#factors that influence treatment outcomes

[totesmag]

The Connection Between Basic Science and Clinical Research in Improving Health Outcomes

Explanation of the topic Medical research is a broad field that encompasses a wide range of studies and activities aimed at advancing knowledge and improving health outcomes. From basic science research that explores the fundamental mechanisms of disease, to clinical research that tests new treatments in real-world settings, medical research plays a crucial role in shaping the future of…

[charmedreincarnation]

Let me share you some examples of people outside of a spiritual realm using the law of consciousness. Reading about placebo opened my eyes to realize whether I believe it or not, use it or not, it is always operating.

1. During wartime, particularly in World War II, when medical supplies were limited, the use of a saline solution as a placebo became prevalent. One notable figure associated with this practice is Henry Beecher, a medic during the war. When morphine, a powerful painkiller, was scarce, Beecher resorted to injecting injured soldiers with a saline solution (a mixture of salt and water) as a substitute.The fascinating observation was that many soldiers responded positively to the saline placebo, reporting a reduction in pain. Beecher’s experience led him to further investigate what is now known as the placebo effect. He discovered that even inert substances like saline could elicit a therapeutic response in individuals, highlighting the power of belief and the mind’s influence on healing. Using saline as a placebo during wartime was a practical solution to address the scarcity of medical resources. It allowed healthcare providers to provide some form of treatment while conserving limited supplies for critical cases. The phenomenon observed in these wartime placebo administrations contributed to our understanding of the placebo effect and its role in medical practices.

2. And then there was another placebo test done with surgeries demonstrated the power of the placebo effect in the context of surgical interventions for knee pain.

The study, often referred to as the “fake leg surgery” study, focused on patients with osteoarthritis in the knee. Participants were randomly assigned to either receive real arthroscopic surgery or undergo a sham procedure where no actual surgical intervention took place. The sham surgery involved making small incisions and mimicking the actions and sounds associated with the actual procedure.The surprising finding was that both groups, those who underwent real surgery and those who had the sham surgery, reported similar improvements in their knee pain and functionality. This suggested that the positive outcomes experienced by the participants were not necessarily due to the physical intervention but rather to psychological factors such as the placebo effect.

3. The most fascinating one was this one: The study aimed to explore the role of mindset in reversing some aspects of aging.

In this experiment, Langer and her team created a simulated environment reminiscent of the 1950s to immerse a group of elderly participants. The participants were instructed to act as though they were 20 years younger and encouraged to engage in activities that required physical and mental activity. It aimed to create an atmosphere where the participants felt as if they were stepping back in time.The results of the experiment were described as astonishing. Participants reportedly experienced improvements in various areas, including physical health, cognition, and overall well-being. The study suggested that by changing one’s mindset and engaging in an environment that challenges typical aging stereotypes, individuals may experience positive effects on various aspects of their lives.

4. The Man Who Overdosed on Placebo" is a story about a 26-year-old man, often referred to as "Mr. A," who was part of a clinical trial for an antidepressant drug. In a desperate state of mind, he attempted suicide by ingesting 29 capsules of what he believed to be the experimental drug. This act was triggered by his depression, which had worsened after a breakup with his girlfriend.

However, unbeknownst to him, the pills he had taken were not the actual antidepressant, but rather placebos - essentially inert substances, often sugar pills, used in clinical trials as a control group. Despite this, Mr. A's vitals showed alarming signs similar to those of a drug overdose, reflecting the power of belief over the physical body, a phenomenon known as the "nocebo effect."

The nocebo effect is essentially the evil twin of the placebo effect. While the placebo effect can lead to improvements in health due to positive expectations, the nocebo effect can cause negative symptoms or even exacerbate existing ones due to negative expectations. In this case, Mr. A exhibited symptoms of an overdose solely because he believed he had taken an overdose.

5. Sam Londe, is one of the best but sad classic example of the nocebo effect, as detailed in Dr. Joe Dispenza's book "You Are the Placebo."

Sam Londe was diagnosed with esophageal cancer, a condition known for its grim prognosis. His doctors informed him that he didn't have much time left to live. Accepting this diagnosis, Londe quickly became bedridden and his health deteriorated rapidly, following the trajectory his doctors had predicted.However, upon his death, an autopsy revealed a surprising fact: there was not enough cancer in his body to have caused his death. The small tumor in his esophagus was not large enough or in a position to interfere with his swallowing or breathing. Essentially, Londe didn't die from cancer; he died from believing he was dying of cancer.

This case demonstrates the power of the mind over the body, both positively (the placebo effect) and negatively (the nocebo effect). In this case, Londe's negative beliefs about his prognosis led to physical symptoms and ultimately his death.

I've seen dozens of examples where of stuff like this particularly in the realms of hexing and witchcraft. Honestly, the same could probably be said about subliminals. But it doesn't matter much.Why? Because they work. It's all about observation and choice. You could say it’s the mind but the mind operates on logic. This goes beyond the mind and to your true being, what observes the mind observing the pain in the first place.

Actually I was talking to someone who had been struggling with shifting for a while about this and it really resonated with her which is why I decided to share it. She took a water bottle, labeled it shifting juice and just assumed that when she finishes the bottle she has “full access to shifting powers” is that how it works. Nope. Did she shift after two years of struggling. Yep. It doesn’t matter what story you create yourself whether you want to use logic or not whatever you assume and persist in and know as a fact will harden into truth and therefore reality.I just wanted to share this story bc I find it absolutely hilarious how we sometimes take it so seriously yet it can be so easy. I know placebo is just an assumption. It’s like when you tell children you checked under their bed for the monsters and drafted them and they assume so so they can sleep soundly at night. Call it whatever you want assumption, placebo, it’s all just words and each community calls it something different but at the end of the day it works wether you know the truth behind it or not.

[covid-safer-hotties]

Also preserved on our archive

By Bill Shaw

A new study in eClinicalMedicine has found that healthy volunteers infected with SARS-CoV-2 had measurably worse cognitive function for up to a year after infection when compared to uninfected controls. Significantly, infected controls did not report any symptoms related to these cognitive deficits, indicating that they were unaware of them. The net effect is that potentially billions of people worldwide with a history of COVID-19, but no symptoms of long COVID, could have persistent cognitive issues without knowing it.

The study’s lead author, Adam Hampshire, professor of cognitive and computational neuroscience at King's College London, said:

"It … is the first study to apply detailed and sensitive assessments of cognitive performance from pre to post infection under controlled conditions. In this respect, the study provides unique insights into the changes that occurred in cognitive and memory function amongst those who had mild COVID-19 illness early in the pandemic."

This news comes as pandemic mitigation measures have all but been abandoned by governments across the globe. Public health practice has been decimated to the point where even surveillance data on SARS-CoV-2 infections and resulting hospitalizations, deaths, and other outcomes are barely collected let alone published.

The data that are available indicate, per the most recent modeling from the Pandemic Mitigation Collaborative (PMC) on September 23, that since the beginning of August there have been over 1 million infections per day in the US alone. This level of transmission is expected to persist through the remainder of September and all of October. For the months of August through October, these levels of transmission are the highest of the entire pandemic

The study on cognitive deficits has been shared widely across social media, with scientists and anti-COVID advocates drawing out its dire implications.

Australian researcher and head of the Burnet Institute, Dr. Brendan Crabb, who has previously advocated for a global elimination strategy to stop the pandemic, wrote:

"Ethical issues aside, this is a powerful addition to an already strong dataset on Covid-driven brain damage affecting cognition & memory. Given new (re)infections remain common, this work… should influence a re-think on current prevention/treatment approaches."

The study enrolled 36 healthy volunteers. These individuals had no history of prior SARS-CoV-2 infection, no risk factors for severe COVID-19, and no history of SARS-CoV-2 vaccination. The researchers determined whether the volunteers were seronegative prior to inoculation, meaning that they had no detectable antibodies to SARS-CoV-2. If such antibodies were present, it would indicate past infection or vaccination.

These procedures resulted in a total of data from 34 volunteers being included for analysis. Two volunteers were excluded from analysis because they had seroconverted to positive for SARS-CoV-2 antibodies between the time of screening and inoculation. Notably, these two volunteers participated in all subsequent study activities, enabling a sensitivity analysis of the results that included them.

