Saturday, November 5, 2016

LSD helps to treat alcoholism


LSD blotter
                                                           DEA/Science Faction/Corbis




Nature | News

LSD helps to treat alcoholism

Retrospective analysis shows hallucinogenic drug helped problem drinkers.



An analysis of old studies suggests LSD may have a role to play in treating alcoholism.

The powerful hallucinogen LSD (lysergic acid diethylamide) has potential as a treatment for alcoholism, according to a retrospective analysis of studies published in the late 1960s and early 1970s.

The study1, by neuroscientist Teri Krebs and clinical psychologist Pål-Ørjan Johansen of the Norwegian University of Science and Technology in Trondheim, is the first-ever quantitative meta-analysis of LSD–alcoholism clinical trials. The researchers sifted through thousands of records to collect data from randomized, double-blind trials that compared one dose of LSD to a placebo.

Of 536 participants in six trials, 59% of people receiving LSD reported lower levels of alcohol misuse, compared to 38% of people who received a placebo. “We were surprised that the effect was so clear and consistent,” says Krebs. She says that the problem with most studies done at that time was that there were too few participants, which limited statistical power. “But when you combine the data in a meta-analysis, we have more than 500 patients and there is definitely an effect,” she says. In general, the reported benefits lasted three to six months. Their findings are published today in the Journal of Psychopharmacology.

Psychedelics were promoted by psychiatrists in the 1950s as having a range of medical uses — to treat conditions such as schizophrenia, for example — before political pressures in the United States and elsewhere largely ended the work. “Alcoholism was considered one of the most promising clinical applications for LSD,” says Johansen. Alcoholics Anonymous co-founder Bill Wilson is said to have espoused the benefits of LSD in the book Pass It On: The Story of Bill Wilson and How the AA Message Reached the World.

In the last decade or so, however, a new generation of researchers have been interested in harnessing the therapeutic benefits of illicit drugs — such as 3,4-methylenedioxymethamphetamine (MDMA or ecstasy) for post-traumatic stress disorder, ayahuasca for drug and alcohol dependency, and psilocybin, the active ingredient in hallucinogenic mushrooms, for smoking cessation.

The snow globe of perception?

How psychedelics exert such effects, especially after a single dose, remains unclear. LSD and its chemical cousins share structural similarities with the neurotransmitter serotonin, which is linked to many aspects of mood, memory and pleasure. These psychedelics also bind the same receptor sites in the brain as serotonin, but there the similarity may end — studies have shown that the hallucinogens elicit chemical cascades different from other compounds that bind at the same receptor2. To complicate matters further, LSD also acts at other receptors3.

For the moment, studying human behavioural responses rather than brain chemistry may be more helpful in understanding how the drugs work. Robin Carhart-Harris, a psychopharmacologist at Imperial College London who has researched how psilocybin could treat depression, says that psychedelics must work at both biological and psychological levels. “Psychedelics probably work in addiction by making the brain function more chaotically for a period — a bit like shaking up a snow globe — weakening reinforced brain connections and dynamics,” he says.

Roland Griffiths, a behavioural biologist at the Johns Hopkins University School of Medicine in Baltimore, Maryland, is investigating the influence of psilocybin on smoking cessation, and says that psychedelics sometimes give rise to distinctive, insightful experiences that can produce enduring positive changes in attitude, mood and behaviour.

“This is impressive and important work,” says Matthew Johnson, a psychiatrist also at Johns Hopkins University who is now running a small trial looking at the effectiveness of psilocybin to treat nicotine addiction. “Although this meta-analysis does not replace the need to test the approach in new, well-designed and rigorous clinical trials, it puts some more muscle behind the interpretation that the older literature shows hints that psychedelic therapy might really help addiction.”

However, Ken Checinski, a consultant addiction psychiatrist and independent researcher based in London, says that although the results are exciting, no pharmacological treatment should be seen as a magic bullet and that modern therapeutic techniques have improved. “The included LSD trials pre-date the use of psychological techniques such as motivational interviewing and cognitive behaviour therapy,” he says.
Nature
doi:10.1038/nature.2012.10200

References

  1. Krebs, T. S. & Johansen, P-O. J. Psychopharmacol. http://dx.doi.org/10.1177/0269881112439253 (2012).
  2. González-Maeso, J. et al. J. Neurosci. 23, 88368843 (2003).
  3. Halberstadt, A. L. & Geyer, M. A. Neuropharmacology 61, 364381 (2011).








