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[ { "answer_id": 13182, "author": "player777", "author_id": 11004, "author_profile": "https://health.stackexchange.com/users/11004", "pm_score": -1, "selected": false, "text": "<p>I do software as apart of my job, and I drink tea, coffee, eat icecream as an antidepressant, have warm baths with sea salt, go for a walk every day and 1-4 fishing per year, you need a medical examination, if you feel really bad to treat progressing diseases, you need clean oxygen, comfortable sleep and clean water and food to restore yourself</p>\n" }, { "answer_id": 13209, "author": "DeeKey", "author_id": 11027, "author_profile": "https://health.stackexchange.com/users/11027", "pm_score": 1, "selected": false, "text": "<ul>\n<li><p>Good breathing exercises keeps your lympha in motion and is good for cleaning and detoxing as well as making you in a better calmer state. When the fluid is in motion the body is too.</p></li>\n<li><p>Exercise in between every other 15 minutes is super important. If you can, try work while standing. Do some stretching, 3x10 squats and get your body moving. I always work out directly after work, that makes me more alert and\nnot that tired, I know it's difficult to push me go to the gym but do\na workout that's fun, crossfit? Do some strength training and some cardio afterwards for 15 minutes and enjoy a good meal after that.</p></li>\n<li><p>I'd also say that nutrition could be an 80% factor, avoid sugar in the morning, what do you eat for breakfast for example? Eat eggs, yoghurt, seeds (I do pumpkin+sunflower seeds), oats and good stuff. Avoid juice (sugar) and processed stuff. Lunch, eat a lean lunch that's not that huge and you'll get food coma, I eat salad, light protein and light grains (quinoa, brown rice, pasta). Maybe do a mozzarella salad or so. Pizza, burger and fatty stuff...avoid. Try eat as natural as possible. Have some nuts as a snack and drink a coffee after work and go to the gym :) </p></li>\n</ul>\n\n<p>Nutrition is So important here! PM me if you want and I'll help ya! \nCheers!</p>\n" } ]

[ "https://health.stackexchange.com/questions/12725", "https://health.stackexchange.com", "https://health.stackexchange.com/users/2314/" ]

[ { "answer_id": 17686, "author": "Bruce Kirkpatrick", "author_id": 14251, "author_profile": "https://health.stackexchange.com/users/14251", "pm_score": 0, "selected": false, "text": "<p>From the (almost nonexistent) research I could find related to the presence of underwear and concomitant testicular torsion, I think that loose underwear or complete nudity would actually <strong>increase</strong> your risk of testicular torsion, as the testicles are more mobile without restriction by a form-fitting garment. The only resource I can find supporting your original claim is an answer on <a href=\"https://www.quora.com/Can-tight-underwear-cause-testicular-pain\" rel=\"nofollow noreferrer\">Quora</a>, which I would not necessarily trust.</p>\n<blockquote>\n<p><strong><a href=\"https://www.sciencedirect.com/science/article/pii/S1522840109000135\" rel=\"nofollow noreferrer\">&quot;Diagnosis and Management of Testicular Torsion, Torsion of the Appendix Testis, and Epididymitis.&quot; Shan Yin, Jennifer L. Trainor. <em>Clinical Pediatric Emergency Medicine.</em> 2009.</a></strong></p>\n<p>In addition, scrotal support with a pediatric athletic supporter or tight-fitting brief-style underwear can minimize mobility of the testicle and hence pain.</p>\n</blockquote>\n<p>Although this doesn't specifically mention loose-fitting underwear as a potential risk factor for testicular torsion, I don't think it's an unreasonable inference to draw, especially given corroborating research in adolescent athletes:</p>\n<blockquote>\n<p><strong><a href=\"https://www.sciencedirect.com/science/article/pii/S0022534705672655\" rel=\"nofollow noreferrer\">&quot;Testicular Health Awareness in Pubertal Males.&quot; Phillip Nasrallah, Giju Nair, Joseph Congeni, Cynthia L. Bennett, Daniel McMahon. <em>The Journal of Urology.</em> 2000.</a></strong></p>\n<p>...5% of athletes reported tight underwear or compression\nshorts as their only type of protection [against testicular torsion].</p>\n</blockquote>\n" }, { "answer_id": 17692, "author": "Chris Rogers", "author_id": 7951, "author_profile": "https://health.stackexchange.com/users/7951", "pm_score": 3, "selected": true, "text": "<p>Testicular torsion occurs when the spermatic cord to a testicle twists, cutting off the blood supply (a condition called ischemia). The most common symptom is the rapid onset of acute testicular pain and prolonged testicular torsion will result in the death of the testicle and surrounding tissues (<a href=\"https://emedicine.medscape.com/article/2036003-overview#showall\" rel=\"nofollow noreferrer\">Ogunyemi, et al. 2018</a>).</p>\n\n<p>Generally, testicular torsion requires emergency surgery. If treated within a few hours, the testicle can usually be saved. However, waiting longer for treatment can cause permanent damage and may affect the ability to father children. When blood flow has been cut off for too long, a testicle may become so badly damaged it has to be removed.</p>\n\n<p>Wearing underpants will not necessarily prevent testicular torsion. Males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum. This inherited condition often affects both testicles (<a href=\"https://www.mayoclinic.org/diseases-conditions/testicular-torsion/symptoms-causes/syc-20378270\" rel=\"nofollow noreferrer\">Mayo Clinic, 2018</a>).</p>\n\n<p>In men and boys who are at risk of testicular torsion, the condition often occurs with no apparent trigger. Testicular torsion often occurs several hours after vigorous activity, after a minor injury to the testicles or while sleeping. Cold temperature or rapid growth of the testicle during puberty also might play a role.</p>\n\n<p>The risk factors are:</p>\n\n<ul>\n<li><strong>Age</strong><br>\nTesticular torsion is most common in males between 10 and 25 years old. </li>\n<li><strong>Previous testicular torsion</strong><br>\nA person that had testicular torsion that went away without treatment is likely to have it again in either testicle unless surgery is performed to correct the underlying problem. </li>\n<li><strong>Climate</strong><br>\nTorsions are sometimes called \"winter syndrome\". This is because they often happen in winter, when it is cold outside. The scrotum of a man who has been lying in a warm bed is relaxed. When he arises, his scrotum is exposed to the colder room air. If the spermatic cord is twisted while the scrotum is loose, the sudden contraction that results from the abrupt temperature change can trap the testicle in that position. The result is a testicular torsion. </li>\n<li><p><strong>Bell clapper deformity</strong><br>\nIn this deformity the testicle is only attached to the spermatic cord, like a bell clapper. A bell clapper deformity is a predisposing factor for testicular torsion in non-neonates. Currently there is no recommended clinical examination for a bell clapper deformity.</p>\n\n<p>Having testicles that can rotate or move back and forth freely in the scrotum is an inherited trait. Some males have this attribute and others do not. The only way to prevent testicular torsion for a man with this trait is through surgery to attach both testicles to the inside of the scrotum so that they cannot rotate freely. (<a href=\"http://www.medicalnewstoday.com/articles/190514.php\" rel=\"nofollow noreferrer\">Brunner, 2010</a>)</p></li>\n</ul>\n\n<p>With these facts in mind, with exception of a slight plausability created through the climate issue, neither being clothed or practicing nudism/naturism (<a href=\"https://en.wikipedia.org/wiki/Naturism\" rel=\"nofollow noreferrer\">whichever you wish to call it</a>) can prevent testicular torsion.</p>\n\n<h2>Other aspects aside from testicular torsion</h2>\n\n<p>With regards to protection from urine, semen and faeces, with good personal hygiene, these won’t pose a problem.\nThe combination of heat, sweat, and friction in your nether regions is not only uncomfortable, it can be unhealthy. Tight and non-breathable clothing traps heat and moisture, which can encourage the growth of candida, and lead to an unbearable yeast infection. That's not the only thing you have to worry about. When bacteria travel from back to front, it increases your risk for contracting an uncomfortable urinary tract infection (UTI) as well.</p>\n\n<p>For men, the temperature of the testes is at issue: In order for testes to produce sufficient quality and quantity of sperm, the temperature of testes must be lower than the core body temperature.</p>\n\n<blockquote>\n <p>\"That is why [testes] are located outside of the body,\" explains Celia E. Dominguez, reproductive endocrinologist, Centre for Reproductive Medicine at the Emory University School of Medicine. \"Testes were made to be out in the breeze.\" (<a href=\"http://www.webmd.com/infertility-and-reproduction/features/boxers-vs-briefs-increasing-sperm-count\" rel=\"nofollow noreferrer\">Davis, 2004</a>)</p>\n</blockquote>\n\n<p>Testes can overheat when a man wears brief underwear. If the testes are too hot — several degrees above where they should be — they are not able to produce sufficient sperm, resulting in low sperm count.</p>\n\n<h2>References</h2>\n\n<p>Brunner, S. (2010). What Is Testicular Torsion? What Causes Testicular Torsion? <em>Medical News Today</em> [Online]<br>\nRetrieved from: <a href=\"http://www.medicalnewstoday.com/articles/190514.php\" rel=\"nofollow noreferrer\">http://www.medicalnewstoday.com/articles/190514.php</a></p>\n\n<p>Davis, J. L. (2004). Boxers vs. Briefs: Increasing Sperm Count. <em>WebMD</em> [Online]<br>\nRetrieved from: <a href=\"http://www.webmd.com/infertility-and-reproduction/features/boxers-vs-briefs-increasing-sperm-count\" rel=\"nofollow noreferrer\">http://www.webmd.com/infertility-and-reproduction/features/boxers-vs-briefs-increasing-sperm-count</a></p>\n\n<p>Mayo Clinic. (2018). Testicular Torsion, <em>Mayo Clinic</em> [Online]<br>Retrieved from: <a href=\"https://www.mayoclinic.org/diseases-conditions/testicular-torsion/symptoms-causes/syc-20378270\" rel=\"nofollow noreferrer\">https://www.mayoclinic.org/diseases-conditions/testicular-torsion/symptoms-causes/syc-20378270</a></p>\n\n<p>Ogunyemi, O. I., Weiker, M., &amp; Abel, E. J. (2018). Testicular Torsion, <em>Medscape</em> [Online]<br>Retrieved from: <a href=\"https://emedicine.medscape.com/article/2036003-overview#showall\" rel=\"nofollow noreferrer\">https://emedicine.medscape.com/article/2036003-overview#showall</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/12737", "https://health.stackexchange.com", "https://health.stackexchange.com/users/7951/" ]

[ { "answer_id": 13018, "author": "Tami", "author_id": 9814, "author_profile": "https://health.stackexchange.com/users/9814", "pm_score": 2, "selected": false, "text": "<p>This question cannot be answered. It is individual and based on, among many other things, red blood cell survival. To understand why this is so, you need to understand than A1C is more accurately called Hemoglobin A1c <em>or</em> glycated hemoglobin. It's a form of hemoglobin that is formed due to hemoglobin's exposure to plasma glucose.<br>\nIt has been found that red blood cell (the cells that contain hemoglobin) survival <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604523/\" rel=\"nofollow noreferrer\">has considerable variation, even in hematologically normal people</a>. </p>\n\n<p>Ultimately, however, it is more important to realize that HbA1c is a measure for <a href=\"http://www.diabetes.co.uk/what-is-hba1c.html\" rel=\"nofollow noreferrer\">glucose control over a few months</a>, than to know how long exactly it \"has been measuring for\"</p>\n" }, { "answer_id": 23137, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 3, "selected": true, "text": "<p>It should be noted that the HbA1c is an approximation to an average of the glucose levels over the period of the life of red cells for an individual. There is considerable variability in the result</p>\n\n<blockquote>\n <p>RESULTS—The slope (95% CI) for mean sensor glucose concentration (area under the curve)\n versus a centrally measured HbA1c was 24.4 mg/dL (22.0–26.7) for each 1% change in HbA1c,\n with an intercept of 216.2 mg/dL (232.9 to 0.6). Although the slope did not vary with age or\n sex, there was substantial individual variability, with mean sensor glucose concentrations ranging from 128 to 187 mg/dL for an HbA1c of 6.9–7.1%. The root mean square of the errors\n between the actual mean sensor glucose concentration versus the value calculated using the\n regression equation was 14.3 mg/dL, whereas the median absolute difference was 10.1 mg/dL</p>\n</blockquote>\n\n<p>The test measures how much hemoglobin becomes glycosalated which means that how many glucose molecules attach to the hemoglobin molecule. The amount of hemoglobin around depends on the number of red cells, and the number of red cells depends on the red cell life, their production and destruction. Some conditions shorten the life of a red cell from the average of 120 days but in sickle cell disease it can drop to 28 days</p>\n\n<p>As red cells age they accumulate more glycosalated hemoglobin so conditions which shorten red cell life span would tend to lower the HbA1c</p>\n\n<blockquote>\n <p>Blood HbA1c is a mean for RBCs with values that range from very low for reticulocytes to approximately twice the mean for the oldest RBCs.</p>\n</blockquote>\n\n<p>We also see that diabetic patients can have RBCs with shorter lives</p>\n\n<blockquote>\n <p>The mean age of circulating RBCs ranged from 39 to 56 days in diabetic subjects and 38 to 60 days in nondiabetic controls</p>\n</blockquote>\n\n<p>but anemia, and even exercise can shorten the life of a red cell</p>\n\n<blockquote>\n <p>Exercise and professional sport increase RBC turnover and maximize oxygen delivery to the tissues (Mairbäurl, 2013). Maturation and aging of RBCs is accompanied by multiple processes occurring at various rates driving the circulating RBCs from adolescence to senescence within approximately 120 days (Lew and Tiffert, 2013; Lutz and Bogdanova, 2013). The resulting “markers of senescence” are recognized by the macrophages and clearance of RBCs is promptly initiated (de Back et al., 2014). Premature clearance is a hallmark of various disorders associated with anemia. In each case one or multiple markers of senescence appear prematurely. Those include excessive oxidative stress (Mohanty et al., 2014), excessive cation leak with the following dehydration (Wang et al., 2014), decrease in RBC size and loss of RBC membrane through vesiculation (Alaarg et al., 2013), metabolic abnormalities (Vives-Corrons et al., 2013), or following auto-immune diseases (Lutz and Bogdanova, 2013). Blood storage damages RBCs facilitating aging. As a result clearance of transfused cells is dramatically facilitated (Bosman, 2013; Flatt et al., 2014).</p>\n</blockquote>\n\n<p>With normal activity, and no other health conditions that affect red cell life, one can expect the HbA1c to apply over a period of 115 days +/- 15% which is the average life span of red cells.</p>\n\n<p><img src=\"https://i.imgur.com/WYlgSDa.png\" alt=\"Imgur\"></p>\n\n<p><a href=\"https://ashpublications.org/blood/article/45/2/273/160155/Red-cell-life-span-in-sickle-cell-hemoglobin-C\" rel=\"nofollow noreferrer\">https://ashpublications.org/blood/article/45/2/273/160155/Red-cell-life-span-in-sickle-cell-hemoglobin-C</a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2581997/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2581997/</a></p>\n\n<p><a href=\"https://www.frontiersin.org/articles/10.3389/fphys.2014.00269/full\" rel=\"nofollow noreferrer\">https://www.frontiersin.org/articles/10.3389/fphys.2014.00269/full</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/12746", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9100/" ]

[ { "answer_id": 12760, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 4, "selected": true, "text": "<p>Caffeine is readily absorbed, with up to 99% absorbed within 45 minutes of ingestion.<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK223808/\" rel=\"nofollow noreferrer\">[1]</a></p>\n\n<p>The mean half-life in healthy individuals is 5 hours, although this varies widely between individuals, ranging from 1.5 to 9.5 hours. For our purposes, we'll use the mean of 5 hours.<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK223808/\" rel=\"nofollow noreferrer\">[1]</a></p>\n\n<p>Knowing the above plus how much caffeine you've ingested will allow you to plot caffeine levels over time. Given the wide variation in half-life, I'm going to ignore the 99% absorption and treat it as 100%. Using your example we get:</p>\n\n<ul>\n<li>The 180 mg you ingested 5 hours ago is now down to 90 mg.</li>\n<li>The 180 mg you ingested 2 hours ago is now down to 136 mg. </li>\n<li>Therefore, there are now 90 + 136 = 226 mg in your system. </li>\n</ul>\n\n<p>Clearly that's only a ballpark figure given the wide variance of half-life times, but it's probably as close as you can get without more rigorous measuring techniques.</p>\n" }, { "answer_id": 17000, "author": "Jonathan", "author_id": 809, "author_profile": "https://health.stackexchange.com/users/809", "pm_score": 2, "selected": false, "text": "<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC370671/\" rel=\"nofollow noreferrer\">This study</a> correlated blood pressure and caffeine, and it showed that the body regulated after 4 days of consumption, therefore if you goal is to measure blood pressure, keep in mind <a href=\"https://health.stackexchange.com/a/16996/809\">tolerance</a> </p>\n\n<blockquote>\n <p>Acute caffeine in subjects who do not normally ingest methylxanthines\n leads to increases in blood pressure, heart rate, plasma epinephrine,\n plasma norepinephrine, plasma renin activity, and urinary\n catecholamines. Using a double-blind design, the effects of chronic\n caffeine administration on these same variables were assessed. Near\n complete tolerance, in terms of both humoral and hemodynamic\n variables, developed over the first 1-4 d of caffeine. No long-term\n effects of caffeine on blood pressure, heart rate, plasma renin\n activity, plasma catecholamines, or urinary catecholamines could be\n demonstrated. Discontinuation of caffeine ingestion after 7 d of\n administration did not result in a detectable withdrawal phenomenon\n relating to any of the variables assessed.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/12759", "https://health.stackexchange.com", "https://health.stackexchange.com/users/7111/" ]

[ { "answer_id": 12815, "author": "user1258361", "author_id": 9695, "author_profile": "https://health.stackexchange.com/users/9695", "pm_score": -1, "selected": false, "text": "<p>The answer is far more complicated. First, some sugars are far better at promoting cavities than others. Next, starches (such as potatoes and breads) slowly convert to sugar in the mouth due to amylase in saliva. Even worse, starches are better than straight up sugary liquids at sticking to teeth, which means that eating potatoes or bread and leaving the pieces in your mouth over the day could be worse for your teeth than a sugar-sweetened tea or coffee (where the sugar will tend to be washed away quickly).</p>\n\n<p>Meats and nuts are usually sugar-free or almost sugar-free and are generally OK for eating after brushing, except if you glazed, marinaded, or dipped them in something sweet or starchy.</p>\n" }, { "answer_id": 13820, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>After brushing your teeth, eventually you will have to eat again. And of course you can/may eat, for example nuts, after brushing your teeth. It depends on the timing. And of course: the way this question is phrased it is more along the lines of \"Is it a good idea to brush teeth, then eat nuts and then go to sleep?\"</p>\n\n<p>Then the answer is a definite no.</p>\n\n<p>My friend the dentist used to say: \"A clean tooth is a healthy tooth\"; so that commercial is not as bad as advertisements usually go.</p>\n\n<hr>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Sugar\" rel=\"nofollow noreferrer\">Sugar</a> is just a subtype of <a href=\"https://en.wikipedia.org/wiki/Carbohydrate\" rel=\"nofollow noreferrer\">carbohydrates</a> and carbohydrate digestion actually starts in your mouth. The starch <a href=\"https://en.wikipedia.org/wiki/Amylose\" rel=\"nofollow noreferrer\">amylose</a> from potatoes for example is broken down by the <a href=\"https://en.wikipedia.org/wiki/Enzyme\" rel=\"nofollow noreferrer\">enzyme</a> called <a href=\"https://en.wikipedia.org/wiki/Amylase\" rel=\"nofollow noreferrer\">amylase</a> found in your saliva into <a href=\"https://en.wikipedia.org/wiki/Maltose\" rel=\"nofollow noreferrer\">maltose</a>. This a disaccharide like common table sugar and food for acid producing and <a href=\"https://en.wikipedia.org/wiki/Tooth_decay\" rel=\"nofollow noreferrer\">cariogenic</a> bacteria.</p>\n\n<p><a href=\"http://apjcn.nhri.org.tw/server/info/books-phds/books/foodfacts/html/data/data2f.html\" rel=\"nofollow noreferrer\">The amount of carbohydrates contained in the things you eat varies, but is very seldom zero (especially if the food is <em>somehow prepared/processed</em>).</a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11021636\" rel=\"nofollow noreferrer\">Starches</a>, especially <a href=\"http://www.tandfonline.com/doi/pdf/10.3109/09637489709028590\" rel=\"nofollow noreferrer\">processed ones</a>, tend to <a href=\"http://www.tandfonline.com/doi/pdf/10.3109/09637489709028590\" rel=\"nofollow noreferrer\">cling to your teeth</a> and prolong the time the bacteria have an ample <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/7867054\" rel=\"nofollow noreferrer\">supply of food to produce cariogenic acid</a> and multiply themselves. That means bread after brushing is a foolishly stupid idea.</p>\n\n<p>Since you will not be able able to avoid any and all carbohydrate intake for eternity it is already self-evident that never brushing again is not the smartest choice available. But aside from tooth decay caused by carbohydrate metabolising bacteria (that you now have <em>'avoided in theory'</em>) there is an additional aspect that will come into play even if total 'no-carb diet' was to be followed through:</p>\n\n<p>Dental calculus or tartar buildup (From: \"Supragingival Calculus: Formation and Control\"):</p>\n\n<blockquote>\n <p><a href=\"http://journals.sagepub.com/doi/abs/10.1177/154411130201300506\" rel=\"nofollow noreferrer\">Dental calculus is composed of inorganic components and organic matrix. Brushite, dicalcium phosphate dihydrate, octacalcium phosphate, hydroxyapatite, and whitlockite form the mineral part of dental calculus. Salivary proteins selectively adsorb on the tooth surface to form an acquired pellicle. It is followed by the adherence of various oral micro-organisms. Fimbriae, flagella, and some other surface proteins are essential for microbial adherence. Microbial co-aggregation and co-adhesion enable some micro-organisms, which are incapable of adhering, to adhere to the pellicle-coated tooth surface. Once organisms attach to the tooth surface, new genes could be expressed so that mature dental plaque can form and biofilm bacteria assume increased resistance to antimicrobial agents. Supersaturation of saliva and plaque fluid with respect to calcium phosphates is the driving force for plaque mineralization. Both salivary flow rate and plaque pH appear to influence the saturation degree of calcium phosphates. Acidic phospholipids and specific proteolipids present in cell membranes play a key role in microbial mineralization.</a> </p>\n</blockquote>\n\n<p>This is problematic because they are <a href=\"http://onlinelibrary.wiley.com/doi/10.1034/j.1600-0757.2002.280102.x/abstract\" rel=\"nofollow noreferrer\">Dental biofilms: difficult therapeutic targets (10.1034/j.1600-0757.2002.280102.x):</a></p>\n\n<blockquote>\n <p>Periodontal diseases are infections caused by micro-organisms that colonize the tooth surface at or below the gingival margin. While these infections have many properties in common with other infectious diseases, they exhibit unique properties conferred by their site of colonization and the nature of the en- vironment in which they reside.</p>\n</blockquote>\n\n<p>Never brushing again will certainly shorten your life you live in comfort, regardless of how extreme you try to adapt your dietary ideas. Caries, periodontitis and other sorts of inflammation and infections would be very likely to increase.</p>\n" } ]

[ "https://health.stackexchange.com/questions/12800", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9691/" ]

[ { "answer_id": 13019, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 3, "selected": false, "text": "<p>Autoimmunity triggered by vaccination is a documented, but <strong>rare occurrence</strong>. The current research shows a correlation between autoimmune conditions and elevated levels of HLA proteins. Certain HLA proteins tend to have a predilection for activating the immune system against “self” cells. <strong><em>HLA proteins also can explain why certain people are more prone to autoimmune conditions that are induced or exacerbated by vaccines.</em></strong></p>\n\n<p>The risk of vaccine-related autoimmunity is by orders of magnitude lower than that of autoimmunity triggered by infectious disease. Since the latter includes vaccine-preventable infections, for most autoimmune conditions there is a <strong>net protective effect of vaccination</strong>. </p>\n\n<p>Current evidence supports administering appropriate vaccines in the absence of specific contraindications.</p>\n\n<hr>\n\n<p><strong><em>Sources</em></strong></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26728772\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/26728772</a><br>\n <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/27435705\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/27435705</a><br>\n <a href=\"http://www.sciencedirect.com/science/article/pii/S104366181400139X\" rel=\"noreferrer\">http://www.sciencedirect.com/science/article/pii/S104366181400139X</a><br>\n <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/25937813\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/25937813</a><br>\n <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/10648110\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/10648110</a><br>\n <a href=\"https://www.researchgate.net/profile/Srdja_Jankovic/publication/315656865_Vaccination_and_Autoimmune_Phenomena/links/58e1ed7eaca272059ab07f9c/Vaccination-and-Autoimmune-Phenomena.pdf\" rel=\"noreferrer\">https://www.researchgate.net/profile/Srdja_Jankovic/publication/315656865_Vaccination_and_Autoimmune_Phenomena/links/58e1ed7eaca272059ab07f9c/Vaccination-and-Autoimmune-Phenomena.pdf</a><br></p>\n" }, { "answer_id": 13039, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 2, "selected": false, "text": "<p>Like many health issues that are currently on the rise, anything you can potentially say is vaccine related can also easily be said to be environmental toxin related. There is quite a bit of research on autoimmune issues as it's currently a serious cause for concern to many researchers. It is much more common today than it was 50 years ago and they are trying to understand why &amp; what we might be able to do to stem that increase. This book is a great one for explaining the links between toxic exposures &amp; why it is believed to be the major factor in autoimmune disorder. <a href=\"https://donnajacksonnakazawa.com/the-autoimmune-epidemic-excerpt/\" rel=\"nofollow noreferrer\">https://donnajacksonnakazawa.com/the-autoimmune-epidemic-excerpt/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/12886", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9765/" ]

[ { "answer_id": 13019, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 3, "selected": false, "text": "<p>Autoimmunity triggered by vaccination is a documented, but <strong>rare occurrence</strong>. The current research shows a correlation between autoimmune conditions and elevated levels of HLA proteins. Certain HLA proteins tend to have a predilection for activating the immune system against “self” cells. <strong><em>HLA proteins also can explain why certain people are more prone to autoimmune conditions that are induced or exacerbated by vaccines.</em></strong></p>\n\n<p>The risk of vaccine-related autoimmunity is by orders of magnitude lower than that of autoimmunity triggered by infectious disease. Since the latter includes vaccine-preventable infections, for most autoimmune conditions there is a <strong>net protective effect of vaccination</strong>. </p>\n\n<p>Current evidence supports administering appropriate vaccines in the absence of specific contraindications.</p>\n\n<hr>\n\n<p><strong><em>Sources</em></strong></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26728772\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/26728772</a><br>\n <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/27435705\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/27435705</a><br>\n <a href=\"http://www.sciencedirect.com/science/article/pii/S104366181400139X\" rel=\"noreferrer\">http://www.sciencedirect.com/science/article/pii/S104366181400139X</a><br>\n <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/25937813\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/25937813</a><br>\n <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/10648110\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/10648110</a><br>\n <a href=\"https://www.researchgate.net/profile/Srdja_Jankovic/publication/315656865_Vaccination_and_Autoimmune_Phenomena/links/58e1ed7eaca272059ab07f9c/Vaccination-and-Autoimmune-Phenomena.pdf\" rel=\"noreferrer\">https://www.researchgate.net/profile/Srdja_Jankovic/publication/315656865_Vaccination_and_Autoimmune_Phenomena/links/58e1ed7eaca272059ab07f9c/Vaccination-and-Autoimmune-Phenomena.pdf</a><br></p>\n" }, { "answer_id": 13039, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 2, "selected": false, "text": "<p>Like many health issues that are currently on the rise, anything you can potentially say is vaccine related can also easily be said to be environmental toxin related. There is quite a bit of research on autoimmune issues as it's currently a serious cause for concern to many researchers. It is much more common today than it was 50 years ago and they are trying to understand why &amp; what we might be able to do to stem that increase. This book is a great one for explaining the links between toxic exposures &amp; why it is believed to be the major factor in autoimmune disorder. <a href=\"https://donnajacksonnakazawa.com/the-autoimmune-epidemic-excerpt/\" rel=\"nofollow noreferrer\">https://donnajacksonnakazawa.com/the-autoimmune-epidemic-excerpt/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/12961", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9818/" ]

[ { "answer_id": 12994, "author": "user 33690", "author_id": 9702, "author_profile": "https://health.stackexchange.com/users/9702", "pm_score": 3, "selected": true, "text": "<p>Rice can be primarily distinguished as:</p>\n<p>A)polished termed as &quot;white rice&quot;</p>\n<p>B)unpolished(whole)termed as &quot;brown rice&quot;</p>\n<h2><strong>HOW ARE THEY PRODUCED:</strong></h2>\n<p>When only the outermost layer of a grain of rice (the husk) is removed, brown rice is produced.</p>\n<p>When the next layers underneath the husk (the bran layer and the germ) are removed, leaving mostly the starchy endosperm,white rice is produced.</p>\n<h2><strong>WHY BROWN RICE IS NUTRITIONALLY BETTER THAN WHITE RICE:</strong></h2>\n<p>Several vitamins ,dietary minerals and essential fatty acids are lost in this removal and the subsequent polishing process.Vitamins lost are-B1,B3 ,traces of vitamin A and E.Minerals lost are iron,magnesium etc.Essential fatty acids in the bran oil and fibres are also lost.</p>\n<p>Germinated brown rice is nutritionally better because germination activates various enzymes in the rice, giving rise to a more complete amino acid profile, including GABA.</p>\n<h2><strong>MEASURES TAKEN TO IMPROVE WHITE RICE:</strong></h2>\n<p>Fortified rice has been produced with the help of biotechnology which is fortified with traces of the lost minerals,vitamins and other substances into the starchy grain matter itself.Such bio fortified white rice may be nutritious.One such is called <a href=\"https://en.m.wikipedia.org/wiki/Golden_rice\" rel=\"nofollow noreferrer\">golden rice</a> which is fortified with added micronutrients.</p>\n<p>Another measure is parboiling the rice before polishing.Parboiling helps the minerals and vitamins to be impregnated to some extent into the starchy grain.</p>\n<h2><strong>CONCERNS ABOUT ARSENIC CONTENT OF RICE:</strong></h2>\n<p>FIRSTLY,it depends on the type of soil,pesticide used during farming and varies from place to place.\nIndeed it possess more threat to people eating brown rice than those eating parboilt, fortified white rice.</p>\n<p>SECONDLY several measures are being taken to prevent such casualties.(pls check the reference below)</p>\n<p>THIRDLY,researchers have discovered a transporter protein in rice that sequesters arsenic in vacuoles, preventing the toxic element from traveling into grains.</p>\n<p>REFERENCES:11. ^ Yandell, Kate (2014-10-04). &quot;How Rice Overcomes Arsenic&quot; . Retrieved 2015-03-27.<a href=\"https://en.m.wikipedia.org/wiki/Brown_rice\" rel=\"nofollow noreferrer\">[source]</a></p>\n<h2><strong>WHY IS COLOURED RICE GRAIN MORE NUTRITIOUS THAN THE WHITE:</strong></h2>\n<p>The genetic colouration of the grain is due to the higher iron,anthocyanin and other antioxidant concentration,absent in white rice.</p>\n<p>REFERENCE:<a href=\"http://m.food.ndtv.com/food-drinks/white-rice-brown-rice-or-red-rice-which-one-is-the-healthiest-747933\" rel=\"nofollow noreferrer\">[link]</a></p>\n" }, { "answer_id": 13061, "author": "Bhumi Thakore", "author_id": 3184, "author_profile": "https://health.stackexchange.com/users/3184", "pm_score": 0, "selected": false, "text": "<p>Yes. Brown rice is more nutritious than polished rice as polishing process removes some vitamins and minerals in the process. However, it takes longer to cook, is brown in colour, so less attractive and has chewy mouth feel. Similarly it takes longer to digest too. Some people not used to eating a lot of fibre may initially have some gastric discomfort in the beginning. Parboiling rice does help retain some of the nutrients while milling and is easier on the stomach. It also requires less cooking time than brown rice. </p>\n" } ]

[ "https://health.stackexchange.com/questions/12980", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8418/" ]

[ { "answer_id": 15273, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 3, "selected": false, "text": "<p>Some vendors publish the pH values for the products they sell (<a href=\"https://health.stackexchange.com/a/13623/11231\">examples in this answer</a>). But that seems to be only the case if their product really stands out to the competition with high pH levels. Simple carbonated water (de-ionised) can have quite a low pH but other factors come into play for the acidity of the finished item. </p>\n\n<p>This brand's website has a section on this:</p>\n\n<blockquote>\n <p><a href=\"http://www.lacroixwater.com/nutritional-faqs/\" rel=\"noreferrer\"><strong>What is the PH balance of LaCroix waters?</strong></a></p>\n \n <p>_{The pH level of LaCroix varies by flavor and is less acidic than traditional soft drinks, 100% juice and juice drinks, and other typical beverages without the calories! If there are any concerns about your acidity consumption, please consult your physician.}</p>\n \n <p>_{Dr. Matthew Messina, a dentist and spokesperson for the American Dental Association, told MUNCHIES, a website and digital video channel, that “the health risks of sugarless, naturally carbonated waters like La Croix and Perrier are nowhere near those of sugary sodas, despite their textural similarities. There is no scientific evidence that sparkling waters are any more dangerous or damaging to the teeth than regular water.”}</p>\n</blockquote>\n\n<p>Real answer: \"What the hell, we won't tell!\"</p>\n\n<p>Of course, the real pH depends not only on the other salts in the water but on what exactly is used for flavouring it. If it is citric acid for example, and all too often it is, then chances for a drink low in acidity dwindle fast.</p>\n\n<blockquote>\n <p><a href=\"http://www.eatthis.com/la-croix-healthy/\" rel=\"noreferrer\"><strong>This Is Why You Should Stop Drinking LaCroix</strong></a> \n <a href=\"http://www.chicagotribune.com/lifestyles/health/ct-flavored-water-effects-on-teeth20170427-story.html\" rel=\"noreferrer\"><strong>Flavored waters — yes, including La Croix — are eroding your teeth</strong> (2017)</a></p>\n</blockquote>\n\n<p>It is really a pity and disgrace that \"sparkling water\" often refers to acidified flavoured sparkling water. Regarding dental health these are quite different.</p>\n\n<blockquote>\n <p><a href=\"http://www.leesimondds.com/dental-news-and-updates/why-flavored-waters-are-bad-for-your-teeth\" rel=\"noreferrer\">**Why flavored waters are bad for your teeth ** (2017)</a>\n Carbonating that (which is adding carbonic acid) lowers its pH to about 5. (Happily, that is well in the tooth-safe zone, so you can go ahead and drink your plain sparkling water without worry.) The trouble starts when flavors are added, and the citric acid commonly used in bottled flavored waters is considered especially insidious because besides lowering pH it also may remove calcium from the teeth. A 2016 report published in the Journal of the American Dental Association found that un-carbonated flavored waters such as grape, lemon or strawberry Dasani had a pH of 3, only somewhat better than RC Cola and Coca-Cola, which were among the most acidic tested, at 2.32 and 2.37 respectively (and which are close to the pH 2.25 of pure lemon juice). On its website, the brand Hint says the pH of its waters range from 3.5 to 4.</p>\n</blockquote>\n\n<p>Not only single expert opinions support this view. Some studies that support the </p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11556958\" rel=\"noreferrer\"><strong>Investigation of mineral waters and soft drinks in relation to dental erosion.</strong> (2001)</a></p>\n \n <p><a href=\"http://onlinelibrary.wiley.com/doi/10.1111/j.1365-263X.2006.00784.x/abstract\" rel=\"noreferrer\"><strong>The erosive potential of flavoured sparkling water drinks</strong> (2007)</a>\n <strong>Conclusions:</strong>  Flavoured sparkling waters should be considered as potentially erosive, and preventive advice on their consumption should recognize them as potentially acidic drinks rather than water with flavouring.\n <a href=\"https://i.stack.imgur.com/u4NVL.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/u4NVL.png\" alt=\"Apaptite dissolution capacity\"></a>\n _{Mean hydroxyapatite dissolution and standard deviation, expressed as the theoretical mass of phosphate (μg) present in 1.5 mL of test solution, both after the immediate opening of the test liquid and after 30 min of exposure of the carbonated water to air. Each value is based on the average of 10 replicate samples.}</p>\n</blockquote>\n\n<p>That has to be put into perspective. Even citric acid is not the devil. The pH is not everything. Amount of drink you consume and exposure time to your teeth are much more meaningful and harder to measure but better controllable than this easy to measure but harder to control number that is pH. </p>\n\n<blockquote>\n <p><a href=\"http://jada.ada.org/article/S0002-8177(14)60548-1/fulltext\" rel=\"noreferrer\"><strong>The effects of beverages on plaque acidogenicity after a sugary challenge</strong> (2013)</a></p>\n</blockquote>\n\n<p>Companies adding needlessly such superfluous ingredients like citric or other acids to \"sparkling water\" should be held responsible for diluting the meaning of that term and sued if they continue to sell this with a misleading claim like \"healthy\", since all around these flavoured waters are apparently not tooth friendly. Not drinking them might be one sane option. </p>\n\n<p>Insisting to ingest might warrant the following precautionary measures: </p>\n\n<p>Copied from the Chicago Tribune article:</p>\n\n<blockquote>\n <ul>\n <li>Don't use it as your primary hydration </li>\n <li>Minimize time exposure</li>\n <li>Drink it with a meal or snack</li>\n <li>Don't be a swisher</li>\n </ul>\n</blockquote>\n\n<p>The company does not release pH levels for its products. Given the question's interest in lime, lemon it is quite reasonable to assume a significant amount of citric acid used or the \"flavour\". This will bring down the pH-level to significantly lower than real, unflavoured water. If it does not contain citric acid or similar compounds under the label of so-called \"flavour\" then another indicator is the fact that it does not contain any sodium. The less minerals such a water contains, the more pronounced the resulting pH from the added carbonic acid. Let me be bold and cast an educated guess: the pH level will be well below 4.</p>\n\n<p>For comparison some of these \"water\" drinks were classified as such:</p>\n\n<blockquote>\n <p><a href=\"http://jada.ada.org/article/S0002-8177(15)01050-8/pdf\" rel=\"noreferrer\"><strong>The pH of beverages in the United States</strong> (2015):</a><br>\n This comprehensive pH assessment of commercially available beverages in the United States found that most are potentially erosive to the dentition. </p>\n \n <p>Erosive ___________________________________ pH<br>\n Activ Water Power Strawberry Kiwi _____________ 3.38<br>\n Clear American (flavored water) Kiwi Strawberry __ 3.70<br>\n Skinny Water Acai Grape Blueberry ____________ 3.81<br>\n Sobe Life Water Acai Fruit Punch ______________ 3.22<br>\n Vitamin Water Connect Black Cherry-Lime _______ 2.96</p>\n</blockquote>\n\n<p>As long as the company decides to keep silent about the ingredients and the FDA continues to allow them this practice:</p>\n\n<blockquote>\n <p><a href=\"https://www.wired.com/2016/12/heres-lacroix-addictive/\" rel=\"noreferrer\">What's actually in this stuff? And why is it so incredibly addicting?</a></p>\n \n <p>Part of the problem is that there's actually no way to know for sure what gives this very subtly flavored drink its ambiguous \"essence.\" Look at a LaCroix can and you'll see it has no artificial sweeteners, no calories, no sodium, no nothing. The only two ingredients are carbonated water and natural flavor, which means almost nothing. Carbonated water is water with CO2 in it. Sure, it creates a little carbonic acid in the drink, which some folks have said could harm your teeth, but so long as you're healthy your saliva easily neutralizes those acids. It's the second ingredient—natural flavor—that holds the key to LaCroix's allure.</p>\n \n <p>According to the FDA, natural flavor can be anything that adds flavor to a product so long as it comes directly from a plant or animal source. That's a pretty wide range, but it's further muddled by the fact that natural flavors can be made up of more than one ingredient—including artificial ingredients that help preserve the flavor or help it mix well with the other ingredients. \"You see 'natural flavor' on a label and it's really a black box of secrecy in terms of what's being added to that product,\" says David Andrews, a chemist from the Environmental Working Group.</p>\n \n <p>Just like their artificial counterparts, natural flavors are complex chemical formulas invented by food companies and a small handful of flavor houses around the world. The FDA lets companies call these formulas natural even if they have synthetic solvents or preservatives because it classifies those filler ingredients as \"incidental additives,\" which usually come in trace amounts and get a pass from ingredient disclosure laws.</p>\n \n <p>Before you start panic-counting the gallons of LaCroix you've consumed in the last two days alone, know that National Beverage, the obscure Florida-based company that owns LaCroix, claims that it doesn't add anything artificial to its flavors. Instead, they use \"natural essence oils ... extracted from the named fruit used in each of our LaCroix flavors,\" a company spokeswoman said in an email.</p>\n \n <p><a href=\"http://www.dentistryiq.com/articles/2016/03/the-skinny-on-sparkling-water-does-it-erode-teeth.html\" rel=\"noreferrer\">The skinny on sparkling water: Does it erode teeth?</a><br>\n <a href=\"https://www.mcgill.ca/oss/article/health-and-nutrition-quackery/carbonated-water-bad-your-teeth\" rel=\"noreferrer\">Is Carbonated Water Bad for Your Teeth?</a> (Has some further measurements on pH levels.) </p>\n</blockquote>\n" }, { "answer_id": 20725, "author": "Dean J", "author_id": 17333, "author_profile": "https://health.stackexchange.com/users/17333", "pm_score": 2, "selected": false, "text": "<p>This research article is maybe useful:</p>\n\n<p><strong>The pH of beverages available to the American consumer</strong>\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808596/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808596/</a></p>\n\n<p>Perrier is a 5.5 pH, albeit unflavored, and the article points out that anything over a 4.0 isn't bad for teeth. LaCroix didn't exist when it was written, so we dig farther. </p>\n\n<p><strong>Temperature</strong></p>\n\n<p>This one's also interesting, as it shows pH is much higher/less acidic... when carbonated beverages are warm:\n<a href=\"https://www.mcgill.ca/oss/article/health-and-nutrition-quackery/carbonated-water-bad-your-teeth\" rel=\"nofollow noreferrer\">https://www.mcgill.ca/oss/article/health-and-nutrition-quackery/carbonated-water-bad-your-teeth</a></p>\n\n<p><strong>Data</strong></p>\n\n<p>Here's someone directly testing LaCroix and getting a ~6 pH, which seems impossible... unless they add buffering agents to raise the pH, which is also possible.</p>\n\n<p><a href=\"https://www.reddit.com/r/lacroix/comments/be273e/i_ph_tested_my_lacroix/\" rel=\"nofollow noreferrer\">https://www.reddit.com/r/lacroix/comments/be273e/i_ph_tested_my_lacroix/</a></p>\n\n<p>Here's someone with a much more accurate test method... at 3.8, which makes more sense. They measured the grapefruit flavor, and I have bets about the temperature.</p>\n\n<p><a href=\"https://www.reddit.com/r/lacroix/comments/9jrrfm/i_got_a_ph_meter_so_i_measured_the_ph_of_my/\" rel=\"nofollow noreferrer\">https://www.reddit.com/r/lacroix/comments/9jrrfm/i_got_a_ph_meter_so_i_measured_the_ph_of_my/</a></p>\n\n<p><strong>TLDR</strong></p>\n\n<p>Yup, it's acidic. And delicious. As a combo of deliciousness and tooth protecting, you might drink it warm.</p>\n" } ]