The researchers inoculated all 36 volunteers with SARS-CoV-2 virus in the nose and then quarantined them for at least 14 days. Volunteers only returned home once they had two consecutive daily nasal and throat swabs that were negative for virus. Thus, those volunteers who had an infection after inoculation spent the duration of their infection in quarantine. This quarantine was required by ethical study protocols, in order that the study itself not increase community transmission of the virus.

The researchers collected data on the volunteers daily during quarantine and at follow-up visits at 30, 90, 180, 270, and 360 days post-inoculation. The assessments included body temperature, viral loads from throat and nasal swabs, surveys on symptoms, and computer-based cognitive tests on 11 major cognitive tasks. The cognitive testing varied the particular exercise for each of the 11 tasks to avoid learning and memorization of solutions in subsequent sessions. Nevertheless, some tasks were more prone to learning so the researchers also studied the effect of infection on “learning” vs. “non-learning” tasks.

Of the 36 inoculated volunteers, 18 became infected and developed COVID-19 and 16 did not. The two groups did not differ significantly in key demographics. No volunteers required hospitalization or supplemental oxygen during the study. Every volunteer completed all five follow-up visits. 15 volunteers acquired a non-COVID upper respiratory tract infection in their community between the end of quarantine and the fifth visit at day 360.

The researchers found that the infected group had significantly lower average “baseline-corrected global composite cognitive score” (bcGCCS) than the uninfected group at all follow-up intervals. At baseline, the two groups did not differ significantly. The difference between the two groups did not significantly vary by time, meaning that the infected group’s bcGCCS did not improve during the nearly year-long study.

Because the bcGCCS was a composite based on individual scores for the 11 cognitive tasks, the researchers also looked at which tasks in particular were impacted. They found that the most affected task was related to immediate object memory, in particular, recall of the spatial orientation of the object. There was no difference in picking the correct object itself, just its spatial orientation. This means that infected individuals had a hard time choosing the correct spatial orientation of the object they had just seen, for example, erroneously picking a mirror image of the object they had just seen.

The results were not different based on sex, learning vs. non-learning tasks, or whether individuals received remdesivir or had community-acquired upper respiratory infections.

Because the investigators controlled for so many factors including the strain of SARS-CoV-2, timing of infection, quarantine, and lack of prior infection and vaccination, the study provides high confidence that SARS-CoV-2 infection was responsible for the cognitive defects. The control of the timing of infection also enabled clarification of whether and when cognitive deficits occurred and improved. The differences between the groups were apparent by day 14 of quarantine and as noted previously, the deficits in the infected group did not improve let alone resolve.

The symptom surveys did not differ between the two groups. None of the volunteers, infected or uninfected, reported subjective cognitive issues or symptoms. Thus the infected volunteers with measurable cognitive deficits at one year post-infection were not aware of these deficits.

The study reaffirms prior research into persistent cognitive deficits and brain damage associated with COVID-19, including other studies which have found deficits among patients without symptomatic long COVID. Building upon this prior research, the latest study indicates that basically every single unvaccinated individual with a history of acute COVID-19 is at risk for persistent, measurable cognitive deficits.

Given that other studies have shown that vaccination reduces one’s risk of long COVID by roughly half, similar measurable cognitive deficits are likely prevalent among vaccinated people who suffer “breakthrough” infection, albeit likely at reduced rates of decline.

The study raises the urgent questions about the level of protection provided by vaccination, whether strains since the original “wild type” SARS-CoV-2 strain have similar effects on cognition, and what is the impact of these cognitive deficits on people’s performance at home, work, and school.

The study also adds to the large body of damning evidence that the ruling class’ “forever COVID” policy is of immense criminal proportions. Enabling a dangerous, mind-damaging virus to circulate among humanity worldwide represents a scale of inhumanity and dereliction of duty that is practically unfathomable. The malignity of this intentional policy is underscored by the current situation where the U.S. alone has had over 1 million new infections per day since August, with levels not projected to drop below 1 million until November.

The working class must deepen the struggle to replace the capitalist system that prioritizes profit over lives with a world socialist society that places human needs first.

Study Link: www.thelancet.com/journals/eclinm/article/PIIS2589-5370%2824%2900421-8/fulltext

[eternal-echoes]

“Below are a nearly a dozen different factors that can sometimes influence a person's sense of sexual identity. Rather than saying any of these things "cause gender dysphoria," it is more accurate to say that they could contribute to a person feeling dysphoric about his or her body. Some individuals might find that some of the factors resonate deeply with them, while others might not relate to any of them. The goal isn't to provide an exhaustive list, but to encourage individuals who experience gender dysphoria to listen with compassionate curiosity to their own story.

Sexual abuse

When a person experiences something as traumatic as sexual abuse, he or she often develops survival strategies to cope with the pain and avoid future trauma. Some of these strategies to escape pain are helpful, but others are misdirected. Dr. Lisa Littman explains, "A maladaptive coping mechanism is a response to a stressor that might relieve the symptoms temporarily but does not address the cause of the problem and may cause additional negative outcomes."(19)

One such example of a maladaptive coping mechanism after sexual abuse is to dissociate from one's body. For some, this is a way to distance oneself from negative memories. One young woman who was sexually assaulted her sophomore year of college said, "It absolutely contributed to just this feeling that I wanted to take my body off."(20) Another remarked, "I was deeply uncomfortable with my secondary sex characteristics, which I now understand was a result of childhood trauma and associating my secondary sex characteristics with those events."(21)

For others, dissociating from one's sex is a defense mechanism to become undesirable to those who might repeat the offense. One young woman, after having suffered sexual abuse, decided to gain weight and begin presenting as male. She said, "Nobody would bother me now."(22) Similarly, younger girls may disguise the evidence of their sexual maturation in order to feel safe in an unsafe world. One such girl made an internal vow after her abuse, saying, "I will never let that happen again. If I am a boy, that won't happen again."(23) Others desire to appear neither male nor female, finding a sense of safety in the ambiguity of existing somewhere in between. When a woman is wounded in such a deeply personal way, she may lose all interest in the idea of being sexually intimate with a man. In the absence of such attractions, she may conflate lack of sexual desire with questions about her identity.

Each person who experiences sexual trauma will respond in a unique way, and each deserves careful and compassionate treatment as they navigate through memories of the past and anxieties about the future. But the path to healing must eventually acknowledge that the abuse was not caused by one's body. To believe this is to absorb blame that belongs only to the abuser.”

-Jason Evert, Male, Female, or Other: A Catholic Guide to Understanding Gender

—

Work cited:

19) Littman, "Parent Reports of Adolescents and Young Adults Perceived to Show Signs of a Rapid Onset of Gender Dysphoria," 35.

20) "Reversing a Gender Transition," https://youtu.be/V6V0p3_bd6w?si=xm7VsSG1d0wQgzsl

21) Littman, "Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners," 3369.

22) Soh, The End of Gender, 170.

23) "Transgender" Is an Identity Not a Diagnosis," https://www.youtube.com/watch?v=ZyGZnU_6tj4.

—

For more recommended resources on gender dysphoria, click here.

[religion-is-a-mental-illness]

By: Christina Buttons

Published: Jun 9, 2024

A newly published review in a prestigious medical journal has found that many studies on hormonal treatments for children with gender dysphoria have exaggerated their benefits. The analysis, led by Kathleen McDeavitt from the Menninger Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine, revealed that many studies presented positive conclusions about hormonal interventions even when the findings were insignificant, small, or even negative.

Proponents of early medical transition argue it can reduce suicide risk, often describing hormonal interventions as “life-saving care.” However, McDeavitt's review of 14 long-term studies reveals that the majority did not find improvements in depression or suicidality. In fact, the largest study included in the review reported worse outcomes for depression, an increase in psychiatric visits for suicidality, and a significant rise in antidepressant use after starting hormonal treatments.

For this review, studies were included if they involved pediatric-age patients with gender dysphoria who were taking puberty blockers and/or cross-sex hormones, were longitudinal in methodology, were conducted in a clinical research setting, and reported outcomes related to depression and/or suicidality. 