Aircast Cryo/Cuff Knee with IC Cooler





Aircast Cryo/Cuff Knee with IC Cooler



Aircast Cryo/Cuff Knee with IC Cooler

SKU: OC-4750-IC
Manufacturer: Aircast
 

The IC Cooler includes an integrated pneumatic pump inside the cooler lid!

The Aircast IC Cooler enhances the Cryo/Cuff with two unique functions: continuous cold and pulsating pressure. Continuous cold eliminates the need for manual water recycling by utilizing an electronic pump to exchange warm water for cold. Pulsating pressure resulting from the automatic exchange of water provides comfort and therapeutic benefits of intermittent compression.

Knee Cryo/Cuff 
The Aircast Cryo/Cuff combines focal compression with cold to provide optimal control of swelling, edema, hematoma, hemarthrosis, and pain. Simplicity of design and ease of operation makes it ideal for the ER, post-op, training room and home.

Knee
Leg circumference 6" above the patella / tour de la jambe 6" au-dessus de la rotule
Small / Petit
10"-19" (24-48cm)
Med / Moyen
18"-23" (46-58cm)
Large / Grand
20"-31" (51-79cm)





https://www.orthocanada.com/en/aircast-cryocuff-knee-with-ic-cooler



Exercises for Arthritis of the Knee

Exercises for Arthritis of the Knee

Last reviewed:

Arthritis is a condition where the joints become swollen, hot, and often painful. One joint that is commonly affected by arthritis is the knee, the largest joint in the body.
 
One form of arthritis is osteoarthritis (OA). With OA, the hard tissue that covers the ends of the bones in a joint begins to break down.

Even with medications, the knee pain caused by OA can greatly impact on daily life. However, exercise is another way that people with arthritis of the knee can reduce pain.

Older adults doing tai chi.
  Exercise can reduce knee pain caused by arthritis while also improving motion and flexibility.


Contents of this article:
  1. Arthritis of the knee and exercise
  2. Exercises for building knee strength
  3. Exercises to improve knee flexibility
  4. Exercises to increase stamina

Arthritis of the knee and exercise

According to the Centers for Disease Control and Prevention (CDC), 52.5 million Americans over the age of 18 have been diagnosed with arthritis. Around 49.7 percent of adults aged 65 and older and 30.3 percent of people between 45 and 64 suffer from this condition.


There are two main types of arthritis that can affect knees. The most common type of arthritis is OA. The other is rheumatoid arthritis (RA) which affects around 1.5 million Americans. Left untreated, RA may destroy affected joints over time.

Luckily, there are ways to ease the effects of knee arthritis. By regularly practicing these exercises, people can reduce knee pain, improve motion, decrease stiffness, and increase flexibility.
People with arthritis should always consult a physician before beginning any exercise routine.

In addition to a doctor's recommendations, there are important things to consider:
  • Start slowly. It is important to proceed slowly. People with arthritis should be highly attentive to their body's signals and stop if they experience any pain.
  • Incorporate movement into daily life. People should try to keep joints limber by adding movement into their overall lifestyle. They should not just set aside a specific block of time for rigorous exercise while being inactive the rest of the time.
This list is compiled with that goal in mind. It includes a variety of movements that can be practiced at home or work, while standing, seated, and even lying down.

As people get used to the exercises and discover which ones work best for them, they should try adding them into daily activities. Many of these activities can be carried out during household chores or while sitting at a desk.

Any movement practice for knee pain caused by arthritis should be low-impact and easy to perform.
Each of these exercises will help with building strength, improving flexibility, or increasing stamina. This list also includes which muscles are targeted and any precautions to keep in mind.

