist/index.html</a>, last reviewed 26 Jul 2013, accessed 14 Jul 2017.</p></li>\n<li><p><a href=\"https://www.ecfr.gov/cgi-bin/retrieveECFR?gp=&amp;SID=bc8a6a67e9e36fd0fa15c0de48d34f78&amp;mc=true&amp;n=pt45.1.164&amp;r=PART&amp;ty=HTML#se45.1.164_1501\" rel=\"nofollow noreferrer\">Definitions, C.F.R. § 164.501 (2017)</a>.</p></li>\n</ol>\n", "score": 3 } ]

[ "mental-health", "treatment", "legal", "medical-ethics" ]

[ { "answer_id": 4820, "body": "<p>Although a root canal removes the pulp from the tooth (and the nerve along with it), that doesn't make the tooth immune to infection and the resulting pain. If the tooth or crown is broken or cracked, that can provide a pathway for bacteria to reinfect the tissues beneath and surrounding the tooth, as shown in <a href=\"http://www.aae.org/patients/treatments-and-procedures/endodontic-retreatment-explained.aspx\" rel=\"nofollow noreferrer\">the image below</a>:</p>\n\n<p><a href=\"https://i.stack.imgur.com/QaSB9.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/QaSB9.jpg\" alt=\"Reinfected root canal\"></a></p>\n\n<p>As explained at the link:</p>\n\n<blockquote>\n <p>New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.</p>\n \n <p>A loose, cracked or broken crown or filling can expose the tooth to new infection.</p>\n \n <p>A tooth sustains a fracture.</p>\n</blockquote>\n\n<p>As you might imagine, the new infection at the base of the tooth could cause pain since the nerves surrounding the tooth remain intact. Obviously, only a dentist or endodontist can tell you if this is what happened and how it should be treated. Loss of the tooth is possible, especially if you delay care.</p>\n", "score": 4 } ]

[ "dentistry", "wisdom-teeth" ]

[ { "answer_id": 4829, "body": "<p><strong><em>\"How to know if (or when) I fall asleep, and not merely just lying there doing nothing?\"</em></strong></p>\n\n<p><a href=\"http://www.end-your-sleep-deprivation.com/retrograde-amnesia.html\">Sleep Retrograde Amnesia</a>:</p>\n\n<blockquote>\n <p>Retrograde amnesia refers to the loss of memory for things preceding a\n certain event. When we talk about retrograde amnesia in the context of\n sleep, this event is sleep onset.</p>\n</blockquote>\n\n<p>You not remembering has to do with your short term memory not working during sleep. </p>\n\n<ul>\n<li><p>You could video tape yourself sleeping and this would show you when you appeared to drift off to sleep.</p></li>\n<li><p>You could also monitor your pulse and Blood Pressure to see when you went to sleep. Blood pressure and <a href=\"http://www.livestrong.com/article/105256-normal-heart-rate-sleeping/\">pulse are generally lower</a> when you sleep so if you monitor your pulse when you are asleep you can possibly approximate the time you fell asleep. </p></li>\n<li><p>You could try having motion sensor lights and when you stop moving they shut off. Maybe you can remember them shutting off, maybe not.</p></li>\n</ul>\n\n<hr>\n\n<p><em>If you think you have a sleeping disorder then you should consult your doctor, she/he may order a Sleep study.</em> </p>\n\n<p><a href=\"http://www.mayoclinic.org/tests-procedures/polysomnography/basics/definition/prc-20013229\">Polysomnography (sleep study)</a></p>\n\n<blockquote>\n <p>used to diagnose sleep disorders. Polysomnography records your brain\n waves, the oxygen level in your blood, heart rate and breathing, as\n well as eye and leg movements during the study.......usually is done\n at a sleep disorders unit within a hospital or at a sleep center.\n You'll be asked to come to the sleep center in the evening for\n polysomnography so that the test can record your nighttime sleep\n patterns. Polysomnography is occasionally done during the day to\n accommodate shift workers who habitually sleep during the day.</p>\n</blockquote>\n", "score": 6 }, { "answer_id": 4843, "body": "<p>Modern smartphone apps offer this information. A smartphone has a gyroscope built in, and when you lay it on the mattress close to your body, it picks up tiny movements. As you fall asleep, your musculature relaxes, and the app knows how to distinguish the movements of a person in deep sleep, light sleep, and lying awake. It provides you with a record of your sleep cycles for the night. </p>\n\n<p>It is probably not perfectly accurate, but I find it quite good from personal experience. It certainly can distinguish between times when I lay awake, trying to fall asleep (and not noticeably moving) and times when I am really asleep. I can't say how good it is for hypnogogic states, and it can be fooled somewhat if you are concentrating on not moving while awake (e.g. if you are doing a muscle relaxation exercise or meditating). But for normal sleep, it gives you a nice record. </p>\n\n<p>I have no peer reviewed sources on this, so will have to give you a commercial link: <a href=\"https://play.google.com/store/apps/details?id=com.urbandroid.sleep&amp;hl=en\" rel=\"nofollow\">Sleep as android</a> is the app I use, but AFAIK there are several per platform. If you have a fitness tracker such as Fitbit, it might offer a similar functionality - there are headbands specifically for sleeping, probably more accurate than a smartphone (but also more intrusive). </p>\n", "score": 3 } ]