[ "https://health.stackexchange.com/questions/12981", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9831/" ]

[ { "answer_id": 13044, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 2, "selected": false, "text": "<p>Your actual sperm count will matter as well as volume to <em>some</em> degree, as well as her level of fertility. If your wife is not currently releasing a fertile egg nothing else at all matters of course. If there no fertile egg there to be ready, then volume &amp; count mean nothing. You have to account then for timing as well of course. But you can have a high sperm count with low volume &amp; have better chance than high volume with a low count. </p>\n\n<p><a href=\"http://www.fertilitycenter.com/fertility_cares_blog/andrology-blog-part-ii/\" rel=\"nofollow noreferrer\">http://www.fertilitycenter.com/fertility_cares_blog/andrology-blog-part-ii/</a></p>\n" }, { "answer_id": 13045, "author": "Mark D Worthen PsyD", "author_id": 9632, "author_profile": "https://health.stackexchange.com/users/9632", "pm_score": 3, "selected": false, "text": "<p>No.</p>\n\n<p>The only exception is if your doctor has conducted a <a href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025038/\" rel=\"nofollow noreferrer\">semen analysis</a> and determined that you have <a href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0025036/\" rel=\"nofollow noreferrer\">oligospermia</a>, in which case your doctor <em>might</em> recommend having sexual intercourse with your wife 3-4 times a week instead of every day. </p>\n\n<p><em>The bottom line:</em> Don't start any unproven 'methods' for increasing the chances of pregnancy without talking with your wife about your idea, and asking your doctor(s) if the method has been scientifically proven to work. </p>\n\n<p>Here's what some experts have to say on the topic:</p>\n\n<p>\"...prolonged abstinence has little positive effect on conception and can actually decrease a couple’s chances of [getting pregnant] — even for men with low sperm counts. How so? While holding back does increase the number of sperm, ... abstinence longer than one day <em>decreases</em> sperm [motility]...\" - <a href=\"https://www.whattoexpect.com/preconception/boosting-male-fertility.aspx\" rel=\"nofollow noreferrer\">Boosting Male Fertility</a> (WhatToExpect.com)</p>\n\n<p><a href=\"http://Does%20frequent%20masturbation%20affect%20male%20fertility?\" rel=\"nofollow noreferrer\">Does frequent masturbation affect male fertility?</a> by Erik P. Castle, M.D. - \"Ultimately, having sexual intercourse ... several times a week will maximize your chances of getting your partner pregnant, whether you masturbate or not.\"</p>\n\n<p>Turning it around to what actually works, see: <a href=\"http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=1\" rel=\"nofollow noreferrer\">Healthy sperm: Improving your fertility</a> and <a href=\"http://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2\" rel=\"nofollow noreferrer\">What's the best way to produce healthy sperm?</a> (both on the Mayo Clinic website).</p>\n\n<p>Also on the Mayo Clinic site: <a href=\"https://connect.mayoclinic.org/2016/03/14/how-to-increase-chances-of-pregnancy-5-tips-to-improve-sperm-quality/\" rel=\"nofollow noreferrer\">How To Increase Chances of Pregnancy: 5 Tips To Improve Sperm Quality</a></p>\n\n<p>From <em>PubMed Health</em> - <a href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0076677/\" rel=\"nofollow noreferrer\">Infertility: Overview</a></p>\n\n<p><a href=\"http://www.parentherald.com/articles/28103/20160314/increase-chances-pregnancy-5-tips-improve-sperm-quality.htm\" rel=\"nofollow noreferrer\">How To Increase Chances Of Pregnancy: 5 Tips To Improve Sperm Quality</a> - an interview with Mayo Clinic doctors by <em>Parent Herald</em> online magazine.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13032", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9871/" ]

[ { "answer_id": 13034, "author": "paparazzo", "author_id": 6848, "author_profile": "https://health.stackexchange.com/users/6848", "pm_score": 1, "selected": false, "text": "<p>There are voluntary and involuntary muscles on urination. The default circuit is to close the involuntary during and before bowel. It is a way of the body forcing you to clear the bowel.</p>\n\n<p><a href=\"https://www.britannica.com/science/urination\" rel=\"nofollow noreferrer\">urination</a></p>\n" }, { "answer_id": 13066, "author": "user10899", "author_id": 10899, "author_profile": "https://health.stackexchange.com/users/10899", "pm_score": 0, "selected": false, "text": "<p>They certainly can occur at the same moment, but there are also situations where they might not. Similar to your hypothesis, if someone is for example severely constipated they may not be able to urinate until they have had a bowel movement due to the urethra (the tube that allows urine to leave your bladder) being pinched off from the pressure of the stool. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13033", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9872/" ]

[ { "answer_id": 13034, "author": "paparazzo", "author_id": 6848, "author_profile": "https://health.stackexchange.com/users/6848", "pm_score": 1, "selected": false, "text": "<p>There are voluntary and involuntary muscles on urination. The default circuit is to close the involuntary during and before bowel. It is a way of the body forcing you to clear the bowel.</p>\n\n<p><a href=\"https://www.britannica.com/science/urination\" rel=\"nofollow noreferrer\">urination</a></p>\n" }, { "answer_id": 13066, "author": "user10899", "author_id": 10899, "author_profile": "https://health.stackexchange.com/users/10899", "pm_score": 0, "selected": false, "text": "<p>They certainly can occur at the same moment, but there are also situations where they might not. Similar to your hypothesis, if someone is for example severely constipated they may not be able to urinate until they have had a bowel movement due to the urethra (the tube that allows urine to leave your bladder) being pinched off from the pressure of the stool. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13068", "https://health.stackexchange.com", "https://health.stackexchange.com/users/333/" ]

[ { "answer_id": 13083, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 0, "selected": false, "text": "<ul>\n<li><a href=\"http://www.webmd.com/diet/obesity/features/you-lost-weight-what-about-extra-skin\" rel=\"nofollow noreferrer\">You Lost the Weight. What About That Extra Skin?</a> </li>\n<li><a href=\"http://www.nbcnews.com/health/health-news/after-huge-weight-loss-sagging-skin-remains-n44481\" rel=\"nofollow noreferrer\">After Huge Weight Loss, Sagging Skin Remains</a></li>\n</ul>\n\n<p>Here are two good articles -- hopefully they answer some questions. </p>\n\n<p>Best of luck going forward and congrats on the weight loss!</p>\n" }, { "answer_id": 13125, "author": "Ortund", "author_id": 9812, "author_profile": "https://health.stackexchange.com/users/9812", "pm_score": 2, "selected": false, "text": "<p>Hanging skin is typical when weight loss is sudden or too fast.</p>\n<p>Skin is elastic, remember, so over time it'll shrink or expand as necessary but if you're losing weight too quickly, your skin won't have the time it needs to adapt.</p>\n<p>When losing weight, you'll obviously be working to decrease your calorie intake to a deficit of what your body needs to maintain the weight but this has to be measured carefully if you're going to stay healthy when losing.</p>\n<p>The recommended calorie deficit per day for healthy weight loss is 500 calories less than TDEE (total daily energy expenditure).</p>\n<p>So if your TDEE calories is 1875 (the calories you need to consume to maintain your weight), then you'll want to aim for a maximum daily intake of 1375 calories. You can consider calories lost during exercise as &quot;bonus calories.&quot;</p>\n<h3>Summary</h3>\n<p>Consuming too few calories per day when losing weight will mean you'll lose weight faster which could cause hanging skin.</p>\n<p>Keep your calorie intake per day while losing weight to 500 calories less than you need to maintain your weight for healthy weight loss which will avoid the hanging skin problem.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13077", "https://health.stackexchange.com", "https://health.stackexchange.com/users/3478/" ]

[ { "answer_id": 13230, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 2, "selected": false, "text": "<p>The <a href=\"https://www.cdc.gov/mold/cleanup.htm\" rel=\"nofollow noreferrer\">CDC has a great website on cleanup after mold</a>. Also, this is a <a href=\"https://www.cdc.gov/disasters/hurricanes/pdf/flyer-get-rid-of-mold.pdf\" rel=\"nofollow noreferrer\">simple pamphlet</a>. The degree of decontamination needed <strong>depends on the item and the extent of the mold</strong>. Whether something needs to be thrown out depends on multiple factors. There is too long a list to give a full discussion here, but the fundamentals include:</p>\n\n<ul>\n<li>Bleach can kill spores. Some clothing can be bleached. Nonporous surfaces can be scrubbed with bleach. Carpets cannot, drywall cannot, generally furniture cannot.</li>\n<li>Not everything requires bleach, like clothing/sheets can generally be washed on heavy cycle with detergent in very hot water.</li>\n<li>If mold did not directly grow on an item, sometimes it can be cleaned in other ways, so read about the specific circumstances. E.g. furniture steam cleaning or shampooing can be successful, depending on degree of mold.</li>\n<li>When handling items contaminated with significant amounts of mold, or in a mold-damaged area of the house, wear a respirator mask capable of filtering mold spores (N95) and other protective equipment so that you don't contaminate other areas.</li>\n</ul>\n\n<p>Mold has known deleterious health effects, so especially if you have allergies to mold, make sure you do read the CDC recommendations if you've experienced mold problems. Spores can be transported to a new location and grow there if it encounters favorable circumstances (damp rooms, leaking roof, etc).</p>\n" }, { "answer_id": 13237, "author": "Ne Mo", "author_id": 11063, "author_profile": "https://health.stackexchange.com/users/11063", "pm_score": 1, "selected": false, "text": "<p><em>Note: this is my personal experience, not a scientific opinion or anything like that. I hope it helps.</em></p>\n\n<p>I had a similar situation to you three years ago. We moved out of the damp apartment, full of black mould. We cleaned all of our furniture with ordinary upholstery shampoo, washed our clothes with normal detergent, etc.</p>\n\n<p>We then moved to a nice, dry apartment. No doubt some spores remained on the clothes, etc. However, they did not cause any health effects that we know of. We have moved several times since then and have never had symptoms of anything. The spores need moisture to grow into mould, or they'll die.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13223", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11040/" ]

[ { "answer_id": 13306, "author": "Gova DEster", "author_id": 7977, "author_profile": "https://health.stackexchange.com/users/7977", "pm_score": -1, "selected": false, "text": "<p>To make your immune system stronger simply.....Live in Haiti. </p>\n\n<p>I did for 8 years now I never get sick. </p>\n\n<p>Ok here's a my theory that I learned from 10th grade biology last year. Ok here's how to stronger your immune system. </p>\n\n<p><strong>First</strong></p>\n\n<p>Eat some infected food, like, moldy bread. \nJust eat anything that has bacteria in it! \nDon't eat to much obviously, the bacteria can overcome your body which can be fatal. \nJust eat enough to get you a bit sick. </p>\n\n<p><strong>Second</strong></p>\n\n<p>Now once you start feeling a bit sick, guess what, your body is producing antibodies to fight off the bacteria that is invading. When you body produces a certain type of antibodies it will \"store\" the DNA of that antibody and will produce it again if that same bacteria or like it invades again. (So if you want to protect against the flu..simply kiss your wife who already has the flu). \nYou body will produce antibodies that fight the flu bacteria or virus. You will want to take some antibiotics. Antibiotics just stimulate the immune system to create <strong>more</strong> antibodies. This is a faster way to become immune to a certain bacteria(sickness)</p>\n\n<p>If you didn't take antibiotics your bodies antibodies will likely get dominated by the bacteria that you got from your wife! Then you will have to go to the doctor and tell them about what you read from me on Stack. Then he will likely sue, you probably will too. Anyway the doctor will then give you some antibiotics and tell you to get some rest.</p>\n\n<p>This theory is mine! </p>\n\n<p>Don't sue me I'm just a 16 year old with no life. </p>\n" }, { "answer_id": 13309, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 1, "selected": false, "text": "<p>I use Vitamin D3 to prevent that sort of illness in my home. It has been used by many doctors &amp; is more &amp; more being promoted for this, as flu season is strongly linked to shortened days &amp; lower D3 levels in research. I do believe it's working as I have seen far fewer illnesses in general and have not gotten the flu now in many years since starting this. </p>\n\n<p>Here is a link to some information about D3 and it's use in this regard. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/</a></p>\n" }, { "answer_id": 13391, "author": "Vlad M-CST", "author_id": 11067, "author_profile": "https://health.stackexchange.com/users/11067", "pm_score": 0, "selected": false, "text": "<p>Whatever you do, please don't deliberately eat moldy bread.\nIt contains a spore/fungus. Ingesting that would be detrimental to the body since spores are exponentially harder to kill than germs or bacteria. \nThe only thing you're getting from moldy bread is food poisoning and pain. </p>\n\n<p>Germs/Bacteria that you find on the playground, when you bite your nails or eat without washing your hands, are the ones that boost your immunity because those kind of germs are easy to kill. The body's immune response is enough to form an antibody against that germ. </p>\n\n<p>If you want to prevent the flu or get rid of it quickly, antibiotics would help. Advil Cold and Sinus works best for my patients. If that's not your path, then you can go with apple cider vinegar TID for 1 week. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13232", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11055/" ]

[ { "answer_id": 13306, "author": "Gova DEster", "author_id": 7977, "author_profile": "https://health.stackexchange.com/users/7977", "pm_score": -1, "selected": false, "text": "<p>To make your immune system stronger simply.....Live in Haiti. </p>\n\n<p>I did for 8 years now I never get sick. </p>\n\n<p>Ok here's a my theory that I learned from 10th grade biology last year. Ok here's how to stronger your immune system. </p>\n\n<p><strong>First</strong></p>\n\n<p>Eat some infected food, like, moldy bread. \nJust eat anything that has bacteria in it! \nDon't eat to much obviously, the bacteria can overcome your body which can be fatal. \nJust eat enough to get you a bit sick. </p>\n\n<p><strong>Second</strong></p>\n\n<p>Now once you start feeling a bit sick, guess what, your body is producing antibodies to fight off the bacteria that is invading. When you body produces a certain type of antibodies it will \"store\" the DNA of that antibody and will produce it again if that same bacteria or like it invades again. (So if you want to protect against the flu..simply kiss your wife who already has the flu). \nYou body will produce antibodies that fight the flu bacteria or virus. You will want to take some antibiotics. Antibiotics just stimulate the immune system to create <strong>more</strong> antibodies. This is a faster way to become immune to a certain bacteria(sickness)</p>\n\n<p>If you didn't take antibiotics your bodies antibodies will likely get dominated by the bacteria that you got from your wife! Then you will have to go to the doctor and tell them about what you read from me on Stack. Then he will likely sue, you probably will too. Anyway the doctor will then give you some antibiotics and tell you to get some rest.</p>\n\n<p>This theory is mine! </p>\n\n<p>Don't sue me I'm just a 16 year old with no life. </p>\n" }, { "answer_id": 13309, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 1, "selected": false, "text": "<p>I use Vitamin D3 to prevent that sort of illness in my home. It has been used by many doctors &amp; is more &amp; more being promoted for this, as flu season is strongly linked to shortened days &amp; lower D3 levels in research. I do believe it's working as I have seen far fewer illnesses in general and have not gotten the flu now in many years since starting this. </p>\n\n<p>Here is a link to some information about D3 and it's use in this regard. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/</a></p>\n" }, { "answer_id": 13391, "author": "Vlad M-CST", "author_id": 11067, "author_profile": "https://health.stackexchange.com/users/11067", "pm_score": 0, "selected": false, "text": "<p>Whatever you do, please don't deliberately eat moldy bread.\nIt contains a spore/fungus. Ingesting that would be detrimental to the body since spores are exponentially harder to kill than germs or bacteria. \nThe only thing you're getting from moldy bread is food poisoning and pain. </p>\n\n<p>Germs/Bacteria that you find on the playground, when you bite your nails or eat without washing your hands, are the ones that boost your immunity because those kind of germs are easy to kill. The body's immune response is enough to form an antibody against that germ. </p>\n\n<p>If you want to prevent the flu or get rid of it quickly, antibiotics would help. Advil Cold and Sinus works best for my patients. If that's not your path, then you can go with apple cider vinegar TID for 1 week. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13238", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11063/" ]

[ { "answer_id": 13267, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 3, "selected": false, "text": "<p><a href=\"https://sleep.org/articles/sleep-hygiene/\" rel=\"noreferrer\">Sleep Hygiene.</a> Learn it, try it, and see if it resolves your issue.</p>\n\n<p>I've answered <a href=\"https://health.stackexchange.com/questions/10855/how-to-get-to-sleep-half-an-hour-an-hour-earlier-than-the-day-before/10939#10939\">this similar question before</a>.</p>\n\n<p>Insomnia has different causes. The most common, outside of poor sleep hygiene, is anxiety or depression. That's something else to consider.</p>\n\n<p>I recommend seeing your doctor in general to discuss it, they can help guide you whether there are any alarm features that might require tests or treatment, like signs of sleep apnea.</p>\n" }, { "answer_id": 13296, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>Insomnia is extremely rare in indigenous populations, as <a href=\"https://www.scientificamerican.com/article/modern-hunter-gatherers-probably-get-less-sleep-than-you-do/\" rel=\"nofollow noreferrer\">mentioned in this article</a> where the sleeping habits of 94 members of the Hadza of Tanzania, the San of Namibia and the Tsimané of Bolivia were studied:</p>\n\n<blockquote>\n <p>Only 1.5 to 2.5 percent of the hunter-gatherers the researchers studied experienced insomnia more than once a year. In comparison, 10 to 30 percent of people in industrial societies report chronic insomnia, the scientists noted. Insomnia was so rare among the San and the Tsimané, they do not have a word for the disorder.</p>\n</blockquote>\n\n<p>As suggested in the article, one can then try to adopt some of the relevant lifestyle factors that are plausibly involved in sleep. A new finding was the importance of temperature:</p>\n\n<blockquote>\n <p>The scientists found that the amount of sleep these hunter-gatherers got had less to do with the length of daylight hours than with temperature. These groups sleep an hour more in the winter than they do in the summer.\n \"In natural conditions, humans sleep [more] during a period of declining temperature,\" Siegel said. \"In contrast, in most modern settings, while we may turn the temperature down at night, it is not declining.\"\n In other words, modern life has \"almost completely eliminated a major sleep regulator,\" he said.</p>\n</blockquote>\n\n<p>Another thing that is mentioned in the article is that these indigenous people sleep less than we tend to do:</p>\n\n<blockquote>\n <p>Investigations showed that these traditional peoples slept slightly less than 6.5 hours a night on average. In comparison, people in industrial societies usually average seven to eight hours per night.</p>\n</blockquote>\n\n<p>This combined with the fact that these people get a lot more exercise than most of us get radically changes the balance between sleep and daytime exertion. And the diet has a totally different balance between fats and carbohydrates. As <a href=\"https://www.theguardian.com/society/2017/mar/17/tsimane-of-the-bolivian-amazon-have-worlds-healthiest-hearts-says-study\" rel=\"nofollow noreferrer\">mentioned here</a>:</p>\n\n<blockquote>\n <p>A high carbohydrate diet of rice, plantain, manioc and corn, with a small amount of wild game and fish – plus around six hours’ exercise every day – has given the Tsimané people of the Bolivian Amazon the healthiest hearts in the world.</p>\n</blockquote>\n\n<p>.............</p>\n\n<blockquote>\n <p>Their diet is high in unrefined carbohydrates (72%) with about 14% protein and it is very low in sugar and in fat – also 14%, which amounts to about 38g of fat a day including 11g of saturated fat. </p>\n</blockquote>\n\n<p>So, the bigger picture that we don't get if we only study sleep in Western societies, is that the Western lifestyle is not so robust at preventing insomnia compared to indigenous populations. The people who sleep well in Western societies are still just one or two steps away of getting insomnia, while the way indigenous populations live, put them many more steps away from getting insomnia, which makes insomnia far less likely to occur there, so much so that their languages <a href=\"http://news.nationalgeographic.com/2015/10/20151015-paleo-sleep-time-hadza-san-tsimane-science/\" rel=\"nofollow noreferrer\">don't have a word for it</a>:</p>\n\n<blockquote>\n <p>The San and Tsimané languages have no word for insomnia, and when researchers tried to explain it to them, “they still don’t seem to quite understand,” Siegel says.</p>\n</blockquote>\n\n<p>which really emphasizes the point that insomnia just doesn't happen there, otherwise the people there would be able to understand it from their own personal experience. From my personal experience, I think that sleep time and exercise may be the most important factor. I run every day for about one hour (and quite fast with my heart rate at about 150 bpm), and I sleep on average slightly less than 7 hours a day. When I was younger I slept for 8 hours and I didn't exercise anywhere near my current level. I did have sleeping problems far more frequently than I have today. So, to me at least, this seems to be a a problem that's caused by the body getting way too much rest and way too little exertion. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13266", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9268/" ]

[ { "answer_id": 13293, "author": "Virginia", "author_id": 9246, "author_profile": "https://health.stackexchange.com/users/9246", "pm_score": 2, "selected": false, "text": "<p>Stress- relief techniques can help manage anxiety... specific ones to incorporate based on anxiety are... </p>\n\n<p>Mindful meditation as shown by the study in this article... <a href=\"http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.149.7.936\" rel=\"nofollow noreferrer\">http://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.149.7.936</a> Meditation can be performed in the morning before the toddlers awake, or after they go to bed. Even 5 minutes consistently done on a daily basis can help you to focus and reduce anxiety throughout the day.</p>\n\n<p>Yoga may be effective based on this article, although I know it can be difficult to do with toddlers, but if you have the time before they wake up, or during nap time. <a href=\"http://www.biomedsearch.com/article/effects-yoga-anxiety-stress/286390903.html\" rel=\"nofollow noreferrer\">http://www.biomedsearch.com/article/effects-yoga-anxiety-stress/286390903.html</a></p>\n\n<p>Deep breathing can also reduce anxiety, during an episode of anxiety <a href=\"http://www.anxieties.com/57/panic-step4#.WY9xmlGGOUk\" rel=\"nofollow noreferrer\">http://www.anxieties.com/57/panic-step4#.WY9xmlGGOUk</a> Basically when someone is anxious their breathing and heart rate go up, which affects other things as well. By controlling your breathing, your heart rate can go down, and help regulate the other symptoms of anxiety. This can be done at any time anywhere.</p>\n\n<p>Also don't stress if you can't do the above consistently... Stressing over not using stress relief techniques in counter productive. Also, depending on your situation you could ask for help from family and friends. I think sometimes us Moms think we have to do everything ourselves, when we don't.</p>\n" }, { "answer_id": 13323, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 1, "selected": false, "text": "<p>I recommend seeing a counselor/therapist/psychologist ASAP to help you with this. <a href=\"https://en.wikipedia.org/wiki/Cognitive_behavioral_therapy\" rel=\"nofollow noreferrer\">Cognitive Behavioral Therapy</a> is one of many approaches to anxiety. But a professional can help identify what you need to focus on. They are the branch of healthcare that manages mental health with behavioral interventions rather than medications (or in addition to medications from an MD in some cases, as they don't prescribe meds)</p>\n" }, { "answer_id": 13336, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 0, "selected": false, "text": "<p>If this level of anxiety kicked in after having children it may qualify as <a href=\"https://www.anxietybc.com/parents/new-moms/feeling-anxious/recognizing-post-partum-anxiety\" rel=\"nofollow noreferrer\">PPA - post partum anxiety</a>. People often think of depression, but anxiety is also incredibly common. There are varying degrees you can experience such things and <em>sometimes</em> it might be a good idea to consider medication <em>while</em> making lifestyle changes to assist you. </p>\n\n<p>As a mother to young kids myself, I know that I am prone to anxiety. What I didn't know initially was that I am also prone to developing something called post partum hyper-thyroiditis. So this was doubly awful. I was loosing weight like crazy, unable to sleep, and having all sorts of symptoms due to my thyroid which also increases anxiety for some, and having anxiety with the two together had me convinced for a while that I had to have cancer or some awful thing happening, because of all my strange symptoms (especially excess weight loss). I tell you that because pregnancy also puts a strain &amp; sometimes that means it can change our health. It is always advisable to <em>talk</em> to the doctor about any symptoms you are having, even anxiety, simply because there can be a biological component to it. I could have never yoga-d my way into a healthy thyroid. That wasn't going to work, right? So a check up &amp; talk with the doctor is seldom a bad idea. If they advise a medication you prefer not to take, you don't <em>have</em> to take it, but it's still worth looking at all options and ensuring you don't have anything else causing you to have more intense anxiety.</p>\n\n<p>That said, the rest of what I do. I have recently started a supplement called <a href=\"https://www.psychologytoday.com/blog/integrative-mental-health-care/201703/l-theanine-reduces-symptoms-anxiety\" rel=\"nofollow noreferrer\">L Theanine</a>. It's an extract found in tea. It simply helps me feel more calm &amp; focused. The strength <em>I</em> take is about what you get in 2 cups of tea, so not much, and it's not magical, but it helps a little. </p>\n\n<p>Avoiding caffeine helps me as well. That was one my doctor advised right off. I again, can't say it magic, but also better.</p>\n\n<p>CBT is one that is commonly used clinically. I was already versed in meditation, so for <em>me</em> I've just reapplied myself to that, which in many ways is not too terribly far removed from the techniques of CBT, such that now there is MCBT that is a marriage of the two. <a href=\"http://www.harleytherapy.co.uk/counselling/cbt-mbct-difference.htm\" rel=\"nofollow noreferrer\">http://www.harleytherapy.co.uk/counselling/cbt-mbct-difference.htm</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/13292", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11110/" ]

[ { "answer_id": 15324, "author": "faustus", "author_id": 12881, "author_profile": "https://health.stackexchange.com/users/12881", "pm_score": 2, "selected": false, "text": "<p>Yes. This is an interesting question. </p>\n\n<p>I can think of two examples, one which I think is closer to what you're thinking about, and another being related conceptually. </p>\n\n<h2><strong>1. Prodromal phase of schizophrenia</strong></h2>\n\n<blockquote>\n <p>then surely it should reason that there are people who experience delusions that are the opposite of distress i.e pleasure </p>\n</blockquote>\n\n<p>What you're describing, if it does occur, generally happens during the prodromal phase of schizophrenia, which is a period of one or two years prior to the first episode of florid psychosis. This is thought to be related to the <em>hyperdopaminergic</em> state that characterises the positive symptoms of schizophrenia e.g. hallucinations, delusions.</p>\n\n<p>Although the lay view of dopamine's role is one relating to pleasure, it's generally thought to be related to <em>incentive salience</em>. The prodrome may describe the whole world as \"lighting up\" or \"finally making sense\". Oftentimes there can be metaphysical undertones.</p>\n\n<p>From <a href=\"https://academic.oup.com/schizophreniabulletin/article/34/2/381/1923247\" rel=\"nofollow noreferrer\">The Phenomenological Critique and Self-disturbance: Implications for Ultra-High Risk (“Prodrome”) Research</a>:</p>\n\n<blockquote>\n <p>A common finding in studies of the prodromal period has been of a\n developing preoccupation with philosophical, supernatural, and\n metaphysical themes. The rupture in “normal” self-experience\n motivates such a preoccupation; in cognitive terms, the patient is\n attempting to accommodate his anomalous experience to existing\n schemas. Feelings of centrality or solipsism may come to the fore.</p>\n</blockquote>\n\n<p>And from <em><a href=\"https://doi.org/10.1053/comp.2003.50017\" rel=\"nofollow noreferrer\">Phenomenology of anomalous self-experience in early schizophrenia</a></em>:</p>\n\n<p><a href=\"https://i.stack.imgur.com/89qNd.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/89qNd.png\" alt=\"enter image description here\"></a></p>\n\n<p>A classic is <em>Knots (1970)</em> by R.D. Laing who was both a psychiatrist and someone who experienced psychosis. I recommend getting a hold of it. It's very short and will make no sense. But it also will, and that's the entire point:</p>\n\n<p><a href=\"https://i.stack.imgur.com/okxa5.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/okxa5.png\" alt=\"enter image description here\"></a></p>\n\n<h2><strong>2. Mystical experience</strong></h2>\n\n<p>Psychosis and mystical experience are two antipodal human experiences but they both have something in common: they are both departures from our everyday experience of reality. </p>\n\n<p>The following is from William James' <em>The Varieties Of Religious Experience (1901)</em> which is considered a classic:</p>\n\n<blockquote>\n <p>Open any one of these, and you will find abundant cases in which\n ‘mystical ideas’ are cited as characteristic symptoms of enfeebled or\n deluded states of mind. <strong>In delusional insanity, paranoia, as they\n sometimes call it, we may have a diabolical mysticism, a sort of\n religious mysticism turned upside down.</strong> The same sense of ineffable\n importance in the smallest events, the same texts and words coming\n with new meanings, the same voices and visions and leadings and\n missions, the same controlling by extraneous powers; only this time\n the emotion is pessimistic: instead of consolations we have\n desolations; the meanings are dreadful; and the powers are enemies to\n life.</p>\n</blockquote>\n\n<p>The point I am making here is that the \"pleasurable form of psychosis\" you are asking about is not called <em>psychosis</em>. It's called <em>mystical experience</em>. Claiming you have insight into the nature of reality will not be called psychosis if one displays minimal or no impairment, and if you can convince others that what you're experiencing is a reality of a <em>type</em> they are willing to entertain as existing. Even still, the presence of unpleasantness/impairment need to necessarily translate into a label of pathology.</p>\n\n<p>From <a href=\"http://psycnet.apa.org/record/2007-13101-001\" rel=\"nofollow noreferrer\">\"Dark nights of the soul\": Phenomenology and neurocognition of spiritual suffering in mysticism and psychosis</a>:</p>\n\n<p><a href=\"https://i.stack.imgur.com/DGp9g.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/DGp9g.png\" alt=\"enter image description here\"></a></p>\n\n<p>The similarity between psychosis and mysticism is an elephant in the room for religion and psychiatry. It's as though when they carved up their dominion over aspects of reality, psychiatry had to make some concessions. From DSM-V:</p>\n\n<p><a href=\"https://i.stack.imgur.com/cu1A7.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/cu1A7.png\" alt=\"enter image description here\"></a></p>\n\n<p>And of the experience itself, this is a description from Dostoevsky's <em>The Idiot (1868)</em>, detailing what we would characterise as a mystical experience associated with epilepsy:</p>\n\n<blockquote>\n <p>For several instants I experience a happiness that is impossible in an\n ordinary state, and of which other people have no conception. I feel\n full harmony in myself and in the whole world, and the feeling is so\n strong and sweet that for a few seconds of such bliss one could give\n up ten years of life, perhaps all of life.</p>\n \n <p>I felt that heaven descended to earth and swallowed me. I really\n attained god and was imbued with him. All of you healthy people don't\n even suspect what happiness is, that happiness that we epileptics\n experience for a second before an attack.</p>\n</blockquote>\n" }, { "answer_id": 15338, "author": "Chris Rogers", "author_id": 7951, "author_profile": "https://health.stackexchange.com/users/7951", "pm_score": 1, "selected": false, "text": "<p>To answer your question you need to break the psychology terms up into their components.</p>\n\n<p>First of all let's look at Psychosis.</p>\n\n<p>Psychosis certainly isn't</p>\n\n<blockquote>\n <p>a loss of contact from impaired thoughts and emotions</p>\n</blockquote>\n\n<p>Psychosis is</p>\n\n<blockquote>\n <p>the presence of delusions, hallucinations without insight, or both. (Arciniegas, 2015)</p>\n</blockquote>\n\n<p>or more simply put...</p>\n\n<blockquote>\n <p>an abnormal condition of the mind that results in difficulties telling what is real and what is not. (<a href=\"https://en.wikipedia.org/wiki/Psychosis\" rel=\"nofollow noreferrer\">source</a>)</p>\n</blockquote>\n\n<p>Psychosis is a <strong>symptom</strong> of certain mental <strong>disorders</strong> and not a disorder in itself.</p>\n\n<p>A <strong>disorder</strong> is defined in psychology (emphasis mine) as a:</p>\n\n<blockquote>\n <p>behavioral or mental pattern that causes significant distress <strong>or</strong> impairment of personal functioning. (Bolton, 2008).</p>\n</blockquote>\n\n<p>Because of the <strong>or</strong> in Bolton's definition you could assume that happiness/pleasure can be experienced whilst in a psychotic state, and there was a study on it.</p>\n\n<p>When Pawel D. Mankiewicz et al. (2013) looked at happiness in severe mental illness, he found that</p>\n\n<blockquote>\n <p>Psychosis did not appear to prevent individuals from experiencing happiness, although when associated with depression, life satisfaction was lowered.</p>\n</blockquote>\n\n<h2>References</h2>\n\n<p>Arciniegas, D. B. (2015). Psychosis. <em>Continuum (Minneap Minn)</em> 21(3 Behavioral Neurology and Neuropsychiatry): 715–736.<br>PMCID: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455840\" rel=\"nofollow noreferrer\">PMC4455840</a> DOI:  <a href=\"https://doi.org/10.1212/01.CON.0000466662.89908.e7\" rel=\"nofollow noreferrer\">10.1212/01.CON.0000466662.89908.e7</a></p>\n\n<p>Bolton, D. (2008). <em><a href=\"https://books.google.co.uk/books?id=Ohzt1HBilXcC&amp;pg=PA6&amp;redir_esc=y#v=onepage&amp;q&amp;f=false\" rel=\"nofollow noreferrer\">What is Mental Disorder?: An Essay in Philosophy, Science, and Values</a></em>. Oxford: Oxford University Press p. 6. ISBN 9780198565925.</p>\n\n<p>Mankiewicz P. D. et al. (2013) Happiness in severe mental illness: exploring subjective wellbeing of individuals with psychosis and encouraging socially inclusive multidisciplinary practice. <em>Mental Health and Social Inclusion</em>, 17(1): pp.27-34<br>DOI: <a href=\"https://doi.org/10.1108/20428301311305287\" rel=\"nofollow noreferrer\">10.1108/20428301311305287</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/13305", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11117/" ]

[ { "answer_id": 13343, "author": "Smeato", "author_id": 7303, "author_profile": "https://health.stackexchange.com/users/7303", "pm_score": 1, "selected": false, "text": "<p>This might sound unfortunately obvious, but exercising and reducing fatty food intake is all you can do to reduce body fat. There's no real trick other than to change your diet and put a time investment into exercise.</p>\n\n<p>Something I've noticed is that it is difficult to maintain a diet while working in an office. It's difficult to focus mentally when you're hungry. I noticed that working manual jobs (I emptied shipping containers for a while) it was easier to eat less since you didn't need to be mentally focused. </p>\n\n<p>That pretty much leaves exercise as your best bet. Is it possible for you to start cycling to work? This is a real 'two birds, one stone' solution. Working full time, you lack the free time to fully dedicate to exercise. Your commute is time wasted as it is, so why not cycle some or all of the way to your office? \n<a href=\"https://www.forbes.com/sites/kevinmurnane/2017/04/25/new-research-indicates-cycling-to-work-has-extraordinary-health-benefits/#7aac183c3e62\" rel=\"nofollow noreferrer\">https://www.forbes.com/sites/kevinmurnane/2017/04/25/new-research-indicates-cycling-to-work-has-extraordinary-health-benefits/#7aac183c3e62</a></p>\n\n<p>It's great for cardio, great for weight loss (the calories you burn are huge), and makes your legs look damn sexy.</p>\n\n<p>Otherwise, swimming is another good option because it exercises your whole body and isn't a huge time sink. You don't need to do a lot to gain huge results. You can swim and hour in the morning/on your lunch/after work and gain a huge amount from it. </p>\n\n<p>Ultimately the key is to cut your diet down and exercise and you should see results in no time. Just doing one or the other may disappoint you, in my own experience, over how slow progress you may make, and cause you to give up, but if you do both for a month or so you'll notice the difference. This should give you a huge confidence and motivational boost to keep going and go harder. </p>\n" }, { "answer_id": 13345, "author": "Tyler Durden", "author_id": 5371, "author_profile": "https://health.stackexchange.com/users/5371", "pm_score": -1, "selected": false, "text": "<p>Don't eat much.</p>\n\n<p>Your body consumes about 2500 calories per day. You can get a more precise estimate by adding three factors, the Basal Metabolic Rate (BRM), <a href=\"http://www.nutristrategy.com/caloriesburned.htm\" rel=\"nofollow noreferrer\">calories consumed by activity</a> and food processing calorie consumption.</p>\n\n<blockquote>\n <p>Adult male: 66 + (6.3 x body weight in lbs.) + (12.9 x height in\n inches) - (6.8 x age in years)</p>\n \n <p>Adult female: 655 + (4.3 x weight in lbs.) + (4.7 x height in inches)\n - (4.7 x age in years)</p>\n</blockquote>\n\n<p>So, for example, if you weigh 200 pound, are 5'10\", male and 40 years old, then your estimated BMR is 66 + (6 * 200) + (12.9 * 70) - (6.8 * 40 ) = 1957 calories. If we add in 300 calories for walking around and 200 calories for processing food (10% of the food consumed), then the total is around 2500 calories. A weight loss diet could be, for example, half of that, which 1250 calories per day. A person with this nutrition profile will steadily lose fat if they eat below 2500 calories per day.</p>\n\n<p>The rate of weight loss depends on how big the caloric deficit is. So, in the above example, a person with a 2500 requirement and a 1250 diet will lose about 1250 calories per day. A pound of body fat will generate about 3500 calories of energy. That means with a 1250 deficit, the person will lose 1/3 pound per day, or 10 pounds every month.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13341", "https://health.stackexchange.com", "https://health.stackexchange.com/users/10984/" ]