Exercises for building knee strength

1. Leg lifts (standing)

Targets: Hips and glutes (buttocks).
Purpose: Leg lifts are an important leg exercise to improve stability, balance, and strength, reducing the impact on the knees.
Steps:
  • Stand against a wall
  • Raise a leg to the side without rotating toe to the side; keep toe pointing forward or slightly in
  • Avoid leaning to stationary side
  • Lower leg down
  • Repeat 15-20 times on each side

2. Sit and stand (seated and standing)

Targets: Quadriceps (front of thigh) and glutes.
Purpose: This repetitive motion is central to improving the range of knee movement and overall leg strength. Over time, it will become easier to stand up pain-free in everyday life.
Steps:
  • Sit straight in a chair with feet flat on floor
  • Cross arms over chest
  • Stand straight up slowly
  • Slowly return to seated
  • Repeat for 1 minute

3. Kick-backs (standing)

Targets: Hamstrings (back of thigh).
Purpose: This exercise is great for strengthening leg muscles and reducing knee stiffness.
Steps:
  • Stand up straight
  • Lift a foot off the floor and bend the knee, bringing the heel toward the buttocks
  • Hold for a few seconds, then lower down
  • Knees should be aligned and posture straight
  • Repeat 10-25 times, and repeat a few times per day

4. The "clam" (lying down)

Targets: Glutes.
Purpose: Knee strain is often at least partially due to weak glutes, resulting in too much shock being absorbed by the knee joint. Strengthening the buttocks leads to a reduced impact on knees.
Steps:
  • Lie down on side
  • Bend hips and knees to 90 degrees with shoulders, hips, and feet aligned
  • Keep feet together
  • Lift top knee up as far as possible, then slowly lower it
  • Hold for 3-5 seconds and repeat 10-25 times, twice daily
  • Repeat on both sides
If lying exercises are too difficult or painful, people can still work their glutes by doing seated buttock clenches or backward leg lifts.

Exercises to improve knee flexibility

5. Quadriceps stretch (lying down)

Targets: Quadriceps.
Purpose: To improve the flexibility of the quadriceps, and the range of motion for the knee.
Steps:
  • Lie down on stomach
  • Place right forearm in front for support
  • Bend left knee and grab ankle or shin with left hand
  • Gently lift knee off floor until feeling slight stretch
  • Hold for a few seconds, repeating alternative sides a few times
  • Switch sides

6. Hamstrings stretch (lying down)

A physiotherapist stretches a woman's leg.

                                                      
                                             Stretching the hamstring 
can help improve a knee's range of motion.

Targets: Hamstrings.
Purpose: To improve the flexibility of the hamstrings, improving range of motion of the knee.
Steps:
  • Lie down on back with legs outstretched
  • Bend right knee and grab the back of thigh with both hands
  • Gently pull the leg toward the chest
  • Relax arms so knee is pointed straight up
  • Straighten this leg toward the sky, or as much as possible
  • Bend knee again, then outstretch it once more
  • Repeat on both legs for a few times each

7. Leg cross (seated)

Targets: Whole leg, especially quadriceps.
Purpose: To improve the range of motion of knees as well as strengthen every muscle surrounding the knees.
Steps:
  • Cross ankles over each other while contracting the thighs
  • Hold to 10-30 seconds
  • Switch sides, and do three to four sets per side
  • Alternatively, repeat the same exercise with legs outstretched
This movement is great "hidden" exercise that can be done anywhere, even at the office. It also improves posture.

Exercises to increase stamina

8. Elliptical training

A person using a recumbent bicycle.

Recumbent bicycles put less weight and strain on the knees than traditional bicycles.

Targets: Arms and legs.

Purpose: A low-impact cardiovascular exercise preferable to running or jogging for those with knee pain or weak knees.

The exercise uses a device called an elliptical trainer, also known as a cross trainer, that copies the movement of walking, running, and climbing.

9. Recumbent cycling

Targets: A low-impact cardiovascular exercise targeting the whole leg.

Purpose: Cycling is usually considered a lower-impact exercise than walking or running. However, cycling on hilly terrain or with incorrect form can put great strain on knees.

A recumbent bike positions the rider in a lying-down position. Doing so reduces the weight and strain on knees. It also decreases the risk of pedaling with the knees pointing outwards, which can be harmful to the joints over time.