[ "sleep", "time-of-day", "waking-up", "naps" ]

[ { "answer_id": 4990, "body": "<p>The quick answer is <strong>no</strong>, if you want to avoid crowding of the bottom teeth in the futur.</p>\n\n<p>The reason is that the mandible (jaw) is constantly being remodelled, as shown on the picture bellow. \n<a href=\"https://i.stack.imgur.com/tCW71.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/tCW71.jpg\" alt=\"Schematic representation of the remodeling of the jaw\"></a></p>\n\n<p>Notice how <strong>near the front teeth, who are in a kind of half-circle, the reformation is inward</strong>. The diameter of the arch (half-circle) is reduced throughout life, and therefore the teeth are forced to get crowded to fit in the reduced space. This can even happen to older people who did not get an orthodontic treatment! The top retainer is there to prevent the top teeth from moving back into their original location. Therefore the fact that you wear the top retainer makes absolutely no difference for the bottom teeth.</p>\n\n<hr>\n\n<p>The second aspect of the question is concerning the health of the gums and periodontal tissues. If you are unable to perform dental hygiene routinely, you should speak to your Orthodontist, and make it known that it is a problem for you.</p>\n\n<p>My orthodontist uses a different design for the bottom lingual wire which only bonds to the canines (see picture bellow), and therefore I can more easily pass the floss. </p>\n\n<p><a href=\"https://i.stack.imgur.com/4FnNV.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/4FnNV.jpg\" alt=\"Hygienic Lower fixed retainer\"></a></p>\n\n<hr>\n\n<p>If you are willing to read some more, a more in-deapth analysis of the concepts can be obtained on the 3rd link in my references.</p>\n\n<hr>\n\n<p>Sources:</p>\n\n<ul>\n<li>(First image) <a href=\"http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S2176-94512014000300026\" rel=\"nofollow noreferrer\">http://www.scielo.br/scielo.php?script=sci_arttext&amp;pid=S2176-94512014000300026</a></li>\n<li>(Second image and information) <a href=\"https://www.orthodontisteenligne.com/en/patient-info/orthodontic-retention/\" rel=\"nofollow noreferrer\">https://www.orthodontisteenligne.com/en/patient-info/orthodontic-retention/</a></li>\n<li>(Explaination of Late Mandibular Incisor Crowding) <a href=\"http://www.braceplace.com/assets/docs/Newsletter_23.pdf\" rel=\"nofollow noreferrer\">http://www.braceplace.com/assets/docs/Newsletter_23.pdf</a></li>\n</ul>\n", "score": 1 } ]

[ "floss-flossing", "gingivitis", "retainers", "teeth-alignment", "dental-braces" ]