[ { "answer_id": 13346, "author": "Tyler Durden", "author_id": 5371, "author_profile": "https://health.stackexchange.com/users/5371", "pm_score": -1, "selected": false, "text": "<p>The problem you are running into is that medicine is a <em>science</em>, but doctors are <em>practitioners</em>. Doctors are not scientists. If your problem does not fit easily into one of their categories, it will be difficult to determine what it is.</p>\n\n<p>Also, remember that doctors spend very little time on any individual patient. You get a 15-minute appointment and some tests, that's it. Not enough time to do serious investigations. If a bio-medical researcher spent every day working, the whole day, working on your case, they could probably figure it out.</p>\n\n<p>The way to solve this problem is to collect as much data as you can. This will make it much easier for a doctor to figure out what might be wrong. The data you should collect is the following:</p>\n\n<ul>\n<li>what you eat</li>\n<li>when the discomfort occurs</li>\n<li>exactly where it occurs each time</li>\n<li>under what circumstances did it occur (sitting, lying down, walking, after eating, 1 hours after eating, during eating, etc)</li>\n</ul>\n\n<p>Basically, you want to create a detailed log of your problem. This data is the starting point for getting a deeper understanding of your problem.</p>\n" }, { "answer_id": 13361, "author": "threetimes", "author_id": 9533, "author_profile": "https://health.stackexchange.com/users/9533", "pm_score": 2, "selected": false, "text": "<p>I am so sorry you are not getting answers. It is very frustrating to seek help and find no relief and no explanation.</p>\n\n<p>Where I live, about an hour from me, is a doctor that is rather unusual but specialized in differential diagnosis. She works in a large compound of her own in the middle of nowhere and all she does is diagnose &amp; then recommend your options. She takes patients only on a retainer and last I knew it was pretty high, like $5000 USD. I have to think she cannot be the only gifted diagnostician out there. I found her asking around in the alternative medicine community about medical doctors that others knew of that might be of help. She is <em>not</em> alternative. She is simply someone who is not within the normal scope of who I might get referred to as she isn't covered by insurance. She didn't just take my money to see me and then charge me a ton more. The retainer covered a lot of things, labs, tests, visits, etc. I believe I saw her about a dozen times (all covered) and she spent 3 hours with me on intake, just asking questions, checking me over, etc. Getting a differential diagnosis the way <em>she</em> does it was nothing like I have ever had before or since. She was absolutely highly involved in time spent with me, with labs onsite and equipment to sometimes get results while I was there. Her recommendations that follow are also pretty different, including dietary recommendations, vitamins, supplements, exercises, the whole thing, on top of any prescribed treatments. And once you are diagnosed, you are done. She is on to other people needing help and you are back to your main care physician with huge folder of test results &amp; documented conclusions. </p>\n\n<p>I tried looking a little online to see if I could find some terminology for you that might assist locating a physician like this, but I am not sure that is the right way. I suggested you asking around as I am not sure I would have ever found her any other way. I will say too that if you suffer, do not give up. There is always a chance they <em>will</em> find an answer and finding your relief is worth that fight. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13342", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11145/" ]

[ { "answer_id": 13395, "author": "Chris Rogers", "author_id": 7951, "author_profile": "https://health.stackexchange.com/users/7951", "pm_score": 3, "selected": true, "text": "<p>I will answer your questions in turn</p>\n\n<h2>How does venous leak develop?</h2>\n\n<p>WebMD <a href=\"http://www.webmd.com/erectile-dysfunction/guide/vascular-disease-ed\" rel=\"nofollow noreferrer\">in the linked article in your question</a> states how Venous Leak can happen</p>\n\n<blockquote>\n <p>It may happen with <a href=\"http://www.webmd.com/heart-disease/vascular-disease#1\" rel=\"nofollow noreferrer\">vascular disease</a>.</p>\n</blockquote>\n\n<p>Vascular diseases affect blood vessels. They lower blood flow to organs such as the heart, brain, and kidneys. If they cut blood flow to the penis, they can cause erectile dysfunction. These diseases may be the cause of ED in as many as 50% to 70% of men who have it.</p>\n\n<blockquote>\n <p>It’s also linked to diabetes, Peyronie's disease (a buildup of scar tissue in the penis that leads to curved, painful erections), some nerve conditions, and even severe anxiety.</p>\n</blockquote>\n\n<h2>What is done to diagnose someone with venous leak?</h2>\n\n<p>For medical diagnosis, <a href=\"http://www.webmd.com/erectile-dysfunction/guide/diagnosing-erectile-dysfunction#1\" rel=\"nofollow noreferrer\">WebMD states</a> that as well as your medical and sexual history, your doctor will check your penis and testicles to make sure they look normal and their nerves work as expected. He may also look for hair loss and larger-than-normal breasts. Both of these can be signs that you have a hormone problem.</p>\n\n<p>He may also check your pulse at your wrists and ankles to see whether your blood flow is normal,listen to your heartbeat to make sure it sounds right, and take your blood pressure.</p>\n\n<p>Based on your physical exam, as well as looking at your medical and sexual history, your doctor may want to order certain blood or urine tests, or even an overnight erection test.</p>\n\n<p>If it looks more likely that a mental or emotional issue is the source of the problem, your doctor will ask you standard questions about your mental well-being. They help him/her check for depression, anxiety, and other common causes of erectile dysfunction.</p>\n\n<h2>Are there effective treatments, such as surgery?</h2>\n\n<p>WebMD <a href=\"http://www.webmd.com/erectile-dysfunction/guide/erectile-dysfunction-treatment#1\" rel=\"nofollow noreferrer\">at this page</a> gives a list of possible treatments depending on the results of the medical examination, including:</p>\n\n<ul>\n<li><strong>Counselling</strong> - for depression or anxiety related problems</li>\n<li><strong>Medications</strong> - Tadalafil, Sildenafil etc.</li>\n<li><strong>Pumps</strong> - vacuum devices</li>\n<li><strong>Surgery</strong></li>\n</ul>\n\n<h2>At what stage surgery is needed?</h2>\n\n<p>This as a last resort (if all else fails). These can include placement of an implant (prosthesis) in the penis or vascular reconstruction surgery to improve blood flow to or reduce blood leakage from the penis and surrounding structures. This procedure works in very few cases.</p>\n" }, { "answer_id": 16635, "author": "EDtreatment", "author_id": 13942, "author_profile": "https://health.stackexchange.com/users/13942", "pm_score": 0, "selected": false, "text": "<p>Venous leakage refers to the inability to trap blood in the penis. Remember that arteries pump blood into the penis, and veins allow blood to flow out. If the veins don't properly constrict, the blood will flow out, and the man will lose his erection.</p>\n\n<p><strong>How does venous leak develop?</strong></p>\n\n<p>There are a number of causes for venous leakage. It can be linked to general vascular health, diabetes, Peyronie's Disease, and even injuries. It generally develops over time, as the underlying cause becomes more severe.</p>\n\n<p><strong>What is done to diagnose someone with venous leak?</strong></p>\n\n<p>The first diagnostic tool is simple observation... if you are able to achieve an erection, but lose it quickly, that is an indicator of venous leakage.</p>\n\n<p>To confirm the diagnosis, a doctor might use a duplex ultrasound to observe the flow of blood in the penis.</p>\n\n<p><strong>Are there effective treatments, such as surgery?</strong></p>\n\n<p>If the leakage is mild, you can compensate for it using typical ED treatments such as Cialis or Viagra. Some men have good results with a constriction band, or \"cock ring,\" which helps trap the blood in the penis.</p>\n\n<p>In some cases surgery may be advised.</p>\n\n<p><strong>At what stage surgery is needed?</strong></p>\n\n<p>Vascular reconstruction surgery can, in some cases, repair venous leakage. </p>\n\n<p>This is generally advised only when the ultrasound shows a clearly correctable condition, and particular if the patient is young and in good health. In these circumstance, the surgery may results in a complete cure of the condition. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13384", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11109/" ]

[ { "answer_id": 13404, "author": "cloudnyn3", "author_id": 2675, "author_profile": "https://health.stackexchange.com/users/2675", "pm_score": 1, "selected": false, "text": "<p>This is not a medical diagnosis, however though; Yes it can be detected. Generally THC can be detected in blood, urine, and hair. The length of detection depends on the method used to determine what substances are in your system and how long you have been consuming them. If you smoke it, detection for single time use is 12-24 hours via blood and 1 - 7 days or more via urine. A hair test could be used for detection of up to months after use. Regular use is A MINIMUM of 6 - 7 days via urine and 2 - 7 days for a blood test.</p>\n" }, { "answer_id": 13412, "author": "Bryan Krause", "author_id": 8728, "author_profile": "https://health.stackexchange.com/users/8728", "pm_score": 4, "selected": true, "text": "<p>There are a <a href=\"https://www.nhlbi.nih.gov/health/health-topics/topics/bdt\" rel=\"noreferrer\">variety of blood tests a medical provider could use</a>. Your medical provider isn't going to do every blood test in existence on your blood, so if your only concern is about THC detection, unless the consultation is a drug screening (for example, if it were mandated by a court due to previous drug convictions, or part of an employment screening that includes drug testing), they have no reason or time to bother testing for THC.</p>\n\n<p>However, partying of any type, even staying up late eating potato chips and watching movies, could influence the results of blood tests (things like blood sugar and cholesterol levels, for example; see some <a href=\"http://www.nhs.uk/chq/Pages/1018.aspx?CategoryID=69\" rel=\"noreferrer\">guidance from the UK's NHS</a>), as well as other tests (your blood pressure <a href=\"http://hyper.ahajournals.org/content/33/1/79.short\" rel=\"noreferrer\">could be elevated post-drinking</a>, for example) and make those tests less useful for diagnosis. Usually your physician will provide instructions prior to such tests (if they don't, <em>ask them</em>, those of us here can only guess what tests they might be running), such as \"no food for ___ hours\" before - that's one of the reasons for the early morning hours, because it is typically easiest to fast overnight.</p>\n\n<p>In conclusion, of course you are safest not consuming illegal substances, but it is important to know the reasons for the medical exam and consider those reasons ahead of the tests.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13402", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11182/" ]

[ { "answer_id": 13410, "author": "Bryan Krause", "author_id": 8728, "author_profile": "https://health.stackexchange.com/users/8728", "pm_score": 5, "selected": true, "text": "<p>When thinking about the nervous system, most people think about the brain and spinal cord: the CNS. However, the <a href=\"https://en.wikipedia.org/wiki/Enteric_nervous_system\" rel=\"noreferrer\">enteric nervous system</a> controlling gut function has another ~500 million neurons.</p>\n\n<p>Among other things, these neurons coordinate the <a href=\"https://en.wikipedia.org/wiki/Peristalsis\" rel=\"noreferrer\">peristaltic contractions</a> of the gut which act to move food through the digestive system.</p>\n\n<p>Peristalsis is under the control of several neurotransmitters and neuromodulators. One of these is acetylcholine. One of the two major classes of acetylcholine receptors are known as the <a href=\"https://en.wikipedia.org/wiki/Nicotinic_acetylcholine_receptor\" rel=\"noreferrer\">nicotinic acetylcholine receptors</a> (nAChR). These receptors are so-named because nicotine, found in cigarettes, is a strong agonist for them (although their typical endogenous agonist is acetylcholine).</p>\n\n<p>There is good evidence that nAChRs are involved in gut peristalsis. Antagonists of nAChRs reduce peristalsis <a href=\"http://ajpgi.physiology.org/content/271/5/G849.full.pdf+html\" rel=\"noreferrer\">Kadowaki et al. 1996</a> and agonists increase peristalsis <a href=\"http://ajpgi.physiology.org/content/257/4/G517.short\" rel=\"noreferrer\">Blank et al. 1999</a>.</p>\n\n<p>Therefore, you can expect that cigarettes, which contain nicotine, would increase gut motility and therefore make bowel movements more likely or more imminent. Of course, there can also be daily cycles of bowel function, so you cannot easily link smoking in the morning to a specific subsequent bowel movement.</p>\n\n<p>References</p>\n\n<hr>\n\n<p>Blank, E. L., Greenwood, B., &amp; Dodds, W. J. (1989). Cholinergic control of smooth muscle peristalsis in the cat esophagus. American Journal of Physiology-Gastrointestinal and Liver Physiology, 257(4), G517-G523.</p>\n\n<p>Kadowaki, M., Wade, P. R., &amp; Gershon, M. D. (1996). Participation of 5-HT3, 5-HT4, and nicotinic receptors in the peristaltic reflex of guinea pig distal colon. American Journal of Physiology-Gastrointestinal and Liver Physiology, 271(5), G849-G857.</p>\n" }, { "answer_id": 19414, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 0, "selected": false, "text": "<p><strong>FOOD</strong></p>\n\n<p>A simple way to stimulate the bowel movement in the morning is to <strong>eat or drink</strong> something - this is known as the <strong>gastrocolic reflex.</strong></p>\n\n<p><a href=\"https://med.libretexts.org/Bookshelves/Anatomy_and_Physiology/Book%3A_Anatomy_and_Physiology_(Boundless)/22%3A_Digestive_System/22.02%3A_Nervous_System_of_the_Digestive_System/22.2B%3A_Gastrointestinal_Reflex_Pathways\" rel=\"nofollow noreferrer\">Medical Libre Texts</a></p>\n\n<blockquote>\n <p>The gastrocolic reflex is the physiological reflex that controls the\n motility, or peristalsis, of the gastrointestinal tract. It involves\n an increase in motility of the colon in response to stretch in the\n stomach and the byproducts of digestion in the small intestine. Thus,\n this reflex is responsible for the urge to defecate following a meal.</p>\n</blockquote>\n\n<p><strong>COFFEE and NICOTINE</strong></p>\n\n<p>Coffee can stimulate the bowel movement but so can water. Nicotine does not - according to this study:</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/16109656\" rel=\"nofollow noreferrer\">Stimulation of defecation: effects of coffee use and nicotine on rectal tone and visceral sensitivity (Scandinavian Journal of Gastroenterology, 2005)</a></p>\n\n<blockquote>\n <p>Rectal tone increased by 45% 30 min after coffee intake and by 30%\n after water intake, but the effects of coffee and water were not\n significantly different. Rectal tone did not change significantly\n after administration of nicotine (7%) or placebo (10%).</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/13409", "https://health.stackexchange.com", "https://health.stackexchange.com/users/3248/" ]

[ { "answer_id": 13421, "author": "cloudnyn3", "author_id": 2675, "author_profile": "https://health.stackexchange.com/users/2675", "pm_score": 3, "selected": true, "text": "<p><a href=\"http://www.brooksspinalcare.com/misaligned-spine.html\" rel=\"nofollow noreferrer\">http://www.brooksspinalcare.com/misaligned-spine.html</a></p>\n\n<p>Yes indeed it can. Even very subtle misalignment can cause a variety of issues. Most commonly it's early joint degradation and odd sensations in the legs due to tension that isn't evenly dispersed. This is somewhat of a controversial topic though, there's limited research on somewhat benign misalignment. Usually more severe cases are studied. You'd need measurements and scans done to determine if it's actually misaligned.</p>\n" }, { "answer_id": 13446, "author": "user11216", "author_id": 11216, "author_profile": "https://health.stackexchange.com/users/11216", "pm_score": 1, "selected": false, "text": "<p>Unfortunately the answer to this question is at this time purely anecdotal. Unless someone can find research studies to back up some of these observations you will have to rely on biased answers such as this one.\nIn my experience as a clinician, the answer is yes. However, in my view spinal misalignment is a laypersons description of what I would call a somatic dysfunction, from the osteopathic field, or a neuromuscular dysfunction, from the physical therapy view point. I have personally experienced and have witnessed in my patients improved wellbeing and decreased pain levels after resolving these dysfunctions. Additional benefits include improved efficiency with balance and force production by athletes.\nMy frustration with the misalignment language is clinicians desire to 'realign' the spine through manipulation. Manipulation can be useful with extremely hypomobile joints. However, since bones do not move themselves and muscles are merely the actuators, the real problem is primarily one of the peripheral nervous system. Manipulation and stretching do help reset the PNS but only for a short time. Techniques such as functional/indirect, muscle energy, and strain counterstrain are much more effective as they deal with directly effecting the underlying tone characteristics of an entire joint. Integrating this joint into a functional chain then becomes possible using neuromuscular reeducation. All of these techniques are only as effective as the practitioner applying them. Hope this helps.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13420", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8087/" ]

[ { "answer_id": 13421, "author": "cloudnyn3", "author_id": 2675, "author_profile": "https://health.stackexchange.com/users/2675", "pm_score": 3, "selected": true, "text": "<p><a href=\"http://www.brooksspinalcare.com/misaligned-spine.html\" rel=\"nofollow noreferrer\">http://www.brooksspinalcare.com/misaligned-spine.html</a></p>\n\n<p>Yes indeed it can. Even very subtle misalignment can cause a variety of issues. Most commonly it's early joint degradation and odd sensations in the legs due to tension that isn't evenly dispersed. This is somewhat of a controversial topic though, there's limited research on somewhat benign misalignment. Usually more severe cases are studied. You'd need measurements and scans done to determine if it's actually misaligned.</p>\n" }, { "answer_id": 13446, "author": "user11216", "author_id": 11216, "author_profile": "https://health.stackexchange.com/users/11216", "pm_score": 1, "selected": false, "text": "<p>Unfortunately the answer to this question is at this time purely anecdotal. Unless someone can find research studies to back up some of these observations you will have to rely on biased answers such as this one.\nIn my experience as a clinician, the answer is yes. However, in my view spinal misalignment is a laypersons description of what I would call a somatic dysfunction, from the osteopathic field, or a neuromuscular dysfunction, from the physical therapy view point. I have personally experienced and have witnessed in my patients improved wellbeing and decreased pain levels after resolving these dysfunctions. Additional benefits include improved efficiency with balance and force production by athletes.\nMy frustration with the misalignment language is clinicians desire to 'realign' the spine through manipulation. Manipulation can be useful with extremely hypomobile joints. However, since bones do not move themselves and muscles are merely the actuators, the real problem is primarily one of the peripheral nervous system. Manipulation and stretching do help reset the PNS but only for a short time. Techniques such as functional/indirect, muscle energy, and strain counterstrain are much more effective as they deal with directly effecting the underlying tone characteristics of an entire joint. Integrating this joint into a functional chain then becomes possible using neuromuscular reeducation. All of these techniques are only as effective as the practitioner applying them. Hope this helps.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13435", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8795/" ]

[ { "answer_id": 13495, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 2, "selected": false, "text": "<p>Articular cartilage, which covers the ends of bones in all synovial joints is avascular. Without a blood supply it is unable to heal or regenerate. Over time the loss of this cartilage is what causes the condition known as osteoarthritis. </p>\n\n<p>The modalities you've listed are indicated for swelling / healing and pain management. So they'll only help with secondary symptoms that are seen with cartilage loss.</p>\n\n<p><a href=\"https://www.hindawi.com/journals/sci/2017/4130607/\" rel=\"nofollow noreferrer\">Stem Cells seem to offer the most promise but nothing has been approved yet.</a></p>\n\n<p>Kobe Bryant had a non FDA approved treatment called <strong>Regenokine</strong> done in Russia, <a href=\"http://bleacherreport.com/articles/1798763-what-is-this-knee-treatment-kobe-bryant-goes-all-the-way-to-germany-for\" rel=\"nofollow noreferrer\">you can read about the procedure here.</a></p>\n" }, { "answer_id": 25364, "author": "Elisha Johnston", "author_id": 21009, "author_profile": "https://health.stackexchange.com/users/21009", "pm_score": -1, "selected": false, "text": "<p>Physician and Professor of Medicine David Rabago (Penn State University) has published multiple articles suggesting the modality known as prolotherapy stimulates cartilage re-growth, including a <a href=\"https://link.springer.com/article/10.1007/s11926-017-0659-3\" rel=\"nofollow noreferrer\">review article</a>, a clinical study with pre/post-arthroscopic images of <a href=\"https://pubmed.ncbi.nlm.nih.gov/27058744/\" rel=\"nofollow noreferrer\">cartilage growth</a>, and a <a href=\"https://jeo-esska.springeropen.com/articles/10.1186/s40634-020-00312-z\" rel=\"nofollow noreferrer\">basic science study on molecular mechanisms</a> of which the poster is a co-author.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13445", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11216/" ]

[ { "answer_id": 14297, "author": "Taylor", "author_id": 8916, "author_profile": "https://health.stackexchange.com/users/8916", "pm_score": 3, "selected": false, "text": "<p><a href=\"https://nei.nih.gov/health/errors/myopia\" rel=\"noreferrer\">Myopia</a>, or nearsightedness, occurs when the eye grows too long from front to back. According to the <a href=\"https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/myopia\" rel=\"noreferrer\">American Optometric Association</a>,</p>\n\n<blockquote>\n <p>Myopia occurs if the eyeball is too long or the cornea (the clear front cover of the eye) is too curved. As a result, the light entering the eye isn't focused correctly, and distant objects look blurred.</p>\n</blockquote>\n\n<p>Instead of focusing images on the <a href=\"https://www.britannica.com/science/retina\" rel=\"noreferrer\">retina</a>, the <a href=\"https://www.britannica.com/science/lens-eye-structure\" rel=\"noreferrer\">lens</a> of the eye focuses the image in front of the retina. In a normal eye, the light focuses on the retina. However, in individuals with myopia, the eyeball is too long and focuses light in front of the retina. </p>\n\n<p>Although genetics plays a major role in the development of myopia, it's development may also be affected by how an individual uses their eyes. For example, individuals who spend a considerable amount of time doing near-work such as reading, writing, and working on a computer have an increased risk of developing myopia. Although it primarily presents in school-aged children, adults may also develop the condition as a result of visual stress or as a complication of another health condition such as diabetes.</p>\n\n<p><strong>Can myopia reversible, naturally or through medication?</strong></p>\n\n<p>Although a cure for nearsightedness has yet to be discovered, several studies suggest it may be possible to at least control myopia by <em>slowing its progression</em>.</p>\n\n<p>An article published by the American Academy of Ophthalmology: ‘<a href=\"https://www.aao.org/eye-health/news/eye-drops-nearsighted-children\" rel=\"noreferrer\">Eye Drops That Can Slow Down Nearsightedness in Children</a>’ references a <a href=\"https://www.aao.org/assets/28fe020e-5f93-4d06-aac1-889cecb15fb2/635835505202800000/atropine-for-myopia-5-yr-clinical-trial-ophthalmology-2015-pdf?inline=1\" rel=\"noreferrer\">clinical trial on atropine</a> which was conducted to compare the safety and efficacy of different concentrations of atropine eye drops for the control of myopia progression. Results of the five-year trial indicate that <strong>a low concentration of atropine drops could potentially be an effective treatment for myopia</strong>.</p>\n\n<blockquote>\n <p>In a five-year clinical trial, investigators there showed that <strong>0.01 percent atropine drops safely slowed down the progression of myopia by about 50 percent</strong> with almost no side effects.</p>\n</blockquote>\n\n<p>'<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697954/\" rel=\"noreferrer\">The Safety of Orthokeratology - A Systematic Review</a>' evaluates the ocular safety of orthokeratology (also known as Ortho-K or OK) for the treatment of myopia.</p>\n\n<blockquote>\n <p>There is sufficient evidence to suggest that <strong>OrthoK is a safe option for myopia correction</strong> and retardation. Long-term success of OrthoK treatment requires a combination of proper lens fitting, rigorous compliance to lens care regimen, good adherence to routine follow-ups, and timely treatment of complications.</p>\n</blockquote>\n\n<p>Another study analyzes the efficacy of atropine eye drops and orthokeratology lenses in controlling myopia progression and elongation of axial length. ’<a href=\"https://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-14-40\" rel=\"noreferrer\">Overnight orthokeratology is comparable with atropine controlling myopia</a>,' a retrospective study, included <strong>105 patients (210 eyes) who wore OK lenses</strong> and <strong>105 patients (210 eyes) who applied 0.125% atropine</strong> every night during the 3 following period.</p>\n\n<blockquote>\n <p>The change in axial length per year was 0.28 ± 0.08 mm, 0.30 ± 0.09 mm, and 0.27 ± 0.10 mm in the OK lens group, and 0.38 ± 0.09 mm, 0.37 ± 0.12 mm, and 0.36 ± 0.08 mm in the atropine group for years 1, 2, and 3, respectively. Linear regression analysis revealed an increase in myopia of 0.28 D and 0.34 D per year, and an increase in axial length of 0.28 mm and 0.37 mm per year in the OK lens and atropine groups, respectively. Repeated measure ANOVA showed significant differences in myopia (p = 0.001) and axial length (p &lt; 0.001) between the atropine and OK lens groups; in astigmatism, there was no significant difference in these parameters (p = 0.320). </p>\n</blockquote>\n\n<p>Comparison of increases in axial length in relation to baseline myopia showed significant correlations both in the OK lens group and atropine group. </p>\n\n<blockquote>\n <p>High myopia patients benefited more from both OK lenses and atropine than did low myopia patients. The correlation of baseline myopia and myopia progression was stronger in the OK lens group than in the atropine group.</p>\n</blockquote>\n\n<p>Results of the study reveal that the <strong>OK lens is a useful method for controlling myopia progression</strong> even in <a href=\"https://www.aao.org/eye-health/ask-ophthalmologist-q/high-myopia\" rel=\"noreferrer\">high myopia</a> patients. </p>\n\n<p>In conclusion, although myopia cannot be reversed (yet), several studies concur that it is possible to control or slow the progression of nearsightedness. </p>\n" }, { "answer_id": 14298, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": false, "text": "<p>There appear to be both genetic and environmental factors for the development of myopia. The results from the Sydney Myopia study found that</p>\n\n<blockquote>\n <p>RESULTS: Children who became myopic spent less time outdoors compared with children who remained nonmyopic (younger cohort, 16.3 vs. 21.0 hours, respectively, P&lt;0.0001; older cohort, 17.2 vs. 19.6 hours, respectively, P=0.001). Children who became myopic performed significantly more near work (19.4 vs. 17.6 hours; P=0.02) in the younger cohort, but not in the older cohort (P=0.06). Children with 1 or 2 parents who were myopic had greater odds of incident myopia (1 parent: odds ratio [OR], 3.2, 95% confidence interval [CI], 1.9-5.2; both parents: OR, 3.3, 95% CI, 1.6-6.8) in the younger but not the older cohort. Children of East Asian ethnicity had a higher incidence of myopia compared with children of European Caucasian ethnicity (both P&lt;0.0001) and spent less time outdoors (both P&lt;0.0001). A less hyperopic refraction at baseline was the most significant predictor of incident myopia. The addition of time outdoors, near work, parental myopia, and ethnicity to the model significantly improved the predictive power (P&lt;0.0001) in the younger cohort but had little effect in the older cohort.</p>\n</blockquote>\n\n<p>In adults refractive surgery can ameliorate myopia but I'm not aware of any drugs that can do this in the adult.</p>\n\n<p>It would seem prudent, especially in at risk populations such as east Asian, and if one has a parent with myopia, to spend adequate hours outside in sunlight to help prevent the development or progression of myopia.</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/23672971/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/m/pubmed/23672971/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/13450", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11221/" ]

[ { "answer_id": 13493, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 3, "selected": false, "text": "<p>This has been a <a href=\"https://mobile.nytimes.com/2009/02/17/health/17real.html?referer=\" rel=\"noreferrer\">controversial question for many years</a>. The current evidence suggests that sunscreen <strong>does block a part of Vitamin D production, but with negligible amounts</strong>.</p>\n\n<blockquote>\n <p>Studies have found that by blocking ultraviolet rays, sunscreen limits\n the vitamin D we produce. But the question is to what extent.</p>\n \n <p>A few studies have concluded that the effect is significant — a\n reduction as great as tenfold. But more recent, <strong>randomized studies\n that followed people for months and in some cases years suggest that\n the effect is negligible.</strong> While sunscreen does hamper vitamin D\n production, these studies say, it is not enough to cause a deficiency.<br>\n <em>[...]</em><br>\n Dr. Lim added that <strong>rather than cutting back on sunscreen</strong>, people\n concerned about vitamin D should <strong>consume more foods rich in vitamin D</strong>,\n like salmon, milk and orange juice. </p>\n \n <p><em>Source: <a href=\"https://mobile.nytimes.com/2009/02/17/health/17real.html?referer=\" rel=\"noreferrer\">New York Times Article</a>, Emphasis Mine</em></p>\n</blockquote>\n\n<hr>\n\n<h2>Studies cited in the article</h2>\n\n<ul>\n<li><p>Matusoka LY et al. <em>Chronic sunscreen use decreases circulating concentrations of 25-hydroxyvitamin D. A preliminary study.</em> <a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/3190255/\" rel=\"noreferrer\">PubMed link</a></p></li>\n<li><p>Marks R et al. <em>The effect of regular sunscreen use on vitamin D levels in an Australian population. Results of a randomized controlled trial.</em> <a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/7726582/\" rel=\"noreferrer\">PubMed link</a></p></li>\n<li><p>Farrerons J et al. <em>Clinically prescribed sunscreen (sun protection factor 15) does not decrease serum vitamin D concentration sufficiently either to induce changes in parathyroid function or in metabolic markers.</em> <a href=\"https://www.ncbi.nlm.nih.gov/m/pubmed/9767286/\" rel=\"noreferrer\">PubMed link</a></p></li>\n</ul>\n" }, { "answer_id": 13523, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": 2, "selected": false, "text": "<p>Vitamin D is produced in the skin. There are two subtypes of UV radiation: UVA and UVB. UVA is primarily responsible for photoaging, and UVB for the superficial burning that results from sun exposure (2).</p>\n\n<p>UVB electromagnetic radiation converts 7-dehydrocholestrol to pre-vitamin D3, which is then converted into Vitamin D3 (1). Sunscreens with an SPF rating absorb or reflect (depending on the filters used) UVB light (2). Without UVB light, 7-dehydrocholestrol cannot be converted into pre-vitamin D. It may also be of interest to note that glass blocks UVB (but not UVA radiation) and thus has a similar effect on Vitamin D production (1). </p>\n\n<p>In reality, however, people rarely apply sunscreen well enough so that Vitamin D production completely ceases (3).</p>\n\n<p>In short, yes sunscreen does inhibit the production of Vitamin D, although in most cases not to such an extent that Vitamin D deficiency becomes a concern. </p>\n\n<p><strong>References</strong></p>\n\n<ol>\n<li><a href=\"https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/\" rel=\"nofollow noreferrer\">https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/</a></li>\n<li><a href=\"http://www.skincancer.org/prevention/uva-and-uvb\" rel=\"nofollow noreferrer\">http://www.skincancer.org/prevention/uva-and-uvb</a></li>\n<li><a href=\"https://www.health.harvard.edu/staying-healthy/6-things-you-should-know-about-vitamin-d\" rel=\"nofollow noreferrer\">https://www.health.harvard.edu/staying-healthy/6-things-you-should-know-about-vitamin-d</a></li>\n</ol>\n" }, { "answer_id": 24144, "author": "eniel.rod", "author_id": 20006, "author_profile": "https://health.stackexchange.com/users/20006", "pm_score": 2, "selected": false, "text": "<p>In addition to the other answers:</p>\n<blockquote>\n<p>[C]linical studies have never found that everyday sunscreen use leads to\nvitamin D insufficiency. In fact, the prevailing studies show that\npeople who use sunscreen daily can maintain their vitamin D levels.</p>\n<p>One of the explanations for this may be that no matter how much\nsunscreen you use or how high the SPF, some of the sun’s UV rays reach\nyour skin. An SPF 15 sunscreen filters out 93 percent of UVB rays, SPF\n30 keeps out 97 percent, and SPF 50 filters out 98 percent. This\nleaves anywhere from 2 to 7 percent of solar UVB reaching your skin,\neven with high-SPF sunscreens. And that’s if you use them perfectly.</p>\n</blockquote>\n<p><a href=\"https://www.skincancer.org/blog/sun-protection-and-vitamin-d/\" rel=\"nofollow noreferrer\">Sun Protection and Vitamin D By Skin Cancer Foundation</a></p>\n<blockquote>\n<p>There are claims that one needs to get a certain amount of sun\nexposure every day in order to produce enough vitamin D to be healthy.\nIt’s just not true</p>\n<p><em>David J. Leffell, MD, Yale Medicine dermatologist and chief of\nDermatologic Surgery</em></p>\n</blockquote>\n<p><a href=\"https://www.yalemedicine.org/stories/vitamin-d-myths-debunked/\" rel=\"nofollow noreferrer\">Vitamin D Myths 'D'-bunked - Yale Medicine</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/13492", "https://health.stackexchange.com", "https://health.stackexchange.com/users/453/" ]

[ { "answer_id": 13502, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 2, "selected": false, "text": "<p>Good question, and this is not a complete answer, as I cannot think specifically of a <em>free course</em>. I will update this if I find one. But a very good resource that I feel provides a great foundation for what balanced nutrition is, with a lot of good explanations (that you don't have to be a scientist to understand), is a Harvard public health website. One of the primary researchers involved did a Skype lecture with us, during which he presented the research behind their information, and we felt it was quite solid: \n<a href=\"https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/\" rel=\"nofollow noreferrer\">https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/</a> </p>\n" }, { "answer_id": 13513, "author": "Don_S", "author_id": 7166, "author_profile": "https://health.stackexchange.com/users/7166", "pm_score": 0, "selected": false, "text": "<p>There are several online learning platforms that offer free and/or paid courses (in some platforms the courses are usually free of charge, and you can pay to get an official completion certificate). Personally, I have used so far only <a href=\"https://www.khanacademy.org/\" rel=\"nofollow noreferrer\">Khan Academy</a> (which is completely free to use and does not offer graduation certificates) and <a href=\"https://www.coursera.org/\" rel=\"nofollow noreferrer\">Coursera</a> (which offers the material for free, but the certificate is paid), but I did not see that they offer such a course.</p>\n\n<p>However, <a href=\"https://www.edx.org/\" rel=\"nofollow noreferrer\">edx.org</a>, with which I have had no experience, seems to offer a course that might be suitable for your needs (free to use, pay for a certificate, according to the course webpage). Check it out <a href=\"https://www.edx.org/course/nutrition-health-micronutrients-wageningenx-nutr102x\" rel=\"nofollow noreferrer\">here</a>.</p>\n\n<p>There may be other online learning platforms as well. If you haven't done that already, browse through <a href=\"https://www.google.co.il/search?q=online%20nutrition%20courses&amp;oq=online%20nutrition%20courses&amp;gs_l=psy-ab.3...422479.423318.0.423558.0.0.0.0.0.0.0.0..0.0....0...1.1.64.psy-ab..0.0.0.Xf-Qg0urrpg\" rel=\"nofollow noreferrer\">this Google search</a>.</p>\n\n<p>Edit: come to think of it, <a href=\"https://www.coursera.org/learn/food-and-health\" rel=\"nofollow noreferrer\">this course</a> by Coursera may also be of use to you (see the syllabus for more details).</p>\n" }, { "answer_id": 13515, "author": "ran8", "author_id": 11254, "author_profile": "https://health.stackexchange.com/users/11254", "pm_score": 1, "selected": false, "text": "<p>The best directory of online courses that I know of is class-central.com. It includes and compares edx.org and Coursera. The more general subject <a href=\"https://www.class-central.com/subject/nutrition-and-wellness?sort=rating-up\" rel=\"nofollow noreferrer\">\"Nutrition &amp; Wellness\"</a> lists 99 courses. Only a few will fit all of your requirements. I have not tried them but they are often university backed and from other subjects I know class-central's rating system is useful. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13501", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 13510, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 4, "selected": true, "text": "<blockquote>\n <p><strong>Please Note: This is not a diagnosis, it is being provided to help you and a health care professional understand possible causes of your\n condition. You must see a local professional for an evaluation and\n orthopedic testing.</strong></p>\n</blockquote>\n\n<hr>\n\n<p>Runners Knee is also known as \"Patellofemoral Pain Syndrome (PFPS)\" which essential describes the symptoms not the cause of the problem.</p>\n\n<p>So you basically were given a term to describe what you already knew (not exactly useful). I’m surprised further testing was not done.</p>\n\n<hr>\n\n<h2>Chondromalacia Patella</h2>\n\n<p>From the limited information I have it sounds like <strong>Chondromalacia Patella</strong>.<br>\nWhich is the combination of patellar tracking issues and deterioration of articular cartilage on the posterior surface of the patella.</p>\n\n<p>I would have to perform special orthopedic tests to narrow down the cause.</p>\n\n<hr>\n\n<blockquote>\n <p>Essentially the information below is what your PT should be looking for to rule in / out this diagnosis <em>(normally the information below isn’t given to\n patients but it sounds like you’ve been getting nowhere with this --\n hopefully this gives your PT a direction to figure out what is going\n on)</em>.</p>\n</blockquote>\n\n<hr>\n\n<h2>Clinical Picture</h2>\n\n<ul>\n<li>Generally there is a gradual onset of diffuse aching pain over the\nanterior or anteromedial aspect of the knee.</li>\n<li><p>There may or may not be inflammatory signs.</p></li>\n<li><p>There is often crepitus (cracking) as the knee moves thru its ROM</p></li>\n<li><p>There is an exacerbation of pain with activities such as squatting,\nkneeling, and ascending stairs.</p></li>\n<li><p>There is what is referred to as a positive movie sign – that means\nthat refers to seating in a movie – fair amount of flexion – will get\nachy in the ant/medial knee to the extent where you have to change\nposition or shake out the knee – patient may also have a feeling of the\nknee catching or giving way.</p></li>\n<li>Typically see mechanical causes of this pathology – will affect not\nonly tracking but also the contact surface areas of the PF jt</li>\n</ul>\n\n<hr>\n\n<h2>Etiology – Mechanical Causes</h2>\n\n<ol>\n<li>Genu Valgum (means knee) – where we are going to see an increase in the valgus vector at the knee- which is going to affect tracking.</li>\n<li>Femoral Anteversion</li>\n<li>Excessive Internal Femoral Rotation- alters the Q angle which\nincreases the lateral stresses.</li>\n<li>Patella Alta – if the length of the patellar tendon exceeds the top\nto bottom displacement of the patella by 15% or 1 cm</li>\n<li>Laxity of medial capsular retinaculum</li>\n<li>Tightness of the lateral retinaculum</li>\n<li>Acute or chronic patellar subluxations</li>\n<li>Pronation of the foot</li>\n<li>External Tibial Torsion</li>\n<li>Weakness of the VMO</li>\n</ol>\n\n<p>This pathology – referred from the floor up – or from the hip down </p>\n\n<blockquote>\n <p>Usually there is something going on above or below the joint – results\n in this pathology – must find what is causing this to be successful</p>\n</blockquote>\n\n<hr>\n\n<h2>Treatment</h2>\n\n<ul>\n<li><p>If you understand the cause you will be able to effectively plan the\nintervention</p></li>\n<li><p>There are things you can’t fix- structural deformities – if it\ninvolves structures that displace the patella laterally</p></li>\n<li><p>The follow will also alter patellar tracking. Excessive pronation of the foot, weakness of VMO, tightness of lateral retinaculum or ITB (ober , patellar tilt test) , weakness of frontal plane hip muscles</p></li>\n</ul>\n\n<hr>\n\n<h2>Misc Notes</h2>\n\n<ul>\n<li>Terminal Extension Exercises - Don’t strengthen the VMO</li>\n<li>Open Kinetic Chain (OKC) – the literature says the OKC ex from a position of 90-45 degrees of flexion is the safe arc in terms of joint reaction forces to do open chain work</li>\n<li>Close Kinetic Chain (CKC) - that arc of safe movement – is from 0-60 degrees of knee flexion </li>\n</ul>\n\n<hr>\n\n<h2>What Professional(s) to See</h2>\n\n<p>An outpatient physical therapist should be able to narrow this down. As far as Musculoskeletal related issues the leading experts in this field are orthopedic surgeons <em>(with physical therapists being #2).</em> </p>\n\n<p><strong><em>Professional Bias</em></strong><br>\nHowever be aware just like a PT will advocate therapeutic exercise - a surgeon will tend to lean toward surgery.</p>\n\n<p>Also see DoctorWhom's post below as he has provided some great insight that should help guide you what to do next.</p>\n\n<hr>\n\n<p><strong>Sources</strong>\n<br><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095938/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5095938/</a>\n<a href=\"http://www.jospt.org/doi/pdf/10.2519/jospt.2010.0302?code=jospt-site\" rel=\"nofollow noreferrer\">http://www.jospt.org/doi/pdf/10.2519/jospt.2010.0302?code=jospt-site</a></p>\n" }, { "answer_id": 13511, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 2, "selected": false, "text": "<p>In addition to the above answer that provides guidance on some things to take into consideration when discussing this with your doctor/therapist, I will recommend how to approach seeking the right provider.</p>\n\n<p>First, you've seen \"GPs, Physiotherapists and Physical therapists\" - but <strong>have you seen an orthopedic surgeon or non-surgical orthopedic physician?</strong> This is a situation where a specialist examination and imaging (perhaps even an MRI but at least Xrays) probably should be done. It is not always clear when to send a patient straight to PT for eval/treatment versus sending them to an orthopedic surgeon/nonsurgical specialist first, but in this case since the previous did not yield sufficient results, I'd recommend going that route.</p>\n\n<p>Seeing an ortho surgeon doesn't mean you're saying you want surgery. They are the best experts for evaluating what is wrong and determining what options for treatment you have. They often work with Physical Therapist experts to determine course of therapy in non-surgical management.</p>\n\n<p>When you go:</p>\n\n<p><strong>Write down and bring with you</strong> a <strong>concise, clear timeline of events</strong> - onset, past injuries, symptoms - and a list of what makes it worse/better. Bring any imaging or results you've had done before, then they can decide if they want to start from scratch or build on the tests/evaluations done before.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13508", "https://health.stackexchange.com", "https://health.stackexchange.com/users/2290/" ]