10. Swimming

Targets: A low-impact cardiovascular exercise targeting the whole body.
Purpose: Swimming is a great form of exercise for people of any age. Many people suffering from arthritis find swimming to be a comfortable, meditative routine that's easy on all joints, especially the knees.
If swimming is too difficult, many of its benefits can also be gained in slower, standing water aerobic exercises performed in shallow water.

Summary

Even after practicing these movements for a while, people should always be sure to pay attention to changes in pain. Training regimes can be changed accordingly or stopped altogether. 

It is important for people with arthritis of the knee to keep their doctor updated on what they're doing.

People with arthritis of the knee should try to lead an overall healthy lifestyle, make regular visits to their doctor, and continue taking any prescribed medications.

Practicing these exercises may also reduce the harmful effects of knee arthritis.


 

MLA
Wu, Brian. "10 Exercises for Arthritis of the Knee." Medical News Today. MediLexicon, Intl., 23 Jun. 2016. Web.
4 Jul. 2016.

APA
Wu, B. (2016, June 23). "10 Exercises for Arthritis of the Knee." Medical News Today. Retrieved from
.

Please note: If no author information is provided, the source is cited instead.

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Saddle Pulmonary Embolism

 Vitamin K injections act as blood clotting agents and an antidote to only warfarin.

Warfarin is an older blood thinner but the only one that can be counteracted with an antidote like vitamin K... the newer blood thinners can get you in real trouble, if you start bleeding.   

DVT and Alcohol - WebMD

Dec 12, 2015 - Alcohol can act as a blood thinner. And a researcher in Norway found studies that show the more you drink, the lower your blood clot risk.

 
 
RISK:

Being inactive for long periods. This can happen when you have to stay in bed after surgery or a serious illness, or when you sit for a long time on a flight or car trip.

Recent surgery that involved the legs, hips, belly, or brain.

.......................................................................................
 

"A blood clot is a mass of blood that changes from liquid to a gel-like or semisolid state." 

When a clot forms inside one of your veins it won’t always dissolve on its own. This can be a very dangerous and even life-threatening situation.

 Early signs may be noticeable in your legs or arms including swelling, pain, or tenderness.

Deep vein thrombosis (DVT) is a clot that occurs in one of the major veins deep inside your body.

It’s most common for this to happen in one of your legs, but it can also happen in your arms, pelvis, lungs, or even your brain. 

An immobile blood clot generally won’t harm you, but there is the chance that it could move and become dangerous. 

If a blood clot breaks free and travels through your veins to your heart and lungs, it can get stuck and prevent blood flow.

When it travels to your lungs, it’s called a pulmonary embolism (PE), which is a medical emergency."
.....................................................
     

Image result for horse spine anatomy

Abstract

BACKGROUND:

Saddle pulmonary embolism represents a large clot and a risk for sudden hemodynamic collapse. 

  However, the clinical presentation and outcomes vary widely. On the basis of the findings of right heart dysfunction on echocardiograms, computed tomography angiography, or cardiac enzyme elevation, some argue for the use of thrombolytics or catheter thrombectomy even for hemodynamically stable patients.

OBJECTIVE:

To investigate the outcomes and management of patients with saddle pulmonary embolism, including radiographic appearance (estimate of clot burden) and echocardiographic features.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:


This study is a retrospective evaluation of all patients with computed tomography angiography positive for pulmonary embolism from June 1, 2004, to February 28, 2009. 

Two radiologists selected those with saddle pulmonary embolism and evaluated the clot burden score. 

The clinical information, echocardiography, treatments, and outcomes of these patients were extracted via chart review. 

Saddle pulmonary embolism was found in 37 of 680 patients (5.4%, 95% confidence interval 4% to 7%) with documented pulmonary embolism on computed tomography angiography. 

For patients with saddle pulmonary embolism, the median age was 60 yrs and 41% were males. 

Major comorbidities were neurologic (24%), recent surgery (24%), and malignancy (22%). Transient hypotension occurred in 14% and persistent shock in 8%. 