[ { "answer_id": 4971, "body": "<p>1) Depending on the location of the cavities, <strong>the fillings could impact your Invisalign treatment</strong>, especially if you have many Invisalign molds that have already been pre-fabricated. This is due to the fact that Invisalign wraps itself tightly around the surface of individual teeth to cause their displacement. Any change of tooth morphology (\"Shape\") could have an impact on how well the Invisalign sits on the teeth and compromise its efficiency. </p>\n\n<p>2) Depending on the depth of the cavity, <strong>the dentist could decide to monitor the cavity instead of immediately filling it</strong>. If dental hygiene is improved, the cavity could stop growing or in some cases the cavity can remineralize. <strong>On the other hand, if it is too deep, it is more urgent to fix the cavity than doing the Invisalign treatment</strong>. Keep in mind that if a tooth is damaged, there is no sense in moving it around in the first place. </p>\n\n<p>To conclude: <strong>Dental Hygene is crucial during ortho treatment</strong>, since the ortho appliances, including Invisalign can Harbor food debris and bacteria, as well as hamper the cleaning action of saliva, causing an increase in the likelihood of getting cavities. <strong>Communication between the orthodontist, the dentist and the patient (you!) is very important</strong>. Everyone has to be aware of each other's wants, needs and actions. If you don't let your dentist know you are getting an orthodontic treatment or you don't tell your orthodontist that you had fillings done, there is a possibility that they won't become aware of a problem which could result in additional fees, and delays in the treatment plans. </p>\n\n<p>Sources:</p>\n\n<ul>\n<li>My field of study</li>\n<li><a href=\"http://www.painfreedentistry.uk.com/index.php?option=com_content&amp;view=article&amp;id=126&amp;Itemid=13\" rel=\"noreferrer\">http://www.painfreedentistry.uk.com/index.php?option=com_content&amp;view=article&amp;id=126&amp;Itemid=13</a></li>\n</ul>\n", "score": 5 } ]

[ "dentistry" ]

[ { "answer_id": 5004, "body": "<p>The article <a href=\"https://www.researchgate.net/profile/Karan_Saluja/publication/246757334_Importance_of_Weak_ABO_Subgroups/links/53d549300cf2a7fbb2ea57da.pdf\" rel=\"nofollow\">The importance of weak ABO subgroups</a> has a section on this, in addition to general information on what weak subgroups are. All quotes in this answer areas from that study. </p>\n\n<p><em>Weak blood types</em></p>\n\n<p>Weak blood types can be caused by a person having a mutation that leads to not expressing the type A or B antibodies as much, or by mutations in the genes coding for these that mean the antibodies they do produce react less when brought into contact with type A and B antigens for testing. </p>\n\n<blockquote>\n <p>These weak phenotypes, in majority of the\n cases result from the expression of an alternate weak allele present at the ABO loci.</p>\n</blockquote>\n\n<p>Weak type A and B are different, and there are also <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/8036794\" rel=\"nofollow\">different weak subtypes for each</a>. For example, here is a case study of a patient with weak type A blood (much of the research is on that, as it is more common than weak type B): <a href=\"http://www.ncbi.nlm.nih.gov/pubmed/16533287\" rel=\"nofollow\">A weak blood group A phenotype caused by a translation-initiator mutation in the ABO gene.</a></p>\n\n<p><em>Blood donors</em></p>\n\n<p>Basically, weak type A or B blood donors's blood may be mistyped as being type O. If it is given to recipients with blood type O, these patients may experience blood agglutination which can be dangerous. </p>\n\n<blockquote>\n <p>Identification of these subgroups is important because these donors may be mistyped as group O individuals. Wrongly grouped as O, weak subgroups of A or B red cells (if transfused to O group individuals) can show decreased survival. </p>\n</blockquote>\n\n<p>This does not concern your case, as it is about weak type A, but I'm including this for completeness sake: One of the weak type A groups, A_x is special, in that people with this blood type should not donate for people with type A blood, as they actually have antibodies against the dominant type A antigen. </p>\n\n<blockquote>\n <p>Similarly since Ax individuals almost always have anti-A1 antibodies in their serum. If clinically significant, they can lead to fatal transfusion reactions on transfusing their whole blood or plasma to group A individuals. </p>\n</blockquote>\n\n<p><em>Blood recipients</em></p>\n\n<p>None of the sources I could find went into much detail what this meant for receiving blood transfusions. None mentioned not being able to receive type A or B blood if the patient is a weak type A or B. </p>\n\n<p>Being mistyped as O when receiving blood is not going to lead to any major problems - however, it means the person will only receive type O blood and not type A or B blood. In situations with a donor blood shortage this might be a disadvantage. </p>\n\n<p>The researchers of the study told the donors, so they would know that their blood could not be given to a type O patient. </p>\n\n<blockquote>\n <p>All the donors were personally informed about their group and were given a special blood group card clarifying their donor as well as recipient status. </p>\n</blockquote>\n\n<p>You might want to give your child something similar to carry around with them. Maybe the doctor/lab that identified the weak blood type has something suiting. </p>\n", "score": 4 } ]