[ { "answer_id": 13516, "author": "StrongBad", "author_id": 55, "author_profile": "https://health.stackexchange.com/users/55", "pm_score": 2, "selected": false, "text": "<p>It seems unlikely that ear wax could cause nasal congestion and restricted breathing, since in relatively healthy individuals, the ear canal is separated from the middle ear by the tympanic membrane (aka the ear drum). If the ear infection, or the Q-Tip, or however you \"flushed\" the middle ear, caused a perforation of the ear drum, lots of things could be going on.</p>\n" }, { "answer_id": 13525, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 2, "selected": false, "text": "<p>In addition to the above, see this diagram. Your <strong>MIDDLE ear (highlighted in blue) connects to your sinus via the Eustachian tube</strong> (where it drains into the sinus cavity isn't showed). Your <strong>EXTERNAL ear canal</strong> is where the wax is, and it's <strong>separated from middle ear by the ear drum</strong> (TM). </p>\n\n<p><a href=\"https://i.stack.imgur.com/d4wRq.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/d4wRq.jpg\" alt=\"External/Middle/Inner Ear and Eustachian tube\"></a></p>\n\n<p>Also, many physicians advise <strong>not to use cotton tipped applicators in the canal;</strong> they tend to just pack wax deeper and cause it to become thicker/harder to remove, and also risk perforating the ear drum.</p>\n\n<p>FYI: It's also actually that <strong>nasal congestion and blocked Eustachian tubes can cause middle ear fluid or infections, not really the other way around.</strong> </p>\n\n<p>If nasal congestion persists, consider seeing a doctor for evaluation, as it may be allergic rhinitis or various other causes, which can cause middle ear effusions if untreated.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13509", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11272/" ]

[ { "answer_id": 13520, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 4, "selected": true, "text": "<h2>TL;DR</h2>\n\n<p><strong>Your gel does not contain an active ingredient that causes arousal.</strong></p>\n\n<p>The antifreeze agent propylene glycol will be perceived as an increase in body temperature, where-ever applied, which is supposed to turn one on.</p>\n\n<p>Most of the ingredients are about the aggregate state and lubricity of the gel. Any drugs that enhance sexual performances (<em>thanks <strong>@CareyGregory</strong> for catching that</em>) are not prescriptive-free.</p>\n\n<h2>What the producing company advertises</h2>\n\n<p>They never say that the gel will cause sexual arousal, their only claim is that a \"warming and cooling, pulsating sensation on the clitoris will be felt if applied\".</p>\n\n<h2>Currently known drugs that can enhance sexual performance</h2>\n\n<p><strong>For Men</strong></p>\n\n<p>To my knowledge, for men the PDE5 inhibitors </p>\n\n<ul>\n<li><a href=\"https://medlineplus.gov/druginfo/meds/a699015.html\" rel=\"noreferrer\">sidenafil</a> (C₂₂H₃₀N₆O₄S) </li>\n<li><p><a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/110634#section=Top\" rel=\"noreferrer\">vardenafil</a>\n(C₂₃H₃₂N₆O₄S)</p></li>\n<li><p><a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/110635\" rel=\"noreferrer\">tadalafil</a>(C₂₂H₁₉N₃O₄) </p></li>\n<li><p><a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/9869929\" rel=\"noreferrer\">avanafil</a>\n(C₂₃H₂₆CIN₇O₃)</p></li>\n</ul>\n\n<p>are the only known chemicals enhancing sexual performance.</p>\n\n<p><strong>For Women</strong></p>\n\n<p><a href=\"https://web.archive.org/web/20081004092107/http://www.femalesexualdysfunctiononline.org/commentaries/commentaries.cfm?abs_id=abs_007\" rel=\"noreferrer\">Before 2015</a>, no pharmaceutical drug has concluded its clinical trial as a substitute of viagra for women. </p>\n\n<p>Today, only the 5-HT_1A agonist </p>\n\n<ul>\n<li><a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/6918248\" rel=\"noreferrer\">flibanserin</a>\n(C₂₀H₂₁F₃N₄O)</li>\n</ul>\n\n<p>is mistakenly dubbed \"female viagra\" (the pharmacodynamics are totally different) as it is known to enhance the sexual performance of women. </p>\n\n<p>The <a href=\"http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm458734.htm\" rel=\"noreferrer\">FDA has approved of the usage of flibanserin</a>, while it is still denied in Europe <a href=\"https://link.springer.com/content/pdf/10.1007%2Fs15006-015-3559-3.pdf\" rel=\"noreferrer\">due to dangerous side-effects (especially in combination with alcohol) and uncertainty about its effectiveness.</a> (German Source Only).</p>\n\n<h2>The ingredients one by one</h2>\n\n<ul>\n<li><p><strong>Aqua</strong>:<br>\n<em>Latin for <strong>water</strong>.</em> That's what it is. </p>\n\n<blockquote>\n <p>It is used to indicate purified water in packages labelled according\n to the International Nomenclature of Cosmetic Ingredients.<br>\n <em>Source: <a href=\"https://en.m.wikipedia.org/wiki/Aqua\" rel=\"noreferrer\">Wikipedia</a></em></p>\n</blockquote></li>\n<li><p><strong>Propylene Glucol</strong>:<br>\nThis is a simple <strong>antifreeze agent</strong> which will increase the received body temperature when applied to the skin.</p>\n\n<blockquote>\n <p>Propylene glycol is a synthetic liquid substance that absorbs water.\n Propylene glycol is also used to make polyester compounds, and as a\n base for deicing solutions. Propylene glycol is used by the chemical,\n food, and pharmaceutical industries <strong>as an antifreeze</strong> when leakage\n might lead to contact with food.<br>\n <em>Source: <a href=\"https://www.atsdr.cdc.gov/substances/toxsubstance.asp?toxid=240\" rel=\"noreferrer\">CDC.gov</a></em></p>\n</blockquote></li>\n<li><p><strong>Glycerin</strong>:<br>\nThis is another name for the sugar alcohol <em>glycerol</em>, commonly used </p>\n\n<blockquote>\n <p>as a <strong>solvent</strong>, emollient, pharmaceutical agent, and sweetening agent.<br>\n <em>Source: <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/glycerol#section=Top\" rel=\"noreferrer\">PubChem.gov</a></em></p>\n</blockquote></li>\n<li><p><strong>Hydroxyethylcellulose</strong>:<br>\nAnother name for the chemical commonly called <em>hetastarch</em>, which is a</p>\n\n<blockquote>\n <p>derivative of starch used as a <strong>plasma expander</strong> when prepared in an isotonic solution.<br>\n <em>Source: <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/24846132#section=Top\" rel=\"noreferrer\">PubChem.gov </a></em> </p>\n</blockquote></li>\n<li><p><strong>PEG-40 Hydrogenated Castor Oil</strong>:<br>\nThis oil is mostly used as a <strong>dissolving agent</strong>:</p>\n\n<blockquote>\n <p>Functions: Fragrance Ingredient; Surfactant - Emulsifying Agent; Surfactant - Solubilizing Agent; PERFUMING<br>\n <em>Source: <a href=\"http://www.ewg.org/skindeep/ingredient/704597/PEG-40_HYDROGENATED_CASTOR_OIL/#.Wa72dD-bGEc\" rel=\"noreferrer\">EWG.org</a></em>.<br>\n .<br>\n PEG Castor Oils and PEG Hydrogenated Castor Oils help to form emulsions by reducing the surface tension of the substances to be emulsified. They also help other ingredients to <strong>dissolve</strong> in a solvent in which they would not normally dissolve.\n <em>Source: <a href=\"http://www.cosmeticsinfo.org/ingredient/peg-40-hydrogenated-castor-oil\" rel=\"noreferrer\">cosmeticsinfo.org</a></em></p>\n</blockquote></li>\n<li><p><strong>Aroma</strong>:<br>\nThis is not specific, so any types of additive that creates flavour falls under this category.</p></li>\n<li><p><strong>Benzoic Acid</strong>:<br>\nThis is one of the most <strong>common food preservatives</strong>.</p>\n\n<blockquote>\n <p>Benzoic acid is a fungistatic compound that is widely used as a food preservative.<br>\n <em>Source: <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/243#section=Top\" rel=\"noreferrer\">PubChem.gov</a></em></p>\n</blockquote></li>\n<li><p><strong>Sodium Hydroxide</strong>:<br>\nA simple <strong>base</strong> (NaOH) used to </p>\n\n<blockquote>\n <p>to <strong>neutralize acids</strong> and make sodium salts.<br>\n <em>Source: <a href=\"https://pubchem.ncbi.nlm.nih.gov/compound/14798#section=Top\" rel=\"noreferrer\">PubChem.gov</a></em></p>\n</blockquote></li>\n</ul>\n" }, { "answer_id": 13563, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>That product is marketed boldly as \"Special formula designed to bring sensual waves of warming, cooling or tingling sensations. Increases sensitivity of her intimate areas for more intense pleasure. Up to 20 earth-shattering orgasms in 1 bottle.\" So it is intended to <em>enhance</em> not cause arousal.</p>\n\n<p>That still sounds quite a bit like an overstatement. Looking through the consumer <a href=\"http://theflipsideoffeminism.com/k-y-intense-reviews.html\" rel=\"nofollow noreferrer\">reviews</a>¹ on various sites gives mixed results, at best. Many negative <a href=\"http://liebe.gofeminin.de/forum/durex-intensiv-gel-wirkts-bei-euch-fd396307\" rel=\"nofollow noreferrer\">experiences</a> are reported (even on commercial sites selling it). Most seem concerned with bad smell, bad taste and, hm, \"lack of action\".</p>\n\n<p>The \"complete\" list of ingredients amounts to only an almost meaningless account of substances. An \"active ingredient\" or \"mechanism of action\" is nowhere to be found. Not on the product, not with the manufacturer and not on review sites or testing agencies.</p>\n\n<p>Most of the ingredients might account for anything:</p>\n\n<ul>\n<li><p><a href=\"https://www.ewg.org/skindeep/ingredient/705315/PROPYLENE_GLYCOL/\" rel=\"nofollow noreferrer\">Propylene Glycol:</a> Declared as emulsifying agent. Is also an <a href=\"http://sexualwellnessnews.com/seven/\" rel=\"nofollow noreferrer\">irritant</a> and <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857673/\" rel=\"nofollow noreferrer\">potential contact allergen</a>. \"Classified as expected to be toxic or harmful\". Hormone-like substance used to <a href=\"http://www.sciencedirect.com/science/article/pii/S0377840104000811\" rel=\"nofollow noreferrer\">increase milk production in turbo cows</a>. <a href=\"https://draxe.com/propylene-glycol/\" rel=\"nofollow noreferrer\">Long list of concerns.</a> Reduces barrier function of the skin. Thereby providing synergistic effects with other ingredients. <a href=\"https://www.codecheck.info/drogerie_toilettartikel/verhuetung_liebesspielzeuge/gleitgel/ean_4002448096870/id_1857873589/Durex_Intense_Orgasmic_Gel.pro\" rel=\"nofollow noreferrer\">Codecheck</a> label: \"slightly questionable\". <br>\nMost likely candidate for <em>the</em> \"active ingredient\". Applied to genitals the most positive way to describe this substance is: it gives reportedly a slightly warming and at the same time cooling sensation before drying out in very short time.</p></li>\n<li><p><a href=\"https://www.ewg.org/skindeep/ingredient/704597/PEG-40_HYDROGENATED_CASTOR_OIL/\" rel=\"nofollow noreferrer\">PEG</a>: <a href=\"http://www.thesmartmama.com/understanding-labels-peg-40-hydrogenated-castor-oil-greenwashing/\" rel=\"nofollow noreferrer\">Wholly classified as dangerous</a> by <a href=\"https://www.treehugger.com/style/beyond-parabens-7-common-cosmetics-ingredients-you-need-to-avoid.html\" rel=\"nofollow noreferrer\">proponents of the organic movement.</a> But also <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4505343/\" rel=\"nofollow noreferrer\">'Considered safe' by traditional standards, although it too is a penetration enhancer</a>, i.e. weakening the barrier function of the skin, again possibly giving synergistic effects with other ingredients. Additionally this substance was often found to have concerning levels of very harmful impurities. Unsafe on damaged skin. Codecheck label: \"questionable\"</p></li>\n<li><p>Aroma (<a href=\"https://www.ewg.org/skindeep/ingredient/702512/FRAGRANCE/\" rel=\"nofollow noreferrer\">Fragrance</a>, Flavour): Under current law this may contain a mix of anything from essential oils to other highly active substances. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5044959/\" rel=\"nofollow noreferrer\">This is a legal loophole</a>: anything <em>declared</em> to be only for smell and flavour can fall under this label <a href=\"http://www.bvl.bund.de/DE/03_Verbraucherprodukte/02_Verbraucher/03_Kosmetik/02_KennzeichnungKosmetik/bgs_kosmetik_kennzeichnung_node.html\" rel=\"nofollow noreferrer\">since only 26 substances have to be listed specifically.</a> The list of ingredients is sorted by weight and Aroma features pretty high on it. Codecheck label: \"not classifiable\"</p></li>\n<li><p><a href=\"https://www.ewg.org/skindeep/ingredient/700679/BENZOIC_ACID/\" rel=\"nofollow noreferrer\">Benzoic Acid:</a> Preservative that is restricted for use in cosmetics in Japan. May have <a href=\"https://endocrinedisruption.org/interactive-tools/tedx-list-of-potential-endocrine-disruptors/search-the-tedx-list\" rel=\"nofollow noreferrer\">hormone-like effects</a> and can be an <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/8132170\" rel=\"nofollow noreferrer\">irritant or allergen.</a> Codecheck label: \"slightly questionable\"</p></li>\n</ul>\n\n<p>Summing this up: unless the manufacturer opens its playbook and explains what is there to do what, this is probably a moderately unhealthy, slightly irritating lube. Together with its advertising framing this seems to be mostly a mind thing if received as pleasurable (<a href=\"https://en.wikipedia.org/wiki/Cantharidin\" rel=\"nofollow noreferrer\">a concept not totally unheard of</a>). Published data on the ingredients and consumer reports seem to indicate that a similar effect might be achieved by mixing equal parts of peppermint and stinging nettle in a water-oil emulsion with milk. </p>\n\n<hr>\n\n<p>¹ This link leads to another product but with very similar ingredients. Main point being propylene glycol is also included in that one and it is at least halfway 'independently' reviewed. Links to commercial sellers of this product are numerous and they do not advertising coming from this site.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13518", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11281/" ]

[ { "answer_id": 13543, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 4, "selected": true, "text": "<p>From what I understand you asking if any type of acute or chronic musculoskeletal issues will arise due to wearing cushioned shoes during a trip. If this is the question:</p>\n\n<blockquote>\n <p><strong>No this is perfectly fine.</strong> The cushioning will actually be beneficial if you're doing any type of extended walking.</p>\n</blockquote>\n\n<p>The only case where this could cause any type of issue would be neglecting to use a medically prescribed orthotic <em>(this is a custom casted shoe insert)</em>. </p>\n\n<p>Any reason you're thinking otherwise?</p>\n" }, { "answer_id": 13559, "author": "Adam", "author_id": 11308, "author_profile": "https://health.stackexchange.com/users/11308", "pm_score": 1, "selected": false, "text": "<p>Dealing with the exact same issue many times, I can tell you that the only troublesome outcome of this would be your running shoes wearing out faster. For example, after 8 months instead of 12 - the exact figure heavily depends on your running / walking habits. As for your question, running with worn-out shoes can cause injuries.</p>\n\n<p>It's not a bad thing to use running shoes for walking/hiking, as long as you take this fact into account. I do this all the time and replace my running shoes more often / use older ones for light walking/dancing.</p>\n" }, { "answer_id": 13579, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 1, "selected": false, "text": "<p>It was not specified what kind of \"trip\" is planned. Extreme weather, height (mountains), ground conditions are quite decisive variables to consider. Then of course there is also the length of the trip.</p>\n\n<p>A 4 day business trip to a coastal <a href=\"http://www.huffingtonpost.com/2013/10/09/shoes-worst-for-feet_n_4069370.html\" rel=\"nofollow noreferrer\">city</a> in temperate climate is very different to actually running in running shoes or to 6 months trecking through the jungle during the monsoon or the Alaskan Rockies in winter. Choose the right tool for the job.</p>\n\n<p><a href=\"https://www.prevention.com/health/shoes-and-foot-pain\" rel=\"nofollow noreferrer\">Most important</a> is of course <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26611985\" rel=\"nofollow noreferrer\">that the shoes do fit!</a></p>\n\n<p>\"Is there <a href=\"http://edition.cnn.com/2011/11/04/health/shoes-feet-hurt-body/index.html\" rel=\"nofollow noreferrer\"><em>any</em> adverse</a> effect to my feet if <a href=\"http://www.netdoctor.co.uk/healthy-living/wellbeing/a26805/shoes-affect-you-health/\" rel=\"nofollow noreferrer\">I wear running shoes</a> <em>all the time?</em>\"</p>\n\n<p>There needs to be some care taken, not only in choosing the shoes but also to your feet as such, to prevent these most common possible conditions:</p>\n\n<ul>\n<li><a href=\"https://en.wikipedia.org/wiki/Blister\" rel=\"nofollow noreferrer\">blisters</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Athlete%27s_foot\" rel=\"nofollow noreferrer\">athlete`s foot</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Onychomycosis\" rel=\"nofollow noreferrer\">onychomycosis</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Ingrown_nail\" rel=\"nofollow noreferrer\">ingrown nails</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Paronychia\" rel=\"nofollow noreferrer\">paronychia</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Immersion_foot_syndromes\" rel=\"nofollow noreferrer\">immersion foot syndromes</a> like <a href=\"http://www.healthline.com/health/trench-foot#overview1\" rel=\"nofollow noreferrer\">trench</a> <a href=\"http://www.foot-pain-explored.com/trench-foot.html\" rel=\"nofollow noreferrer\">foot</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Chilblains\" rel=\"nofollow noreferrer\">chilblains</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Subungual_hematoma\" rel=\"nofollow noreferrer\">subungual hematoma</a> (tennis toe)</li>\n<li><a href=\"https://en.wikipedia.org/wiki/Metatarsophalangeal_joint_sprain\" rel=\"nofollow noreferrer\">metatarsophalangeal joint sprain</a></li>\n</ul>\n\n<p>While these possible conditions from that incomplete list may be a bit on the extreme side of \"any adverse effects\", they are certainly more probable with prolonged use of any shoe. It is still not very advisable to always wear the same pair of shoes. If one somehow has to make do with only one pair of shoes:\n<a href=\"http://www.tandfonline.com/doi/abs/10.1080/19424280903204036\" rel=\"nofollow noreferrer\">Take the shoes off</a> as often as possible, keep your feet dry, airy, clean, change the socks.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13542", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1612/" ]

[ { "answer_id": 13546, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": 3, "selected": false, "text": "<p><a href=\"https://en.wikipedia.org/wiki/Thalidomide#Medical_uses\" rel=\"noreferrer\">Thalidomide</a> is used to treat, among other things, multiple myeloma. Since we know it has adverse effects for pregnant women, we simply don't give it to them.</p>\n\n<p>Almost all drugs have side effects of some kind. We don't ban aspirin or NSAIDS, even though those are all known to have issues with stomach bleeding, for example.</p>\n" }, { "answer_id": 13547, "author": "R.M.", "author_id": 11300, "author_profile": "https://health.stackexchange.com/users/11300", "pm_score": 6, "selected": true, "text": "<p><strong>Because leprosy and multiple myeloma are conditions for which other treatment options are limited.</strong></p>\n\n<p>All treatments have side effects, some more debilitating than others. The trick with pharmacology is to balance the benefit of treatment with the hazards of the side effects.</p>\n\n<p>Take cancer chemotherapy. The drugs we use for cancer chemotherapy are <em>horrible</em> poisons. We literally use <a href=\"https://en.wikipedia.org/wiki/Nitrogen_mustard\" rel=\"noreferrer\">derivatives of chemical weapons</a> to treat cancer. Why do we deliberately poison cancer patients with what amounts to a weapon of mass destruction? Because if we don't, the cancer will kill them. </p>\n\n<p>In pharmacology there's a concept of a <a href=\"https://en.wikipedia.org/wiki/Therapeutic_index\" rel=\"noreferrer\">therapeutic window</a>. That is, there's a particular amount of compound that will cause death or other severe disability. There's another (hopefully lower) level of the compound that will effectively treat the disease. In treating, we hope to hit that middle ground: enough to treat the disease, but not enough to kill the patient.</p>\n\n<p>Different drugs have different therapeutic window. The window for over-the-counter drugs like asprin is rather large: the amount needed for severe side effects is many times higher than what people take to treat headaches. That's why we can allow untrained people to self-dose. (Though look at acetaminophen/paracetamol as an over-the-counter example where the window is not as large as it probably should be.) </p>\n\n<p>In contrast, the threaputic window for many chemotherapy drugs is rather narrow. To make sure we hit that window, they're typically dosed by licensed professionals in a very controlled environment.</p>\n\n<p>Back to thalidomide. The side effects of thalidomide are pretty severe. But to some extent they're controllable. If you scrupulously avoid exposing pregnant women or women who may become pregnant to thalidomide, you can avoid the teratogenic consequences. For the other consequences, you're back to the theraputic window: you want to hit a level of drug that is effective in treating the disease, but minimizes side effects.</p>\n\n<p>That's why thalidomide has been approved. It's a cost/benefit analysis. The approving authorities took a look at the hazards of leaving leprosy and multiple myeloma untreated (or treated with other methods) versus the hazards from exposure to thalidomide. On the whole, they felt that the risks of thalidomide could be mitigated enough that it was the \"lesser evil\" than leaving the diseases untreated.</p>\n\n<p>That said, if someone came out with a wonder drug that was as effective as thalidomide in treating these diseases but had fewer (or more benign) side effects, doctors would drop thalidomide like a hot potato, and the FDA might even revoke its approval. (Similar arguments hold for other potentially hazardous drugs like the nitrogen mustard chemotherapeutics.)</p>\n" } ]

[ "https://health.stackexchange.com/questions/13545", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11301/" ]

[ { "answer_id": 13590, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 2, "selected": false, "text": "<h2>There is no difference between real and added sugar.</h2>\n\n<p>Glucose (C₆H₁₂O₆) as an example can be an additive or a \"original\" nutrition of any natural product.</p>\n\n<p>Carbonated water with sugar additives therefore has the same increasing chance of caries (and cavities) as the same amount of sugar as what companies might advertise as \"Carbonated water with real sugar\". \n<a href=\"https://mobile.nytimes.com/2010/08/17/health/17real.html?referer=\" rel=\"nofollow noreferrer\">Recent research</a> has found that the amount of time spent consuming sugar has a larger effect on the risk of cavities than the amount.</p>\n\n<hr>\n\n<p><a href=\"https://health.stackexchange.com/a/12972/8212\">This previous answer of mine</a> talks about the corrosiveness of carbonated water and comes to the conclusion that </p>\n\n<blockquote>\n <p>carbonated water might have a <a href=\"https://books.google.de/books?id=cIhPAwAAQBAJ&amp;pg=PT998&amp;redir_esc=y#v=onepage&amp;q=carbonated%20water&amp;f=false\" rel=\"nofollow noreferrer\">slightly larger effect on erosion of teeth than normal water</a> because it is <a href=\"http://www.thuisexperimenteren.nl/science/carbonaatkinetiek/Carbondioxide%20in%20water%20equilibrium.doc\" rel=\"nofollow noreferrer\">just a little bit acidic</a>.</p>\n</blockquote>\n" }, { "answer_id": 13754, "author": "sue", "author_id": 7617, "author_profile": "https://health.stackexchange.com/users/7617", "pm_score": 1, "selected": false, "text": "<p>About sugar-sweetened beverages (SSB), the ingestion of 1-2 SSB daily increment the caries incidence at least in 31% (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24813370\" rel=\"nofollow noreferrer\">Source</a>)</p>\n\n<p>The use of carbonate drinks without sugar added increase the incidence of dental erosion (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/28176000\" rel=\"nofollow noreferrer\">source</a>). </p>\n\n<p>Hence, any carbonated liquid is associated with dental erosion. If you add sugar, then is also associated with dental caries. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13572", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9860/" ]

[ { "answer_id": 17444, "author": "Medical Writer", "author_id": 14728, "author_profile": "https://health.stackexchange.com/users/14728", "pm_score": -1, "selected": false, "text": "<p>Well it really doesnt matter. Mostly it depends on the workout and the objective of your workout and more importantly what you are eating after workout.</p>\n\n<p>You seriously dont want to eat a burger or any fast food item after any kind f workout. A protein shake will do fine though.</p>\n\n<p>If you are building muscle and doing workout to grow your body then you must have a meal within 45 minutes of the workout. </p>\n\n<p>Even if you are reducing your body fat or muscle the body needs carbohydrates in order to retain the energy lost during the workout.</p>\n\n<p>Overall, it is never bad or effects of your health or stomach it really depends on what you are feeding your body.</p>\n" }, { "answer_id": 17452, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 4, "selected": true, "text": "<p>There really aren't any known harmful effects for an otherwise healthy person to eat directly after an exercise session. You may not have as much appetite, as the body will somewhat shut down the digestive system and redirect blood and other resources to more needed places in the body, but it is not actively harmful.</p>\n\n<p>In actuality, there are quite a few studies now showing that an immediate feeding after exercise can both help lessen some of the effects of the exercise and promote greater muscle growth and adaptation. It used to be known as the \"golden hour\". Endurance athletes benefit from a drink that is 3:1 ration of carbs to protein, while power/strength athletes do better with an immediate ingestion of protein, and then more protein spaced every 3-4 hours throughout the day.</p>\n\n<p>Here are a few supporting positions and studies:</p>\n\n<p><a href=\"https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0189-4\" rel=\"noreferrer\">International Society of Sports Nutrition</a> - Position paper.</p>\n\n<p><a href=\"https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/jphysiol.2012.244897%4010.1002/%28ISSN%291469-445X%28CAT%29VirtualIssues%28VI%29VirtualIssue2016\" rel=\"noreferrer\">Physiological Society</a> - Immediate ingestion of protein stimulates protein synthesis</p>\n\n<p><a href=\"https://www.jstage.jst.go.jp/article/jnsv1973/45/4/45_4_401/_article/-char/ja/\" rel=\"noreferrer\">Journal Nutritional Science/Vitaminology</a> - Immediate feeding promotes greater muscle mass and lower fat tissue in rats.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13593", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11343/" ]

[ { "answer_id": 17444, "author": "Medical Writer", "author_id": 14728, "author_profile": "https://health.stackexchange.com/users/14728", "pm_score": -1, "selected": false, "text": "<p>Well it really doesnt matter. Mostly it depends on the workout and the objective of your workout and more importantly what you are eating after workout.</p>\n\n<p>You seriously dont want to eat a burger or any fast food item after any kind f workout. A protein shake will do fine though.</p>\n\n<p>If you are building muscle and doing workout to grow your body then you must have a meal within 45 minutes of the workout. </p>\n\n<p>Even if you are reducing your body fat or muscle the body needs carbohydrates in order to retain the energy lost during the workout.</p>\n\n<p>Overall, it is never bad or effects of your health or stomach it really depends on what you are feeding your body.</p>\n" }, { "answer_id": 17452, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 4, "selected": true, "text": "<p>There really aren't any known harmful effects for an otherwise healthy person to eat directly after an exercise session. You may not have as much appetite, as the body will somewhat shut down the digestive system and redirect blood and other resources to more needed places in the body, but it is not actively harmful.</p>\n\n<p>In actuality, there are quite a few studies now showing that an immediate feeding after exercise can both help lessen some of the effects of the exercise and promote greater muscle growth and adaptation. It used to be known as the \"golden hour\". Endurance athletes benefit from a drink that is 3:1 ration of carbs to protein, while power/strength athletes do better with an immediate ingestion of protein, and then more protein spaced every 3-4 hours throughout the day.</p>\n\n<p>Here are a few supporting positions and studies:</p>\n\n<p><a href=\"https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0189-4\" rel=\"noreferrer\">International Society of Sports Nutrition</a> - Position paper.</p>\n\n<p><a href=\"https://physoc.onlinelibrary.wiley.com/doi/abs/10.1113/jphysiol.2012.244897%4010.1002/%28ISSN%291469-445X%28CAT%29VirtualIssues%28VI%29VirtualIssue2016\" rel=\"noreferrer\">Physiological Society</a> - Immediate ingestion of protein stimulates protein synthesis</p>\n\n<p><a href=\"https://www.jstage.jst.go.jp/article/jnsv1973/45/4/45_4_401/_article/-char/ja/\" rel=\"noreferrer\">Journal Nutritional Science/Vitaminology</a> - Immediate feeding promotes greater muscle mass and lower fat tissue in rats.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13596", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11344/" ]

[ { "answer_id": 13627, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 3, "selected": false, "text": "<p>What is reported here about the \"wound care specialist\" sounds like being either badly phrased by the doctor or misunderstood, misremembered or phrased rather unluckily by the OP (no offence, just speculation).</p>\n\n<p>Whatever the reason for this unsatisfactory status of explanation: This treatment is likely not focused on the nitrate part of the formulation alone.</p>\n\n<p><a href=\"https://woundcareadvisor.com/how-to-apply-silver-nitrate/\" rel=\"noreferrer\"><em>Silver</em> nitrate</a> is likely <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22352216\" rel=\"noreferrer\">employed</a> to <a href=\"http://www.podiatrytoday.com/article/3156\" rel=\"noreferrer\">help with the healing process</a>. Quotes from the links:</p>\n\n<blockquote>\n <p>[#]\n Topical application of silver nitrate is often used in wound care to\n help remove and debride hypergranulation tissue or calloused rolled\n edges in wounds or ulcerations. It’s also an effective agent to\n cauterize bleeding in wounds. Silver nitrate is a highly caustic\n material, so it must be used with caution to prevent damage to healthy\n tissues.</p>\n \n <p>[#]\n Whether it is used as a topical ingredient or a dressing ingredient,\n the use of silver in treating wounds has been around for quite some\n time. Silver has an array of beneficial effects in promoting healing.</p>\n \n <p>[#]\n The use of silver nitrate application reduce dramatically the size of\n large wounds, which eventually healed, avoiding the patients to\n undergone surgery.</p>\n</blockquote>\n" }, { "answer_id": 13640, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 3, "selected": true, "text": "<blockquote>\n <p>“the wound has healed too much, and now it can’t heal anymore without knocking it back first.” I asked for more details and got a similar response back. </p>\n</blockquote>\n\n<p>Talking to patients is an art. This doctor lacks that art to some extent.</p>\n\n<p>Wounds left to heal on their own - without stitches - heal by <a href=\"http://woundeducators.com/three-types-of-wound-closure/\" rel=\"nofollow noreferrer\"><em>secondary intention</em></a>, that is, the wound fills in with a temporary tissue called granulation tissue. The best outcome is that enough granulation tissue is laid down to cover the wound, then, within the tissue, the normal components of skin, such as epithelial tissue and blood vessels grow.</p>\n\n<blockquote>\n <p>Epithelialization and neovascularization result from the increase in cellular activity. Stromal elements in the form of extracellular matrix materials are secreted and organized. This new tissue, called granulation tissue, depends on specific growth factors for further organization to occur in the completion of the healing process. This physiologic process occurs over several weeks to months in a healthy individual.</p>\n</blockquote>\n\n<p>However, this is somewhat of a \"dance\" dependent on how much of what kinds of signals the injured tissue sends out, and sometimes the granulation tissue grows too much, and actually impedes the process of epithelialization. In that case, the excess granulation tissue (or even all of it) needs to be removed so the process can start over (the process is dependent on the right amount of the right signals (e.g. growth factors). </p>\n\n<p>This is what was meant by the doctor.</p>\n\n<p>As to why silver nitrate was used, it destroys granulation tissue, but so does just picking it off and other methods.</p>\n\n<p>Your wound specialist really should have this talk down pat enough to give the answer in under a minute. But patients ask questions, and time is getting shorter and shorted for doctors to spend with patients (blame insurance companies for that.) So one way to save time is to avoid answering questions. You'll heal just as well without the information, but it doesn't engender much trust in the doctor.</p>\n\n<p>_{<a href=\"http://emedicine.medscape.com/article/1836438-overview\" rel=\"nofollow noreferrer\">Wound Closure Technique</a>}</p>\n" } ]

[ "https://health.stackexchange.com/questions/13624", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11363/" ]

[ { "answer_id": 13652, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 3, "selected": false, "text": "<p>Hand sanitizers have bactericidal and virucidal properties that <em><a href=\"https://youtu.be/0at_jtzJCDM?t=50\" rel=\"noreferrer\">when used properly</a> in sufficient quantity for at least 20 seconds</em> kill the vast majority of pathogenic organisms/viruses. Alcohol-based sanitizers are superior in spectrum of what it kills.</p>\n\n<p>However, you are correct that it doesn't kill everything, and some of what it doesn't kill is pretty nasty stuff.</p>\n\n<p>For example, spores are formed by some bacteria, including Clostridium difficile, (aka C diff) which is a hard-to-kill bacteria that can cause severe diarrhea (usually in people whose immune system or gut flora are disrupted). It takes substances like bleach to kill the spores, so you have to wash them off instead.</p>\n\n<p>Similarly, fungus isn't always killed by sanitizers. </p>\n\n<p>From the CDC's \"<a href=\"https://www.cdc.gov/handwashing/show-me-the-science-hand-sanitizer.html\" rel=\"noreferrer\">Show Me the Science - When &amp; How to Use Hand Sanitizer</a>\"- </p>\n\n<blockquote>\n <p>Washing hands with soap and water is the best way to\n reduce the number of microbes on them in most situations. If soap and\n water are not available, use an alcohol-based hand sanitizer that\n contains at least 60% alcohol.</p>\n \n <p>Alcohol-based hand sanitizers can quickly reduce the number of\n microbes on hands in some situations, but sanitizers do not eliminate\n all types of germs. Why? Although alcohol-based hand\n sanitizers can inactivate many types of microbes very effectively when\n used correctly, people may not use a large enough volume of the\n sanitizers or may wipe it off before it has dried. Furthermore,\n soap and water are more effective than hand sanitizers at removing or\n inactivating certain kinds of germs, like Cryptosporidium, norovirus,\n and Clostridium difficile.</p>\n</blockquote>\n\n<p>There's also a <a href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5116a1.htm\" rel=\"noreferrer\">short novel on this topic.</a></p>\n" }, { "answer_id": 13659, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 3, "selected": true, "text": "<p>This question seems to ask in which situations hand sanitizers can be a suitable substitute for water and soap.</p>\n\n<blockquote>\n <h1><a href=\"http://news.rutgers.edu/research-news/handwashing-cool-water-effective-hot-removing-germs/20170529\" rel=\"nofollow noreferrer\">Techniques for hand hygiene</a></h1>\n \n <p><strong>Soap and water is still considered the gold standard for hand hygiene.</strong></p>\n \n <p>When using soap and water, it is important to wet the hands first.\n Then apply 3 to 5 mL of soap to the hands, avoiding bar soap. Next rub\n the hands together for a minimum of 15 seconds covering all surfaces\n of the hands and fingers. Finally rinse the hands off with water, dry\n thoroughly with a paper towel and use the paper towel to turn off the\n faucet. </p>\n \n <p><strong>When soap and water is not available, alcohol-based hand rubs (wipes, gels, or foams) should be applied.</strong> When using an\n alcohol-based product, healthcare workers must completely follow the\n manufacturer's label to ensure that the desired efficacy is reached.</p>\n</blockquote>\n\n<p>To answer the initial question properly we have to differentiate the situations:</p>\n\n<ul>\n<li>daily setting, \"normal world\": almost never; only when detergents and water are unavailable and an actual incidence would advise disinfection</li>\n<li><a href=\"http://bigthink.com/amped/humans-10-human-and-90-bacterial\" rel=\"nofollow noreferrer\">health care setting, medical world</a>: still almost never, as a substitute, <strong>but</strong> as an important addition to water and detergent</li>\n</ul>\n\n<h1>For a General Question of daily Hygiene:</h1>\n\n<p>The main effect of a handwash is that it <em>washes</em> <em>away</em> the bacteria/germs. Water, especially warm and hot water does its own thing to remove them, a soap-like substance adds to this effect and so is a towel. Any added ingredients that qualify for actually killing germs are just <a href=\"http://news.rutgers.edu/research-news/handwashing-cool-water-effective-hot-removing-germs/20170529\" rel=\"nofollow noreferrer\">icing on the cake</a>.\nNone of the above methods I listed will so much kill but <em>remove</em> bacteria or dilute them in the sense of reducing their numbers. \nNothing that is not also harmful to you will kill <em>all</em> of the bacteria. As long as you are not ill <em>and required</em> to be or live as sterile as possible that is a good thing.</p>\n\n<p>You are yourself a living being. Sounds like a fun fact but is meant to convey that \"a human\" might have <a href=\"http://bigthink.com/amped/humans-10-human-and-90-bacterial\" rel=\"nofollow noreferrer\">different definitions now</a> than a few decades ago. Not all bacteria are harmful. Most of them are not. Many of them are actually beneficial or even needed, like those in your gut. While gut bacteria might have quite a good reputation by now, those on your skin, that those handwashes would like to kill are only slowly getting a <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3535073/\" rel=\"nofollow noreferrer\">better stand.</a> Everyone lives in a symbiosis with their individual microbiome. Overzealous sanitation at least disrupts this balance. Costs and benefit should be carefully calculated. </p>\n\n<p>Normal handwash is usually (more than) enough. It is not possible to really sterilise everything completely, nor would that be desirable. </p>\n\n<p>Add to that the effects of evolution:\n What does that mean in the slightly longer term?\nIn using sanitizers regularly you create an environment on your skin where the pressure to adapt is directed towards resisting the chemicals used in that agent. Some bacteria survive this attack. Compare that to their phenomenal ability to multiply and <a href=\"https://www.youtube.com/watch?v=yybsSqcB7mE\" rel=\"nofollow noreferrer\">overcome chemical onslaughts with for example antibiotics.</a> This leads to the situation that you un-train your own immune system to deal with any bacteria and disrupt the workings of the good bacteria your microbiome needs or can tolerate. Indiscriminate killing also tends to have the very unwelcome side effect of <a href=\"https://www.nature.com/articles/s41598-017-06055-9\" rel=\"nofollow noreferrer\">giving just the most harmful bacteria an edge</a> in the fight for survival.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13647", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11061/" ]

[ { "answer_id": 13661, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 0, "selected": false, "text": "<h2>A fractured wrist¹, radius or ulna²</h2>\n\n<p>This is the story of my 11 year old self. I played soccer, was the goal keeper, tried to save a ball and broke my wrist. Simple as that³. </p>\n\n<p>The standard treatment of bone fracture is immobilisation of the bone. Either an orthopaedic cast or splint might be necessary, and maybe even a nail if the wrist is messed up really badly. This renders both arm and hand pretty useless, the affected appendage would be basically unusable during the recovery period. The cast will have to be in place until the bone fully healed, which would have taken 2 weeks, if I had listened to the doctors. </p>\n\n<p>If you need a longer time of immobilisation, consider the following: My 11 year old self really wanted to go to my best friend's birthday party. That took place at a swimming pool. Obviously, at some point I had to fall into the water, and it was quite embarrassing telling the doctors that I did not follow their instructions (which was a pretty explicit \"Do NOT let water touch your cast), and the cast had to be redone because it partly dissolved.</p>\n\n<h2>Embarrassment</h2>\n\n<p>I'll leave this up to you. Personally, I find my story pretty embarrassing. Maybe because it happened to <em>me</em>. A few other stories are compiled in <a href=\"https://www.reddit.com/r/AskReddit/comments/gfhy5/dumbestworst_broken_bone_stories/\" rel=\"nofollow noreferrer\">this reddit thread</a>. There are so many ways one can break bones that <em>anything</em> is realistic. It's worth asking a few friends of yours. Fractured bones are so common you will get quite a few good stories from them. </p>\n\n<hr>\n\n<p>¹: A wrist cast will render moving of the hand impossible, but wiggling of fingers is still possible. Further reading for broken wrists: <a href=\"http://www.webmd.com/a-to-z-guides/colles-fracture#2\" rel=\"nofollow noreferrer\">WebMD</a>.</p>\n\n<p>²: Broken radius or ulna will make the arm (to which the hand is attached) not movable, but you could still twist your wrist and wiggle with your fingers depending on the cast.</p>\n\n<p>³: Caveat: It might be a bit simpler for children to brake their bones than adults because children's bones are still developing.</p>\n" }, { "answer_id": 13670, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 3, "selected": true, "text": "<p>Fractures would be a good reason to be fully immobilized in a cast (after the first 5-10 days in a splint to allow swelling to go down) but they usually take <a href=\"https://radiopaedia.org/articles/fracture-healing\" rel=\"nofollow noreferrer\">at least 4-6 weeks to heal</a> enough to remove a cast/brace (one sources says maybe 3 for a minor fracture in a finger). </p>\n\n<p>For your character to have around 2 weeks of immobilization, a few ideas:</p>\n\n<p>Suggestion 1: <strong><a href=\"http://orthoinfo.aaos.org/topic.cfm?topic=a00023\" rel=\"nofollow noreferrer\">A grade 2 (moderate) sprain</a> is an incomplete tear of a ligament and usually involves a week or two of immobilization with a brace.</strong> There are recommendations to start physical therapy early on, so it would be removed for short periods of time to do gradually increasing exercises to strengthen and rehab. Rest, Ice, and Elevation are the other treatments involved. You can sprain things by over-extending past its usual range of motion. To sprain the back of the wrist/hand your character could fall onto the hand when it's flexed (the opposite direction of the photo in that link). I've seen it happen from a motorcycle fall. At 2 weeks they may not be at full function, however, they may still need to continue physical therapy for a while and be careful.</p>\n\n<p>Suggestion 2: <strong>If your character sustained <a href=\"http://www.aafp.org/afp/2000/1101/p2029.html\" rel=\"nofollow noreferrer\">a partial thickness (second-degree) burn</a> on their hand/wrist, the healing time is around 2-3 weeks in most cases.</strong> He/she could have burned themselves on fire, the stove, hot metal or chemicals. If the burn is extensive, especially on the fingers or back of the hand (where there is higher tension on the skin), the doc may apply a semi-immobilizing brace to hold the hand in a neutral position, to prevent the person from flexing the digit/hand and breaking apart the healing skin. Burns are treated with specific creams and bandaging to protect from infection, so the brace is usually removed once or twice a day to change bandages. Burns can, though not always, leave pretty impressive scars.</p>\n\n<p>Suggestion 3: <strong><a href=\"http://www.aafp.org/afp/2008/1015/p945.html\" rel=\"nofollow noreferrer\">Sutures for lacerations</a> on the hand are usually removed at 10-14 days.</strong> Not all lacerations are treated with sutures, but if they are deep OR on the back side of the hand (where there is higher tension on the skin) it is more common. It the injuries are extensive, especially if it's across a joint line (like the wrist or knuckles), then after suturing and bandaging they may apply a similar brace. Note that unlike burns, you usually don't keep a bandage on after a day or two. If they had to leave a brace on, they may just use a non-stick bandage between the sutures and the brace and make sure it's not too tight.</p>\n\n<p>It's pretty easy to find an embarrassing way to have this happen, it all depends on the situation and the character. There are a thousand ways to fall, cut yourself, burn yourself, or otherwise hurt a hand. I've certainly done it. We tend to stick them out to protect ourselves whenever we're falling, to shield ourselves from oncoming harm, or to stop other people/things. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13656", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11384/" ]