Despite being longitudinal, the studies reviewed had short follow-up periods, with half spanning one year or less. Notably, the longest follow-up time, found in two older Dutch studies, spanned six years. This is significant because, given the novelty of this protocol, longer-term data is extremely rare, and transition regret and detransition often occur between four to eight years after transitioning.

Out of the 14 studies reviewed, five had negative outcomes for depression and three had negative outcomes for suicidality. Out of the 13 studies that reported depression outcomes, less than half (six) found positive results; and when positive results were found, the improvements were relatively minor. Notably, in two of these six studies, the improvement was seen in one sex but not the other. 

A recent Finnish study that looked specifically at suicidality found that suicide mortality in this population was rare and did not differ from the general population when controlling for mental health conditions. The researchers concluded there was no evidence to suggest that hormonal interventions prevented suicide.

A key issue discussed in this review is that all the studies were observational, meaning causal factors cannot be inferred because their results can be easily influenced by other variables. Positive results could be due to factors like therapy, medications, support from treatment teams, or other unrelated influences, rather than the hormonal treatments themselves. Because of this, it's hard to say for sure if the treatments caused the improvements. Despite this, many studies, even those with minor or even negative findings, still somehow concluded that the treatments were beneficial.

A strength of this review is that it compared what each study concluded with what the actual results showed. This uncovered a pattern of exaggerating the importance of certain findings, such as being quick to credit hormonal treatments for positive results and focusing more on positive findings than negative ones. For example, the Tordoff et al. study claimed there was clear evidence of improvement, even though the results showed no significant change in depression or suicidality over time. The six studies that reported positive results were not very meaningful, with half showing only small decreases in depression scores.

McDeavitt's findings suggest that the actual impact of hormonal treatments on depression and suicidality in children with gender dysphoria remains unclear. This directly contradicts claims by activists and large US medical institutions that the research consistently shows mental health benefits. The review calls for more rigorous, high-quality research to truly understand the benefits and risks of these treatments.

Following the U.K.'s Cass Review and associated systematic evidence reviews, which found "remarkably weak" evidence supporting medical interventions for gender transition in minors, public health authorities around the world have begun restricting medical transition or reevaluating their stance. However, medical organizations in the United States remain an outlier, showing reluctance to align their guidelines with the best available evidence.

--

https://onlinelibrary.wiley.com/doi/10.1111/apa.17309

Abstract

Aim Systematic literature reviews have found the evidence for hormonal interventions in paediatric-age patients with gender dysphoria is of low certainty. Studies in this field have all been observational, and generally of low quality. Nevertheless, some experts assert that the observational studies in this field have consistently found improvement in mental health, and therefore constitute sufficient evidentiary basis for hormonal interventions. The present review sought to characterise results of the longitudinal clinical research studies that have reported depression and suicidality outcomes.

Methods The present review collated, from examination of six existing reviews, 14 longitudinal clinical research studies that have specifically investigated depression and/or suicidality outcomes.

Results Significantly positive depression outcomes were reported in six studies, and significantly positive suicidality outcomes in two studies. Outcomes were negative in the largest study. Notably, some studies articulated positive conclusions about hormonal interventions even in the setting of insignificant, small or negative findings.

Conclusions Analysis of longitudinal clinical research in this field showed inconsistent demonstration of benefit with respect to depression and suicidality. This analysis suggests that, contrary to assertions of some experts and North American professional medical organisations, the impact of hormonal interventions on depression and suicidality in this population is unknown.

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[daweimedical111]

Bedside Monitors Explained: Functions, Advantages, and Cost Considerations

How do Bedside Monitor Work?

Bedside monitors are essential medical devices designed to continuously track a patient's vital signs in real time. They work by using various sensors and electrodes to capture critical physiological data such as heart rate, blood pressure, oxygen saturation (SpO₂), respiratory rate, and sometimes temperature and other parameters, depending on the model.

The monitor is equipped with multiple sensors or probes that are attached to the patient’s body. Once connected, these sensors continuously send data to the bedside monitor. The device processes the data through algorithms to provide accurate, real-time readings.

The monitor displays the data on a screen, often with individual panels for each parameter. The display is typically bright and easy to read, allowing quick assessment. Monitors are usually set up with alarms to alert caregivers if a reading falls outside of a safe range.

Modern bedside monitors can store data over time for trend analysis and are often connected to a central monitoring system.

Bedside monitors play a critical role in patient care by offering accurate, continuous observation, especially in intensive care, emergency departments, and during surgeries.

What are they used to bedside monitor?

Bedside monitors are used to continuously observe and measure a patient's vital signs, providing essential information for healthcare providers to make informed decisions. Here are some common applications scene for bedside monitors:

Intensive Care Units (ICU): Bedside monitors are crucial in ICUs. They track key metrics such as heart rate, respiratory rate, blood pressure, and oxygen saturation, alerting staff to any changes that may need immediate attention.

Emergency Departments (ED): In emergency settings, bedside monitors are used to assess patients quickly and monitor their stability. They provide real-time data, helping emergency physicians make fast, informed decisions during critical moments.

Operating Rooms (OR): During surgeries, bedside monitors track a patient’s vital signs to ensure they remain stable under anesthesia.

Post-Operative Recovery: After surgery, patients are often monitored until they stabilize.

General Wards and Step-Down Units: Bedside monitors help track vital signs as patients wake from anesthesia and recover, ensuring they respond well and identifying any potential complications.

These monitors allow medical staff to intervene quickly and improve patient outcomes across various medical environments.

What are bedside patient monitors expensive?

Bedside monitors are highly beneficial in healthcare settings due to their ability to provide real-time, continuous monitoring of a patient’s vital signs. Here are some key benefits:

Enhanced Patient Safety: Bedside monitors often include alarms to alert medical staff if any parameter goes beyond a safe range.

Improved Efficiency for Medical Staff: Continuous monitoring reduces the need for frequent manual checks by nurses or doctors, freeing up their time for other patient care tasks.

Better Data for Informed Decision-Making: Bedside monitors collect data over time, allowing healthcare providers to analyze trends and make more informed treatment decisions.

Enhanced Recovery and Post-Operative Care:  Any post-operative complications can be detected and addressed promptly, improving recovery outcomes.

Are bedside patient monitor expensive?

The cost of bedside patient monitors can vary widely depending on the monitor’s features, complexity, and brand. Here are some factors that influence bedside patient monitors' price: Features and Functionality, Display Quality and Size, Technology and Connectivity, Durability and Portability

Basic bedside monitors can range from a few hundred to a few thousand dollars. While the upfront cost of bedside monitors can be high, they are considered a valuable investment because they help prevent complications, improve patient outcomes, and enhance workflow efficiency. Many healthcare providers consider the long-term benefits and cost savings in patient care when deciding on the investment.

Know More>>https://www.daweimed.com/Patient-Monitoring.html

[anaswaraseo]

Clinical Nutrition & Dietetics: Science for Better Health

Clinical Nutrition and Dietetics is a specialized field that uses nutrition to manage and prevent disease, improve health outcomes, and promote overall well-being. Here’s a deep dive into the essential aspects of this field:

What is Clinical Nutrition and Dietetics?

Clinical Nutrition and Dietetics involves assessing, diagnosing, and treating nutrition-related health issues. Dietitians and clinical nutritionists work closely with patients to develop dietary plans tailored to their medical conditions, lifestyle, and specific health goals.

Key Areas of Clinical Nutrition and Dietetics

Medical Nutrition Therapy (MNT): MNT is the cornerstone of clinical dietetics, involving specialized dietary interventions based on scientific evidence. It’s used to treat chronic illnesses like diabetes, cardiovascular disease, cancer, and kidney disease.

Nutritional Assessment: This includes evaluating a patient’s diet, medical history, physical health, and lab results to create personalized nutrition plans. Tools include BMI, body composition analysis, dietary history, and blood tests to assess nutrient levels.

Therapeutic Diets: Dietitians often develop therapeutic diets to manage health conditions, which can include:

Low-sodium diets for hypertension and heart health.

Low-glycemic diets for managing diabetes.

High-protein diets for malnutrition and muscle recovery.

Renal Diets for kidney disease patients to reduce the intake of specific nutrients.