[ "blood", "blood-donation", "blood-type" ]

[ { "answer_id": 5031, "body": "<p>Iodine is absolutely an <a href=\"https://en.wikipedia.org/wiki/Essential_element\" rel=\"noreferrer\">essential mineral</a>, and is required for proper functioning of your body. It is a component of the <a href=\"https://en.wikipedia.org/wiki/Thyroid_hormone\" rel=\"noreferrer\">thyroid hormone</a> <a href=\"https://en.wikipedia.org/wiki/Triiodothyronine\" rel=\"noreferrer\">triiodothyronine</a> (also known as T3) and its precursor form T4 (thyroxine). This hormone is involved in quite a few processes in the body, and acts on nearly every cell in it. </p>\n\n<p>A deficit of iodine can cause a number of diseases, including <a href=\"https://en.wikipedia.org/wiki/Goitre\" rel=\"noreferrer\">goiter</a> (swelling of the thyroid gland in the neck), <a href=\"https://en.wikipedia.org/wiki/Hypothyroidism\" rel=\"noreferrer\">hypothyroidism</a> (can cause increased sensitivity to cold, fatigue, weight gain, constipation, and depression), <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/16642482\" rel=\"noreferrer\">gastric cancer</a>, and <a href=\"https://en.wikipedia.org/wiki/Cretinism\" rel=\"noreferrer\">cretinism</a> (presents as severely stunted development and growth, both physical and mental, but unlikely to affect a healthy adult).</p>\n\n<p>Now, iodized salt is not the only source of iodine in one's food. It can also be found in fish, shellfish, and kelp products, milk and eggs from iodine-sufficient farm animals, and plants grown on iodine-rish soil. The <a href=\"http://iom.nationalacademies.org/~/media/Files/Activity%20Files/Nutrition/DRIs/DRI_Elements.pdf\" rel=\"noreferrer\">recommended intake</a> of iodine varies between 150 &micro;g per day for healthy adults to 250-290 &micro;g/day for pregnant and lactating women, respectively. Children require somewhat lower amounts. On the other hand, the recommended upper limit is around 1100 &micro;g (1.1 mg) per day for adults. </p>\n\n<p>A quarter teaspoon (1.5g) of the iodized sea salt in my cabinet provides \"45%\" of the recommended daily value of iodine (the label doesn't provide mass). Assuming they're using the 150 &micro;g value, that's 67.5 &micro;g iodine in a serving that provides one quarter of your sodium for the day. The table in <a href=\"https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/#h3\" rel=\"noreferrer\">this section</a> of the Health Professional Fact Sheet for iodine from the NIH's Office of Dietary Supplements provides some values for iodine levels in various other food sources:</p>\n\n<p><a href=\"https://i.stack.imgur.com/wlDvz.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/wlDvz.png\" alt=\"iodine levels\"></a></p>\n\n<p>So, bottom line, you are likely getting sufficient iodine in your daily diet, even without using iodized salt. Now, I don't want to discourage the use of it at all, as there is absolutely nothing wrong with it from a health perspective (except from overconsumption, but that applies to most everything). Not everyone (especially in America, the UK, and some other countries) eat very healthy diets, but since the use of iodized salt in restaurants and for food manufacturers is required by law, Westerners are not likely to be under-iodinated.</p>\n\n<p>Of course, the best way to tell is to go to your primary health care provider, explain your situation, and ask if they'd be willing to order a thyroid function blood test. It looks at the levels of thyroid stimulating hormone (TSH, from the pituitary gland) along with thyroid hormone itself. However, as long as you aren't experiencing any of the symptoms of hypothyroidism and don't have a goiter, you're probably OK.</p>\n", "score": 8 } ]

[ "nutrition", "micronutrients", "salt", "minerals" ]