#scrotal botox

[doctorfoxtor]

post ain't long it's wrong, can't study till dawn? yawn

100 days of productivity

day 44 + 45

CVS/RS

rheumatoid pleural effusions closely mimic complicated parapneumonic effusion on analysis, w/ ph <7.2, marked ↑LDH and notably glucose <30 (in fact glucose >30 almost rules out rheumatoid effusion)

in afib, digoxin will slow ventricular rate but is unlikely to cardiovert the rhythm

itraconazole in ABPA causes a 50% reduction in steroid dose and 25% reduction in anti-aspergillus IgE, and either partial or complete resolution of CXR infiltrates or improvement in PFTs/exercise tolerance

TRALI can happen as early as 15 minutes into the transfusion apparently?????

mesothelioma is an abject death sentence. The most you can do for patients beyond stage 1 is chemotherapy (limited survival benefit with platinics), radiotherapy to biopsy/thoracoscopy tracts only and surgery (lung-sparing debulking ± pleurodesis for recurrent effusions; radical surgery has shown no survival benefit)

mild tachy + broad qRs in haemodynamically stable pt s/p PCI for MI → likely to be LBBB developing; watch and wait

CNS/Ophthal/Psych

PSP looks similar to parkinson's bc it affects the opposite pathway as parkinsons (striatonigral vs nigrostriatal)

the best response you can get from deep brain stimulation for parkinsons = the best response you got from medication; DBS will NOT add a greater response compared to maximum medical therapy

without any other information, parkinson's ssx w/ dementia WITHIN 1 year of onset, it's Lewy body dementia; if it's more than 1 year, it's parkinson's w/ 2° dementia

choroidal neovascularisation with NO OTHER fundal signs: wet mac degen > diabetic retinopathy

focal dystonias are better treated with botox than with medication

SAH is unlikely to cause cranial nerve palsies other than III and maybe VI; pituitary apoplexy presents similarly with very severe headache/projectile vomiting/AMS, while affecting nerves III, IV, V-1 and VI

MS relapse: 500 mg PO or 1 g IV methylpred x5 days

there is no difference in risk of progression to Korsakoff when Wernicke is treated w/ glucose first vs w/ thiamine first

Endocrine/Repro

hyperaldosteronism: hyperplasia > adenoma

acute alcohol consumption can trigger hypoglycaemic events as the liver uses up NAD+ for each step of the alcohol detox pathway, where NAD+ is an important cofactor for the malate-oxalate shuttle used in gluconeogenesis

cinacalcet's major indication is hyperparathyroidism taht can't be corrected w/ surgery (eg, unfit pts)

Rheum/Derm/Immuno

topical steroid potency: hydrocortisone < clobetasol butyrate, betamethasone valerate low-dose < betamethasone valerate high-dose, fluticasone propionate < clobetasol propionate

onycholysis: trauma, tinea (infections), thyrotoxicosis, tetracyclines

pseudoxanthoma elasticum is assoc w/ mitral prolapse, renovascular htn, PVD, CAD, GIT bleeds and retinal vessel abnormalities

IgE values are normally distributed, so about 2.5% of the pop has raised IgE and 2.5% has reduced

s/p parathyroidectomy → acute drop in PTH → bones that are used to high levels of PTH experience a relative hypoPTHism → ↑blastic ↓clastic activity → acute bony uptake of calcium, PO4 and importantly magnesium = hungry bone syndrome (replace calcium and magnesium!)

carpal tunnel pain can radiate retrogradely to the forearm and sometimes even the arm

periarticular osteoporosis → RA

punched out erosions in juxtaarticular bone → gout

GIT

Peutz-Jeghers: small bowel hamartomas → intussusception, colorectal cancer, pigmented lesions (classically perioral/mucosal, but also palms/soles)

pernicious anaemia: parietal cell Abs (common) > intrinsic factor Abs (specific)

haemochromatosis: venesection → keep ferritin <50 and transferrin sat <50%

passing stools frequently, elevated inflammatory markers, ↑faecal calprotectin, PPI but not in demographic for IBD → take a colonoscopy and biopsy, this is probably microscopic colitis (and PPIs can trigger at any age)

liver biopsy is not indicated for Gilbert's—it is sufficient to do routine CBCs/LFTs w/ bilirubin analysis

pancreolauryl (fluorescein dilaurate) is quite nonspecific and will not pinpoint the exact pancreatic disease

hep A can be precided by short diarrhoeal illness`

in an IBD (esp UC) pt who comes >10 yrs after initial symptoms with recent change in bowel habits, offer urgent colonoscopy to r/o ca colon BEFORE starting on treatment