Pediatric and Geriatric Nutrition: Clinical dietitians specialize in creating age-appropriate nutritional plans for children and elderly patients, addressing issues like growth, development, bone health, and cognitive function.

Mental Health and Nutrition: Dietitians are increasingly focusing on the connection between nutrition and mental health, as certain nutrients (e.g., omega-3s, and B vitamins) can impact mood and cognitive function.

Emerging Areas in Clinical Nutrition

Functional Foods and Nutraceuticals: Functional foods (like probiotics) and nutraceuticals (such as dietary supplements) are increasingly used in clinical nutrition to support specific health outcomes, such as immune function or gut health.

Personalized Nutrition and Genomics: Nutrigenomics studies how genes influence individual responses to nutrients, leading to personalized nutrition plans based on a patient’s genetic makeup. This method works especially well for treating chronic illnesses.

Integrative and Holistic Nutrition: Integrative nutrition considers lifestyle factors, stress, and mental health along with diet, promoting a more holistic approach to patient care.

Plant-Based Diets: The use of plant-based diets in clinical settings is becoming popular for their benefits in reducing inflammation, improving heart health, and supporting weight management.

Role of Clinical Dietitians in Healthcare Settings

Hospitals: Clinical dietitians are essential in hospitals, where they design dietary plans for patients recovering from surgeries, dealing with chronic illnesses, or undergoing treatment that affects their nutritional status.

Outpatient Clinics: Many dietitians work in clinics, providing ongoing support for patients with chronic conditions like diabetes or high cholesterol.

Rehabilitation Centers: Nutritionists here help patients with recovery, focusing on high-calorie or high-protein diets to promote healing.

Skills for Clinical Dietitians

Analytical Skills: Strong understanding of biochemistry and physiology to interpret lab data and develop dietary plans. Counseling and Communication: The ability to communicate effectively with patients to promote adherence to dietary plans.

Evidence-Based Practice: Staying updated with the latest research to provide science-backed advice. Career Opportunities

Clinical dietitian: employed by long-term care homes, clinics, or hospitals.

Nutrition Researcher: Contributing to research on disease prevention and dietary interventions.

Consultant Dietitian: Providing freelance or consultancy services for healthcare facilities, wellness centers, or private clients.

Corporate Wellness Programs: Supporting employees’ health and well-being through nutritional guidance in corporate settings.

Conclusion

In conclusion, Clinical Nutrition and Dietetics is a transformative field that bridges the gap between nutrition science and patient care, offering personalized approaches to health and wellness. By understanding the intricate relationship between diet, disease, and overall health, clinical dietitians play a crucial role in improving health outcomes and enhancing quality of life. As new research and innovations in nutrition continue to emerge, this field remains essential in advancing preventive care, supporting disease management, and promoting holistic well-being.

[expertacademicassignmenthelp]

Breast Cancer

Introduction

Breast cancer, a multifaceted and prevalent disease, poses a significant health challenge globally, transcending gender lines with its potential impact. Characterized by the abnormal proliferation of cells within breast tissue, breast cancer’s complex etiology remains an area of intense study and concern. Despite notable advancements in medical science and increased awareness, it continues to be a leading cause of morbidity and mortality worldwide. This comprehensive discussion aims to delve into the intricacies of breast cancer, encompassing its causes, risk factors, prevention strategies, diagnostic modalities, treatment options, and the evolving landscape of supportive care.

Causes and Risk Factors

Understanding the underlying causes and risk factors associated with breast cancer is paramount in developing effective prevention and management strategies. While the precise etiology of breast cancer remains elusive, various genetic, hormonal, environmental, and lifestyle factors contribute to its onset and progression. Genetic predispositions, such as mutations in the BRCA1 and BRCA2 genes, significantly elevate the risk of developing breast cancer. Additionally, hormonal influences, including early onset of menstruation, late menopause, and hormone replacement therapy, play a crucial role in disease pathogenesis. Lifestyle factors such as excessive alcohol consumption, obesity, lack of physical activity, and exposure to environmental carcinogens further augment the risk profile.

Preventive Measures

Empowering individuals with knowledge about preventive measures is essential in mitigating the burden of breast cancer. Promoting regular breast self-examinations, clinical breast examinations, and mammographic screenings facilitates early detection and intervention. Emphasizing lifestyle modifications, including maintaining a healthy weight, adopting a balanced diet rich in fruits and vegetables, limiting alcohol intake, and engaging in regular physical activity, can reduce the risk of breast cancer. For individuals with a heightened risk due to genetic predispositions or familial history, prophylactic surgeries, such as mastectomy or oophorectomy, and chemo preventive agents offer viable preventive options.

Diagnostic Modalities

Advances in diagnostic modalities have revolutionized the early detection and diagnosis of breast cancer, enabling prompt initiation of treatment and improved clinical outcomes. Mammography remains the cornerstone of breast cancer screening, capable of detecting abnormalities such as microcalcifications, masses, or architectural distortions. Complementary imaging techniques, including ultrasound, magnetic resonance imaging (MRI), and molecular breast imaging (MBI), enhance diagnostic accuracy, particularly in women with dense breast tissue or high-risk profiles. Biopsy procedures, such as core needle biopsy or surgical excision, facilitate histopathological examination, enabling precise diagnosis and classification of breast lesions.

Treatment Options

Tailoring treatment strategies to individual patient characteristics and disease parameters is essential in optimizing therapeutic outcomes in breast cancer. The treatment landscape encompasses a multidisciplinary approach, integrating surgical, medical, and radiation oncology interventions. Surgical options range from breast-conserving surgeries, such as lumpectomy or segmental mastectomy, to radical procedures like total mastectomy or modified radical mastectomy, depending on tumor size, location, and extent of spread. Adjuvant therapies, including chemotherapy, hormonal therapy, targeted therapy, and immunotherapy, aim to eradicate residual disease, prevent recurrence, and improve overall survival. Radiation therapy, administered either postoperatively or as a primary modality in selected cases, targets residual tumor cells, minimizing locoregional recurrence rates.

Supportive Care and Survivorship

Recognizing the holistic needs of breast cancer patients and survivors is integral in promoting comprehensive care and ensuring optimal quality of life. Supportive care interventions, including symptom management, psychosocial support, nutritional counseling, and rehabilitation services, address the multifaceted challenges associated with cancer diagnosis and treatment. Survivorship programs, focusing on survivorship care planning, surveillance for recurrence, long-term monitoring of treatment-related complications, and health promotion initiatives, facilitate the transition from active treatment to survivorship. Engaging patients and caregivers in survivorship care planning fosters empowerment, resilience, and a sense of agency in navigating the post-treatment phase.

Conclusion

In conclusion, breast cancer represents a formidable health challenge with profound implications for affected individuals, families, and communities worldwide. While significant strides have been made in understanding its pathophysiology, enhancing diagnostic capabilities, and expanding treatment options, concerted efforts are warranted to address existing gaps in prevention, early detection, and access to care. By fostering collaborative partnerships among stakeholders, advocating for evidence-based interventions, and promoting health equity, we can strive towards a future where breast cancer incidence and mortality rates are substantially reduced. Through continued innovation, education, and advocacy, we can transform the landscape of breast cancer care, offering hope, support, and healing to those impacted by this pervasive disease.

We wish you all the best in your medical education journey. In case you need any guidance or assistance during the learning process, do not hesitate to reach out to us.

Email at;

williamsassignmenthelpfredrick@gmail.com

[theaenetworks]

Children are likely to succeed when the environment becomes mild and inspiring, it starts from human interactions breed from the home, with both parents and other family member are there to help such environment in easy sailing. For most average African families lack of proper communication, and devoting more time for their jobs than families make the kids feel not belonged, and once they start to get comfortable outside the family, they will be building from anything they learn outside, and in most likely outcome peer influence drive everything they do and their lives revolve around material things rather finding their purpose and real essence of living.

When children build from home, they tend to become comfortable with everything they do, kids grow in all their endeavours when they have strong family communications, connections which can be built on when they have such thing as family time, and often time dinner time becomes very indispensable to strengthened family bond and help the children to grow. African families that maintain high status financially in the society with both parents living together, always provide excelling environment for their kids, very early they are meant to understand life with purpose and get to be exposed with resources to thrive with everything they want to become, African children from the countryside don’t even know where the next meal is coming from, they could barely have proper sleep to talk more of dreaming for a brighter future.