[ { "answer_id": 17441, "author": "viuser", "author_id": 11471, "author_profile": "https://health.stackexchange.com/users/11471", "pm_score": 1, "selected": false, "text": "<blockquote>\n <p>I have done plenty of research and have found people only talking about E-Cigarettes, leaving me in confusion about if vapes without any nicotine contain harmful substances for your lungs. (I am not talking about E-Cigarettes, which I believe is a vape with nicotine.)</p>\n</blockquote>\n\n<p>Colloquially “vapes” = “vaporizers”. Most vaporizers are e-cigarettes, but some are not. An e-cigarette is like a miniature fog machine: wicking material draws e-liquid onto a heating coil. Dry herb vaporizers (like for cannabis) work differently (e.g. with a heated plate).</p>\n\n<p>E-cigarettes do <strong>not</strong> necessarily contain nicotine. It depends on if the e-liquid contains nicotine.</p>\n\n<p>I have not seen any evidence that the presence of nicotine changes the chemical composition of the e-cigarette vapor (aerosol) besides for the presence of nicotine¹ (obviously) and small amounts of impurities and degradation products (see <em>“Public Health Consequences of E-Cigarettes”</em> by the National Academies of Sciences, Engineering, and Medicine, <a href=\"https://www.nap.edu/read/24952/chapter/8#193\" rel=\"nofollow noreferrer\">page 193</a>). Most importantly, no relevant amounts of tobacco-specific nitrosamines have been found in e-cigarette vapor.</p>\n\n<blockquote>\n <p>In conclusion. If you decide to use a vape, without any nicotine, the question still lingers as to if it is still harmful to your lungs. Is it still causing damage?</p>\n</blockquote>\n\n<p>Well, at this point, we do not have any evidence if e-cigarettes <strong><em>with</em> nicotine</strong> cause respiratory disease or not (also one of <a href=\"http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=24952\" rel=\"nofollow noreferrer\">NASEM's conclusion</a>). So how should we make a comparison? </p>\n\n<p>The amount of known harmful (including pulmonary toxic) substances emitted by e-cigarettes doesn't depend on the nicotine but very much on other factors, like the characteristics of the device². </p>\n\n<p>It may be that nicotine exerts a synergistic effect that increases any harm to the lungs by e-cigarette vapor. You'll certainly find studies which claim that nicotine opens pathways for other substances to harm the lungs (though the context is usually conventional cigarettes in that case), but I don't see something like a scientific consensus or estimations by how much.</p>\n\n<p>Personally, I'd be surprised if the presence or absence of nicotine turns out to be an important factor compared to device design, usage (e.g. wattage) and flavouring. </p>\n\n<p>If I had to choose, I'd use an e-cigarette without nicotine, though, but just because it lacks the addictive effect.</p>\n\n<p><hr>\n¹ nicotine is typically extracted from tobacco and then purified</p>\n\n<p>² It's by thermal degradation, <strong><em>not</em></strong> combustion, how toxic carbonyls like acrolein are formed in e-cigarettes. But contrary to combustion in conventional cigarettes, thermal degradation is an <em>unwanted</em> side effect, and e-cigarette manufacturers can eliminate a lot of it without negatively impacting aerosol generation. <br> Similarly, manufacturers are able (as the study <a href=\"https://ehp.niehs.nih.gov/doi/10.1289/ehp2175\" rel=\"nofollow noreferrer\"><em>Metal Concentrations in e-Cigarette Liquid and Aerosol Samples: The Contribution of Metallic Coils.</em></a> (2018) by Olmedo et al. showed) to reduce emissions of metals down to even environmental standards (this would be an overly strict requirement since environmental standards are about <strong><em>constant</em></strong> inhalation).</p>\n" }, { "answer_id": 17448, "author": "Chris Rogers", "author_id": 7951, "author_profile": "https://health.stackexchange.com/users/7951", "pm_score": 0, "selected": false, "text": "<p>If you are asking about possible lung problems due to reports of <strong>popcorn lung</strong> being caused by vaping, then this is covered in <strong><a href=\"https://medicalsciences.stackexchange.com/a/15147\">my answer</a></strong> to the question <a href=\"https://medicalsciences.stackexchange.com/questions/223/e-cigarette-making-liquid-vs-buying-liquid\">E-cigarette. Making liquid vs. buying liquid</a>.</p>\n\n<blockquote>\n <p><strong><a href=\"https://www.nhs.uk/news/heart-and-lungs/flavouring-found-in-e-cigarettes-linked-to-popcorn-lung/\" rel=\"nofollow noreferrer\">Diacetyl was banned in eliquids in the UK in 2016</a></strong> under the EU Tobacco Products Directive as it was <strong><a href=\"https://vaping.com/blog/comment/diacetyl-now-officially-banned-eliquids-uk/\" rel=\"nofollow noreferrer\">attributed to the cause</a> of <a href=\"https://en.wikipedia.org/wiki/Bronchiolitis_obliterans\" rel=\"nofollow noreferrer\">popcorn lung (also known as Bronchiolitis obliterans)</a></strong>. The thing is, <a href=\"https://en.wikipedia.org/wiki/Acetylpropionyl\" rel=\"nofollow noreferrer\">Acetyl Propionyl</a> and <a href=\"https://en.wikipedia.org/wiki/Acetoin\" rel=\"nofollow noreferrer\">Acetoin</a> are chemically similar to <a href=\"https://en.wikipedia.org/wiki/Diacetyl\" rel=\"nofollow noreferrer\">Diacetyl</a> and therefore it is considered wise to avoid them too.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/13678", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11120/" ]

[ { "answer_id": 13708, "author": "Soapkz", "author_id": 11380, "author_profile": "https://health.stackexchange.com/users/11380", "pm_score": 1, "selected": false, "text": "<p>Short answer yes, unless you have got any condition stopping you from doing so.<br>\nNow the long answer:\nProtein is the building block of the body. If we consider the human body as a huge network of interconnected chemical reactions, we can appreciate it a little better. Mostof chemical reactions in the body use enzymes as catalyst and most enzymes are proteins. A quick google search will provide you info on that matter.\nComing to topic at hand the protein RDA for a normal sedentary individual is <strong>0.8-1g/kg</strong>:\n <a href=\"https://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096\" rel=\"nofollow noreferrer\">https://www.health.harvard.edu/blog/how-much-protein-do-you-need-every-day-201506188096</a> <br>\nThis value pales in comparison to the protein intake of athletes and especially body builders. As you increase your physical activity your body's demand for protein increases,as you're breaking down muscle to build more: <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11023001?dopt=Abstract\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/11023001?dopt=Abstract</a> <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21660839?dopt=Abstract\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/21660839?dopt=Abstract</a><br> This is the reason for the association of high intake of protein with physically active individuals. <br>\nFor someone doing moderate amounts of resistance training 1.6-2g/kg should be fine. <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22150425\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/22150425</a> <br>High intensity strength training individuals have been reported to take around 3g/kg.\n<strong>For better explanation may I suggest this video</strong> <a href=\"https://www.youtube.com/watch?v=JeKn-ym6sgE\" rel=\"nofollow noreferrer\">https://www.youtube.com/watch?v=JeKn-ym6sgE</a></p>\n" }, { "answer_id": 13710, "author": "JohnP", "author_id": 64, "author_profile": "https://health.stackexchange.com/users/64", "pm_score": 3, "selected": true, "text": "<p>It depends on the diet and the person. However, protein myths abound because people look at extreme ends of the scale, and assume that outlier needs are suitable for the masses.</p>\n<p>If you are looking for homeostasis and general maintenance, then the upper limit that has been shown in studies to be beneficial is 1.6g/kg/d, or about .73g/lb/day. 1g/lb/day is a little bit of overkill, but is an easy mark to remember. Where the outlier comes in is people using steroids for bodybuilding, which allows greater protein use than in a naturally training person.</p>\n<p>If you are looking for weight/fat loss with lean mass maintenance (i.e. losing as little muscle as possible while cutting calories), then a higher rate of protein intake is recommended to help make up for caloric deficits in carbohydrates. It is also noted that the higher the level of athlete, the <em>less</em> you need the protein (i.e. elite level athletes need less protein than beginners, as counterintuitive as that sounds).</p>\n<p>From a <a href=\"http://www.tandfonline.com/doi/full/10.1080/02640414.2011.619204?scroll=top&amp;needAccess=true\" rel=\"nofollow noreferrer\">meta analysis by Philips and Loon</a>:</p>\n<blockquote>\n<p>Our consensus opinion is that leucine, and possibly the other branched-chain amino acids, occupy a position of prominence in stimulating muscle protein synthesis; that protein intakes in the range of 1.3–1.8 g · kg−1 · day−1 consumed as 3–4 isonitrogenous meals will maximize muscle protein synthesis. These recommendations may also be dependent on training status: experienced athletes would require less, while more protein should be consumed during periods of high frequency/intensity training. Elevated protein consumption, as high as 1.8–2.0 g · kg−1 · day−1 depending on the caloric deficit, may be advantageous in preventing lean mass losses during periods of energy restriction to promote fat loss.</p>\n</blockquote>\n<p>That article is an excellent read, and contains many links and references to studies on various protein intakes for low to elite level athletes and body builders.</p>\n<p>From <a href=\"https://bayesianbodybuilding.com/the-myth-of-1glb-optimal-protein-intake-for-bodybuilders/\" rel=\"nofollow noreferrer\">another very well written article</a>:</p>\n<blockquote>\n<p>To check if maybe there still isn't a slight benefit of going higher in protein that all these studies couldn't find, I co-authored a meta-analysis with some of the world's leading fitness researchers. We again a cut-off point at exactly 1.6g/kg/d beyond which no further benefits for muscle growth or strength development are seen.</p>\n<p>Based on the sound research, many review papers have concluded 0.82g/lb is the upper limit at which protein intake benefits body composition (Phillips &amp; Van Loon, 2011). This recommendation often includes a double 95% confidence level, meaning they took the highest mean intake at which benefits were still observed and then added two standard deviations to that level to make absolutely sure all possible benefits from additional protein intake are utilized. As such, this is already overdoing it and consuming 1g/lb ”˜to be safe' doesn't make any sense. 0.82g/lb is already very safe.</p>\n</blockquote>\n<p>Examining the article you link in the question, the end includes:</p>\n<blockquote>\n<p>Even though a higher protein intake can have health benefits for many people, it is not necessary for everyone.\n<strong>Most people already eat protein at around 15% of calories, which is more than enough to prevent deficiency</strong>.\nHowever, in certain cases, people can benefit from eating much more than that, or up to 25-30% of calories.</p>\n</blockquote>\n<p>(Emphasis mine)</p>\n<p>It then links to an article on &quot;how much protein you should be eating&quot;, which notes:</p>\n<blockquote>\n<p>A common recommendation for gaining muscle is 1 gram of protein per pound of body weight, or 2.2 grams of protein per kg.\nNumerous studies have tried to determine the optimal amount of protein for muscle gain and many of them have reached different conclusions.\nSome studies show that over 0.8 grams per pound has no benefit (13), while others show that intakes slightly higher than 1 gram of protein per pound is best (14).\n<strong>Although it's hard to give exact figures because of conflicting results in studies, 0.7-1 grams (give or take) per pound of body weight seems to be a reasonable estimate</strong>.</p>\n</blockquote>\n<p>(Emphasis mine)</p>\n<p>So while all the articles agree that a general intake of around 1g/lb/day is the upper limit of beneficial, they also agree that in specific diets and goals, increasing the amount of protein can aid in weight loss and lean mass retention. I believe that is the intent of your original article, despite the somewhat click bait title.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13693", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11231/" ]

[ { "answer_id": 13703, "author": "DoctorWhom", "author_id": 6776, "author_profile": "https://health.stackexchange.com/users/6776", "pm_score": 1, "selected": false, "text": "<p>Answer:</p>\n\n<p>Blood levels for electrolytes are maintained by homeostasis in most people, primarily in the kidneys. But they can actually vary quite widely within hours - depending on health conditions and medications. It can even vary fatally in some (rare) cases.</p>\n\n<p>Why I cannot give a more complete answer:</p>\n\n<p>There are too many possible reasons to discuss adequately in an answer. Therefore it would have to be individualized, which we can't do here. </p>\n\n<p>Advice:</p>\n\n<p>Gather all your results and take them to a primary care doctor (or GP or whatever they're called where you're from) along with a list of your symptoms (in chronological order) and questions. They can guide your evaluation.</p>\n" }, { "answer_id": 14119, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 0, "selected": false, "text": "<p>Yes, there are conditions that cause this. One of the most well known is <a href=\"https://www.merckmanuals.com/professional/pediatrics/inherited-muscular-disorders/familial-periodic-paralysis\" rel=\"nofollow noreferrer\">familial periodic paralysis</a>.</p>\n\n<blockquote>\n <p>Each form of familial periodic paralysis involves a different gene and electrolyte channel. In 70% of affected people, the hypokalemic form is due to a mutation in the alpha-subunit of the voltage-sensitive muscle calcium channel gene on chromosome 1q (HypoPP type I). In some families, the mutation is in the alpha-subunit of the sodium channel gene on chromosome 17 (HypoPP type II).</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/13694", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11419/" ]

[ { "answer_id": 13714, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 6, "selected": true, "text": "<h2>We do not know</h2>\n\n<p>That's a bit unsatisfying as an answer, but it's the truth. Vaping is around for somewhat 13 years (<a href=\"http://articles.latimes.com/2009/apr/25/world/fg-china-cigarettes25\" rel=\"noreferrer\">invented in 2003</a>), but the international breakthrough was so recent that no long term studies have been conducted with meaningful results. </p>\n\n<p>This is all there is to it. Feel free to read extracts from the studies below to get a broader understanding of how complicated and convoluted research in this area is.</p>\n\n<hr>\n\n<p><strong>Sources stating it's at least healthier than tobacco cigarettes</strong> </p>\n\n<p><em><a href=\"http://journals.sagepub.com/doi/10.1177/0194599814536847\" rel=\"noreferrer\">Electronic Nicotine Delivery Systems (“E-cigarettes”)</a></em> \nPaul Truman Harrell, PhD, Vani Nath Simmons, PhD, John Bernard Correa, Tapan Ashvin Padhya, MD, Thomas Henry Brandon, PhD<br>\nOtolaryngology-Head and Neck Surgery Vol 151, Issue 3, pp. 381 - 393<br>\nFirst published date: June-04-2014 , DOI: 10.1177/0194599814536847</p>\n\n<blockquote>\n <p>E-cigarettes currently vary widely in their contents and are sometimes inconsistent with labeling. <strong>Compared to tobacco cigarettes, available evidence suggests that e-cigarettes are often substantially lower in toxic content, cytotoxicity, associated adverse effects, and secondhand toxicity exposure.</strong> Data on the use of e-cigarettes for quitting smoking are suggestive but ultimately inconclusive.</p>\n</blockquote>\n\n<p><em><a href=\"https://www.karger.com/Article/FullText/360220#\" rel=\"noreferrer\">Estimating the Harms of Nicotine-Containing Products Using the MCDA Approach</a></em>. Nutt D, J, Phillips L, D, Balfour D, Curran H, V, Dockrell M, Foulds J, Fagerstrom K, Letlape K, Milton A, Polosa R, Ramsey J, Sweanor D, Eur Addict Res 2014;20:218-225</p>\n\n<blockquote>\n <p><strong>Findings</strong>: Weighted averages of the scores provided a single, overall score for each product. Cigarettes (overall weighted score of 100) emerged as the most harmful product, with small cigars in second place (overall weighted score of 64). After a substantial gap to the third-place product, pipes (scoring 21), all remaining products scored 15 points or less.<br>\n <strong>Interpretation</strong>: Cigarettes are the nicotine product causing by far the most harm to users and others in the world today. <strong>Attempts to switch to non-combusted sources of nicotine should be encouraged as the harms from these products are much lower.</strong></p>\n</blockquote>\n\n<p><em><a href=\"http://journals.lww.com/co-otolaryngology/pages/articleviewer.aspx?year=2015&amp;issue=10000&amp;article=00004&amp;type=abstract\" rel=\"noreferrer\">Preventing or reducing smoking-related complications in otologic and neurotologic surgery.</a></em> Golub, Justin S.; Samy, Ravi N. Otolaryngology &amp; Head &amp; Neck Surgery: October 2015 - Volume 23 - Issue 5 - p 334–340\ndoi: 10.1097/MOO.0000000000000184</p>\n\n<blockquote>\n <p>Cigarette smoking negatively influences otologic surgery results, mostly because of tobacco combustion byproducts. Counseling and, if needed, pharmacologic measures to reduce smoking are recommended. E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking. Our review contributes to the discussion of how the trends of e-cigarette use and marijuana legalization will unfold in the future to affect our patients’ outcomes.</p>\n</blockquote>\n\n<p><em><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4350653/\" rel=\"noreferrer\">Electronic cigarettes: patterns of use, health effects, use in smoking cessation and regulatory issues.</a></em> Rahman MA, Hann N, Wilson A, Worrall-Carter L. Tobacco Induced Diseases. 2014;12(1):21. doi:10.1186/1617-9625-12-21.</p>\n\n<blockquote>\n <p>The literature search revealed 37 relevant articles. Findings suggest that e-cigarettes are mostly used by middle-aged current smokers, particularly males, to help them for quitting or for recreation. E-cigarettes contain very low levels of multiple toxic substances such as formaldehyde and acrolein, <strong>but these levels are many times lower than those found in cigarettes. They were found to have effectiveness in aiding smoking cessation to a limited degree.</strong> Debate continues regarding regulating their use for cessation versus heavy restrictions to control recreational use on the basis that it perpetuates nicotine addiction.</p>\n</blockquote>\n\n<hr>\n\n<p><strong>Sources stating it's as bad as nicotine patches or worse when looking for a substitute to cigarettes</strong> </p>\n\n<p><em><a href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(14)00989-6/abstract\" rel=\"noreferrer\">Counseling Patients on the Use of Electronic Cigarettes</a></em>. Jon O. Ebbert, MD, Amenah A. Agunwamba, ScD, MPH, Lila J. Rutten, PhD, MPH. Mayo Clinic Proceedings. January 2015, Volume 90, Issue 1, Pages 128–134.</p>\n\n<blockquote>\n <p>Clear evidence about the safety of e-cigarettes is <strong>lacking, and laboratory experiments and case reports suggest these products may be associated with potential adverse health consequences</strong>. The effectiveness of e-cigarettes for smoking cessation is <strong>modest and appears to be comparable to the nicotine patch combined with minimal behavioral support</strong>. Although a role for e-cigarettes in the treatment of tobacco dependence may emerge in the future, the potential risk of e-cigarettes outweighs their known benefit as a recommended tobacco treatment strategy by clinicians. Patients should be counseled on the known efficacy and potential risks of e-cigarettes.\n <a href=\"http://www.mayoclinicproceedings.org/article/S0025-6196(14)00989-6/abstract\" rel=\"noreferrer\">http://www.mayoclinicproceedings.org/article/S0025-6196(14)00989-6/abstract</a></p>\n</blockquote>\n\n<hr>\n\n<p><strong>Sources stating it's unclear whether it can be used for tobacco cessation</strong></p>\n\n<p><em><a href=\"http://annals.org/aim/article/2443060/behavioral-pharmacotherapy-interventions-tobacco-smoking-cessation-adults-including-pregnant-women\" rel=\"noreferrer\">Behavioral and Pharmacotherapy Interventions for Tobacco Smoking Cessation in Adults, Including Pregnant Women: U.S. Preventive Services Task Force Recommendation Statement.</a></em> Siu AL. Ann Intern Med. 2015;163:622–634. doi: 10.7326/M15-2023</p>\n\n<blockquote>\n <p>The USPSTF concludes that the current evidence is <strong>insufficient to recommend electronic nicotine delivery systems for tobacco cessation in adults</strong>, including pregnant women. The USPSTF recommends that clinicians direct patients who smoke tobacco to other cessation interventions with established effectiveness and safety.\n <a href=\"http://annals.org/aim/article/2443060/behavioral-pharmacotherapy-interventions-tobacco-smoking-cessation-adults-including-pregnant-women\" rel=\"noreferrer\">http://annals.org/aim/article/2443060/behavioral-pharmacotherapy-interventions-tobacco-smoking-cessation-adults-including-pregnant-women</a></p>\n</blockquote>\n\n<hr>\n\n<h2>Further reading</h2>\n\n<ul>\n<li><a href=\"https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/457102/Ecigarettes_an_evidence_update_A_report_commissioned_by_Public_Health_England_FINAL.pdf\" rel=\"noreferrer\">E-cigarettes: an evidence update. A report commissioned by Public Health England</a></li>\n<li>DrugFacts from DrugAbuse.gov, <a href=\"https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products\" rel=\"noreferrer\">Cigarettes and Other Tobacco Products</a></li>\n<li>The Royal College of Physicians in London: <a href=\"https://www.rcplondon.ac.uk/projects/outputs/nicotine-without-smoke-tobacco-harm-reduction-0\" rel=\"noreferrer\">Nicotine without smoke: Tobacco harm reduction</a></li>\n<li>FDA Rule about Tobacco Products <a href=\"https://www.federalregister.gov/documents/2016/05/10/2016-10685/deeming-tobacco-products-to-be-subject-to-the-federal-food-drug-and-cosmetic-act-as-amended-by-the\" rel=\"noreferrer\">(<em>Deeming Tobacco Products To Be Subject to the Federal Food, Drug, and Cosmetic Act, as Amended by the Family Smoking Prevention and Tobacco Control Act; Restrictions on the Sale and Distribution of Tobacco Products and Required Warning Statements for Tobacco Products</em>)</a></li>\n</ul>\n\n<hr>\n\n<p><a href=\"https://i.stack.imgur.com/5G4Pz.png\" rel=\"noreferrer\"><img src=\"https://i.stack.imgur.com/5G4Pz.png\" alt=\"enter image description here\"></a>\n<strong>References of the image</strong></p>\n\n<ul>\n<li>(28 April 2015). \"E-cigarettes: Considerations for the otolaryngologist.\". International journal of pediatric otorhinolaryngology. DOI:10.1016/j.ijporl.2015.04.032. PMID 25998217.</li>\n<li>(2014). \"Science and Electronic Cigarettes\". Journal of Addiction Medicine 8 (4): 223–233. DOI:10.1097/ADM.0000000000000049. PMID 25089952. PMC: 4122311. ISSN 1932-0620.</li>\n<li>(2016). \"Corneoscleral Laceration and Ocular Burns Caused by Electronic Cigarette Explosions\". Cornea 35 (7): 1015–1018. DOI:10.1097/ICO.0000000000000881. PMID 27191672. PMC: 4900417. ISSN 0277-3740.</li>\n<li>Grana, R (13 May 2014). \"E-cigarettes: a scientific review.\". Circulation 129 (19): 1972–86. DOI:10.1161/circulationaha.114.007667. PMID 24821826. PMC: 4018182.</li>\n<li>Ebbert, Jon O. (2015). \"Counseling Patients on the Use of Electronic Cigarettes\". Mayo Clinic Proceedings 90 (1): 128–134. DOI:10.1016/j.mayocp.2014.11.004. PMID 25572196. ISSN 00256196.</li>\n<li>Orellana-Barrios, Menfil A. (2015). \"Electronic cigarettes-a narrative review for clinicians\". The American Journal of Medicine. DOI:10.1016/j.amjmed.2015.01.033. PMID 25731134. ISSN 00029343.</li>\n<li>(2017). \"E-Cigarettes and Smoking Cessation: A Primer for Oncology Clinicians\". Clin J Oncol Nurs. DOI:10.1188/17.CJON.54-63. PMID 28107337.</li>\n</ul>\n\n<p>Author of the Image: Mikael Häggström<br>\nImage Source: <a href=\"https://en.wikipedia.org/wiki/File:Adverse_effects_of_vaping_(raster).png#Summary\" rel=\"noreferrer\">Wikipedia</a></p>\n" }, { "answer_id": 13724, "author": "SteveRacer", "author_id": 11441, "author_profile": "https://health.stackexchange.com/users/11441", "pm_score": 3, "selected": false, "text": "<p>The question might need isolation into two parts: </p>\n\n<ol>\n<li>Nicotine addiction vs. inhaling combusted natural products </li>\n<li>Cessation and the mere use of vaped products.</li>\n</ol>\n\n<p>There should be little doubt that <em>not</em> habitually inhaling nitrosamines and aldehydes is probably better than doing so. In the end, however, the suggestion is equivalent to \"eating boiled steak is healthier than grilled steak\" - for the very same plethora of chemicals that give flavor, but are the result of combustion - whether fine Turkish tobacco or Kobe beef. I'll still take mine rare and blackened, please.</p>\n\n<p>Also, tempering the large research cited on <a href=\"https://health.stackexchange.com/a/13714\">Narusan-in-coma's answer</a> with the thought that \"vaping\" has created a whole large group of younger people that would not otherwise \"smoke\" burning tobacco, <em>the ultimate effects, as Narusan-in-coma points out, are not known.</em> Nor is research at all simple, as most \"vapor\" folks will not vape Frutopia Fun Blend #7 for decades, inhaling god-knows-what flavoring chemicals, with repeated long-term exposure and dosing.</p>\n\n<p>It can only be concluded that the combustion products are eliminated (or reduced by magnitudes). If <em>those</em> are considered Enemy #1, then one could make the leap to \"healthier\". But only with that assumption in place, and forsaking all others.</p>\n\n<p>\"Substitution\" presumes a nicotine addiction already in place. The health effects of nicotine addiction <em>by itself</em> (without combustion and environmental factors) have not been proven or even justified well in my mind. In fact, tests in rats have shown that nicotine alone may not be addictive at all. Which right or wrong proves <em>nothing</em>.</p>\n\n<p>I worked for many years with a renown DABT toxicologist, building devices to smoke cigarettes in a precise way, and deliver \"precision\" cigarette smoke to lab animals like rodents and lagomorphs. Not just for \"cancer\" type research, but psychology and performance physiology studies as well. In fact, the nicotine and tar content have to be measured constantly and accurately by tobacco companies, for the required labeling, since tobacco is a natural product and can vary from season to season. So I would say that I know a little something about this topic. Very very little.</p>\n\n<p>A mere living will eventually lead to death. Of this, and only this, I am certain.</p>\n\n<p><strong>On Edit:</strong> Cites added to demonstrate some of the claims I made, and to comply with this stack's guidelines. Note that I am not trying to <em>prove</em> anything; I merely demonstrated a \"path\" to a conculsion of \"healthier\" (vaping vs. smoking) - with the provisio assumption that <em>combustion</em> products represent the bulk of the health risk compared to mere nicotene in water vapor. It is only with this grand assumption one could come to a \"healthier\" conclusion. The last cite is an interesting one that suggests the most meaningful \"answer\" to the OP question, within the framework of my assertions.</p>\n\n<p><strong>Summary source detailing the inconsistent results in animal testing demonstrating nicotene alone, devoid of other environmental factors, is addictive in of itself:</strong></p>\n\n<blockquote>\n <p><strong>Effects of nicotine in experimental animals and humans: an update on addictive properties</strong></p>\n \n <p>Nicotine, a psychoactive component of tobacco,\n appears to play a major role in tobacco dependence, but reinforcing\n effects of nicotine have often been difficult to demonstrate directly\n in controlled studies with laboratory animals or human subjects: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687081/\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687081/</a></p>\n</blockquote>\n\n<p><strong>Sources alluding that aldehydes and nitrosamines are some of the most signifigant carcinogenic / COPD causal chemicals in burning tobacco:</strong></p>\n\n<blockquote>\n <p><strong>It is time to regulate carcinogenic tobacco-specific nitrosamines in cigarette tobacco</strong></p>\n \n <p>... immediate regulation of the carcinogenic tobacco-specific\n nitrosamines 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and\n N’-nitrosonornicotine (NNN) in cigarette tobacco as a logical path to\n cancer prevention. NNK and NNN, powerful carcinogens in laboratory\n animals, have been evaluated as “carcinogenic to humans” by the\n International Agency for Research on Cancer. \n <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135519/\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135519/</a> </p>\n \n <p><strong>Critical role of aldehydes in cigarette smoke-induced acute airway inflammation.</strong></p>\n \n <p>Cigarette smoking (CS) is the most important risk factor for COPD,\n which is associated with neutrophilic airway inflammation. We\n hypothesize, that highly reactive aldehydes are critical for\n CS-induced neutrophilic airway\n inflammation:<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/23594194\" rel=\"noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/23594194</a></p>\n \n <p><strong>E-cigarettes generate high levels of aldehydes only in “dry puff” conditions</strong> </p>\n \n <p>...reports, accompanied by huge media campaigns, stating that e-cigarettes generate many times higher levels of carcinogenic\n aldehydes compared to tobacco cigarettes. We have always responded\n that such findings were the result of severe overheating of the\n device, which the vapers identify and avoid. We have repeatedly\n referred to the dry puff phenomenon as an explanation of these\n findings...:\n <a href=\"http://www.ecigarette-research.org/research/index.php/research/research-2015/210-ald\" rel=\"noreferrer\">http://www.ecigarette-research.org/research/index.php/research/research-2015/210-ald</a></p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/13713", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8212/" ]

[ { "answer_id": 13732, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": 3, "selected": false, "text": "<p>Don't worry! You should be totally fine. It sounds like flying early in pregnancy does not have any negative side affects.</p>\n\n<p>From the <a href=\"http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/air-travel-during-pregnancy/faq-20058087\" rel=\"noreferrer\">Mayo Clinic</a>:</p>\n\n<blockquote>\n <p>Generally, commercial air travel before week 36 of pregnancy is\n considered safe for women who have healthy pregnancies</p>\n</blockquote>\n\n<p>If you wanted more links:</p>\n\n<p><a href=\"http://www.nhs.uk/chq/Pages/927.aspx?CategoryID=54\" rel=\"noreferrer\">http://www.nhs.uk/chq/Pages/927.aspx?CategoryID=54</a></p>\n\n<p><a href=\"http://www.webmd.com/baby/taking-to-the-skies-pregnant-and-safe#1\" rel=\"noreferrer\">http://www.webmd.com/baby/taking-to-the-skies-pregnant-and-safe#1</a></p>\n\n<p>Also Congratulations! </p>\n" }, { "answer_id": 13733, "author": "Joe", "author_id": 7282, "author_profile": "https://health.stackexchange.com/users/7282", "pm_score": 4, "selected": false, "text": "<p>Specific to the health of the baby, no, you should not have any concerns over a single flight, or even over an occasional flight. From the American Congress of Obstetricians and Gynecologists is this <a href=\"https://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Air-Travel-During-Pregnancy\" rel=\"noreferrer\">helpful guide to air travel during pregnancy</a>, where they specifically discuss a few risks which I will summarize below. All of this assumes a healthy pregnancy, and before term.</p>\n<p>The abstract summarizes it well:</p>\n<blockquote>\n<p>In the absence of obstetric or medical complications, pregnant women can observe the same precautions for air travel as the general population and can fly safely. Pregnant women should be instructed to continuously use their seat belts while seated, as should all air travelers. Pregnant air travelers may take precautions to ease in-flight discomfort and, although no hard evidence exists, preventive measures can be used to minimize risks of venous thrombosis. For most air travelers, the risks to the fetus from exposure to cosmic radiation are negligible. For pregnant aircrew members and other frequent flyers, this exposure may be higher. Information is available from the FAA to estimate this exposure.</p>\n</blockquote>\n<p>My summary of the specific risks from the longer paper:</p>\n<ol>\n<li><p>Environmental conditions</p>\n<p>The pressurized environment of the aircraft can lead to some changes in the mother's blood pressure and heart rate; there is currently no evidence this is likely to cause an issue with a developing fetus, but you can take preventative measures such as wearing support stockings, walking around periodically, and drinking sufficient water.</p>\n</li>\n<li><p>Turbulence</p>\n<p>Turbulence can cause the expectant mother to fall and be injured (which could in theory do harm to the fetus), so when possible sit down with your seatbelt fastened.</p>\n</li>\n<li><p>Cosmic radiation, etc.</p>\n<p>An occasional flight will not cause you to receive more ionizing radiation than the generally accepted safe level; however, many flights could put you at risk of surpassing that level. The specifics, and a link to determine her specific exposure:</p>\n</li>\n</ol>\n<blockquote>\n<p>Available information suggests that noise, vibration, and cosmic radiation present a negligible risk for the occasional pregnant air traveler (6, 7). Both the National Council on Radiation Protection and Measurements and the International Commission on Radiological Protection recommend a maximum annual radiation exposure limit of 1 millisievert (mSv) (100 rem) for members of the general public and 1 mSv over the course of a 40-week pregnancy (7). Even the longest available intercontinental flights will expose passengers to no more than 15% of this limit (7); therefore, it is unlikely that the occasional traveler will exceed current exposure limits during pregnancy. However, aircrew or frequent flyers may exceed these limits. The Federal Aviation Administration and the International Commission on Radiological Protection consider aircrew to be occupationally exposed to ionizing radiation and recommend that they be informed about radiation exposure and health risks (8, 9). A tool to estimate an individual exposure to cosmic radiation from a specific flight is available from the Federal Aviation Administration on its web site (<a href=\"http://jag.cami.jccbi.gov/cariprofile.asp\" rel=\"noreferrer\">http://jag.cami.jccbi.gov/cariprofile.asp</a>).</p>\n</blockquote>\n<p>So - no, your partner did not put the fetus at particular risk by flying while pregnant; however, if she is likely to fly many times during the pregnancy (such as, if she works in sales and flies on a weekly basis), she should talk to her obstetrician and ask them whether the particular flight frequency and duration is safe throughout the pregnancy.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13730", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11652/" ]

[ { "answer_id": 13736, "author": "cloudnyn3", "author_id": 2675, "author_profile": "https://health.stackexchange.com/users/2675", "pm_score": 3, "selected": false, "text": "<p>This is most commonly a precaution to prevent Mal-absorption. Milk has copious amounts of calcium which bond with the antibiotic in the gut. Once the tetracycline (antibiotic) bonds, it creates a neutral environment for food to digest in. Once the calcium bonds with mil it breaks down the antibiotic as well as the stomach acid used to break it down.This will not only cause Mal-absorption of nutrients through your G.I. tract, but will also keep your body from breaking down the medication as efficiently or at all. Gastroparesis in combination with tetracycline is also sometimes reported, dairy products could exacerbate this, but this was out of an old medical journal, I don't know the validity of that so take it with a grain of salt.. High calcium foods should be avoided while on treatment. </p>\n\n<p>There's the breakdown of why you shouldn't take them in combination.</p>\n\n<p>Here's more information on what to avoid and why.</p>\n\n<p><a href=\"https://medlineplus.gov/druginfo/meds/a682098.html\" rel=\"noreferrer\">https://medlineplus.gov/druginfo/meds/a682098.html</a></p>\n" }, { "answer_id": 13739, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 6, "selected": true, "text": "<p>Products high in calcium and magnesium should not be taken at the same time as antibiotics of the tetracycline (tetracycline, doxicycline, etc.) class, and milk should also be avoided with the quinolone class. They have the ability to bind the antibiotic in the gut, decreasing absorption. <strong>There is no reason to avoid dairy products while taking other antibiotics</strong> (such as the penicillin class, the one you're taking. The clavulanic acid is to increase it's strength against certain bacteria.) If the antibiotic package insert (or the pharmacists's instruction sheet) states it should be taken on an empty stomach, take it with water. But what you eat when you eat is your choice.</p>\n\n<p>Some doctors believe that milk products cause increased production or thickening of secretions, and that's a problem if you have a middle ear infection. If there is fluid in the middle ear, especially infected fluid, you want the fluid to drain out of the middle ear via the eustacian tube into the back of your throat. So, the thinking that milk makes mucus worse means recommending a decrease in milk products.</p>\n\n<p>Is that thinking correct? Probably not. Milk does not affect mucous production or quality.</p>\n\n<p>In one study of 60 volunteers,</p>\n\n<blockquote>\n <p>We conclude that no statistically significant overall association can be detected between milk and dairy product intake and symptoms of mucus production in healthy adults, either asymptomatic or symptomatic, with rhinovirus infection.</p>\n</blockquote>\n\n<p>This has been confirmed in other studies as well. In a subset of asthmatic patients, cessation of milk consumption improved symptomatology, but this is thought to be due to an allergy to a component of milk.</p>\n\n<hr>\n\n<p>The advice to eat yogurt is in all likelihood an attempt to reduce the risk of C. diff (aka Antibiotic Associated Diarrhea), which is present with any antibiotic. Antibiotics upset gut flora. Live culture yogurt has some beneficial gut bacteria species. However, this, too, depends on the yogurt. Probiotics <em>are</em> helpful, but many yogurts are monocultures and/or don't contain enough bacteria to make a difference to the gut. Some do, however. So, the advice to eat yogurt is good; it may not help, but it might. Look for yogurt with live cultures (plural).</p>\n\n<p>One meta analysis looked at research done on this very topic (which is hot in medicine right now.)</p>\n\n<blockquote>\n <p>Antibiotic-associated diarrhoea can be attributed in part to imbalances in intestinal microflora. Therefore, probiotic preparations are used to prevent this diarrhoea. </p>\n</blockquote>\n\n<p>It concluded,</p>\n\n<blockquote>\n <p>The results suggest a strong benefit of probiotic administration on antibiotic-associated diarrhoea, but further data are needed. The evidence for beneficial effects is still not definitive. Published studies are flawed by the lack of a placebo design and by peculiar population features.</p>\n</blockquote>\n\n<p>Personally, whenever I put patients on antibiotics, I also <em>prescribed</em> two yogurt brands, one serving of one in the morning and another serving of the second in the evening. The brands I recommended were shown to have sufficient CFUs (colony forming units) of several important beneficial gut inhabitants. (There weren't any single yogurt brand that had the big five.)</p>\n\n<p>_{<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/2154152\" rel=\"noreferrer\">Relationship between milk intake and mucus production in adult volunteers challenged with rhinovirus-2.</a>}<br>\n_{<a href=\"http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2002.01318.x/full\" rel=\"noreferrer\">Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea</a>} </p>\n" } ]

[ "https://health.stackexchange.com/questions/13735", "https://health.stackexchange.com", "https://health.stackexchange.com/users/729/" ]