Onc/Haem

MTX + antifolate antibiotics: makes sense not to give them together—they can cause fulminant marrow failure

leukaemia can very rarely lead to acute painful scrotal swelling

5q- syndrome = myelodysplasia, but with thrombocytosis; diff from essential thrombocythaemia by anaemia with normal reticulocyte count and leukopaenia in the former

radiotherapy is a primary modality of tx in retinal, CNS, skin, oesophageal, cervical, vaginal and prostatic tumours; it is adjuvant in all other tumours

the commonest presentations of CMV s/p txp are pneumonia or pulmonary infiltrates

Renal/Biochem

SIADH causing drugs - SIADH Causes Poor Voiding: Sedatives (barbiturates), Indomethacin (NSAIDs), Antidepressants (TCAs/SSRIs), thiazide Diuretics, 1st gen antiHistamines, Cyclophosphamide/antiConvulsants, 1st gen antiPsychotics, Vinca alkaloids

malaria: irreversible nephrosis (esp memb or FSGS) > nephritis

2° syphilis: reversible nephritis > nephrosis

even if the patient doesn't qualify for ACEis/ARBs for HTN, give them first-line anyway if concomitant renal disease

kidney size difference >1 cm is significant

for drugs that will be dialysed out on dialysis days, dose them immediately after dialysis on those days

only urge incontinence is not primarily managed with pelvic floor exercises

Pharm/Toxo

valproate ADRs - VALPROATE: Vomiting, Alopecia/Anorexia, Liver tox, Pancreatitis/PCOS, Redistributed fat (weight gain/lipodystrophy), Oedema, hyperAmmonaemia/Ataxia, Tremor/Thrombocytopaenia, Enzyme inhibitor

opioid withdrawal: methadone is the best single tx and avoids needing to give multiple drugs to cover ssx (eg, clonidine + dextromethorphan + loperamide)

aminoglycosides preferentially affect proximal tubular cells

the classic pattern of symptoms in both cotton workers and workers at factories that process nitrates is that of 'Monday disease'

toxicities for which measuring the blood levels is indicated - SLIME TiPP: Salicylates, Lithium, Iron, Methanol, Ethylene glycol, Theophylline, Paraquat, Paracetamol

amphetamine tox → hyponatraemia due to water retention, worsened by the excessive thirst; hyperkalaemia → rhabdo; hypokalaemia not seen because amphetamines tho sympathetomimetic do not have affinity for the β2 receptor like cocaine does

[ldbroder]

Botox in Scrotum.

Botox

Botox has now been used for more than 10 years for cosmetic purposes.  It has a proven safety record that is unrivaled.  A purified protein, Botox is used to relax the muscles of facial expression that cause wrinkles.  It takes 1-2 days to see some effect and 1-2 weeks to see full effect.  The effects of Botox last for 3-4 months and must be repeated for continued effect.

The Scrotum.

As…

[holckkline60-blog]

Taking care of Severe Allergies

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[sextoyorgasm]

Guys Are Getting Botox in Their Balls to Enhance Sex (for Both Partners)&mdash;But Does That Really Work?

New Post has been published on http://sextoyorgasm.com/guys-are-getting-botox-in-their-balls-to-enhance-sex-for-both-partnersmdashbut-does-that-really-work/

Guys Are Getting Botox in Their Balls to Enhance Sex (for Both Partners)—But Does That Really Work?

[brightcove:5159289060001 default]

Few drugs have more varied applications than Botox. Aside from its FDA-approved uses to ease crossed eyes, chronic migraines, excessive sweating, neck spasms, overactive bladder, and, of course, crow’s feet, it is used off-label to battle depression and cold hands.

The latest off-label use that’s been gaining attention has been dubbed “Scrotox.” As in, Botox injections into a guy’s scrotum.

Nuts, right?

But what was good for a laugh just a few years ago is apparently now a thing among millennial men seeking testicles that look smoother, sweat less, and hang lower and look larger. It’s even touted to enhance sex (for both partners). How? Apparently, with freer-swinging balls, more scrotal skin comes into contact with a partner’s skin, thus enhancing sensation and pleasure. Plus, having “the testicles of the bulldog” (in the words of one purveyor of Scrotox) may help a guy channel his inner alpha, thereby boosting confidence. In an age in which vaginal rejuvenation is big business, it seems only fair that the boys come in for some cosmetic love, too.