Family values are the key factor for kids to form resistance whenever they encounter difficult outside the home, family bonds lower the chances of poor outcomes in children, such as obscene behaviours and engaging in drug abuse, with family connections they are integrated properly with high self-esteem and they will be no victim for any kind of bullying. This is what children yawn for, when they see other kids dropped off by their parents in the school, they really wished if they can get such treatment and have their parents say “be a smart kid” before going to work place.

Family connection is associated with progress in growth, having goals and focused mind as a kid, with thriving and surviving, they avoid being misled and harm coming their way. Parents are very pivotal tools in upbringing stage, anything they want their children can become, if they established that necessary connections that will make the kids feel so comfortable anytime they are around. In remote African villages, where they have no access to basic amenities, and parents can’t afford to provide basic education for the kids, they join in doing menial jobs, from there they began to nurture that they have restricted access in life, and the chances of dreaming big become slim.

It is about understanding the language of the children when you establish connections with them, they crave for your support in anything they want to do, once you’re supportive and active in their lives they count it as a bonus to inspire. Expression, they are eager to learn and express themselves in any possible way they can, and be totally respectful while correcting them, they are not going to get everything right, but your approach when they faulter really needs to be at its peak. The importance of family connection is to build identity, it gives children the feeling of belonginess and accepted by the family members, it gives them the necessary tools to learn what their strengths and weaknesses are in a safer environment.

In upbringing, children learning their strengths and weaknesses are one of the most important essence of family connections, while their strengths provide them with basic ideas to flourish, and find their purpose in life, they work to curtail their weaknesses. In Africa children are not overtly exposed to the environment to be able to know where their strengths and weaknesses lie, they struggle throughout to deal with it, when they come of age, they have shaky career because the foundation wasn’t solid. Sometimes in Africa, children barely see their fathers excepts on weekends, it is either they are fast asleep before he returns from work or go out early to work before they could wake up, and the family connection is absence because mothers can’t really do all the jobs in keeping the children highly focused.

The fulcrum of family connection is exposing children to have purpose and meaningful life, and it is down to good life, when the parents play active role in the lives of their kids without suffocating and bombarding them with problems. It is highly difficult for families in poverty line to keep the kids high-spirited, while financial circumstances and food insecurity become the major focus. Parents have their homes under control especially in dealing with the emotional weather, it is imperative to create enabling environment where children can be heard and feel safe, and parents often time should try and suspend judgement and communicate it when they deemed it very necessary, if they establish such healthy relationships at home, they tend to have more healthy trusting relationships as grown-ups.

https://anthonyemmanuel.com/children-likely-to-succeed-in-such-environment-upbringing-stage-key-factor-in-setbacks-for-african-children/

#parenting #parentingtips #parenthood #ParentingJourney #africanchildren #upbringing #children #kids

[reignforestmagicnugalmanac]

Impact of Cannabis on Genetic Activity

Recent studies have unveiled a surprising link between cannabis consumption and alterations in genetic activity. While the use of cannabis has been a topic of discussion for its therapeutic benefits and potential risks, its influence on our genetic makeup adds a new dimension to the ongoing debate. Researchers are delving into how cannabis can modify gene expression, impacting various body functions and health outcomes. These findings are crucial for both medical professionals and users, emphasizing the importance of understanding long-term effects. This article explores the science behind this relationship and its implications for societal perspectives on cannabis use.

Cannabis, a substance derived from the Cannabis sativa plant, has gained widespread popularity for both recreational and medicinal purposes. Despite its popularity, the biological effects of cannabis, particularly its impact on our genes, remain a developing field of study. Genetic activity refers to how active or inactive certain genes are in response to environmental factors, including substances we consume. Cannabis compounds, notably THC and CBD, interact with the body’s endocannabinoid system, which controls various physiological processes. Recent studies suggest that this interaction may lead to changes in the expression of specific genes. These changes could, in turn, influence a person’s susceptibility to diseases or conditions, thereby altering their overall health profile.

The research into cannabis’s role in genetic modulation sheds light on diverse health implications. Preliminary findings suggest that long-term cannabis use may affect genes related to neurological functions and immune system responses. For instance, chronic users may experience altered gene expression that modifies brain pathways, potentially impacting cognitive abilities and mental health. Simultaneously, these genetic shifts could either enhance or suppress the immune system’s functionality, affecting how the body responds to infections. Understanding these genetic interactions is crucial as it could help in personalizing medical treatments and predicting health trajectories for cannabis users.

Despite the promising data, there is still much to be researched regarding cannabis and its genetic effects. Scientists are focusing efforts on determining the precise changes in gene expression and how these changes translate to tangible health outcomes. This knowledge is especially significant for healthcare professionals prescribing cannabis for medicinal use and policymakers involved in regulation. Furthermore, understanding the genetic implications can aid in developing guidelines for safer consumption and recommending appropriate doses. With cannabis legalization expanding, it becomes increasingly important to continue this research to support informed decisions both at the individual and community levels.

The revelation that cannabis can influence genetic activity provides a new perspective on its holistic impact on humans. While cannabis continues to offer therapeutic benefits, especially in pain management and symptom relief for various conditions, these genetic considerations suggest that caution is warranted. The potential for cannabis to alter gene expression calls for a balanced approach to its consumption, taking into account personal health risks and benefits. As research progresses, it becomes vital for scientists, medical practitioners, and users to stay informed about the genetic dimension of cannabis use. Sustainable consumption practices, guided by scientific understanding, can provide a safe pathway forward. This newfound insight reiterates the importance of personalized healthcare, acknowledging that the impact of cannabis may vary greatly among individuals based on their unique genetic makeup. The future of cannabis use and regulation undoubtedly lies in a nuanced comprehension of its genetic effects, fueling more targeted and effective clinical applications while ensuring public health safety.

[jcsmicasereports]

Myxoid liposarcoma of the spermatic cord: A rare entity by Emmanuel E. Sadava in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

An 81-year-old man consulted at our hospital for evaluation of a long-established left inguinal mass. The patient denied experiencing pain, food intolerance, constipation or urinary tract symptoms in the past. A physical examination revealed a 15x10cm painless mass in the left inguinal region, distinct from the testicle, with no palpable changes during Valsalva´s maneuver. Magnetic resonance imaging (MRI) showed a 79mm heterogeneous lesion of the spermatic cord which projected itself through the inguinal canal into the scrotal sac, displacing the testis inferiorly. Laboratory testings were negative for testicular tumor markers such as α fetoprotein and human chorionic gonadotropin-β. A surgical resection of the inguinal tumor with an “en-bloc” inguinal orchiectomy was performed. The inguinal floor was repaired with a modified Bassini technique without the use of a mesh. The histopathological report confirmed findings were consistent with a myoxid liposarcoma. No further treatment was indicated and the patient continued follow-up with bi-annual MRIs. 18 months later, the patient continues with no signs of recurrence.

Key words: liposarcoma, liposarcoma of the spermatic chord, abdominal wall surgery, inguinal mass.

Introduction

Sarcomas constitute a heterogeneous group of rare solid tumors of mesenchymal cell origin. Collectively they account for approximately 1% of all adult malignancies with an annual incidence of 2.5 cases per million population[1]. In adults, the most common soft tissue sarcomas are liposarcomas. Overall, they account for approximately 17% of all soft tissue sarcomas. Most cases arise from de novo, therefore, the development from a preexisting benign lipoma is rare. Liposarcomas usually appear as a slowly enlarging, painless mass in a middle-aged person with a slightly higher incidence in men.

These tumors are classified in three main biologic forms: 1) well-differentiated liposarcoma; 2) myxoid and/or round cell; and 3) pleomorphic. The latter being a rare high-grade with a high recurrence rate and poor prognosis. The well-differentiated and myxoid types have favorable prognoses. However these tumors locally recur after incomplete excision[2].