[ { "answer_id": 23353, "author": "D.Tan", "author_id": 13163, "author_profile": "https://health.stackexchange.com/users/13163", "pm_score": 0, "selected": false, "text": "<p>According to <a href=\"https://emedicine.medscape.com/article/222040-differential\" rel=\"nofollow noreferrer\">Emedicine medscape</a>:</p>\n\n<blockquote>\n <p>Appreciate that EBV may trigger chronic fatigue, but it does not cause chronic fatigue. </p>\n</blockquote>\n\n<p>In their page on <a href=\"https://emedicine.medscape.com/article/235980-overview#a4\" rel=\"nofollow noreferrer\">Chronic Fatigue Syndrome</a>:</p>\n\n<blockquote>\n <p>CFS is a biological illness, not a psychologic disorder. The <strong>exact pathogenesis is unknown</strong>. Numerous mechanisms and molecules have been implicated that lead to abnormalities in immune dysfunction, hormonal regulation, metabolism and response to oxidative stress to include impaired natural killer cell function and/or T-cell function, elevated cytokines, and autoantibodies (rheumatic factor, antithyroid antibodies, antigliadin, anti–smooth muscle antibodies, and cold agglutinins). [3, 4] Infections have been suspected; however, no causal role has been established.</p>\n</blockquote>\n\n<p>The sources cited:</p>\n\n<ol start=\"3\">\n<li><a href=\"https://www.cdc.gov/me-cfs/index.html\" rel=\"nofollow noreferrer\">https://www.cdc.gov/me-cfs/index.html</a></li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/28760971\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/28760971</a></li>\n</ol>\n" }, { "answer_id": 24057, "author": "Mousey", "author_id": 1127, "author_profile": "https://health.stackexchange.com/users/1127", "pm_score": 1, "selected": false, "text": "<p>There is no consensus on the exact cause, although in Chronic Epstein-Barr Activation (CEBA) it has been linked to the effects of inflammation (eg a cytokine storm), plus immune activation and <a href=\"https://www.sciencedirect.com/science/article/abs/pii/S0165032707003321\" rel=\"nofollow noreferrer\">tryptophan degradation</a>.</p>\n<p>In the more common, non-CEBA Epstein-Barr infection immune system responses are also suggested to be linked to the fatigue.\n<em>&quot;Presently, therefore the is no proven fatigue-causing substance or fatigue transmitting substance.\nHowever, the most probable candidates for such fatigue-inducing or fatigue transmitting substances are cytokines, including interferon.&quot;</em><a href=\"http://www.med.or.jp/english/pdf/2006_01/027_033.pdf\" rel=\"nofollow noreferrer\">2</a></p>\n<p>Lasting fatigue is found in a number of viruses, including a number of Covid-19 patients.<a href=\"https://link.springer.com/article/10.1186/s12974-017-0796-7\" rel=\"nofollow noreferrer\">3</a> This may be related to Interleukin-1 levels, an inflammatory cytokine.</p>\n<p>Long term fatigue is often termed &quot;Chronic fatigue&quot;, &quot;post-fatigue infection&quot; or &quot;post-viral fatigue&quot; (without the syndrome part).</p>\n" } ]

[ "https://health.stackexchange.com/questions/13773", "https://health.stackexchange.com", "https://health.stackexchange.com/users/2882/" ]

[ { "answer_id": 23353, "author": "D.Tan", "author_id": 13163, "author_profile": "https://health.stackexchange.com/users/13163", "pm_score": 0, "selected": false, "text": "<p>According to <a href=\"https://emedicine.medscape.com/article/222040-differential\" rel=\"nofollow noreferrer\">Emedicine medscape</a>:</p>\n\n<blockquote>\n <p>Appreciate that EBV may trigger chronic fatigue, but it does not cause chronic fatigue. </p>\n</blockquote>\n\n<p>In their page on <a href=\"https://emedicine.medscape.com/article/235980-overview#a4\" rel=\"nofollow noreferrer\">Chronic Fatigue Syndrome</a>:</p>\n\n<blockquote>\n <p>CFS is a biological illness, not a psychologic disorder. The <strong>exact pathogenesis is unknown</strong>. Numerous mechanisms and molecules have been implicated that lead to abnormalities in immune dysfunction, hormonal regulation, metabolism and response to oxidative stress to include impaired natural killer cell function and/or T-cell function, elevated cytokines, and autoantibodies (rheumatic factor, antithyroid antibodies, antigliadin, anti–smooth muscle antibodies, and cold agglutinins). [3, 4] Infections have been suspected; however, no causal role has been established.</p>\n</blockquote>\n\n<p>The sources cited:</p>\n\n<ol start=\"3\">\n<li><a href=\"https://www.cdc.gov/me-cfs/index.html\" rel=\"nofollow noreferrer\">https://www.cdc.gov/me-cfs/index.html</a></li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/28760971\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/28760971</a></li>\n</ol>\n" }, { "answer_id": 24057, "author": "Mousey", "author_id": 1127, "author_profile": "https://health.stackexchange.com/users/1127", "pm_score": 1, "selected": false, "text": "<p>There is no consensus on the exact cause, although in Chronic Epstein-Barr Activation (CEBA) it has been linked to the effects of inflammation (eg a cytokine storm), plus immune activation and <a href=\"https://www.sciencedirect.com/science/article/abs/pii/S0165032707003321\" rel=\"nofollow noreferrer\">tryptophan degradation</a>.</p>\n<p>In the more common, non-CEBA Epstein-Barr infection immune system responses are also suggested to be linked to the fatigue.\n<em>&quot;Presently, therefore the is no proven fatigue-causing substance or fatigue transmitting substance.\nHowever, the most probable candidates for such fatigue-inducing or fatigue transmitting substances are cytokines, including interferon.&quot;</em><a href=\"http://www.med.or.jp/english/pdf/2006_01/027_033.pdf\" rel=\"nofollow noreferrer\">2</a></p>\n<p>Lasting fatigue is found in a number of viruses, including a number of Covid-19 patients.<a href=\"https://link.springer.com/article/10.1186/s12974-017-0796-7\" rel=\"nofollow noreferrer\">3</a> This may be related to Interleukin-1 levels, an inflammatory cytokine.</p>\n<p>Long term fatigue is often termed &quot;Chronic fatigue&quot;, &quot;post-fatigue infection&quot; or &quot;post-viral fatigue&quot; (without the syndrome part).</p>\n" } ]

[ "https://health.stackexchange.com/questions/13830", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11560/" ]

[ { "answer_id": 13879, "author": "Dan", "author_id": 11597, "author_profile": "https://health.stackexchange.com/users/11597", "pm_score": 0, "selected": false, "text": "<p>Short answer is the ED will try and stabilize the patient as best as they can with fluids and pressors if needed. But patient will need surgery to figure out where the bleed is coming from. </p>\n" }, { "answer_id": 13881, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 3, "selected": false, "text": "<p>In the US this should be a very rare event. Every state (or region) has hospitals designated as level 1 trauma centers. Being certified as a level 1 trauma center means they have all the personnel and facilities necessary to handle any type of trauma at any time. That means surgical teams and all the support staff and facilities such as radiology, blood bank, pharmacy and all the necessary personnel are on site and available 24/7. Surgeons being \"on call\" isn't good enough.</p>\n\n<p>Along with trauma centers, there is a system of regulations governing which patients qualify as trauma patients and how EMS must handle them. When EMS responds to a 911 call and they determine that the patient meets trauma criteria, they <strong><em>must</em></strong> transport that patient to the nearest trauma center. (This is one of the few times that EMS can overrule a conscious, sober, adult patient's choice of hospitals.)</p>\n\n<p>However, exceptions can and do happen. For example, a patient has suffered massive blood loss. The trauma center is 45 minutes away and the patient is deteriorating rapidly and unlikely to survive the trip, but another hospital is 5 minutes away that has a blood bank and surgical capabilities. In that case the medics would contact their own medical control (usually an ED doctor where they're based) and request a diversion. If approved, they would then contact the new destination hospital to give them a heads up on what's headed their way. You don't take a critical patient somewhere without knowing for sure they can accept them. The idea here is the patient will be stabilized at the smaller hospital and then transferred to the trauma center ASAP. </p>\n\n<p>So the scenario you ask about should almost never happen. There's no benefit to taking a trauma patient somewhere where there are no surgeons since there's little a hospital can do that the medics can't. It's better to fly the patient if possible or simply keep moving. Time is everything in trauma and diverting to a hospital without the necessary resources would be a waste of precious time. </p>\n\n<p>In comments Narusan raises a good question: What if the patient travels to the smaller hospital himself? In that case the same thing would happen. They would stabilize the patient to the best of their abilities and then transfer them to a trauma center as soon as possible. </p>\n\n<p><a href=\"https://www.ems.gov/pdf/advancing-ems-systems/Provider-Resources/EMS_Trauma_Agenda.pdf\" rel=\"nofollow noreferrer\">https://www.ems.gov/pdf/advancing-ems-systems/Provider-Resources/EMS_Trauma_Agenda.pdf</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/13875", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11610/" ]

[ { "answer_id": 13889, "author": "Oscar", "author_id": 11608, "author_profile": "https://health.stackexchange.com/users/11608", "pm_score": 3, "selected": true, "text": "<p>It depends what your definition of <code>healthy</code> is really. If you're looking for something low calorie, I would suggest a large bowl of steamed vegetables. If you heavily season them avoiding salt if you can - think pepper and paprika, they are surprisingly delicious. </p>\n\n<p>Just cook frozen vegetables like brocoli, corn or peas in a bowl. You can buy them from any supermarket for super cheap, and the meal takes 5 mins in the microwave with basically no prep.</p>\n\n<p>10/10 healthy\n10/10 easy</p>\n" }, { "answer_id": 14626, "author": "oandersonm", "author_id": 12296, "author_profile": "https://health.stackexchange.com/users/12296", "pm_score": 1, "selected": false, "text": "<p>If you get hungry very fast, you are most likely not eating enough for your activity level or not getting the right nutrient ratios. Typically, if you up the protein and fiber content in your meals/snacks you'll be less hungry in general.</p>\n\n<p>If you feel you are eating enough, check on whether or not your hunger is \"real\". Sometimes things like not drinking enough water, too little sleep, etc. can trick you into thinking you are hungry, or, you may just wanting something to snack on out of boredom. If this is the case, good snacks may be food that are lower calorie but high in volume, like:</p>\n\n<ul>\n<li>Vegetables (and if you aren't a big fan, try adding some seasoning and roasting until crunchy)</li>\n<li>Apple slices, banana, berries</li>\n<li>Sunflower seeds (which take a while to eat shelled)</li>\n<li>Air popped popcorn</li>\n</ul>\n\n<p>For more nutrient dense snacks when you are truly hungry, find foods with a higher healthy fat content (will keep you focused and full) and a higher protein content (keeps you fuller longer), like:</p>\n\n<ul>\n<li>1oz of nuts (not strictly 1oz, but it is easy to overeat nuts)</li>\n<li>An egg or two on toast</li>\n<li>Banana or apple with peanut/nut butter and cinnamon</li>\n<li>Protein shake or bar</li>\n<li>Avocado on toast</li>\n<li>Veggies and hummus</li>\n<li>Grilled chicken</li>\n</ul>\n\n<p>And if you find that you are lacking energy to get through the day or that exercise is abnormally draining, you may want to add more carbohydrates, like:</p>\n\n<ul>\n<li>Bakes potato/Sweet potato</li>\n<li>Rice and beans</li>\n<li>Sprouted grain toast </li>\n<li>English muffin</li>\n</ul>\n\n<p>These are just some simple suggestions, but hopefully this helps!</p>\n" } ]

[ "https://health.stackexchange.com/questions/13888", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8973/" ]

[ { "answer_id": 13904, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 5, "selected": true, "text": "<p>That problem is already solved for you, at least in the US.</p>\n\n<p>Current guidelines issued by the American Heart Association no longer require rescue breathing. Chest compressions alone are now <a href=\"http://cpr.heart.org/AHAECC/CPRAndECC/Programs/HandsOnlyCPR/UCM_473196_Hands-Only-CPR.jsp\" rel=\"nofollow noreferrer\">the standard</a> for community CPR (vs professional CPR). They refer to it as <em>hands only CPR</em>.</p>\n\n<p>On an anecdotal note, I've done mouth-to-mouth on a perfect stranger. He was a young adult male drowning victim. It's not as off-putting as you might think. However, had he vomited, which is common in cardiac arrest, that would have made me wish for a pocket mask. </p>\n\n<p><strong>Edit in response to edit to the question:</strong></p>\n\n<p>If protective equipment like a pocket mask isn't available and omitting mouth-to-mouth isn't an option, then there aren't many options left. A piece of cloth used as a barrier might help reduce the gross factor, but I doubt it will do much to protect you from bacteria and viruses. If vomit is present, you need to clear the airway first anyway, which should have been covered in your CPR class. If blood is present, now you have to ask yourself how much risk you're willing to take since you could be exposing yourself to dangerous bloodborne pathogens. Although it's okay to wipe the mouth and face off with a wet cloth, it's not okay to try and rinse the mouth. </p>\n\n<p>Honestly, should you find yourself in the situation of using your CPR training, I think you'll find that you'll be too busy and focused to even notice the off-putting aspects unless the patient is a real mess. Just do what needs to be done and what your risk assessment allows you to do. You'll probably be surprised how much work CPR is. Even professionals come away from a 'code' sweating. </p>\n" }, { "answer_id": 13907, "author": "Tom", "author_id": 11618, "author_profile": "https://health.stackexchange.com/users/11618", "pm_score": 2, "selected": false, "text": "<p>The British came across this exact problem. CPR was seen as a tricky business, especially when it was considered complicated and might involve mouth-to-mouth. </p>\n\n<p>Their solution was (as Carey Gregory mentioned) to recommend chest-compressions in time to a relatively popular (and more importantly, catchy) song. Their logic was that even a simple step like that was much better than people standing about doing nothing out of fear of getting it wrong.</p>\n\n<p>There was a big push to get this message out via an advert the British Heart Foundation ran with a famous actor (Vinnie Jones) in which he literally says the line: \"No kissing, you only kiss your Mrs on the lips\".</p>\n\n<p>You can find it here: <a href=\"https://www.youtube.com/watch?v=hcQG2MMegXw\" rel=\"nofollow noreferrer\">https://www.youtube.com/watch?v=hcQG2MMegXw</a> or by searching \"Vinnie Jones' hard and fast hands-only CPR\". </p>\n" } ]

[ "https://health.stackexchange.com/questions/13902", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9465/" ]

[ { "answer_id": 14117, "author": "Taylor", "author_id": 8916, "author_profile": "https://health.stackexchange.com/users/8916", "pm_score": 3, "selected": false, "text": "<p>Hyperventilation can lead to reduced oxygen transport to cells. As a result, ineffective breathing patterns can cause cell and tissue hypoxia, chronic inflammation, immunosuppression, and many other negative effects caused by low body-oxygen levels and hypocapnia (reduced CO2 levels). </p>\n\n<p>Hypoxia has been found to be a driving force in several health conditions including heart disease, diabetes, chronic fatigue, and has become a widely known key cause of <em>cancer</em> on the cellular level. </p>\n\n<p><a href=\"https://www.nobelprize.org/nobel_prizes/medicine/laureates/1931/warburg-bio.html\" rel=\"noreferrer\">Dr. Otto Warburg</a> investigated the metabolism of tumors and the respiration of cancer cells. In 1931, he was awarded the Nobel Prize for his discovery of the nature and mode of action of the respiratory enzyme as it relates to cellular metabolism and cellular respiration. His studies led to the discovery that</p>\n\n<blockquote>\n <p>...cancerous cells can live and develop, even in the absence of oxygen.</p>\n</blockquote>\n\n<p>Under normal conditions, abnormal cells are detected by the immune system and destroyed. However, the work of macrophages, enzymes and other agents of the immune system is severely restricted when hypoxia exists.</p>\n\n<p>For example, <a href=\"https://medicine.yale.edu/intranet/facultybydept/sara_rockwell-2.profile\" rel=\"noreferrer\">Dr. Rockwell from Yale University School of Medicine</a> studied malignant changes on the cellular level and wrote in an abstract, titled ‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/9406244\" rel=\"noreferrer\">Oxygen delivery: Implications for the biology and therapy of solid tumors</a>,’</p>\n\n<blockquote>\n <p>The physiologic effects of hypoxia and the associated microenvironmental inadequacies increase mutation rates, select for cells deficient in normal pathways of programmed cell death, and contribute to the development of an increasingly invasive, metastatic phenotype.</p>\n</blockquote>\n\n<p>Malignant cells normally and constantly appear and exist in any human organism due to the billions of cell divisions and mutations. As described in ‘<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK26891/\" rel=\"noreferrer\">Molecular Biology of the Cell. 4th Edition</a>,’</p>\n\n<blockquote>\n <p>A tumor is considered cancer only if it is malignant, that is, only if its cells have acquired the ability to invade surrounding tissue. Invasiveness usually implies an ability to break loose, enter the bloodstream or lymphatic vessels, and form secondary tumors, called metastases, at other sites in the body.</p>\n</blockquote>\n\n<p>‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/3759546?dopt=Abstract\" rel=\"noreferrer\">Acute hypoxia in tumors: implications for modifiers of radiation effects</a>,’ describes methods that were developed in selecting and analyzing cells from tumors as a function of their distance from the tumor blood supply. </p>\n\n<blockquote>\n <p>This information provides direct evidence that, at least for that tumor, hypoxia can result from transient fluctuations in blood perfusion.</p>\n</blockquote>\n\n<p>There is evidence about the fast growth of tumors when the condition of hypoxia is present. ‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/15456710\" rel=\"noreferrer\">Microenvironmental and cellular consequences of altered blood flow in tumours</a>’ gives credence to this notion, stating</p>\n\n<blockquote>\n <p>...tumor angiogenesis is triggered by various signals characteristic of the tumor microenvironment, including low oxygen tension, low extracellular pH and low glucose concentration. </p>\n</blockquote>\n\n<p>The abstract also draws a correlation between hypoxia and cancer metastasis: </p>\n\n<blockquote>\n <p>Exposure to hypoxia either induces or selects for cells that are hyper glycolytic, and this in turn produces local <em>acidosis</em> which is also a common feature of solid tumors…Evidence linking tumor acidity with increased activity of several extracellular matrix-degrading enzyme systems is examined…High levels of lactate, another end-product of glycolysis, in primary lesions have been correlated with increased likelihood of metastasis...adoption of a hyper glycolytic phenotype is a necessary feature of carcinogenesis itself and confers a survival and proliferative advantage to tumor cells over surrounding normal cells. Empirical evidence supporting this \"acid-mediated tumor invasion\" model is discussed.</p>\n</blockquote>\n\n<p>Additionally, ’<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/8640781\" rel=\"noreferrer\">Tumor oxygenation predicts for the likelihood of distant metastases in human soft tissue sarcoma</a>’ explores the relationship between tumor oxygenation and treatment outcome in human soft tissue sarcoma, claiming that tumor oxygenation predicts chances of cancer invasion.</p>\n\n<blockquote>\n <p>...anaerobic culture of fibrosarcoma and melanoma cells followed by reoxygenation led to both significant DNA over replication and an increased level of distant metastases. Entry of hypoxic cells such as these into the systemic circulation and subsequent sequestration into the oxygen-rich environment of the lungs could explain the results of the present study…</p>\n</blockquote>\n\n<p>Hypoxia can also affect cancer development, treatment, and prognosis according to ‘<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC110663/\" rel=\"noreferrer\">Regulation of Proliferation-Survival Decisions during Tumor Cell Hypoxia</a>,’</p>\n\n<blockquote>\n <p>Hypoxia may thus produce both treatment resistance and a growth advantage.</p>\n</blockquote>\n\n<p>And in ‘<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2752413/\" rel=\"noreferrer\">Hypoxia and radiation therapy: Past history, ongoing research, and future promise</a>’, </p>\n\n<blockquote>\n <p>...changes in blood flow and oxygen consumption during the course of multi fraction and multi-agent therapy alter tumor oxygenation and are probably critical in determining the efficacy of many widely used therapeutic regimens.</p>\n</blockquote>\n\n<p>In ‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12767506\" rel=\"noreferrer\">Prognostic significance of tumor oxygenation in humans</a>, </p>\n\n<blockquote>\n <p>Low tissue oxygen concentration has been shown to be important in the response of human tumors to radiation therapy, chemotherapy and other treatment modalities. Hypoxia is also known to be a prognostic indicator, as hypoxic human tumors are more biologically aggressive and are more likely to recur locally and metastasize.</p>\n</blockquote>\n\n<p>And lastly, in ‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12947397\" rel=\"noreferrer\">Investigating hypoxic tumor physiology through gene expression patterns</a>,’</p>\n\n<blockquote>\n <p>Clinical evidence shows that tumor hypoxia is an independent prognostic indicator of poor patient outcome. Hypoxic tumors have altered physiologic processes, including increased regions of angiogenesis, increased local invasion, increased distant metastasis and altered apoptotic programs.</p>\n</blockquote>\n\n<p>Based on the findings of the previously mentioned studies, the appearance, development, and metastasis of cancer can be attributed to cell hypoxia which can occur as result of extended hyperventilation. Therefore, the Wim Hof method may not be advantageous when included in a cancer-prone individual's \"prevention plan\" due to the potential risks involved with hypoxia (as a potential consequence resulting from the hyperventilation component of the breathing exercise). </p>\n" }, { "answer_id": 14124, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 4, "selected": true, "text": "<p>Apart from monks and nuns who showcase impressive abilities Wim Hof is onto something. One anecdote reads as follows:</p>\n\n<blockquote>\n <p><a href=\"http://www.tdathletesedge.com/blog/2017/7/2/guest-blog-by-vince-tsai-the-power-of-breathing\" rel=\"nofollow noreferrer\">I’ve also experienced the positive changes myself, […] My cardiovascular and muscular endurance has increased substantially too, with a reduction in my run times, thanks to the over-saturation of oxygen to my cells, activation of my autonomic nervous system and the overriding my hypothalamus, and the changing of my body’s pH level to a more alkaline state. All the changes to my physiology from practicing the Wim Hof Technique consistently, has improved my overall health and athletic performance considerably.</a></p>\n</blockquote>\n\n<p>But anecdotes from believers are of course not very useful. Scientists are nevertheless intrigued by all those world records Hof has collected:</p>\n\n<blockquote>\n <p><a href=\"https://www.sciencedirect.com/science/article/pii/S0262407914616274\" rel=\"nofollow noreferrer\">At first this seems a ridiculous idea, because our body’s innate immune system has long been known to operate in an autonomic fashion: we can’t voluntarily control it. But what if this understanding was wrong? Dutchman Wim Hof, better known as “the iceman”, certainly thinks so. Hof holds several world records for withstanding extreme cold, such as immersion in ice for almost 2 hours. Over the years, he developed techniques that allowed him to withstand low temperatures. These include meditation, breathing methods and repeated exposure\n to cold. But he also made the outlandish claim that he could exert control over his immune system. In 2011, although we were sceptical, we put Hof’s claim to the test. […] When we got back to the Netherlands, we tested the volunteers’ immune responses using the endotoxin model. The results were remarkable: the volunteers trained by Hof, who practised the breathing techniques during the experiment, showed exceptionally high adrenaline levels – even higher than those measured in people bungee jumping for the first time (PNAS, vol 111, p 7379). They also reported fewer flu-like symptoms, experienced lower fevers and had cytokine levels of less than half those of the control group. These results show, for the first time, that it is indeed possible to voluntarily influence the SNS and hence the innate immune system.</a></p>\n</blockquote>\n\n<p>The same study in a peer reviewed journal comes with more data:</p>\n\n<p><a href=\"http://www.pnas.org/content/111/20/7379.short\" rel=\"nofollow noreferrer\">Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans</a>:</p>\n\n<blockquote>\n <p><strong>Significance</strong>\n Hitherto, both the autonomic nervous system and innate immune system were regarded as systems that cannot be voluntarily influenced. The present study demonstrates that, through practicing techniques learned in a short-term training program, the sympathetic nervous system and immune system can indeed be voluntarily influenced. Healthy volunteers practicing the learned techniques exhibited profound increases in the release of epinephrine, which in turn led to increased production of anti-inflammatory mediators and subsequent dampening of the proinflammatory cytokine response elicited by intravenous administration of bacterial endotoxin. This study could have important implications for the treatment of a variety of conditions associated with excessive or persistent inflammation, especially autoimmune diseases in which therapies that antagonize proinflammatory cytokines have shown great benefit.</p>\n \n <p><strong>Abstract</strong>\n Excessive or persistent proinflammatory cytokine production plays a central role in autoimmune diseases. Acute activation of the sympathetic nervous system attenuates the innate immune response. However, both the autonomic nervous system and innate immune system are regarded as systems that cannot be voluntarily influenced. Herein, we evaluated the effects of a training program on the autonomic nervous system and innate immune response. Healthy volunteers were randomized to either the intervention (n = 12) or control group (n = 12). Subjects in the intervention group were trained for 10 d in meditation (third eye meditation), breathing techniques (i.a., cyclic hyperventilation followed by breath retention), and exposure to cold (i.a., immersions in ice cold water). The control group was not trained. Subsequently, all subjects underwent experimental endotoxemia (i.v. administration of 2 ng/kg Escherichia coli endotoxin). In the intervention group, practicing the learned techniques resulted in intermittent respiratory alkalosis and hypoxia resulting in profoundly increased plasma epinephrine levels. In the intervention group, plasma levels of the anti-inflammatory cytokine IL-10 increased more rapidly after endotoxin administration, correlated strongly with preceding epinephrine levels, and were higher. Levels of proinflammatory mediators TNF-α, IL-6, and IL-8 were lower in the intervention group and correlated negatively with IL-10 levels. Finally, flu-like symptoms were lower in the intervention group. In conclusion, we demonstrate that voluntary activation of the sympathetic nervous system results in epinephrine release and subsequent suppression of the innate immune response in humans in vivo. These results could have important implications for the treatment of conditions associated with excessive or persistent inflammation, such as autoimmune diseases.</p>\n</blockquote>\n\n<p>A second study also sees changes resulting from practicing the technique, this time stripping the method of its Asian mysticism parts and thereby westernising it:\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612090/\" rel=\"nofollow noreferrer\">Neurocognitive and somatic components of temperature increases during g-tummo meditation: legend and reality:</a></p>\n\n<blockquote>\n <p>Stories of g-tummo meditators mysteriously able to dry wet sheets wrapped around their naked bodies during a frigid Himalayan ceremony have intrigued scholars and laypersons alike for a century. Study 1 was conducted in remote monasteries of eastern Tibet with expert meditators performing g-tummo practices while their axillary temperature and electroencephalographic (EEG) activity were measured. Study 2 was conducted with Western participants (a non-meditator control group) instructed to use the somatic component of the g-tummo practice (vase breathing) without utilization of meditative visualization. Reliable increases in axillary temperature from normal to slight or moderate fever zone (up to 38.3°C) were observed among meditators only during the Forceful Breath type of g-tummo meditation accompanied by increases in alpha, beta, and gamma power. The magnitude of the temperature increases significantly correlated with the increases in alpha power during Forceful Breath meditation. The findings indicate that there are two factors affecting temperature increase. The first is the somatic component which causes thermogenesis, while the second is the neurocognitive component (meditative visualization) that aids in sustaining temperature increases for longer periods. Without meditative visualization, both meditators and non-meditators were capable of using the Forceful Breath vase breathing only for a limited time, resulting in limited temperature increases in the range of normal body temperature. Overall, the results suggest that specific aspects of the g-tummo technique might help non-meditators learn how to regulate their body temperature, which has implications for improving health and regulating cognitive performance.</p>\n</blockquote>\n\n<p>That sounds indeed promising. But in what way remains mostly unclear. \"Attenuating immune response\"? Well, lowering the immune system's activity might be a bad idea in relation to cancer, putting a brake on overshooting inflammatory processes might be good. Is any of this studied in a larger group? Is any of this studied over a longer time frame?</p>\n\n<p><em>Temporary</em> short time hyperventilation or even hypoxia may have some kind of <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29045191\" rel=\"nofollow noreferrer\">training</a> <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29023329\" rel=\"nofollow noreferrer\">effect</a> that <em>might</em> lead to improved oxygenation of body tissues overall. Doing this repeatedly or routinely may also have quite <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29053942\" rel=\"nofollow noreferrer\">unwelcome</a> effects. But the <em>local</em> 'tumor hypoxia' effects of cancer that appear as <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/17656037\" rel=\"nofollow noreferrer\">sustained</a> under-oxygenation of the affected cells are not necessarily the same as what happens in breathing a few times like the Hof.</p>\n\n<blockquote>\n <p><a href=\"http://www.tandfonline.com/doi/full/10.1080/23328940.2017.1329001\" rel=\"nofollow noreferrer\">There is, however, a string attached to the Wim Hof Method, <strong>that is the risk that people may think the method is scientifically valid.</strong> Wim is a wholehearted speaker, but his scientific vocabulary is galimatias. With conviction, he mixes in a non-sensical way scientific terms as irrefutable evidence. Many less scientifically literate people believe what he says and several seriously diseased people have used his method as the final straw. Stories of believers circulate on the Internet, in popular magazines and are broadcasted as well. <strong>The scientific investigations are often presented with a biased view.</strong> <br> \n When practicing the Wim Hof Method with a good dose of common sense (for instance, not hyperventilating before submerging in water) and without excessive expectations: it doesn't hurt to try. <strong>Although the effects on our health wait to be proven, people may feel healthier.</strong><br>\n All in all, I think it is worthwhile to sort out whether and which of the training aspects of Wim's method affect our immune system and metabolism. And, with respect to the extreme challenges, is Wim special? Or are we all, as he himself proclaims, ice(wo)men?</a>[emphasis added]</p>\n</blockquote>\n\n<h3>Summary</h3>\n\n<p>So, Wim Hof is onto something. But what is it? <a href=\"http://www.sciencedirect.com/science/article/pii/S0079612308621597\" rel=\"nofollow noreferrer\">Western</a> <a href=\"http://www.sciencedirect.com/science/article/pii/S0167527303003504\" rel=\"nofollow noreferrer\">science</a> has optimised <a href=\"http://online.liebertpub.com/doi/abs/10.1089/acm.2009.0044\" rel=\"nofollow noreferrer\">meditation</a> <a href=\"http://www.sciencedirect.com/science/article/pii/S0165032705002570\" rel=\"nofollow noreferrer\">techniques</a> and <a href=\"http://www.sciencedirect.com/science/article/pii/S1360859209000230\" rel=\"nofollow noreferrer\">proven</a> many benefits one can gain from these practices, even in their archaic or <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29020861\" rel=\"nofollow noreferrer\">mysticised</a> form. Better breathing patterns and more activity as opposed to sedentary life are without question positive changes for many 'civilised' people. </p>\n\n<p>This answer assumes a somewhat mediated approach to the technique. There are always <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/15136413\" rel=\"nofollow noreferrer\">extreme</a> cases that seem to invalidate a common sense evaluation. Trying to do this in a \"cancer prone\" individual? The relation to cancer seems currently indirect at best. If you overdo it, and what is meant by that is completely undetermined, it is very probably bad. As Taylor above has found this post:<br>\n<a href=\"https://probablyhealthy.com/2016/02/15/13-observations-after-5-months-and-200-sessionsof-wim-hof-breathing-method/\" rel=\"nofollow noreferrer\">13 observations after 5 months and 200+ sessions of Wim Hof Breathing Method</a> some aspects become quite clear though: 120 minutes sessions, doing in a car or in icy water, and possibly alone, there are quite a number of such immediate risks involved in practicing this to these extremes. How much more likely cancer is due to these exercises if done so often and so long to <em>really</em> stress out and damage the system is not known via scientific studies. Overdoing it will very probably lead to very unwelcome effects, like driving off the road, so quickly that any increase in risk for cancer will be moot.</p>\n\n<p>Unless this Hof-method or the tummo meditation are more researched we have to conclude for now that there are many anecdotes but almost no real evidence as defined to our standards that this works either way or better than simply \"do more sports\". Only indicators, but a few, point into the direction of overall improved health, if one doesn't faint from the hyperventilation. </p>\n\n<p>Being the optimist I await much more studies on this. Until those arrive: I guess it doesn't hurt much, it doesn't help much.</p>\n\n<hr>\n" }, { "answer_id": 23668, "author": "David", "author_id": 19649, "author_profile": "https://health.stackexchange.com/users/19649", "pm_score": -1, "selected": false, "text": "<p>The point about reduced hyperventilating leading to reduced oxygen/hypoxia, and subsequent extensive evidence provided with it, misses the point entirely! The method has been proven to increase the oxygen content and capacity of the blood not reduce it. Temporary hypoxia is part of the training process. You train by stressing something (be it muscle or mind) until it’s temporarily weakened. The result is a strengthening through discipline. To negate the benefits of the Win Hof method based on the negative effects of hypoxia is redundant. </p>\n\n<p>Admittedly further studies are needed to verify potential benefits/dangers but the emerging evidence of the hugely positive effects this is having is certainly worth that study. I for one will be trying it myself as opposed to clinging to what we learned was correct. Our loyalty to societal and academic constructs is the biggest blight to progress. Don’t react with knee jerk scepticism! Read with an open mind and try yourself!</p>\n" } ]

[ "https://health.stackexchange.com/questions/13926", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11609/" ]

[ { "answer_id": 13944, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 2, "selected": false, "text": "<h2>Brand Name</h2>\n<p>When a company first develops a drug and releases it on the market, they will have a patent for the drug (usually lasting 20 years). A good example for a brand name is Aspirin from the German company Bayer.</p>\n<p>The brand name is somewhat the equivalent of a car name, as an example Renault Megan.</p>\n<h2>Generic Name</h2>\n<p>After a patent expires, other companies can produce the same drug, under a different name.</p>\n<blockquote>\n<p>A generic drug is a medication that has exactly the same active ingredient as the brand-name drug and yields the same therapeutic effect. It is the same in dosing, safety, strength, quality, the way it works, the way it is taken, and the way it should be used. Generic drugs do not need to contain the same inactive ingredients as the brand name product.</p>\n<p>However, a generic drug can only be marketed after the brand-name drug's patent has expired, which may take up to 20 years after the patent holder’s drug is first filed with the U.S. Food and Drug Administration (FDA).</p>\n<p>Generic drugs are usually much less expensive than brand name drugs once they reach the market.<br />\n<em>Source: <a href=\"https://www.drugs.com/generic_drugs.html\" rel=\"noreferrer\">Drugs.com</a></em></p>\n</blockquote>\n<p>In the case of Aspirin, Aspirin is still a registered trademark, but aspirin isn't. But because the drug is so famous, it is retailed by different companies under the name <em>aspirin</em> (lower-case a), which is not trademarked.</p>\n<h2>Active Ingredient</h2>\n<p>The active ingredient of Aspirin is acetylsalicylic acid. <strong>This is what a doctor should prescribe</strong> (but because aspirin is so famous, most people use that name instead of acetylsalicylic acid), <strong>and this is of interest to other doctors, pharmacists etc.</strong>. It basically tells you what the drug does, <a href=\"https://health.stackexchange.com/questions/9210/what-can-you-learn-from-the-parts-of-the-name-of-a-drug\">adhering to the nomenclature explained in this answer</a>.</p>\n<p>I've also encountered quite a few doctors, nurses or EMT's who said that there is sometimes confusion because brand names are so popular people refer to the active ingredient by the brand name (see acetylsalicylic acid).</p>\n" }, { "answer_id": 13952, "author": "slp09", "author_id": 11662, "author_profile": "https://health.stackexchange.com/users/11662", "pm_score": -1, "selected": false, "text": "<p>To clarify simply:</p>\n\n<p>Brand name - Whatever the name the company come up with for their medical products e.g. Viagra</p>\n\n<p>Generic name = Active Ingredient - are the same - they both refer to what the medicine common name is Viagra = Sildenafil Citrate. </p>\n\n<p>Generic medicine are what they referred to medicines made by other manufacturer that copied the original company who invented the drug after the drug have come off patent. So to save money - go for the generic medicine but sometime they may not work as well as the original medicine, because they try to cut cost - so the taste, the packaging tends to be lower quality. But they should both deliver the same active ingredient of medicine, just all the other ingredients that help make the drug will be different.</p>\n" } ]

[ "https://health.stackexchange.com/questions/13933", "https://health.stackexchange.com", "https://health.stackexchange.com/users/55/" ]

[ { "answer_id": 13975, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 4, "selected": false, "text": "<p>It depends on how long the patient has been on insulin, and whether \"pancreatic exhaustion\" has been reached.</p>\n\n<p>If the person has been on insulin only a few years when there is still endogenous insulin production ( check by doing a C-peptide test ), then yes, it's possible.</p>\n\n<p>See the work by Prof Taylor at Newcastle, England using extreme low calorie diets which rapidly reverse hepatic and pancreatic steatosis, restoring hepatic sensitivity to glucose levels.</p>\n\n<p>And for pathogenesis <a href=\"https://link.springer.com/article/10.1007%2Fs00125-008-1116-7\" rel=\"nofollow noreferrer\">https://link.springer.com/article/10.1007%2Fs00125-008-1116-7</a></p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21656330\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/21656330</a></p>\n\n<p><strong>Update:</strong> The 12 month results from the DiRECT study show that 50% of the patients in the intervention arm ( The intervention comprised withdrawal of antidiabetic and antihypertensive drugs, total diet replacement (825–853 kcal/day formula diet for 3–5 months), stepped food reintroduction (2–8 weeks), and structured support for long-term weight loss maintenance ) went into remission off all diabetic drugs. The greater the weight loss, the more likely remission was achieved.</p>\n\n<p><a href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext\" rel=\"nofollow noreferrer\">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext</a></p>\n" }, { "answer_id": 13977, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 2, "selected": false, "text": "<p>As Neil Barnard <a href=\"https://www.youtube.com/watch?v=lLqINF26LSA\" rel=\"nofollow noreferrer\">explains in this video</a>, a low fat whole food plant based diet has yielded positive results. But note here that you don't need to go full vegan for this to work, the most important element is to drastically increase your whole grain carb intake, drastically reduce your fat intake, and increase your physical activity levels. This is best done under medial supervision because your medication will have to be adjusted to deal with the increased carb load.</p>\n\n<p>In contrast, the popular low carb, high fat ketogenic diet while having some benefits for diabetes patients, allowing people to reduce their medicine intake, is not usually not going to reverse diabetes, and this diet comes with serious adverse health risks. Anthony Lim explains <a href=\"https://www.youtube.com/watch?v=tbH6TIdtZ3Q\" rel=\"nofollow noreferrer\">in this video</a> that he used to recommend the low carb approach to his patients with some success, but how doing the opposite led to complete cures.</p>\n\n<p>An important factor that causes people to get type 2 diabetes and keep them diabetic is the indoctrination of the general public that eating large amounts of (unrefined) carbs is bad for health. I experience this almost every time when I'm ordering my diet in restaurants, particularly in North America. On one occasion a very obese waiter told me that the 1 kg of potatoes I ordered for dinner is bad for health. </p>\n" }, { "answer_id": 14058, "author": "Tom Mercer", "author_id": 11740, "author_profile": "https://health.stackexchange.com/users/11740", "pm_score": 2, "selected": false, "text": "<p>Yes. T2D is reversible, with some caveats.</p>\n\n<p>T2D is essentially a set of symptoms in a body that has ingested too much sugar, and has lost insulin sensitivity. \"Type 2 diabetes primarily occurs as a result of obesity and lack of exercise.\" --wikipedia Diabetes_mellitus_type_2</p>\n\n<p>T2D is an arbitrary diagnosis based on the easily-measurable blood glucose level: wikipedia Diabetes_mellitus_type_2#Diagnosis</p>\n\n<p>Outside the arbitrary medical definition, which has a binary diagnosis, it's much more meaningful to talk about insulin sensitivity as a spectrum.</p>\n\n<p>Some people are insulin-sensitive superstars, far better at efficiently digesting sugars than \"normal\" people, and generally speaking T2 diabetics are less insulin-sensitive than normal people.</p>\n\n<p>A helpful analogy is IQ. The arbitrary definition of moron is a person with IQ between 50-69, an imbecile has an IQ from 20-49, and idiots have IQs below 20. That's pretty easy to measure, and also pretty meaningless. A much more useful application of IQ scores is to try to make ALL people improve their own individual IQ score over time through education.</p>\n\n<p>We don't focus enough on the fasting blood glucose level, or response of blood glucose level to ingested sugar <em>as a spectrum of insulin-sensitivity</em>. Instead, we just have 1 label, T2D. Kinda like if we ignored geniuses, morons, and regular people, and just had a single \"disease\", called \"dumb\", for people with an arbitrary IQ, let's say below 73.</p>\n\n<p>When you ask about reversing diabetes, what you're really asking is, can a person use diet to improve their insulin sensitivity, as measured by fasting blood glucose, and/or response of blood glucose to ingestion of sugar. The answer is <strong>yes</strong>!</p>\n\n<p><strong><em>Diet is the strongest factor in improving insulin sensitivity.</em></strong></p>\n\n<p>Carbs are just sugar chains consisting of 3 or more sugars, so it's useful to divide all nutrition into simply sugar, fat, and protein, and never use the word carbs again. Just call them long-chain or complex sugars, so you don't camouflage diabetes-inducing sugars as nutritive-sounding \"carbohydrates\".</p>\n\n<p>Eating very low-sugar diets (ketogenic, atkins, or even many low-calorie diets) improves insulin sensitivity. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313649/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3313649/</a></p>\n\n<p>Here are some caveats:</p>\n\n<ol>\n<li><p>Most, if not all, T2Ds are terrible eaters who consume(d) loads of sugars, so dietary changes are difficult for many T2Ds.</p></li>\n<li><p>Some damage caused by eating sugar is irreversible. If you got your legs sawed off because you were extremely insulin-resistant for a long time, they won't grow back. Somewhere around 100,000 diabetes leg amputations happen every year in the US. This is a huge problem.</p></li>\n<li><p>Reversal is slow, unless the person commits to a very drastic change, like a ketogenic diet (for most people this means &lt;40g of sugar per day). Humans usually believe in lucky positive events, and expect to see immediate feedback from any changes, but most important achievements in life require small investments of energy and attention every day, over periods of months or years. This is why so few people are financially secure, physically fit, happily married, well-adjusted, and healthy. All of the important problems in life require consistent attention and near-daily investments of effort in PROCESSES over long investment horizons. The positive events, like winning Mr. Olympia, cover modelling on Forbes, and celebrating a happy 50th anniversary, aren't really \"events\", so much as results flowing naturally from slow, consistent processes. The behaviors that will reverse T2D are not comfortable, and your aunt will have to take those actions every day for months before seeing any positive results.</p></li>\n</ol>\n\n<p>If you can make your aunt see that sugar caused her T2D, and that not eating sugar will reverse it, and she carries a powerful enough \"WHY\", such as not getting her legs sawn off, being able to hike mountains with her nieces and nephews, living a long and happy life, then she will start substituting fat for sugar in her diet, and live happily ever after.</p>\n\n<p>Just be aware, it's a psychological battlefield, and the same thinking and actions that got her where she is will NOT get her out.</p>\n\n<p>Other Sources:</p>\n\n<ul>\n<li><a href=\"http://www.ncl.ac.uk/press/news/2017/09/type2diabetesisreversible/\" rel=\"nofollow noreferrer\">http://www.ncl.ac.uk/press/news/2017/09/type2diabetesisreversible/</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Diabetes_mellitus_type_2#Diagnosis\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Diabetes_mellitus_type_2#Diagnosis</a></li>\n</ul>\n" } ]