The procedure is relatively straightforward: The scrotal sack is cleaned, a topical anesthetic applied, and then the needles work their magic. Costs range from $500-$1,000 and beyond per session, with results lasting about four months. Aside from the usual caveats applied to Botox injections (such as the neurotoxin inadvertently spreading to surrounding tissue), some experts warn of potential affects on sperm count. Since Scrotox is done off-label on a strictly cosmetic basis, there is no research available on the effectiveness or long-term safety of the procedure.

RELATED: 14 Fascinating Things All Women Should Know About Orgasms

But the question remains: Are lower-hanging ‘nads really what guys, and gals, want?

I figured it was worth a try, so I made an appointment for an injection with…

Yeah, no.

But I did call up sexual medicine expert Lauren Streicher, MD, associate clinical professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University, for her take.

“Since when did guys want longer, baggier, saggier scrotums?” Dr. Streicher mused.

But could Scrotox, and the smoother, freer-swinging balls that result, enhance a woman’s pleasure?

The short answer: unlikely.

“From a gynecologist’s point of view, female pleasure during sexual activity is generally from anything that enhances clitoral stimulation. Having a stretched-out scrotum does not enhance clitoral stimulation," she explained. "That said, if the guy with the stretched-out scrotum is holding a nice vibrator… then maybe we’ve got something.”

Source link

[sextoyorgasm]

Guys Are Getting Botox in Their Balls to Enhance Sex (for Both Partners)&mdash;But Does That Really Work?

New Post has been published on http://www.sextoyorgasm.com/wp/guys-are-getting-botox-in-their-balls-to-enhance-sex-for-both-partnersmdashbut-does-that-really-work/

Guys Are Getting Botox in Their Balls to Enhance Sex (for Both Partners)—But Does That Really Work?

[brightcove:5159289060001 default]

Few drugs have more varied applications than Botox. Aside from its FDA-approved uses to ease crossed eyes, chronic migraines, excessive sweating, neck spasms, overactive bladder, and, of course, crow’s feet, it is used off-label to battle depression and cold hands.

The latest off-label use that’s been gaining attention has been dubbed “Scrotox.” As in, Botox injections into a guy’s scrotum.

Nuts, right?

But what was good for a laugh just a few years ago is apparently now a thing among millennial men seeking testicles that look smoother, sweat less, and hang lower and look larger. It’s even touted to enhance sex (for both partners). How? Apparently, with freer-swinging balls, more scrotal skin comes into contact with a partner’s skin, thus enhancing sensation and pleasure. Plus, having “the testicles of the bulldog” (in the words of one purveyor of Scrotox) may help a guy channel his inner alpha, thereby boosting confidence. In an age in which vaginal rejuvenation is big business, it seems only fair that the boys come in for some cosmetic love, too.

The procedure is relatively straightforward: The scrotal sack is cleaned, a topical anesthetic applied, and then the needles work their magic. Costs range from $500-$1,000 and beyond per session, with results lasting about four months. Aside from the usual caveats applied to Botox injections (such as the neurotoxin inadvertently spreading to surrounding tissue), some experts warn of potential affects on sperm count. Since Scrotox is done off-label on a strictly cosmetic basis, there is no research available on the effectiveness or long-term safety of the procedure.

RELATED: 14 Fascinating Things All Women Should Know About Orgasms

But the question remains: Are lower-hanging ‘nads really what guys, and gals, want?

I figured it was worth a try, so I made an appointment for an injection with…

Yeah, no.

But I did call up sexual medicine expert Lauren Streicher, MD, associate clinical professor of obstetrics and gynecology at the Feinberg School of Medicine at Northwestern University, for her take.

“Since when did guys want longer, baggier, saggier scrotums?” Dr. Streicher mused.

But could Scrotox, and the smoother, freer-swinging balls that result, enhance a woman’s pleasure?

The short answer: unlikely.

“From a gynecologist’s point of view, female pleasure during sexual activity is generally from anything that enhances clitoral stimulation. Having a stretched-out scrotum does not enhance clitoral stimulation," she explained. "That said, if the guy with the stretched-out scrotum is holding a nice vibrator… then maybe we’ve got something.”

Source link