The anatomic site of the primary disease represents an important prognostic factor, influencing treatment and outcome. Extremities (43%), the trunk (10%), visceral (19%), retroperitoneum (15%), or head and neck (9%) are the most common primary sites. Scrotal location is relatively rare, accounting for 3.6% of all liposarcomas. The origin of intra scrotal liposarcomas include the spermatic cord (76%), testicular tunic (20%), and the epididymis (4%).

Case Report

An 81-year-old man with a medical history of follicular cutaneous lymphoma and an open left hemi-colectomy for colon cancer consulted at our hospital for evaluation of a long-established left inguinal mass. The patient denied experiencing pain, food intolerance, constipation or urinary tract symptoms in the past. A physical examination revealed a 15x10cm painless mass in the left inguinal region, distinct from the testicle, with no palpable changes during Valsalva´s maneuver. Magnetic resonance imaging (MRI) showed a 79mm heterogeneous lesion of the spermatic cord which projected itself through the inguinal canal into the scrotal sac, displacing the testis inferiorly. Laboratory testings were negative for testicular tumor markers such as α fetoprotein and human chorionic gonadotropin-β. Ultrasound-guided biopsies of the mass were requested and their histopathology analysis revealed myxoid stroma with fusocelular proliferation.

A radical resection was suggested but, a week prior to the surgical procedure, the patient was diagnosed with COVID infection during which he intercurred with myocardial infarction and ischemic stroke. He underwent a double coronary angioplasty with drug-eluted stents and required anticoagulation and antiplatelet therapy posteriorly. The case was discussed at a multidisciplinary meeting and a conservative management of the inguinal tumor was decided. The patient was reassessed 12 month later with a new MRI, which showed the inguinal mass increased in size (99mm) compared to the previous study, and a computed tomography (CT) with no evidence of metastatic disease. A surgical resection of the inguinal tumor with an “en-bloc” inguinal orchiectomywas performed. The inguinal floor was repaired with a modified Bassini technique without the use of a mesh. The patient had an uneventful recovery and was discharged from the hospital on postoperative day two.

The histopathological report confirmed a 130x120x120mm low-grade fibro myxoid neoplasm. The surgical margins were negative. Immunohistochemistry showed strong reactivity for S100 and vimentin, whereas SOX10, desmin, CD34 and estrogen receptors were negative. These findings were consistent with a myoxid liposarcoma. No further treatment was indicated and the patient continued follow-up with bi-annual MRIs. 18 months later, the patient continues with no signs of recurrence.

Discussion

Liposarcomas invade through local extension and rarely invade through the lymphatic route, making regional lymph node dissection lose its value and having no impact on survival. Nevertheless, high-grade subtypes are associated with high rates of recurrence and hematogenous spread; lungs, liver and peritoneum being the most common sites of metastasis.  Surgical resection (with appropriate negative margins: >1cm) is the standard primary treatment in most patients with stromal cell sarcomas. Complete tumor resection is the primary prognostic factor for local recurrence, and liposarcomas are not the exception. Performing an “en-bloc” resection involving a high orchiectomy (including the surrounding tissue) is important to obtain negative margins [1].

Local recurrence rates for sarcomas, including liposarcomas of the spermatic cord, have been reported to be as high as 30-50%. Because of this, and despite the patient’s disease-free status, long term follow-up remains a crucial step in the detection of recurrences that might still be potentially curable. Current controversy arises on the use of adjuvant chemotherapy or radiotherapy. Being a rare and infrequent entity makes it hard for a single institution to accumulate enough cases to perform prospective randomized controlled trials. Extrapolated data from retrospective analyses support the use of adjuvant radiation on selected high-risk situations (tumor recurrence, high-grade tumors or residual disease). Concerning the role of chemotherapy, the use of adjuvant chemotherapy remains controversial and there is no definitive role in the management of localized liposarcomas[3].

In conclusion, myxoid liposarcomas of the spermatic cord are infrequent entities. As most soft tissue sarcomas, they have an indolent course and should be considered as a differential diagnosis of inguinal masses with no palpable changes during Valsalva´s maneuver. Complete surgical resection with high-orchidectomy “en-bloc” is encouraged.

[orchidbreezefc]

the real problem with propagation: observation collapsing potentialities

time for another theory about the mechanics of time travel in woe.begone! the first one is [here]. i'm pretty confident that we've really cracked the case this time. thanks @solipsistful , @fortunechaos , and @whirlwindsworld for helping hammer this out!

let's talk about schrödinger's cat; the actual proposal, in which the cat literally is both dead and alive until the box is opened. both outcomes are actually, literally real, so long as you don't know which one it is. once you open that box and find out for sure, that becomes the only real outcome; the alternative is erased. the very observation of a state is what ensures it.

i believe propagation boils down to being such an observation, and that's why it's dangerous. knowing about an event prior to its occurrence sets that event in stone. knowing the outcome makes it the only real outcome; the alternative is erased.

some events in w.bg appear to be inevitable in every timeline. history doesn't repeat itself, but it rhymes. you can change or remove the causal factors that lead to certain events happening, and circumstances rearrange themselves so that the event happens anyway. even if you take away the instigator, 357A still explodes, and hunter still receives a scar. even if you take michael out of the timeline, cowboy influence still leaks in. even if you take mike walters out of the timeline--well. it seems like you can't.

i believe these inevitable events, these cross-timeline constants, were each caused by propagation. mike gets the cauliflower ear in different circumstances than the ones in which michael got his--we don't know how different, but michael's circumstances didn't involve two other mikes present, so, definitely different. the cauliflower ear seems inevitable. it's also an example of propagation--mike sees michael with this injury before it happens to himself. the awareness of this injury is propagated into 2022 through michael's mere visibility, and so becomes inevitable.

consider also edgar's death. michael is excruciatingly clear that it's inevitable--there is no way to prevent it with time meddling, because if there were, he would have found it. he spent 2 years trying. he probably dragged edgar to an MRI every month to pinpoint the exact day the brain bleed manifested, and then tried every form of treatment, catching it as early as temporally possible. nothing worked. michael is very clear that this will happen to the other mikes' edgars as well. it is a certainty in every timeline.

and we know the awareness of edgar's death was propagated! mustardseed's scheme was prompted by learning about his own death. the fact of learning about it is what set the outcome in stone. that's why edgar's so strict on propagation and michael is uncharacteristically studious about following this one rule. it's what made edgar's early death immutable fact.

mike talks about collapsed potentialities. he says how at one point in your life you could have become an astronaut, but eventually the potentialities collapsed until that outcome became impossible. you lost your chance. and you know it's impossible--not in a literal time travel sense, but maybe intentionality counts for something after all. you know you won't be an astronaut. you won't pursue that path. and so the potentiality collapses. the 'not being an astronaut' outcome becomes inevitable.

in my previous post i touched on the fact that the boulders and continuous corrections technology seem to be the exception to the general implication that only one timeline can exist at once in woe.begone. we are given to understand continuous corrections can briefly bring alternative timelines into being without overwriting the current timeline, and the boulders can be used to send information to iterations in timelines that shouldn't currently exist.

we know little about those two technologies, but what we do know is that both of them are used for sharing information and making observations. edgar uses continuous corrections for the specific purpose of observing alternative scenarios. edgar says intentionality is an uncertain hypothesis but that it's the best model they have to explain certain things; i think observation is a form of intentionality unto itself. how else do you classify the complete certainty something is going to happen?

[covid-safer-hotties]

No Amount of Hand-Washing Can Make COVID-19 a Seasonal Virus - Published Aug 14, 2024

Needless to say, words have meaning. The selection of words modulates the message understood by the receiver. With regard to COVID, terms such as “seasonal”, “like a cold”, and “like the flu” can be selected by writers to paint a portrait that lulls the reader into a false sense of security, drawing comparisons between a virus that has been around for less than five years to other viruses or conditions with respect to which the audience has grown familiar with. Moreover, even stock photos selected for certain news articles can subtly influence your response to the content expressed in that piece. A selected photo of a person gently cradling a tissue paper over their nose, instead of a person waiting for treatment in the ER, may give off the impression that they are harmlessly recovering from a tear-jerking soap opera instead of from a viral illness. In fact, we want to believe that COVID-19 is as gentle as a cold, as this outcome is far more pleasing, so this skewed presentation of the risk is far more palatable than what is expressed in the scientific literature.