[ "https://health.stackexchange.com/questions/13956", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11667/" ]

[ { "answer_id": 14010, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 3, "selected": true, "text": "<p>It's just empirical data <em>suggesting</em> that the weaker <a href=\"https://en.wikipedia.org/wiki/Immune_system\" rel=\"nofollow noreferrer\">immune system</a> of young humans is typically not 'yet <a href=\"https://en.wikipedia.org/wiki/Vaccine_efficacy\" rel=\"nofollow noreferrer\">finished</a>' reacting to the <a href=\"https://en.wikipedia.org/wiki/Vaccine\" rel=\"nofollow noreferrer\">vaccine</a> with <a href=\"https://en.wikipedia.org/wiki/Adaptive_immune_system\" rel=\"nofollow noreferrer\">building</a> <em>enough</em> anti-bodys (<a href=\"https://en.wikipedia.org/wiki/Immune_response\" rel=\"nofollow noreferrer\">and the rest</a>…) after just one <a href=\"https://en.wikipedia.org/wiki/Influenza_vaccine\" rel=\"nofollow noreferrer\">flu shot</a>. Being &quot;primed&quot; might be perceived as a popularising phrase but it is not that far off either. One shot was observed to be not as effective in the past while two were apparently seen as similar effective as compared to shots for people older than children.</p>\n<p>The relevant excerpt from the CDC for the upcoming season is really quite comprehensive and I cannot dump all the studies <em>they considered</em> in reaching this conclusion:\nFrom <a href=\"https://www.cdc.gov/mmwr/volumes/65/rr/rr6505a1.htm#children_aged_6mths_8yrs\" rel=\"nofollow noreferrer\">Prevention and Control of Seasonal Influenza with Vaccines\nRecommendations of the Advisory Committee on Immunization Practices — United States, 2016–17 Influenza Season</a>:</p>\n<blockquote>\n<p>Children aged ≥6 months typically develop protective levels of antibodies against specific influenza virus strains after receiving the recommended number of doses of seasonal IIV (101,105,131–134). Immunogenicity studies using the A(H1N1)pdm09 monovalent vaccine indicated that 80%–95% of vaccinated children developed protective antibody levels to the 2009 A(H1N1) influenza virus after 2 doses (135,136); response after 1 dose was 50% for children aged 6–35 months and 75% for those aged 3–9 years (137).</p>\n<p><strong>Studies involving seasonal IIV among young children have demonstrated that 2 vaccine doses provide better protection than 1 dose during the first season a child is vaccinated.</strong> In a study during the 2004–05 season of children aged 5–8 years who received IIV3 for the first time, the proportion of children with protective antibody responses was significantly higher after 2 doses than after 1 dose of IIV3 for each antigen (p = 0.001 for influenza A[H1N1]; p = 0.01 for influenza A[H3N2]; and p = 0 0.001 for influenza B) (138). <br>\n<strong>Vaccine effectiveness is lower among children aged &lt;5 years who have never received influenza vaccine previously or who received only 1 dose in their first year of vaccination than it is among children who received 2 doses in their first year of being vaccinated.</strong> <br>_{A retrospective study of billing and registry data among children aged 6–21 months conducted during the 2003–04 season found that although receipt of 2 doses of IIV3 was protective against office visits for ILI, receipt of 1 dose was not (139). Another retrospective cohort study of children aged 6 months through 8 years, the majority of whom received IIV3 (0.8% received LAIV3), also conducted during the 2003–04 season, found no effectiveness against ILI among children who had received only 1 dose (140). In a case-control study of approximately 2,500 children aged 6–59 months conducted during the 2003–04 and 2004–05 seasons, being fully vaccinated (having received the recommended number of doses) was associated with 57% effectiveness (95% CI = 28–74) against LCI for the 2004–05 season; a single dose was not significantly effective (too few children in the study population were fully vaccinated during the 2003–04 season to draw conclusions) (141).} <br> The results of these studies support the recommendation that all children aged 6 months–8 years who are being vaccinated for the first time should receive 2 doses separated by at least 4 weeks. [emphasis added]</p>\n</blockquote>\n<p>This might be visualised like in &quot;<a href=\"http://Efficacy%20of%20a%20single%20dose%20of%20live%20attenuated%20influenza%20vaccine%20in%20previously%20unvaccinated%20children:%20A%20post%20hoc%20analysis%20of%20three%20studies%20of%20children%20aged%202%20to%206%20years\" rel=\"nofollow noreferrer\">Efficacy of a single dose of live attenuated influenza vaccine in previously unvaccinated children: A post hoc analysis of three studies of children aged 2 to 6 years</a>&quot;:</p>\n<p><a href=\"https://i.stack.imgur.com/var1y.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/var1y.png\" alt=\"Kaplan-Meier curve for the time to first episode of culture-confirmed influenza illness in year 1 of the study by Bracco Neto et al among previously unvaccinated children aged ≥2 years. LAIV = live attenuated influenza vaccine.\" /></a></p>\n<p>This indicates that children are strictly speaking not <em>required</em> to be vaccinated two times, since a single flu shot also provides some significant protection. But a second vaccination likely increases the potential benefit substantially. That's why a second round is <em>recommended</em>.</p>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5218633/\" rel=\"nofollow noreferrer\">Influenza Vaccine Effectiveness for Fully and Partially Vaccinated Children 6 months to 8 Years Old during 2011–2012 and 2012–2013: The Importance of Two Priming Doses</a></p>\n<blockquote>\n<p>In conclusion, during 2011–12 and 2012–13, vaccination with IIV3 reduced the risk of outpatient medical visits for ARI associated with influenza virus infection by about half. Vaccinations received in previous seasons had preventive value in subsequent seasons in the form of residual protection for those who missed vaccination in and priming which boosted the benefit of IIV. <strong>Most notably, children primed with 2 doses of influenza vaccine in the previous same season appeared to enjoy even greater preventive benefit from IIV3 and may have reduced their risk of A(H3N2) illness by two-thirds.</strong></p>\n</blockquote>\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/18022736\" rel=\"nofollow noreferrer\">Immunogenicity and reactogenicity of a trivalent influenza split vaccine in previously unvaccinated children aged 6—9 and 10—13 years</a></p>\n<blockquote>\n<p>Immunization of previously unvaccinated children against influenza is thought to require two doses of vaccine. There is currently no general consensus regarding the age cut-off for a two-dose vaccination regimen. <strong>A second vaccine dose in previously unvaccinated children appears advisable because of the limited immunogenicity of a single dose of influenza vaccine in young children. […] These recommendations are based on the premise that a significant proportion of these children are immunologically na ̈ıve…</strong></p>\n</blockquote>\n<p>Anyone who was exposed to the antigens of the viruses develops some residual immunity. This limited immunity further weakens over time since the viruses change so much and so rapidly. Thus people might require 'an update' to these antibody information for the immune system based on the 'currently trending' virus strains. Young children have a weaker adaptive immune response and <em>presumably</em> no residual immunity. Both points are thought to be addressed by the two vaccination regimes.</p>\n" }, { "answer_id": 14064, "author": "Taylor", "author_id": 8916, "author_profile": "https://health.stackexchange.com/users/8916", "pm_score": 3, "selected": false, "text": "<p>In 2015-16, The Advisory Committee on Immunization Practices issued a report on <a href=\"https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm\" rel=\"noreferrer\">Prevention and Control of Influenza with Vaccines</a> that recommended that all children (under nine years old) should get <em>two doses</em> of flu vaccine the first year that they are vaccinated against the flu. The second flu shot — a <a href=\"https://www.merriam-webster.com/medical/booster%20dose\" rel=\"noreferrer\">booster dose</a>, improves the effectiveness of the flu vaccine in children. According to the <a href=\"https://www.cdc.gov/mmwr/volumes/65/rr/rr6505a1.htm\" rel=\"noreferrer\">CDC</a>,</p>\n\n<blockquote>\n <p>In a study during the 2004–05 season of children aged 5–8 years who received IIV3 for the first time, the proportion of children with protective antibody responses was significantly higher after 2 doses than after 1 dose of IIV3 for each antigen (p = 0.001 for influenza A[H1N1]; p = 0.01 for influenza A[H3N2]; and p = 0 0.001 for influenza B) (138).</p>\n</blockquote>\n\n<p>The “interaction” you reference draws a correlation to <em>adaptive immunity</em> — the process in which the body develops antibodies against the virus. <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK21070/\" rel=\"noreferrer\">The adaptive immune system</a>, also called acquired immunity, uses specific antigens to strategically mount an immune response. The adaptive immunity is activated by exposure to pathogens (for example, the flu virus), and uses an <em>immunological memory</em> to learn about the threat and enhances the immune response accordingly. More specifically, the adaptive immune system relies on <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/9107415\" rel=\"noreferrer\">B cells and T cells</a> to carry out its task.</p>\n\n<blockquote>\n <p>Evidence is reviewed that suggests that B cells essentially recognize antigen patterns, whereas T cells react against antigens newly brought into lymphoid tissues. </p>\n</blockquote>\n\n<p>Because the adaptive immune system can learn and remember specific pathogens, it can provide long-lasting defense and protection against recurrent infections. </p>\n" } ]

[ "https://health.stackexchange.com/questions/13974", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11686/" ]

[ { "answer_id": 14467, "author": "Taylor", "author_id": 8916, "author_profile": "https://health.stackexchange.com/users/8916", "pm_score": 3, "selected": true, "text": "<p>There are many factors that can determine how well an individual will heal and scar. While many treatments have been suggested for the treatment of scars, only a few of them have been supported by prospective studies with an adequate control group. As a result, the development of hypertrophic scars and keloids remains an unsolved problem in the process of wound healing. An abstract titled, ‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/9810992?dopt=Abstract\" rel=\"nofollow noreferrer\">The use of silicone occlusive sheeting (Sil-K) and silicone occlusive gel (Epiderm) in the prevention of hypertrophic scar formation</a>' confirms,</p>\n<blockquote>\n<p>For this reason, a successful treatment to prevent excessive scar formation still has yet to be found.</p>\n</blockquote>\n<p>Therefore, as it relates to the <em>effectiveness</em> of topical scar treatments -- there isn't one particular type that is <em>completely effective</em>. The potential for achieving results from a topical scar treatment is usually dependent on the age, thickness, and location of the scar.</p>\n<p>However, clinical support of topical gel products, relative to all alternative scar therapies, is considered the &quot;internationally recommended first-line form of scar management&quot;, though there continues to be ongoing deliberation over the exact mechanism of action of silicone in improving a scar. '<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486716/\" rel=\"nofollow noreferrer\">The Use of Silicone Adhesives for Scar Reduction</a>' explains,</p>\n<blockquote>\n<p>At present it is likely that through occlusion of the scar site and hydration of the wound bed, the overactivity of scar-related cells is suppressed, and their activity normalized.</p>\n</blockquote>\n<p>Whereas occlusion and hydration may also be achieved by other scar care products, '<a href=\"http://europepmc.org/articles/PMC2989813;jsessionid=B8FC345F5F30BF514B5D53722310AA86\" rel=\"nofollow noreferrer\">An Evaluation of Evidence Regarding Application of Silicone Gel Sheeting for the Management of Hypertrophic Scars and Keloids</a>' recognizes the benefits of silicone gel sheeting, stating it</p>\n<blockquote>\n<p>…has been clinically proven to also address pruritus, skin pigmentation changes, and primary prevention...Hypertrophic and keloid scar-related physical discomfort ranging from itching to pain have been seen to improve dramatically upon SGS treatment.</p>\n</blockquote>\n<p>Additional benefits include:</p>\n<blockquote>\n<p>...no skin stripping, and no painful skin or hair pulling; but another advantage also lies in the fact that...unlike alternatives, have a low viscous component that limits their flow and consequently their readiness to absorb materials at the surface of the skin such as stratum corneum cells and lipids. The adhesive surface...remains relatively clean and can be removed, reused and cleaned repeatedly without diminishing its integrity.</p>\n<p>...used in scar treatment for more than 30 years, demonstrating safety and efficacy recognized by wound care professionals.</p>\n<p>...silicone gel sheeting has been demonstrated to reduce incidence of hypertrophic scars.</p>\n</blockquote>\n<p>The same abstract references several topical silicone-containing scar care products and, when comparing <strong>silicone gel</strong> and <strong>silicone gel sheeting</strong>, the limitations of silicone gel sheeting specifically</p>\n<blockquote>\n<p>...can be cumbersome to keep on the scar, with some patients showing an aversion to wearing SGS in visible areas</p>\n</blockquote>\n<p>On the other hand, silicone gel was said to have</p>\n<blockquote>\n<p>…a higher compliance than gel sheeting, due primarily to ease of use and convenience...[but] A few studies have suggested no significant difference between the gel and gel sheeting.</p>\n</blockquote>\n<p>Although the abstract also confesses that additional studies are needed with all therapies used to treat scars, your question is still addressed to some degree.</p>\n<blockquote>\n<p>…<strong>silicone gel sheeting can be employed, especially as an <em>adjunct in combination</em> with other hypertrophic scar and keloid treatments.</strong></p>\n</blockquote>\n<p>Based on the provided information, you can <em>technically</em> use both topical scar treatments at the same time but may not receive an added benefit from the combination. Thus, using one or the other should be just as effective. The effectiveness of using one or both products will likely depend on your individual biology because (as with any therapy), individual responses and results may vary.</p>\n<p>In conclusion, it is always in your best interest to consult with your primary care physician or dermatologist to discuss the best treatment option(s) for your specific condition and individual needs.</p>\n" }, { "answer_id": 25494, "author": "Franck Dernoncourt", "author_id": 43, "author_profile": "https://health.stackexchange.com/users/43", "pm_score": 0, "selected": false, "text": "<blockquote>\n<p>Can [silicone gels and silicone plasters] be used simultaneously to enhance their positive effect?</p>\n</blockquote>\n<p>No, according to <a href=\"https://www.myscaraway.com/faq/#toggle-id-16\" rel=\"nofollow noreferrer\">ScarAway's user manual</a> (ScarAway is one of the main brands for silicone gels and silicone sheets in the United States):</p>\n<blockquote>\n<p>Do not use [silicone gels and silicone sheets] at the same time.</p>\n</blockquote>\n<p>I guess that the reason is that using silicone gels and silicone sheets (= plasters) at the same time would interfere with the adherence of the sheets to the skin, thereby reducing its effect.</p>\n<p>However, as mentioned on <a href=\"https://www.myscaraway.com/faq/#toggle-id-16\" rel=\"nofollow noreferrer\">https://www.myscaraway.com/faq/#toggle-id-16</a>, you can use the silicone gel when not using the silicone sheets:</p>\n<blockquote>\n<p>Can I use ScarAway® Scar Diminishing Gel with ScarAway® Silicone Scar Sheets?Yes. ScarAway® Scar Diminishing Gel may be used as part of your complete scar treatment regimen. Simply apply ScarAway® Scar Diminishing Gel as directed when not wearing your ScarAway® Silicone Sheet.</p>\n</blockquote>\n<p>Note that ScarAway's packaging mentions:</p>\n<blockquote>\n<p>For best results: Use as part of a complete scar treatment regimen, alternating use with ScarAway Silicone Scar Sheets.</p>\n</blockquote>\n<p><a href=\"https://i.stack.imgur.com/r3ZPD.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/r3ZPD.jpg\" alt=\"enter image description here\" /></a></p>\n<p>However no evidence is given of the usefulness of alternating Scar Sheets with gel and obviously, there could be a financial bias.</p>\n<hr />\n<p>ScarAway's user manual:</p>\n<p><a href=\"https://i.stack.imgur.com/ZyUNa.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/ZyUNa.jpg\" alt=\"enter image description here\" /></a></p>\n<p><a href=\"https://i.stack.imgur.com/duIiY.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/duIiY.jpg\" alt=\"enter image description here\" /></a></p>\n" } ]

[ "https://health.stackexchange.com/questions/14001", "https://health.stackexchange.com", "https://health.stackexchange.com/users/6830/" ]

[ { "answer_id": 14026, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 3, "selected": true, "text": "<p>The <a href=\"https://www.nhs.uk/Conditions/Head-lice/Pages/Treatment.aspx\" rel=\"nofollow noreferrer\">NHS recommends <strong>not to use</strong> any of the following treatment options</a>:</p>\n<ul>\n<li>products containing permethrin</li>\n<li>head lice &quot;repellents&quot;</li>\n<li>electric head lice combs</li>\n<li><strong>tree and plant oil treatments, such as tea tree oil, eucalyptus oil, and lavender oil</strong></li>\n<li><strong>herbal remedies</strong></li>\n</ul>\n<h2><a href=\"https://www.nhs.uk/Conditions/Head-lice/Pages/Treatment.aspx\" rel=\"nofollow noreferrer\">The very basic option</a>:</h2>\n<blockquote>\n<p>Wet combing involves removing head lice with a special fine-toothed\ncomb. It's suitable for everyone and is relatively inexpensive. A\nnumber of lice removal combs are available to buy. Combs with\nflat-faced teeth spaced 0.2-0.3mm apart are best for removing head\nlice, although combs with smaller gaps can be used to remove eggs and\nnits (egg cases) after treatment. The comb may come with instructions\noutlining how to use it.\nA commonly used method is described in the linked article.</p>\n</blockquote>\n<h2><a href=\"https://www.webmd.com/children/tc/lice-topic-overview\" rel=\"nofollow noreferrer\">The simple option</a>:</h2>\n<p>Because Wet-Combing can fail (lice cling to the hair and scalp of the host): you could buy an over-the-counter Lotion that is supposed to kill lice, follow the instruction and comb your hair with a specially designed comb for lice (you can usually find that at your local drug store). If no lice are brushed out, you don’t have lice. This will kill other parasites as well.</p>\n<p><a href=\"http://kids.nationalgeographic.com/content/dam/kids/photos/animals/Bugs/H-P/head-louse-from-above.jpg\" rel=\"nofollow noreferrer\">National Geographic Image</a> for reference (Note that lice are very small and appear like small black dots to the naked eye, if you are unsure, use a magnifying glass):\n<a href=\"https://i.stack.imgur.com/MZ0RM.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/MZ0RM.jpg\" alt=\"enter image description here\" /></a></p>\n<h2>Visit a doctor</h2>\n<p><strong>If this doesn’t solve your issue and the itching preservers</strong>, visit a General Practitioner. <a href=\"https://www.webmd.com/children/tc/lice-when-to-call-a-doctor\" rel=\"nofollow noreferrer\">WebMD has further recommendations who to see when.</a></p>\n<hr />\n<p>For more information on lice lotions, visit the <a href=\"https://www.cdc.gov/parasites/lice/head/treatment.html\" rel=\"nofollow noreferrer\">CDC and go to section Over-the-Counter.</a></p>\n" }, { "answer_id": 14031, "author": "padma", "author_id": 9667, "author_profile": "https://health.stackexchange.com/users/9667", "pm_score": 1, "selected": false, "text": "<p>You could use a lice comb and look for nits as well. My family and I had them once after traveling and we used olive oil and a lice comb and it worked well.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14025", "https://health.stackexchange.com", "https://health.stackexchange.com/users/115/" ]

[ { "answer_id": 14072, "author": "user11750", "author_id": 11750, "author_profile": "https://health.stackexchange.com/users/11750", "pm_score": 2, "selected": false, "text": "<p>This is generally unhealthy, especially as sleep cannot be made up or paid back like financial debt. Try to get back to at least seven hours. As always, consult with a doctor.</p>\n\n<p>See: <a href=\"http://www.sciencedirect.com/science/article/pii/S2352721815000157\" rel=\"nofollow noreferrer\">National Sleep Foundation’s sleep time duration recommendations</a>.</p>\n" }, { "answer_id": 14883, "author": "PCARR", "author_id": 238, "author_profile": "https://health.stackexchange.com/users/238", "pm_score": 1, "selected": false, "text": "<p>The way you are sleeping is <em>not necessarily unhealthy</em>, but this is easily debatable and you should probably look at what social and lifestyle factors may be affecting your sleep duration and consider some adjustments.</p>\n\n<p>To quote from an <a href=\"http://www.mindupdate.com/2007/04/the-mystery-of-sleep-and-the-lucky-few-who-dont-need-it/\" rel=\"nofollow noreferrer\">article</a> on the <a href=\"http://www.mindupdate.com/2007/04/the-mystery-of-sleep-and-the-lucky-few-who-dont-need-it/\" rel=\"nofollow noreferrer\">\"Mystery of Sleep and the Lucky Few Who Don't Need It\"</a></p>\n\n<blockquote>\n <p>Also interesting is how we perceive the amount of sleep we’ve gotten. A study by Dr. Allison Harvey, of Berkley, measured how much sleep a group of insomniacs actually got compared to their perception of it. It turns out that they only received 35 minute less than those who had no trouble sleeping, yet when asked how long they had slept, the insomniacs reported only 2-3 hours of actual sleep.</p>\n</blockquote>\n\n<p>Perhaps your perception is skewed? Or perhaps you are one of the lucky few who simply require less sleep? </p>\n" } ]

[ "https://health.stackexchange.com/questions/14057", "https://health.stackexchange.com", "https://health.stackexchange.com/users/3244/" ]

[ { "answer_id": 14074, "author": "Nditah", "author_id": 3693, "author_profile": "https://health.stackexchange.com/users/3693", "pm_score": 1, "selected": false, "text": "<p>Glycemic index (GI) helps to rates carbohydrate-containing foods (or drinks) by how much they boost blood sugar (blood glucose).\nAlthough GI offers useful information that can help you choose foods that have kinder, gentler effects on blood sugar, it is not a perfect guide for choosing a healthy diet. Why ? According to According to <a href=\"https://www.health.harvard.edu/blog/use-glycemic-index-to-help-control-blood-sugar-201208135154\" rel=\"nofollow noreferrer\">Patrick J. Skerrett, Former Executive Editor, Harvard Health</a>, </p>\n\n<blockquote>\n <p>Some foods, like carrot and watermelon, have a high glycemic index, but a serving contains so little carbohydrate that the effect on blood sugar is small. Others, like sugary soda, have a moderate glycemic index because they contain a fair amount of fructose, which has relatively little effect on blood sugar. But they also pack plenty of glucose, which does boost blood sugar. </p>\n</blockquote>\n\n<p>Secondly, he suggested that the GI of a particular drink (or food) can also be influenced by what it is eaten with. </p>\n\n<blockquote>\n <p>Olive oil or something acidic, like vinegar or lemon juice, can slow the conversion of starch to sugar, and so lower the glycemic index.</p>\n</blockquote>\n\n<p>Now over to the exact matter:</p>\n\n<p>Does adding water to drinks reduce their glycemic index? </p>\n\n<p>Indirectly? Arguably YES since this will reduce insulin resistance and help a person reduce their hunger/thirst (thus reducing consumption). According to <a href=\"https://www.sharecare.com/health/diabetes/drinking-water-blood-sugar\" rel=\"nofollow noreferrer\">Eliot LeBow -Diabetes on Sharecare.com</a> </p>\n\n<blockquote>\n <p>proper hydration seems to reduce one's blood sugars by decreasing insulin resistance while at the same time reduces a person's need to take more \n drinks or food during the day. Also, enough water will help remove the \n excess sugar and ketones out of your system.</p>\n</blockquote>\n" }, { "answer_id": 14089, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 2, "selected": false, "text": "<p><strong>Question:</strong> Does reducing the sweetness of a drink by diluting it with water reduces the likelihood of acne?</p>\n\n<p><strong>Short answer:</strong> Not necessary.</p>\n\n<p>I am not aware of any study that would show an association between the mere <em>sweetness</em> of a food and the risk of acne.</p>\n\n<p>There is some evidence that <strong>low-glycemic load diet</strong> may help reduce acne (<a href=\"http://www.cochrane.org/CD009436/SKIN_complementary-therapies-acne-vulgaris\" rel=\"nofollow noreferrer\">Cochrane</a>, <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106357/\" rel=\"nofollow noreferrer\">PubMed Central</a>).</p>\n\n<p>Glycemic load = glycemic index x grams of carbohydrates in the food. Glycemic index is an estimation of the effect of a food on the blood glucose level after its ingestion.</p>\n\n<p>Examples of <strong>high-glycemic index foods</strong> (GI >70) are some sweet beverages, cornflakes, instant oatmeal, white rice, potatoes, white bread, pasta, biscuits and other baked goods made from white flour and little fiber (<a href=\"https://www.health.harvard.edu/diseases-and-conditions/glycemic-index-and-glycemic-load-for-100-foods\" rel=\"nofollow noreferrer\">Harvard</a>).</p>\n\n<p>As you can see, high-glycemic foods are not necessary sweet.</p>\n\n<p>Diluting \"the sweetness\" of a food or beverage may not reduce its glycemic index. The <a href=\"http://www.glycemicindex.com/faqsList.php\" rel=\"nofollow noreferrer\">Glycemicindex.com</a> gives this example (but no link to any study):</p>\n\n<blockquote>\n <p>A more dilute solution, say 25 grams fructose in 500 mL water will\n have a <strong>higher</strong> GI than 25 grams fructose in 250 mL.</p>\n</blockquote>\n\n<p>Such estimation sounds counterintuitive, but it makes sense, because a beverage with 5% sugar (25 g fructose in 500 mL water) usually empties from the stomach faster than a beverage with 10% sugar (25 g sugar in 250 mL water) (<a href=\"https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-6-9\" rel=\"nofollow noreferrer\">Nutrition and Metabolism</a>). So, the diluted beverage passes from the stomach into the intestine faster, which results in faster glucose absorption and thus in higher GI.</p>\n\n<p>To decrease the glycemic load of the meals, you can decrease the amount of high glycemic index foods, for example, eating whole-grain bread (high in fiber) instead of white flour products (low in fiber).</p>\n" } ]

[ "https://health.stackexchange.com/questions/14068", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11747/" ]

[ { "answer_id": 14077, "author": "Count Iblis", "author_id": 856, "author_profile": "https://health.stackexchange.com/users/856", "pm_score": 3, "selected": true, "text": "<p>Stomach acid helps to get iron absorbed from food. Calcium supplements in the form of calcium carbonate will lower stomach acid levels and thereby impede iron absorption. One can avoid that problem by using calcium citrate supplements. The calcium that's naturally present in foods is not in the form of calcium salts like calcium carbonate or calcium citrate. Instead, the calcium in vegetables sits inside an organic molecule, a so called molecular complex. In some cases this leads to poor absorption for calcium, e.g. in case of spinach the calcium is bound to oxalate and only 5% of the calcium is absorbed. The calcium in kale, in contrast, has a 50% bioavailability. The calcium in typical dairy products have about 30% biovailability.</p>\n\n<p>Another thing to keep in mind when you try to get your minerals like calcium and iron from vegetables instead of dairy and meat products, is to make sure you eat a lot of vegetables. While only a few slices of cheese and small piece of meat is sufficient to get to the RDA for calcium and iron, the volume of vegetables you need to eat to meet the RDA is huge by ordinary standards. The best way to go about this is to include vegetables in your lunch and even in your breakfast if you struggle to eat large volumes in single meals.</p>\n" }, { "answer_id": 14081, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": false, "text": "<p>There doesn't seem to be a problem when you look at iron status so there may be other mechanisms at play that compensate for the effect of calcium on iron absorption.</p>\n\n<blockquote>\n <p>Studies on human subjects have shown that calcium (Ca) can inhibit iron (Fe) absorption, regardless of whether it is given as Ca salts or in dairy products. This has caused concern as increased Ca intake commonly is recommended for children and women, the same populations that are at risk of Fe deficiency. However, a thorough review of studies on humans in which Ca intake was substantially increased for long periods shows no changes in hematological measures or indicators of iron status. Thus, the inhibitory effect may be of short duration and there also may be compensatory mechanisms. </p>\n</blockquote>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21462112\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/21462112</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/14075", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11730/" ]

[ { "answer_id": 14085, "author": "Mike-DHSc", "author_id": 8806, "author_profile": "https://health.stackexchange.com/users/8806", "pm_score": 2, "selected": false, "text": "<p>The largest organ in your body does -- the skin.</p>\n\n<p>The most sensitive area would be any distal (meaning the farthest away) extremities. Areas that require fine control (such as dexterity). Your finger tips or genitals would be #1.</p>\n" }, { "answer_id": 14087, "author": "bummi", "author_id": 527, "author_profile": "https://health.stackexchange.com/users/527", "pm_score": 2, "selected": false, "text": "<p>If we are talking about <a href=\"https://en.wikipedia.org/wiki/Tactile_corpuscle\" rel=\"nofollow noreferrer\">Tactile corpuscle</a> or Meissner's corpuscles and <a href=\"https://en.wikipedia.org/wiki/Lamellar_corpuscle\" rel=\"nofollow noreferrer\">Lamellar corpuscle</a> it would be the fingertips followed by lips.</p>\n<p>I did not find a reference in English, only a <a href=\"https://books.google.de/books?id=jwUjBAAAQBAJ&amp;pg=PA376&amp;lpg=PA376&amp;dq=%22Meissner-K%C3%B6rperchen%22+h%C3%B6chste+dichte&amp;source=bl&amp;ots=oEPxFkoYdY&amp;sig=bXTN27hyrrCBvvqfvYgTt5IMEDg&amp;hl=de&amp;sa=X&amp;ved=0ahUKEwiO2tS23YbXAhWkIsAKHbETCy04ChDoAQgvMAI#v=onepage&amp;q=%22Meissner-K%C3%B6rperchen%22%20h%C3%B6chste%20dichte&amp;f=false\" rel=\"nofollow noreferrer\">German</a>:</p>\n<blockquote>\n<p>Die Fingerspitzen weisen die höchste Rezeptorendichte auf. Damit wird Begreifen möglich.</p>\n<p>^{<em>Lang, Phillip, Lang, Florian</em>: Basiswissen Physiology, Springer-Verlag, 2007; Seite 376}</p>\n<p>The fingertips have the highest density of receptors. This is why grasping is possible.</p>\n<p>^{Translation into English}</p>\n</blockquote>\n<p>The all over highest density in receptors can be found in the <a href=\"https://en.wikipedia.org/wiki/Fovea_centralis\" rel=\"nofollow noreferrer\">Fovea centralis</a>.</p>\n" }, { "answer_id": 14114, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 1, "selected": false, "text": "<h2>If you want to build a vibrator, you need to look for erogenous zones, not just sensitive zones</h2>\n<blockquote>\n<p>An erogenous zone (from Greek ἔρως, érōs &quot;love&quot; and English -genous &quot;producing&quot; from Greek -γενής, -genḗs &quot;born&quot;) is an area of the human body that has heightened sensitivity, the stimulation of which may generate a sexual response, such as relaxation, the production of sexual fantasies, sexual arousal and orgasm.</p>\n<p>^{<em><a href=\"https://en.wikipedia.org/wiki/Erogenous_zone#Specific_zones\" rel=\"nofollow noreferrer\">Wikipedia.Org</a></em>}</p>\n</blockquote>\n<p><a href=\"http://www.cirp.org/library/anatomy/winkelmann/\" rel=\"nofollow noreferrer\">This article gives a good overview</a>:</p>\n<blockquote>\n<p><strong>There are two types of erogenous zones: nonspecific and specific. Those of the nonspecific type depend upon exaggeration of a basic tickle sensation.</strong> Specific erogenous zones, the mucocutaneous zones of human and animal, have special neural and cutaneous anatomic characteristics. The mucocutaneous end-organs in any given species appear to be identical in all of the the zones. The endings of the primates are markedly different from those of lower animals. <strong>Development of the nerve endings is principally postfetal and may coincide with the organization of oral, anal and genital patterns of behavior.</strong></p>\n<p>^{<em>Winkelmann, RK. (1959). &quot;<a href=\"http://www.cirp.org/library/anatomy/winkelmann/\" rel=\"nofollow noreferrer\">Erogenous zones: their nerve supply and significance</a>&quot;. Mayo Clin Proc. 34 (2): 39–47.</em>}</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/14080", "https://health.stackexchange.com", "https://health.stackexchange.com/users/6912/" ]

[ { "answer_id": 14094, "author": "user11764", "author_id": 11764, "author_profile": "https://health.stackexchange.com/users/11764", "pm_score": -1, "selected": false, "text": "<p>I know a man who is now a healthy 84 years old and still going strong and still works at his small business store. He smoked for 30 years, I think up to 2 packs a day. When he quit, he was a health nut and continues to be a health nut -- lots of vegetables for dinner, no alcohol, no smoking, no drugs. His only vice now is sugar -- candy bars and ice cream.</p>\n\n<p>I also know of a 85 year old man - a math professor - who actually still smokes everyday (in his office, too!) and is still kicking and going strong and teaching and working on a new book.</p>\n\n<p>So, I'd have to say that genetics probably* plays a huge* role in determining whether you will land up with health issues / cancer from smoking. If you are predisposed to cancer / did not win the genetics lottery, you will suffer the consequences of smoking more so than others who may have \"better\" genetics than you.</p>\n\n<p>Bottom line: look ahead, move forward in time. Don't beat yourself up over your past vices. Take steps toward living a healthier life.</p>\n" }, { "answer_id": 14153, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>This has to be a speculative answer. <a href=\"https://well.blogs.nytimes.com/2013/01/23/putting-a-number-to-smokings-toll/\" rel=\"nofollow noreferrer\">Putting a Number on Smoking’s Toll</a>?\nImportant is this: </p>\n\n<blockquote>\n <p>People who quit between 25 and 34 years of age <em>gained about 10 years of life</em> compared to those who continued to smoke.</p>\n</blockquote>\n\n<p>Positive changes are not to be discounted. And stopping reduces risks.</p>\n\n<blockquote>\n <p><a href=\"https://www.oncolink.org/risk-and-prevention/smoking-tobacco-and-cancer/former-smokers-and-cancer-risk\" rel=\"nofollow noreferrer\">Many current and former smokers want to know their risk of developing lung cancer in numbers. For example, some people want information such as \"I have a 10% chance of developing the disease.\" Assigning a number to risk is very complicated and is often hard to interpret – while one person may think 10% is a high chance, another thinks that is a relatively low number. And for the person who is in that 10% and develops the cancer, the number is meaningless. Remember that statistics like these are numbers based on large groups of people. It can be difficult to translate what that means for any one individual. In other words, don't let the number convince you that it is okay to continue smoking.</a></p>\n \n <ul>\n <li><p>5 years after quitting <br>\n Your risk of stroke is reduced to that of a non-smoker 2-5 years after quitting. The risk of cancer of the mouth, throat, esophagus and bladder is cut in half after 5 years. (US Surgeon General's Report, 2010)</p></li>\n <li><p>10 years after quitting<br>\n The lung cancer death rate is about half that of a person who is still smoking. (US Surgeon General's Report, 2010)</p></li>\n <li><p>15 years after quitting<br>\n The risk of coronary heart disease is that of a non-smoker's. (US Surgeon General's Report, 1990)</p></li>\n </ul>\n</blockquote>\n\n<p>These are findings just about a subgroup of risks and they are presented to encourage people to stop smoking. Since <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/27613764\" rel=\"nofollow noreferrer\">reduction</a> of smoking or smoking cessation seems always <a href=\"https://www.nhlbi.nih.gov/health/health-topics/topics/smo/benefits\" rel=\"nofollow noreferrer\">beneficial</a>, this is much more motivating and indeed a positive outlook. The longer you live <em>after you stop</em> smoking, the stronger the <a href=\"https://www.webmd.com/smoking-cessation/news/20080506/quit-smoking-death-risk-drops-fast#1\" rel=\"nofollow noreferrer\">reduction of risks</a> related to <a href=\"https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cessation/quitting/index.htm\" rel=\"nofollow noreferrer\">smoking</a>. </p>\n\n<p>But that is not precisely what is asked for here. Calculating the reduced life expectancy by simply subtracting the risks or reductions mentioned above does not work very well. (Of course you can always do the math, but numbers can get meaningless.)</p>\n\n<p>The calculation of expected negativity just criticised may be done as follows:\n<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117323/\" rel=\"nofollow noreferrer\">Time for a smoke? One cigarette reduces your life by 11 minutes</a>:</p>\n\n<p>10 years x 365 days x 20 cigarettes = 73000 cowboy moments </p>\n\n<p>73000 cm x 11 rf = 803000 minutes lr</p>\n\n<p>Exact calculations for the risks of an individual are impossible. Also keep in mind that the above calculation is based on just one paper, that only assigned and calculated numbers. That is quite different from measuring it. And applied to everyone the above formula is very imprecise, since there are many contributing factors, like <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/26581335\" rel=\"nofollow noreferrer\">age of smoking initiation</a>, simply left out.</p>\n\n<p>To look at the first quote from another perspective:</p>\n\n<blockquote>\n <p><a href=\"http://www.stopsmokingcenter.net/education/benefits.aspx\" rel=\"nofollow noreferrer\">Life Expectancy</a></p>\n \n <ul>\n <li>If a smoker quits before age 35, their life expectancy is the same as non-smokers.</li>\n <li>If a smoker quits between the age of 35 and 65, add 5 years to their life expectancy as compared to others who continues to smoke.</li>\n <li>If a smoker quits between the age of 65 and 74, add 1 year to their life expectancy as compared to someone who continues to smoke.</li>\n </ul>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/14093", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11763/" ]

[ { "answer_id": 17723, "author": "kit", "author_id": 14957, "author_profile": "https://health.stackexchange.com/users/14957", "pm_score": 1, "selected": false, "text": "<p>It will most likely depend on the location of the injury if there's tension (joint areas) and not the depth, size or type of injury.</p>\n\n<p>\"There is evidence suggesting that increased mechanical tension can initiate hypertrophic scars formation.Based on this hypothesis, it makes sense to minimize mechanical forces after surgery. Surgical excision scars should be positioned along, rather than across, relaxed skin tension lines whenever possible\"</p>\n\n<p>And also \"Inflammation is also known to contribute to hypertrophic scarring, and every attempt to minimize the inflammatory response should be made by ascertaining clean surgery and good wound care to prevent infection thereafter. Using inert suture materials is also important in this context\"</p>\n\n<p>Source:(lifted from)</p>\n\n<p>Update on hypertrophic scar treatment\nFelipe Bettini Rabello, Cleyton Dias Souza, and Jayme Adriano Farina Júnior.</p>\n\n<p>Source link: <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129552/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4129552/</a></p>\n" }, { "answer_id": 17734, "author": "darriage", "author_id": 14979, "author_profile": "https://health.stackexchange.com/users/14979", "pm_score": 0, "selected": false, "text": "<p>Another factor that comes into play is related to the individual, and not just the location, type, and severity of the injury. For example, some connective tissue disorders, such as Ehlers Danlos Syndrome (particularly classical type), can make you higher risk for hypertrophic, atrophic, and keloid scarring. Depending on the severity of skin involvement, even relatively minor injuries can result in such types of scarring. </p>\n" } ]

[ "https://health.stackexchange.com/questions/14096", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8483/" ]