One patient required mechanical ventilation. Echocardiography was performed in 27 patients (73%). Right ventricle enlargement and dysfunction were found in 78% and elevated pulmonary artery systolic pressure in 67%. Computed tomography angiography demonstrated a high median pulmonary artery clot burden score of 31 points. The median right ventricle to left ventricle diameter ratio was 1.39. Inferior vena cava filters were placed in 46%. 


Unfractionated heparin was administered in 33 (87%) and thrombolytics infour (11%). The median hospital length of stay was 9 days. Two of 37 saddle pulmonary embolism patients (5.4%) died in the hospital (95% confidence interval 0.7% to 18%).


CONCLUSIONS:


Most patients with saddle pulmonary embolism found on computed tomography angiography responded to the standard management for pulmonary embolism with unfractionated heparin. 

Although ominous in appearance, most patients with saddle pulmonary embolism are hemodynamically stable and do not require thrombolytic therapy or other interventions.





Source: www.webmd.com/dvt/dvt-alcohol



Deadly measles complication is more common than thought



Photo published for New data shows a deadly measles complication is more common than thought



https://www.washingtonpost.com/news/to-your-health/wp/2016/10/28/new-data-show-a-deadly-measles-complication-is-more-common-than-thought/?wpisrc=nl_rainbow&wpmm=1




New data shows a deadly measles complication is more common than thought

UNDATED: In this handout from the Centers for Disease Control and Prevention (CDC), a thin-section transmission electron micrograph (TEM) reveales the ultrastructural appearance of a single virus particle, or "virion", of measles virus. in this undated image. Measles outbreaks have been reported throughout the U.S., with the latest reported February 5, 2015 at a daycare in suburban Chicago where as many as five children under the age of one have been infected. (Photo by CDC via Getty Images)
  A single particle of measles virus. Measles outbreaks have been reported throughout the United States. (CDC via Getty Images)
 




NEW ORLEANS — A complication of measles that kills children years after they have been infected is more common than previously thought, according to disturbing data released Friday.

The research, presented at IDWeek, the annual meeting of four professional infectious disease organizations, underscores the critical importance of vaccination for everyone who is eligible. Such widespread vaccination, which results in herd immunity, protects children who can't be immunized. Particularly vulnerable are babies younger than 12 months, who because of their age cannot get the vaccine known as MMR, for measles, mumps and rubella.

The complication is a neurological disorder that can lie dormant for years and then is 100 percent fatal. Researchers don't know what causes the virus to reactivate, and there is no cure once it does. The only way to prevent the disorder is by vaccinating everyone possible against measles.
Measles is an extremely contagious respiratory infection caused by a virus. Once common in the United States, it was eliminated nationally in 2000, but has made a comeback, mostly because of the growing number of people who refuse to vaccinate their children or delay those vaccinations, experts say.

The first MMR dose is administered at 12 to 15 months of age. Babies younger than that can be infected with measles and later develop this complication, which is called subacute sclerosing panencephalitis, or SSPE.


Thursday, September 15, 2016

A lion in Japan lunged at a two-year-old, but instead smashed into the zoo's glass wall







A lion in Japan lunged at a two-year-old, but instead smashed into the zoo's glass wall




Hand Fusion



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Amir Khan ✔ @amirkingkhan




Amir Khan pays tribute to surgeon who mended his broken hand

He appears to have a fusion of his hand similar to my foot...all the screws and things remain in my foot.  Amir probably needs to have the screws removed before he fights...

Amir Khan broken hands
                                Jim Clarke

And this is what the surgery looked like…


Image result for triple arthrodesis
triple arthrodesis




Wednesday, June 8, 2016

Perceptions

"To change ourselves effectively, we first had to change our perceptions." ~ Stephen Covey

Monday, June 6, 2016

Medical Imagery




A chest X-ray in progress at Dr. Maxime Menard's radiology department at the Cochin hospital in Paris, c.1914.

Partially dissected cadavers on tables in the dissecting room at Jefferson Medical College in Philadelphia, c.1902.











Medical Historian. DeathXpert. Creator of THE CHIRURGEON'S APPRENTICE and UNDER THE KNIFE. Working on book with and .
London, United Kingdom