However, COVID-19 is not a cold or the flu. Understanding that this virus is not a seasonal nuisance like the common cold is crucial in the fight against it, as explained herein.

We emphasize that the purpose of this piece is to correct some of the language circulating in the media and to arm you with accurate information so that you can make reasoned decisions that are aligned with your health goals. As much as an athlete who is training for a triathlon may want to avoid regularly smoking or taking recreational drugs, COVID-19 should be factored into your day-to-day health decisions, especially if you are conscious about achieving a greater healthy lifespan.

But before delving into a comparison between COVID-19 and the flu, here is a primer on COVID-19.

A COVID-19 Primer Long Term Risk COVID-19 continues to present an important risk to your long-term health. This means that after you test negative, you can still develop medical conditions or disorders that can impact your quality of life as a result of that COVID infection. In other words, the cost of COVID on your life is not just the loss that you experience as you wait for your negative test. While individuals can remain infectious for an average of 10 days [1], the disease often takes a toll that can manifest months to even years after your acute-stage infection. COVID can take away the opportunity of a professional athlete to join a national team, or from competing in an Olympic event for which the athlete has been training for years [2]. COVID can rob a doctor, a nurse, a teacher, or a lawyer, of a successful career. COVID can disrupt the health of a family. And this can happen after every infection, not just after your first infection. The odds of developing long-term conditions add up after each infection. Despite reducing the risk to varying degrees ranging from 15% to 50%, vaccinations do not eliminate the problem. For these reasons, it is important for you to appreciate how, and when, COVID circulates and can infect you.

How Do You Catch COVID? COVID spreads principally through the air. This means that handwashing is not the key solution for keeping you safe from COVID. Now, handwashing is a good practice, but you need to become mindful of the air that you breathe in order to protect your health and future, as well as those of your loved ones, from this disease. Just like you would not drink stagnant water from a pond in the city, do not inhale unfiltered dirty air. You can filter your air by wearing N95 masks (respirators) or better. Favor outdoor air over indoor air. Clean the indoor air by using HEPA filters to remove the virus. Dilute contaminated indoor air by bringing in clean outdoor air through ventilation. The World Health Network has released numerous resources on this topic [3-5].

When Does COVID Spread? The Myth Regarding Seasonality News outlets have been circulating the premise that COVID is a seasonal virus, with little-to-no transmission during the warmer days of the year. However, at the time of writing this piece, in Summer 2024, the U.S., the UK, and many countries around the world are currently experiencing a major COVID wave.

We have learned over the last few years that COVID-19 does not follow seasonal patterns. COVID waves are not merely a fall or winter phenomenon, nor do they follow any other predictable seasonal pattern.

This distinction from seasonal pathogens, such as influenza, is crucial for several reasons and highlights the unique challenges and dangers posed by this novel coronavirus. As seasonal viruses infect people predominantly in the cold winter months, this makes those colder months more dangerous and other months less dangerous for those viruses. Examples of such diseases include the flu, rhinovirus, RSV, parainfluenza viruses, adenoviruses, enteroviruses, and human metapneumovirus.

Read the rest of the article and access the sources at either link!

[mcatmemoranda]

Rheumatoid Arthritis:

Refer to rheumatologist.

●Nonpharmacologic measures – Nonpharmacologic measures, such as patient education, psychosocial interventions, and physical and occupational therapy, should be used in addition to drug therapy. Other medical interventions that are important in the comprehensive management of RA in all stages of disease include cardiovascular risk reduction and immunizations to decrease the risk of complications of drug therapies.

●Initiation of DMARD therapy soon after RA diagnosis – We suggest that all patients diagnosed with RA be started on disease-modifying antirheumatic drug (DMARD) therapy as soon as possible following diagnosis, rather than using antiinflammatory drugs alone, such as nonsteroidal antiinflammatory drugs (NSAIDs) and glucocorticoids (Grade 2C). Better outcomes are achieved by early compared with delayed intervention with DMARDs.

●Tight control of disease activity – Tight control treatment strategies to "treat to target" are associated with improved radiographic and functional outcomes compared with less aggressive approaches. Such strategies involve reassessment of disease activity on a regularly planned basis with the use of quantitative composite measures and adjustment of treatment regimens to quickly achieve and maintain control of disease activity if targeted treatment goals (remission or low disease activity) have not been achieved. (

●Pretreatment evaluation – Laboratory testing prior to therapy should include a complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), aminotransferases, blood urea nitrogen, and creatinine. Patients receiving hydroxychloroquine (HCQ) should have a baseline ophthalmologic examination, and most patients who will receive a biologic agent or Janus kinase (JAK) inhibitor should be tested for latent tuberculosis (TB) infection. Screening for hepatitis B and C should be performed in all patients. Some patients may require antiviral treatment prior to initiating DMARD or immunosuppressive therapy, depending upon their level of risk for hepatitis B virus (HBV) reactivation.

●Adjunctive use of antiinflammatory agents – We use antiinflammatory drugs, including NSAIDs and glucocorticoids, as bridging therapies to rapidly achieve control of inflammation until DMARDs are sufficiently effective. Some patients may benefit from longer-term therapy with low doses of glucocorticoids.

●Drug therapy for flares – RA has natural exacerbations (also known as flares) and reductions of continuing disease activity. The severity of the flare and background drug therapy influence the choice of therapies. Patients who require multiple treatment courses with glucocorticoids for recurrent disease flares and whose medication doses have been increased to the maximally tolerated or acceptable level should be treated as patients with sustained disease activity. Such patients require modifications of their baseline drug therapies.

●Monitoring – The monitoring that we perform on a regular basis includes testing that is specific to evaluation of the safety of the drugs being; periodic assessments of disease activity with composite measures; monitoring for extraarticular manifestations of RA, other disease complications, and joint injury; and functional assessment.

●Other factors affecting target and choice of therapy – Other factors in RA management that may influence the target or choice of therapy include the disabilities or functional limitations important to a given patient, progressive joint injury, comorbidities, and the presence of adverse prognostic factors.

Osteoarthritis

General principles – General principles of osteoarthritis (OA) management include providing continuous care that is tailored to the patient according to individual needs, goals, and values and should be patient-centered. Treatment can be optimized by OA and self-management education, establishing treatment goals, and periodic monitoring.

●Monitoring and assessment – The management of OA should include a holistic assessment which considers the global needs of the patient. Patient preferences for certain types of therapies should also be assessed, as compliance and outcomes can be compromised if the care plan does not meet the patient's preferences and beliefs.

●Overview of management – The goals of OA management are to minimize pain, optimize function, and beneficially modify the process of joint damage. The primary aim of clinicians should include targeting modifiable risk factors. Due to the modest effects of the individual treatment options, a combination of therapeutic approaches is commonly used in practice and should prioritize therapies that are safer.

●Nonpharmacologic therapy – Nonpharmacologic interventions are the mainstay of OA management and should be tried first, followed by or in concert with medications to relieve pain when necessary. Nonpharmacologic therapies including weight management and exercises, braces and foot orthoses for patients suitable to these interventions, education, and use of assistive devices when required.

●Pharmacologic therapy – The main medications used in the pharmacologic management of OA include oral and topical nonsteroidal antiinflammatory drugs (NSAIDs). Other options include topical capsaicin, duloxetine, and intraarticular glucocorticoids. Our general approach to pharmacotherapy is described below.

•In patients with one or a few joints affected, especially knee and/or hand OA, we initiate pharmacotherapy with topical NSAIDs due to their similar efficacy compared with oral NSAIDs and their better safety profile.

•We use oral NSAIDs in patients with inadequate symptom relief with topical NSAIDs, patients with symptomatic OA in multiple joints, and/or patients with hip OA. We use the lowest dose required to control the patient's symptoms on an as-needed basis.

•We use duloxetine for patients with OA in multiple joints and concomitant comorbidities that may contraindicate oral NSAIDs and for patients with knee OA who have not responded satisfactorily to other interventions.

•Topical capsaicin is an option when one or a few joints are involved and other interventions are ineffective or contraindicated; however, its use may be limited by common local side effects.

•We do not routinely use intraarticular glucocorticoid injections due to the short duration of its effects (ie, approximately four weeks).

•We avoid prescribing opioids due to their overall small effects on pain over placebo and potential side effects (eg, nausea, dizziness, drowsiness), especially for long-term use and in the older adult population.

•We do not routinely recommend nutritional supplements such as glucosamine, chondroitin, vitamin D, diacerein, avocado soybean unsaponifiables (ASU), and fish oil due to a lack of clear evidence demonstrating a clinically important benefit from these supplements. Other nutritional supplements of interest that may have small effects on symptoms include curcumin (active ingredient of turmeric) and/or Boswellia serrata, but the data are limited.

●Role of surgery – Surgical treatment is dominated by total joint replacement, which is highly effective in patients with advanced knee and hip OA when conservative therapies have failed to provide adequate pain relief.

●Factors affecting response to therapy – The discordance of radiographic findings to pain supports the notion that the mechanisms of pain are complex and likely multifactorial. The placebo effect is also known to impact response to therapy.

●Prognosis – Although there is great variability among individuals and among different phenotypes of OA, courses of pain and physical functioning have been found to be predominantly stable, without substantial improvement or deterioration of symptoms over time.

[wyola-normiss]

The Tenth House (horary)

Will my project be successful?

Analysis:

10 house: Symbolizes the project, its potential and the possibility of success. The manager of the 10th house: shows the factors that can influence the outcome of the project. Ruler of the 5th house: Symbolizes creativity, initiative, and efforts that are invested in the project. The Sun: The planet of success, recognition, power and influence.

Example:

Ruler 10 houses in a harmonious aspect with the Sun: This may indicate that the project will be successful and bring recognition.

The steward of the 10th house is in conflict with the steward of the 5th house: this may indicate difficulties in the implementation of the project due to lack of resources, creative impulse or support.

(Questions asked in the context of 10 at home can help you understand how to develop a professional life, what steps to take to achieve goals, or what hinders successful career growth.)

It is also no less important to find out if the boss will raise the salary. In this case, an analysis of the position of the steward of the 10th house will help to understand how favorable the circumstances are in the working environment. If the connections or aspects point to a positive, it may mean that your work will be appreciated properly.

How is my mom's health?

Analysis:

10 house: Symbolizes the mother as an important figure in the life of the questioner. The steward of the 10th house: shows the factors that can affect the health of the mother. Moon: Symbolizes health, emotions and feelings. The ruler of the 6th house: symbolizes health, illness, and treatment.

Example:

The ruler of the 10th house in conjunction with the Moon in the sign of Aquarius: This may indicate that Mom may have some health problems related to the nervous system, but she has a strong spirit and can recover quickly.

The steward of the 10th house is in conflict with the steward of the 6th house: this may indicate that the mother may need medical attention or treatment.

For example, the question "Is it worth getting this job?" It opens up an opportunity for us to look at the planets that control the 10th house. By checking the position of Saturn or Mercury, you can assess how well this work meets your long-term goals.

Also, by asking the question "Is the judge in the case corrupt?", we can consider the influence of Jupiter and Pluto on the current legal situation. Also, the question about meeting mom on the weekend is "Will I meet mom on the weekend?" It can reveal aspects of the Moon and Venus that help to understand the emotional connection and support within the family. A proper analysis of these issues can provide meaningful foresight and guide you on the right path.

Another interesting question may sound like this: "What skills should I develop for successful career growth?" Here the key point will be the study of the third and ninth houses, which are related to learning and knowledge transfer.

Will I have a trial?

Analysis:

10th house: symbolizes judge, prosecutor, jury, justice. The steward of the 10th house: shows the factors that can influence the court's decision. The ruler of the 7th house: symbolizes relationships, cooperation, conflicts, contracts. Mars: The planet of conflict, struggle, aggression.

Example:

The ruler of the 10th house in conflict with Mars: this may indicate the possibility of litigation related to conflict, dispute, or violence.

The steward of the 10th house in a harmonious aspect with the steward of the 7th house: This may indicate that the trial will be resolved amicably or through mediation.

Another important point is the attitude towards the Sun, which also symbolizes personal ambitions. If the Sun forms harmonious aspects to the planets from the 10th house, this may indicate support from colleagues and superiors. It will be important to test several questions linked to different time periods in order to more accurately predict the position of the person interested in the professional field.

There are also often questions about the desire to change a profession or go into another field.

The First House (horary)- "I myself"

The Second House (horary) - "My resources"

The Third House (horary) -"Household"

The Fourth House (horary) - "Homeland"

The Firth House (horary) - "creativity"

The Sixth House (horary) - "ailments"

The Seventh House (horary) - "other people"

[drsanjaygupta-1]

Best Orthopaedic Doctor Vaishali Ghaziabad

Finding the Best Orthopaedic Doctor in Vaishali, Ghaziabad: A Spotlight on Dr. Sanjay Gupta

When it comes to maintaining a healthy, active lifestyle, your bones and joints play a crucial role. Whether you're dealing with chronic pain, a recent injury, or looking to prevent future issues, finding the right orthopaedic doctor is essential. For residents of Vaishali, Ghaziabad, Dr. Sanjay Gupta stands out as a top choice for orthopaedic care. In this blog, we'll explore why Dr. Gupta is highly regarded and what makes his practice a leading option for those seeking expert orthopaedic treatment.

Why Choose Dr. Sanjay Gupta?

Expertise and Experience: Dr. Sanjay Gupta brings a wealth of experience to his practice. With years of specialized training and hands-on experience in orthopaedics, he is well-versed in diagnosing and treating a wide range of musculoskeletal issues. His expertise encompasses everything from sports injuries and fractures to complex joint replacements and spinal surgeries.

Comprehensive Care: One of the hallmarks of Dr. Gupta’s practice is his commitment to providing comprehensive care. He doesn’t just treat the symptoms; he focuses on understanding the root cause of your issues and developing a personalized treatment plan. This approach ensures that patients receive care that is tailored to their specific needs, leading to more effective outcomes.

State-of-the-Art Facilities: Dr. Gupta’s clinic is equipped with the latest diagnostic tools and treatment technologies. This allows him to provide precise diagnoses and cutting-edge treatments. Whether it's advanced imaging techniques or minimally invasive surgical options, patients benefit from the best that modern medicine has to offer.

Patient-Centric Approach: At Dr. Gupta’s clinic, the patient always comes first. He emphasizes clear communication and ensures that patients fully understand their condition and treatment options. His empathetic approach helps in alleviating the anxiety often associated with orthopaedic issues and empowers patients to make informed decisions about their care.

Positive Patient Outcomes: Dr. Gupta’s track record speaks for itself. His patients often commend him for his skillful treatment and the positive impact it has had on their quality of life. Many have reported significant improvements in mobility and pain relief, contributing to enhanced overall well-being.

What to Expect During Your Visit

When you visit Dr. Gupta for an orthopaedic consultation, you can expect a thorough evaluation. He will take the time to discuss your symptoms, medical history, and any concerns you might have. Following a detailed examination, he will recommend a treatment plan that could include physical therapy, medication, or surgical options, depending on your condition.

Dr. Gupta’s approach is holistic, addressing not just the immediate issue but also considering factors that might contribute to your musculoskeletal health in the long term. His goal is to ensure that you not only recover but also achieve optimal functional recovery.

Getting in Touch

If you’re in Vaishali, Ghaziabad, and are seeking expert orthopaedic care, Dr. Sanjay Gupta is a name you can trust. For appointments or more information about his services, visit Dr. Sanjay Gupta’s website or call his clinic directly.

Final Thoughts

Choosing the right orthopaedic doctor is a critical decision that can greatly influence your recovery and overall health. Dr. Sanjay Gupta’s expertise, combined with his patient-centric approach and advanced facilities, makes him an excellent choice for anyone in need of orthopaedic care in Vaishali, Ghaziabad. Don’t let musculoskeletal issues hold you back—reach out to Dr. Gupta and take the first step towards a healthier, pain-free future.

📍 Location: Unit 3D - 5L, Wave City Center, Sector 32, Noida, Uttar Pradesh 201301 🌐 Website: https://drsanjaygupta.info/