[ { "answer_id": 14168, "author": "player777", "author_id": 11038, "author_profile": "https://health.stackexchange.com/users/11038", "pm_score": -1, "selected": false, "text": "<p>It is treated surgically only. that disease has a high lethality. Thoracotomy may be a life-saving option if other actions fail <a href=\"http://www.trauma.org/archive/thoracic/CHESTtension.html\" rel=\"nofollow noreferrer\">http://www.trauma.org/archive/thoracic/CHESTtension.html</a></p>\n" }, { "answer_id": 25135, "author": "Gregorio Litenstein", "author_id": 8186, "author_profile": "https://health.stackexchange.com/users/8186", "pm_score": 1, "selected": false, "text": "<p>Tension pneumothorax is an emergency in that it an kill somebody quickly.\nVenous catheters are part of standard management in trauma or resuscitation settings.</p>\n<p>As for pneumothorax itself; keep in mind that the needle decompression is not actually a definitive treatment but rather something to buy you time to do something more definitive like a tube thoracostomy.</p>\n<p>If you read the article carefully, you can see that those recommendations are in a prehospital setting for a patient that will essentially die if you don't do something right away.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14104", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8212/" ]

[ { "answer_id": 14168, "author": "player777", "author_id": 11038, "author_profile": "https://health.stackexchange.com/users/11038", "pm_score": -1, "selected": false, "text": "<p>It is treated surgically only. that disease has a high lethality. Thoracotomy may be a life-saving option if other actions fail <a href=\"http://www.trauma.org/archive/thoracic/CHESTtension.html\" rel=\"nofollow noreferrer\">http://www.trauma.org/archive/thoracic/CHESTtension.html</a></p>\n" }, { "answer_id": 25135, "author": "Gregorio Litenstein", "author_id": 8186, "author_profile": "https://health.stackexchange.com/users/8186", "pm_score": 1, "selected": false, "text": "<p>Tension pneumothorax is an emergency in that it an kill somebody quickly.\nVenous catheters are part of standard management in trauma or resuscitation settings.</p>\n<p>As for pneumothorax itself; keep in mind that the needle decompression is not actually a definitive treatment but rather something to buy you time to do something more definitive like a tube thoracostomy.</p>\n<p>If you read the article carefully, you can see that those recommendations are in a prehospital setting for a patient that will essentially die if you don't do something right away.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14131", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11798/" ]

[ { "answer_id": 14139, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": false, "text": "<p>The only effective management of viruses is by vaccination. In this way diseases such as measles have been eradicated from some countries.</p>\n\n<p>Currently there is no vaccine available so ecological measures such as controlling the mosquito vector need to be employed.</p>\n\n<p>Vaccines are under development eg. <a href=\"http://www.nature.com/nm/journal/v23/n2/full/nm.4253.html\" rel=\"nofollow noreferrer\">http://www.nature.com/nm/journal/v23/n2/full/nm.4253.html</a></p>\n" }, { "answer_id": 14141, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>Since 'the cure' or rather a vaccine against the virus is still only on the horizon, affected populations have to resort to prevention measures and supportive care, once the infection breaks out. Even with a vaccine, <a href=\"http://whqlibdoc.who.int/publications/1982/9241700661_eng.pdf\" rel=\"nofollow noreferrer\">mosquito population control</a> and bite prevention will be necessary to control chikungunya disease.</p>\n\n<p><a href=\"http://www.nejm.org/doi/10.1056/NEJMp1408509\" rel=\"nofollow noreferrer\">Chikungunya at the Door — Déjà Vu All Over Again</a></p>\n\n<blockquote>\n <p>We now face a new threat posed by the unrelated chikungunya virus, which causes a disease clinically similar to dengue in a similar epidemiologic pattern, which is transmitted by the same mosquito vectors, and for which we also lack vaccines and specific treatments. […] Thus, the current chikungunya threat to the United States must be met primarily with standard public health approaches such as mosquito control and avoidance. In addition, there is an important role for astute clinicians in diagnosing and reporting the disease when it occurs.</p>\n</blockquote>\n\n<p>The Do's include limiting the habitat and reach of the mosquitos. \nIf possible any open <a href=\"https://en.wikipedia.org/wiki/Stagnant_water\" rel=\"nofollow noreferrer\">still waters</a> should be <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC149385/\" rel=\"nofollow noreferrer\">drained</a>, <a href=\"http://www.who.int/denguecontrol/control_strategies/en/\" rel=\"nofollow noreferrer\">closed</a> or <a href=\"https://www.ncbi.nlm.nih.gov/books/NBK143163/\" rel=\"nofollow noreferrer\">covered</a>. Uneven spots of ground where puddles are forming after a rain should be filled with earth or other material. Wholes in a road should be fixed as soon as possible.</p>\n\n<p>Tightly woven <a href=\"https://en.wikipedia.org/wiki/Window_screen\" rel=\"nofollow noreferrer\">screens</a> in front of doors and windows might help to keep the insects out of homes, <a href=\"http://www.sciencedirect.com/science/article/pii/S0001706X09001910\" rel=\"nofollow noreferrer\">nets</a> around beds to keep those already in away from sleeping humans. Wearing long clothes helps to prevent the incidents of bites.</p>\n\n<p>Insect <a href=\"https://en.wikipedia.org/wiki/Insect_repellent\" rel=\"nofollow noreferrer\">repellent</a> chemicals like <a href=\"https://en.wikipedia.org/wiki/DEET\" rel=\"nofollow noreferrer\">DEET</a>, <a href=\"https://doi.org/10.2987%2F8756-971X%282006%2922%5B507%3APARBMR%5D2.0.CO%3B2\" rel=\"nofollow noreferrer\">p-Menthane-3,8-diol</a> or <a href=\"https://en.wikipedia.org/wiki/Icaridin\" rel=\"nofollow noreferrer\">Icaridin</a> applied to the exposed skin, clothing and even parts of a house structure might help to keep them away. If those strong chemicals arr either not available, not affordable or not well tolerated by the people who should apply them, much weaker <a href=\"https://en.wikipedia.org/wiki/Insect_repellent#Common_natural_insect_repellents\" rel=\"nofollow noreferrer\">natural repellents</a> might be worth a try. </p>\n\n<p>Since the disease vector is an insect, very <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925229/\" rel=\"nofollow noreferrer\">targeted</a> and limited usage of pesticides might be an option to consider. This is an option that has rather wide spread consequences beyond just <a href=\"https://en.wikipedia.org/wiki/Integrated_pest_management\" rel=\"nofollow noreferrer\">killing</a> the mosquitos and those might develop resistance or already are <a href=\"http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0005054\" rel=\"nofollow noreferrer\">resistant</a> to the chemicals to employed there. Most of those insecticides are not really safe for humans to use and the actual way they are used (misused, misapplied, over-dosed, under-dosed etc.) might have a net effect that's undesirable.</p>\n\n<p>A more humane and less environmental destructive method of <a href=\"https://en.wikipedia.org/wiki/Insect_trap\" rel=\"nofollow noreferrer\">limiting</a> the number of mosquitos is to <a href=\"https://youtu.be/VAT3Kq_w_VM\" rel=\"nofollow noreferrer\">trap</a> them. Their are two ways in principle to achieve this: either sexual stimulation with pheromones, leading the insects to sticky traps from where they do not escape. Or exploiting their <a href=\"https://www.youtube.com/watch?v=rovuyeXl42Y\" rel=\"nofollow noreferrer\">target acquisition</a> system, by presenting them <a href=\"https://www.youtube.com/watch?v=pNjyLRQutXs\" rel=\"nofollow noreferrer\">decoy</a> signals that will steer a significant number of them away from humans and animals and into the traps.</p>\n\n<p>Since a significant number of infections result from bites of the insects while being outside, long clothing, repellents should be among the first things to do for individuals. A number of larger scale fan traps might be worth to try in a community effort to decrease the spread of the insects and reduce the number of bites for people being outside.</p>\n\n<p>Although it is about the similar disease called Dengue fever, this guide:\n<a href=\"https://www.ncbi.nlm.nih.gov/books/NBK143163/\" rel=\"nofollow noreferrer\">Vector Management and Delivery of Vector Control Services</a> – and others like it – should be read and everything in there that an individual can do should be put into action and tried as soon as possible. If any aspect in there is of a size too large for individuals these components should be addressed by the local community and even escalated to higher authorities.</p>\n" }, { "answer_id": 14181, "author": "user1258361", "author_id": 9695, "author_profile": "https://health.stackexchange.com/users/9695", "pm_score": -1, "selected": false, "text": "<p>Your probably meant this:</p>\n\n<p><a href=\"https://en.wikipedia.org/wiki/Gene_drive\" rel=\"nofollow noreferrer\">https://en.wikipedia.org/wiki/Gene_drive</a></p>\n\n<p>A relatively new technology where a specially structured gene sequence is added to a species in such a way that it encourages the spread of the sequence through the population. This includes malicious sequences designed to extinct or near-extinct a species. Gene drives work best in quickly-reproducing species, making them perfect for eradicating pest species that spread dangerous diseases.</p>\n\n<p>The 2 most obvious pest species to eradicate (providing the most benefit per cost): mosquitoes and rats.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14133", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11799/" ]

[ { "answer_id": 14169, "author": "player777", "author_id": 11038, "author_profile": "https://health.stackexchange.com/users/11038", "pm_score": -1, "selected": false, "text": "<p>many reasons: pancreas traumas and inflammation, sedentary life, medications, alcohol excess, viruses, stresses and inheritance contribute, written in any medicine textbook like Harisson`s</p>\n" }, { "answer_id": 14773, "author": "User 25125", "author_id": 12413, "author_profile": "https://health.stackexchange.com/users/12413", "pm_score": 2, "selected": false, "text": "<blockquote>\n <p>Type 2 diabetes is characterized by a combination of peripheral\n insulin resistance and inadequate insulin secretion by pancreatic\n beta cells. Insulin resistance, which has been attributed to\n <strong>elevated levels of free fatty</strong> acids and <strong>proinflammatory cytokines</strong> in\n plasma, leads to decreased glucose transport into muscle cells,\n elevated hepatic glucose production, and increased breakdown of fat.</p>\n</blockquote>\n\n<p><br/></p>\n\n<blockquote>\n <p>For type 2 diabetes mellitus to occur, both <strong>insulin resistance</strong> and\n <strong>inadequate insulin secretion</strong> must exist. For example, all overweight\n individuals have insulin resistance, but diabetes develops only in\n those who cannot increase insulin secretion sufficiently to compensate\n for their insulin resistance. Their insulin concentrations may be\n high, yet inappropriately low for the level of glycemia.</p>\n</blockquote>\n\n<p>A simplified scheme for the pathophysiology of abnormal glucose metabolism in type 2 diabetes mellitus is depicted in the image below:</p>\n\n<p><a href=\"https://i.stack.imgur.com/XQ7E5.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/XQ7E5.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>Reference</p>\n\n<ol>\n<li><a href=\"https://emedicine.medscape.com/article/117853-overview#a3\" rel=\"nofollow noreferrer\">Type 2 Diabetes Mellitus: Pathophysiology</a></li>\n</ol>\n" }, { "answer_id": 14776, "author": "PousaliDey", "author_id": 7643, "author_profile": "https://health.stackexchange.com/users/7643", "pm_score": 0, "selected": false, "text": "<p>When a person (pancreas) is unable to produce requisite amount of insulin to maintain blood glucose levels or when their body is not able to utilize the manufactured insulin, that person is said to have affected by Type 2 diabetes.</p>\n\n<p>Probable causes include but are not limited to: person's age, weight, genetics, lack of exercise, ethnicity and lifestyle.</p>\n\n<blockquote>\n <p>Risk factors for the development of type 2 diabetes: There is evidence\n that certain ethnic groups have a predisposition to type 2 diabetes in\n the presence of the same risk factors. For example, among adult South\n Asians there are higher rates of obesity, central fat distribution,\n and resulting insulin resistance than in white populations.\n Nutritional factors (reduced intake of vitamin B12 and folate, because\n of prolonged cooking of vegetables) and lower levels of habitual\n physical activity also play their part in increasing the risk of\n diabetes in these population groups.</p>\n</blockquote>\n\n<p>Here's a reference <a href=\"http://pmj.bmj.com/content/81/958/486\" rel=\"nofollow noreferrer\">link</a>.</p>\n" }, { "answer_id": 15664, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": false, "text": "<p>The modern theory on the causation of Type 2 Diabetes Mellitus is known as the twin cycle hypothesis</p>\n\n<p><a href=\"https://i.stack.imgur.com/nG9k6.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/nG9k6.jpg\" alt=\"Twin cycle hypothesis\"></a>.</p>\n\n<blockquote>\n <p>The twin cycle hypothesis of the etiology of type 2 diabetes. During long-term intake of more calories than are expended each day, any excess carbohydrate must undergo de novo lipogenesis, which particularly promotes fat accumulation in the liver. Because insulin stimulates de novo lipogenesis, individuals with a degree of insulin resistance (determined by family or lifestyle factors) will accumulate liver fat more readily than others because of higher plasma insulin levels. In turn, the increased liver fat will cause relative resistance to insulin suppression of hepatic glucose production. Over many years, a modest increase in fasting plasma glucose level will stimulate increased basal insulin secretion rates to maintain euglycemia. The consequent hyperinsulinemia will further increase the conversion of excess calories to liver fat. A cycle of hyperinsulinemia and blunted suppression of hepatic glucose production becomes established. Fatty liver leads to increased export of VLDL triacylglycerol,85 which will increase fat delivery to all tissues, including the islets. This process is further stimulated by elevated plasma glucose levels.85 Excess fatty acid availability in the pancreatic islet would be expected to impair the acute insulin secretion in response to ingested food, and at a certain level of fatty acid exposure, postprandial hyperglycemia will supervene. The hyperglycemia will further increase insulin secretion rates, with consequent enhancement of hepatic lipogenesis, spinning the liver cycle faster and driving the pancreas cycle. Eventually, the fatty acid and glucose inhibitory effects on the islets reach a trigger level that leads to a relatively sudden onset of clinical diabetes. </p>\n</blockquote>\n\n<p>The observation that bariatric surgery often reversed T2DM was the genesis of this theory, and extreme low calorie diets have confirmed the reversal of T2DM simulating the period of starvation that occurs following bariatric surgery. Interestingly, even though insulin sensitivity is restored in the liver by calorie loss, it is still present in the peripheral muscles.</p>\n\n<p>Another recent observation is that <a href=\"https://academic.oup.com/ajcn/article/105/3/723/4569701\" rel=\"nofollow noreferrer\">diets high in saturated fat</a> predispose to peripheral insulin resistance.</p>\n\n<blockquote>\n <p>Conclusions: In a Mediterranean trial focused on dietary fat interventions, baseline intake of saturated and animal fat was not associated with T2D incidence, but the yearly updated intake of saturated and animal fat was associated with a higher risk of T2D. Cheese and butter intake was associated with a higher risk of T2D, whereas whole-fat yogurt intake was associated with a lower risk of T2D. [2]</p>\n</blockquote>\n\n<p>So excess calories, particularly of saturated fat, would appear to be the cause of T2DM.</p>\n\n<ol>\n<li><a href=\"https://www.medscape.com/viewarticle/781719_7\" rel=\"nofollow noreferrer\">https://www.medscape.com/viewarticle/781719_7</a></li>\n<li><em>The American Journal of Clinical Nutrition, Volume 105, Issue 3, 1 March 2017, Pages 723–735, <a href=\"https://doi.org/10.3945/ajcn.116.142034\" rel=\"nofollow noreferrer\">https://doi.org/10.3945/ajcn.116.142034</a></em></li>\n</ol>\n" } ]

[ "https://health.stackexchange.com/questions/14135", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11231/" ]

[ { "answer_id": 14217, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 2, "selected": false, "text": "<h2>TL;DR: No, sunscreen needs to be re-applied every 2 hours</h2>\n\n<hr>\n\n<h2>Your product is the same as SPF 30 sunscreen</h2>\n\n<blockquote>\n <p><strong>SPF is a measure of how much solar energy (UV radiation) is required to produce sunburn on protected skin (i.e., in the presence of sunscreen) relative to the amount of solar energy required to produce sunburn on unprotected skin.</strong> As the SPF value increases, sunburn protection increases.</p>\n \n <p>^{<em>FDA</em>: <strong><a href=\"https://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm106351.htm\" rel=\"nofollow noreferrer\">Sun Protection Factor (SPF)</a></strong>}</p>\n</blockquote>\n\n<p>This is irrelevant whether you apply sunscreen with an SPF of 30, or vanilla ice cream with an SPF of 30, or zinc sun block moisturiser with an SPF of 30. The FDA approves all 3 products, and the SPF value is an absolute, standardised value and does not depend on type of product.</p>\n\n<p>So, using a SPF 30 zinc sun blocker blocks equal amounts of UV radiation as a SPF 30 sunscreen. In fact, <a href=\"https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm239463.htm#ingredients\" rel=\"nofollow noreferrer\">zinc oxide even is one of the multiple possible active ingredients in a sunscreen</a>, and yes, you are right, it is a physical blocker and therefore better than most sun screens as it protects from UVA and UVB also.</p>\n\n<h2>How long does an SPF 30 sunscreen protect my skin?</h2>\n\n<blockquote>\n <p>“<strong>If you’re in the sun, your sunscreen is good for a max of two hours</strong>, and depending on the sunscreen it might not even last that long,” Garner says. The skin literally “uses up” the active ingredient in the lotion over time, meaning it can’t do any more. </p>\n \n <p>^{<em>Laura Schoecker</em>. <strong><a href=\"https://www.huffingtonpost.com/2013/06/05/sunscreen-mistakes-tips_n_3377817.html\" rel=\"nofollow noreferrer\">8 Sunscreen Mistakes You’re Probably Making</a></strong>. HuffingtonPost. 2013}</p>\n</blockquote>\n\n<p>The FDA agrees:</p>\n\n<blockquote>\n <p>Reapply [sunscreen] <strong>at least every two hours, and more often if you’re swimming or sweating.</strong></p>\n \n <p>People should also be aware that no sunscreens are \"waterproof.” All sunscreens eventually wash off. Sunscreens labeled \"water resistant\" are required to be tested according to the required SPF test procedure. The labels are required to state whether the sunscreen remains effective for 40 minutes or 80 minutes when swimming or sweating, and all sunscreens must provide directions on when to reapply.</p>\n \n <p>^{<em>FDA</em>. <strong><a href=\"https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/UnderstandingOver-the-CounterMedicines/ucm239463.htm\" rel=\"nofollow noreferrer\">Sunscreen: How to Help Protect Your Skin from the Sun.</a></strong>}</p>\n</blockquote>\n\n<p>However, this is the case with chemical sunblockers. Physical sunblockers do not get absorbed as easily by the skin (The swimming and sweating still holds, though):</p>\n\n<blockquote>\n <p>There are differences between the two main types of sunscreens: physical and chemical. <strong>A chemical sunscreen is absorbed by the skin.</strong> Sunlight is deactivated or degraded after contact with the organic chemicals contained in the sunscreen. Chemical sunscreens typically contain a range of ingredients like benzones, aminobenzoic acid and cinnamates that, together, protect against UVA and UVB.</p>\n \n <p>A physical block, in contrast, sits on the skin’s surface and contains inorganic compounds like titanium dioxide or zinc oxide that are not absorbed into the skin. In this case, light is either absorbed into sunblock material or reflected away from the skin, similar to a mirror or aluminum foil. <strong>Ingredients in physical sunblocks protect against both UVA and UVB and, because they are not absorbed into the skin</strong>, they are nonirritating and nonallergenic.</p>\n \n <p>^{<em>Dr. Doris J. Day</em>, <strong><a href=\"https://consults.blogs.nytimes.com/2009/06/10/what-to-look-for-in-a-sunscreen/\" rel=\"nofollow noreferrer\">What to Look for in a Sunscreen</a></strong>. New York Times. 2009}</p>\n</blockquote>\n\n<p>Nevertheless, both the FDA and multiple interviews with doctors I have seen encourage patients to use physical sun blockers and re-apply sunscreen every 2 hours. </p>\n\n<blockquote>\n <p><strong>Remember that sunscreen needs to be reapplied every two hours</strong>, or more frequently after swimming, heavy perspiration, or toweling off. Also remember, no matter how much sunscreen you apply, the SPF should be 15 or higher for adequate protection – and ideally 30 or higher for extended time spent outdoors.</p>\n \n <p>^{<em>Elizabeth Kale</em>, <strong><a href=\"http://www.skincancer.org/skin-cancer-information/ask-the-experts/how-much-sunscreen-should-i-be-using-on-my-face-and-body\" rel=\"nofollow noreferrer\">Ask The Epxert</a></strong>. Skin Cancer Foundation. 2010}</p>\n \n <p>In addition to sunscreens, <strong>sun smart behavior including avoiding the midday sun, staying in the shade when you can, and wearing a hat and sun protective clothing. Use an SPF of 15 or higher, and reapplying it every two hours or more often if you are swimming or sweating, is critical</strong>.</p>\n \n <p>^{<em>Dr. Doris J. Day</em>, <strong><a href=\"https://consults.blogs.nytimes.com/2009/06/10/what-to-look-for-in-a-sunscreen/\" rel=\"nofollow noreferrer\">What to Look for in a Sunscreen</a></strong>. New York Times. 2009}</p>\n</blockquote>\n\n<hr>\n\n<h2>Beware of a common misconception</h2>\n\n<p>I've read the claim on multiple, reputable websites that SPF multiplies the time you can normally stay in the sun without burns.</p>\n\n<blockquote>\n <p>Sunscreens provide protection by absorbing, reflecting or scattering the sun's rays. They may also contain chemicals that interact with the skin to protect it from UV rays. Sunscreens are rated according to their effectiveness by the sun protection factor (SPF). A product's SPF number helps determine how long the product will protect you before you need to re-apply it - how long you can stay in the sun without burning. For example, you may normally burn in 20 minutes. If you apply an SPF 15 sunscreen, you'll be protected for about 300 minutes, or five hours (SPF 15 x 20 minutes = 300 minutes). A person with lightly pigmented skin who burns in 10 minutes would be protected for only about two-and-a-half-hours with SPF 15 (SPF 15 x 10 minutes = 150 minutes).</p>\n \n <p>^{<em>American Skin Association</em>. <strong><a href=\"http://www.americanskin.org/resource/safety.php\" rel=\"nofollow noreferrer\">Sun Safety</a></strong>}</p>\n</blockquote>\n\n<p><strong>According to the FDA, this is a common misconception</strong>.</p>\n\n<blockquote>\n <p><strong>There is a popular misconception that SPF relates to time of solar exposure. For example, many consumers believe that, if they normally get sunburn in one hour, then an SPF 15 sunscreen allows them to stay in the sun 15 hours (i.e., 15 times longer) without getting sunburn. This is not true because SPF is not directly related to time of solar exposure but to amount of solar exposure.</strong> Although solar energy amount is related to solar exposure time, there are other factors that impact the amount of solar energy. For example, the intensity of the solar energy impacts the amount. </p>\n \n <p>^{<em>FDA</em>: <strong><a href=\"https://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm106351.htm\" rel=\"nofollow noreferrer\">Sun Protection Factor (SPF)</a></strong>}</p>\n</blockquote>\n" }, { "answer_id": 14231, "author": "Taylor", "author_id": 8916, "author_profile": "https://health.stackexchange.com/users/8916", "pm_score": 3, "selected": false, "text": "<p>Zinc oxide is an inorganic compound with the formula ZnO. ZnO is a white powder that is insoluble in water and is widely used as an additive in numerous materials and products including rubbers, plastics, ceramics, glass, cement, lubricants, foods, and as a sunblock. </p>\n\n<p>For material science applications, zinc oxide has a high <a href=\"https://www.britannica.com/science/refractive-index\" rel=\"noreferrer\">refractive index</a>, high <a href=\"http://www.dictionary.com/browse/thermal-conductivity\" rel=\"noreferrer\">thermal conductivity</a>, binding, antibacterial and UV-protection properties.</p>\n\n<p>Zinc oxide can be used in ointments, creams, and lotions to protect against <em>sunburn</em> and other damage to the skin caused by UV light. It is the broadest spectrum UVA and UVB absorber that is approved for use by the FDA and is completely <a href=\"https://www.merriam-webster.com/medical/photostable\" rel=\"noreferrer\">photostable</a>. As stated in an article titled ‘<a href=\"http://www.jaad.org/article/S0190-9622(99)70532-3/fulltext\" rel=\"noreferrer\">Microfine zinc oxide (Z-Cote) as a photostyable UVA/UVB sunblock agent</a>' the suitability of microfine zinc oxide as a broad-spectrum photo protective agent was assessed by examining the properties considered important in suncreens: <a href=\"https://www.britannica.com/science/attenuation-spectrum\" rel=\"noreferrer\">attenuation spectrum</a>, sun protection factor (SPF) contribution, photostability, and <a href=\"https://en.oxforddictionaries.com/definition/photoreaction\" rel=\"noreferrer\">photoreactivity</a>.</p>\n\n<blockquote>\n <p>Results: Microfine zinc oxide attenuates throughout the UVR spectrum, including UVA I. It is photostable and does not react with organic sunscreens under irradiation. Conclusion: Microfine zinc oxide is an effective and safe sunblock that provides broad-spectrum UV protection, including protection from long-wavelength UVA.</p>\n</blockquote>\n\n<p>In 1999, the FDA issued a notice of proposed rule making that amended the tentative final monograph (proposed rule) for over-the counter (OTC) sunscreen drug products. ‘<a href=\"https://www.fda.gov/ohrms/dockets/98fr/102298b.txt\" rel=\"noreferrer\">Sunscreen Drug Products for Over-the-Counter Human Use</a>' states the following:</p>\n\n<blockquote>\n <p>The agency discussed a study submitted to the Panel using zinc oxide alone and in combination with phenyl salicylate, another sunscreen ingredient (58 FR 28194 at 28213). The study was designed to measure the ability of zinc oxide (15 to 33.3 percent) to absorb ultraviolet (UV) radiation over a broad range of wavelengths.</p>\n</blockquote>\n\n<p>In the proposed rule, the agency also discussed the public health significance of ultraviolet A (UVA) radiation and the characteristics and proposed labeling of OTC sunscreen drug products that claim to provide protection from UVA radiation. One comment measured the spectral absorbance of three formulations: (1) 4 percent zinc oxide, (2) 25 percent zinc oxide, and (3) 2 percent oxybenzone.</p>\n\n<blockquote>\n <p>Albino hairless mouse stratum corneum/epidermis samples were prepared by mechanical removal of the dermis using a dulled razor\n blade. The samples were cut into 1-inch circles and maintained in a hydrated state by floating the samples (dermal side down) on a water bath. The absorbance of each skin sample was measured and recorded. Ten microliters (L) of sunscreen were applied to the skin substrate, allowed to dry for 15 minutes, and the absorbance measured. The absorbance of each sunscreen treated sample was subtracted from the absorbance of the skin (without sunscreen) to yield the absorbance of the sunscreen. Five replicate measurements for each sunscreen formula were averaged and plotted with standard deviations at each 10 nm.</p>\n</blockquote>\n\n<p>The spectral absorbance plots established that</p>\n\n<blockquote>\n <p>...zinc oxide has a relatively flat and broad absorbance curve from 250 nm through 370 nm with a sharp drop in absorbance beyond 370 nm and extending into the visible spectrum. Comparison of the measurements of the 4 percent zinc oxide with 25 percent zinc oxide showed that the magnitude of absorbance is related to the amount of zinc oxide in the formulation.</p>\n</blockquote>\n\n<p>These measurements adequately demonstrated that zinc oxide</p>\n\n<blockquote>\n <p>...absorbs radiation between 290 and 380 nm and, thus, support effectiveness.</p>\n</blockquote>\n\n<p>Another comment included the results of in vitro testing of a formulation containing 15 percent zinc oxide in a stable emulsion. The transmittance data supported the premise that </p>\n\n<blockquote>\n <p>...zinc oxide can protect against UV radiation, including both UVB and UVA.</p>\n</blockquote>\n\n<p>One comment included a spectral profile of attenuation for zinc oxide alone in a cosmetic formulation and from 1:1 and 3:1 combinations of zinc oxide and titanium dioxide. These spectral profiles of zinc oxide in various formulations demonstrated that</p>\n\n<blockquote>\n <p>...zinc oxide as a single ingredient can provide protection in both the UVB and UVA spectral regions.</p>\n</blockquote>\n\n<p>Recent scientific advances in understanding the photochemistry and photobiology of sunscreen drug products have raised many issues regarding sunscreen active ingredients, including zinc oxide and titanium dioxide. Because zinc oxide and titanium dioxide have many similar physical characteristics and may be used in combination in OTC sunscreen drug products, the following discussion addresses both ingredients.</p>\n\n<blockquote>\n <p>There has been renewed interest in using physical sunscreens, i.e., zinc oxide and titanium dioxide, in sunscreen formulations because these ingredients may confer protection for a broad range of the UV radiation spectrum. Some manufacturers have developed ultrafine forms of these ingredients in the range of 0.02 to 0.10 microns that are transparent on the skin, may offer both UVA and UVB protection, and are esthetically pleasing…</p>\n</blockquote>\n\n<p>Sunscreens have been generally classified as chemical (organic) or physical (inorganic) depending on whether they absorb specific UV radiation wavelengths or reflect and scatter UV radiation.</p>\n\n<blockquote>\n <p>Zinc oxide and titanium dioxide have been described as physical sunscreen ingredients that provide protection from UV radiation through reflection and scattering. However, new data and information indicate that they also absorb UV radiation as well as scatter visible light.</p>\n</blockquote>\n\n<p>Various authors have shown that these ingredients exhibit a semiconductor optical absorption gap meaning they absorb most radiation at wavelengths shorter than the gap (approx. 380nm) and scatter radiation at wavelengths longer than the gap.</p>\n\n<blockquote>\n <p>When zinc oxide and titanium dioxide are irradiated with light containing energy greater than the band gap (approximately 3 electron volts), an electron from the valence band can be excited to the conduction band, thus creating an electron-hole pair.</p>\n</blockquote>\n\n<p>There are many formulation variables that may affect the photocatalytic capability of zinc oxide and titanium dioxide.</p>\n\n<blockquote>\n <p>Such variables include mineral components, particle size, surface area, crystalline structure, particle coatings, pH of the medium, differences in the refractive index of the medium, and other components in the formulation.</p>\n</blockquote>\n\n<p>Although the FDA continues to evaluate data and information for the purpose of proposing a monograph method for determining UVA radiation protection, it nonetheless finds</p>\n\n<blockquote>\n <p>there is ample data demonstrating that zinc oxide provides protection against UVA radiation.</p>\n</blockquote>\n\n<p>As it relates to the frequency one should apply sunscreen, a common recommendation by many public health agencies is to reapply sunscreen every <em>two to three hours</em>. Is this recommendation effective in minimizing ultraviolet exposure of the skin during time in the sun? ’<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11712033\" rel=\"noreferrer\">When should sunscreen be applied?</a>’ studied how the time of sunscreen reapplication affects the solar ultraviolet exposure of the skin.</p>\n\n<blockquote>\n <p>A mathematical model was derived that took into account typical amounts of sunscreen application and sunscreen substantivity to determine how these factors, when combined with the time of sunscreen reapplication, influence the photoprotection provided by sunscreen during exposure for several hours around mid day in strong sunshine.</p>\n</blockquote>\n\n<p>Results of the study were as follows:</p>\n\n<blockquote>\n <p>Using a sunscreen that is readily removed from the skin achieves little in the way of sun protection, no matter when it is reapplied. For sunscreens that bind moderately or well to skin, typical of modern waterproof or water-resistant products, the lowest skin exposure results from early reapplication into the sun exposure period, and not at 2 to 3 hours, after initial application. Typically reapplication of sunscreen at 20 minutes results in 60% to 85% of the ultraviolet exposure that would be received if sunscreen were reapplied at 2 hours.</p>\n</blockquote>\n\n<p>The concluding statement advises sunscreen users </p>\n\n<blockquote>\n <p>…to apply sunscreen liberally to exposed sites 15 to 30 minutes before going out into the sun, followed by reapplication of sunscreen to exposed sites 15 to 30 minutes after sun exposure begins. Further reapplication is necessary after vigorous activity that could remove sunscreen, such as swimming, toweling, or excessive sweating and rubbing.</p>\n</blockquote>\n\n<p>Another abstract, ‘<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/15767357\" rel=\"noreferrer\">A noninvasive objective measure of sunscreen use and reapplication</a>’, studied whether a noninvasive swabbing technique can detect sunscreen use for up to 6 hours, and whether the technique can detect reapplication of sunscreen. </p>\n\n<blockquote>\n <p>Thirty volunteer office workers were randomly assigned to have one of a variety of sunscreens applied using recommended application techniques, and half were randomly assigned to have sunscreen reapplied after 3 hours. Alcohol-based swabs were used to obtain a sample from participants' arm at 20 minutes, and hourly from 1 to 6 hours post-application. Absorption readings were analyzed using an UV-visible spectrophotometer…The “swabbing technique” was consistently able to distinguish the sunscreen from control swabs for up to 6 hours. The absorption readings between 20 minutes and 6 hours were significantly higher than control swabs. There were no differences between the group that had sunscreen reapplied and the group that did not.The swabbing technique was consistently able to distinguish the sunscreen from control swabs for up to 6 hours. The absorption readings between 20 minutes and 6 hours were significantly higher than control swabs. There were no differences between the group that had sunscreen reapplied and the group that did not.</p>\n</blockquote>\n\n<p>The study concluded with evidence indicating that the sunscreen swabbing technique is</p>\n\n<blockquote>\n <p>an effective noninvasive method for detecting a variety of sunscreen products in adults over a 6-hour period. No differences in absorption readings were found with sunscreen reapplication. This procedure will be a useful adjunct to other objective measures of sun protection and UV radiation exposure, resulting in a more accurate picture of the sun protection habits of individuals.</p>\n</blockquote>\n\n<p>Moreover, the Skin Cancer Foundation answers several relevant questions in an article titled ‘<a href=\"http://www.skincancer.org/prevention/sun-protection/sunscreen/sunscreens-explained\" rel=\"noreferrer\">Sunscreens Explained</a>’. </p>\n\n<blockquote>\n <p>How much Sunscreen Should I Use and How Often Should I Put it On?\n To ensure that you get the full SPF of a sunscreen, you need to apply 1 oz – about a shot glass full. Studies show that most people apply only half to a quarter of that amount, which means the actual SPF they have on their body is lower than advertised. During a long day at the beach, one person should use around one half to one quarter of an 8 oz. bottle. Sunscreens should be applied 30 minutes before sun exposure to allow the ingredients to fully bind to the skin. Reapplication of sunscreen is just as important as putting it on in the first place, so reapply the same amount every two hours. Sunscreens should also be reapplied immediately after swimming, toweling off, or sweating a great deal.</p>\n</blockquote>\n\n<p>Finally, to address your question: “Why do I need to reapply a zinc sun blocker if it has not been exposed to sun or sweat?”; The International Agency for Research on Cancer’s ‘<a href=\"http://www.iarc.fr/en/publications/pdfs-online/prev/handbook5/index.php\" rel=\"noreferrer\">IARC Handbook of Cancer Prevention Volume 5</a>,’ explains in Chapter 6: <a href=\"http://www.iarc.fr/en/publications/pdfs-online/prev/handbook5/Handbook5_Sunscreens-6.pdf\" rel=\"noreferrer\">Other beneficial effects of sunscreens</a>, that there are other potential beneficial effects of sunscreens that are not related to the prevention of skin cancer include prevention of painful sunburns, photodamage and photoageing UVR-induced provocation of certain cutaneous diseases, and photoimmune suppression.</p>\n\n<blockquote>\n <p>Use of sunscreens can prevent skin diseases from progressing acutely after exposure to the sun; these diseases include cutaneous lupus erythematosus…and reactivation of herpes labialis… The other potential benefits of sunscreens are related to the type and duration of exposure to UVR. Prevention of photodamage and photoageing, which are related to cumulative exposure to UVR, in countries where solar irradiance is intense throughout the year requires daily, longterm sun protection… Prevention of acute flares of cutaneous diseases, which may be related to episodic exposure to UVR, requires anticipatory use of sun protection.</p>\n</blockquote>\n\n<p>Under certain circumstances, diseases of various etiologies can be aggravated by sunlight in people who on other occasions may react normally.</p>\n\n<blockquote>\n <p>These diseases include lupus erythematosus, lichen planus and herpes simplex. The disease most frequently recognized as requiring careful photoprotection from both UVB and UVA is lupus erythematosus in the discoid, systemic and subacute forms…The available evidence suggests that regular use of sunscreens reduces morbidity from both cutaneous and systemic lupus erythematous.</p>\n</blockquote>\n\n<p>Therefore, if you are unsure about whether it is necessary to wear sunscreen indoors, you may want to consider your medical history and potential predisposition toward developing a disease that may increase the need for more intensive \"sun-blocking\" protective measures. However, it is always advisable to consult with your primary care physician and/or dermatologist with any personal health-related questions or concerns.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14184", "https://health.stackexchange.com", "https://health.stackexchange.com/users/15/" ]

[ { "answer_id": 14312, "author": "D Bagnall", "author_id": 11940, "author_profile": "https://health.stackexchange.com/users/11940", "pm_score": 0, "selected": false, "text": "<p>Short answer: the kidneys and liver don't care if it's 500mg once a day or 250mg twice a day.</p>\n\n<p>One must consider two things: the amount of medication needed to relieve symptoms and how long it lasts. </p>\n\n<p>The body metabolizes 500mg and 250mg at the same rate, therefore 500mg won't last twice as long as 250mg. But if the 250mg isn't strong enough to reduce the symptoms, it makes no sense to take it at that dose.</p>\n" }, { "answer_id": 14315, "author": "BillDOe", "author_id": 2833, "author_profile": "https://health.stackexchange.com/users/2833", "pm_score": 2, "selected": false, "text": "<p>Naproxen has a half-life of between twelve and seventeen hours.<a href=\"https://www.drugs.com/pro/naproxen.html\" rel=\"nofollow noreferrer\">¹</a> Constant steady-state serum levels of Naproxen are produced after four to five days..<a href=\"https://www.drugs.com/pro/naproxen.html\" rel=\"nofollow noreferrer\">¹</a> It stands to reason that the lower the dose the lower the renal and hepatic load and vice versa; the higher dosage requires the kidneys and liver to remove more of the drug. @D Bagnall is correct, however, that the half-life is not affected by the dosage, other than the obvious fact that a higher initial dose leaves more drug in your body after the half-life period than a lower dose.<br><br>Most NSAIDs produce their effect by inhibiting the production of the COX-1 and COX-2 enzymes.<a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036662/\" rel=\"nofollow noreferrer\">²</a> COX-1, and (to a lesser effect) COX-2 help protect the stomach from its acidic environment.<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11595412\" rel=\"nofollow noreferrer\">³</a> Contrary to popular believe, NSAIDs do not \"burn\" a hole in your stomach. Because of the protective effect of these enzymes, NSAIDs should be take only while symptoms persist. If needed for longer periods, you should consult with your physician.<br><br>But to answer your main question: As far as your liver and kidneys care it's the dosage that matters. One should always take the lowest dose that produces the desired effect.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14240", "https://health.stackexchange.com", "https://health.stackexchange.com/users/453/" ]

[ { "answer_id": 14310, "author": "D Bagnall", "author_id": 11940, "author_profile": "https://health.stackexchange.com/users/11940", "pm_score": 0, "selected": false, "text": "<p>So think about fat stored in your body as being like money in a 401K.</p>\n\n<p>You decide you need groceries, so you go to the store, but you can't use the money in the 401K to buy them, you need cash or a credit card.</p>\n\n<p>Your body is the same; it needs immediate cash (carbohydrates/sugars...) for the day to day needs, and it tells you it needs them through hunger. Just like the 401K won't help you buy groceries, fat won't stop day to day hunger, so you have to eat.</p>\n" }, { "answer_id": 14321, "author": "Kate Gregory", "author_id": 400, "author_profile": "https://health.stackexchange.com/users/400", "pm_score": 3, "selected": true, "text": "<p>Hunger is far more complicated than \"my weight is below normal for my height, I should eat now.\" It's not some sort of correction mechanism that turns on and off to make your weight go up and down.</p>\n\n<p>On a first approximation, you feel hungry because your stomach is empty and/or your blood sugar is low. People can drink water or eat lettuce to fill up their stomachs, and that works a little. Often, if you eat something very high in sugar, not mediated by anything slower to digest, you will be even hungrier afterwards because of your body's insulin response. The web is full of \"foods that make you hungry\", \"what to do instead of eating when you're hungry\" and such like, some of which have a grain of truth in them, and that certainly demonstrate how complicated hunger is in humans.</p>\n\n<p>Studies have been done showing that people can get hungry for a variety of reasons that have nothing to do with their current weight. Here's <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/3894001/\" rel=\"nofollow noreferrer\">a review</a> of various papers relating to insulin levels and cognitive factors such as looking at or thinking about food.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14273", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11918/" ]

[ { "answer_id": 14309, "author": "D Bagnall", "author_id": 11940, "author_profile": "https://health.stackexchange.com/users/11940", "pm_score": 0, "selected": false, "text": "<p>Scoliosis is a natural and very common phenomenon. Generally we don't see or feel scoliosis, rather, it is something that shows up by chance on an x-ray.</p>\n\n<p>People with mild scoliosis are not limited by it, and exercise, all kinds of exercise, is not harmful. I encourage my patients to exercise as much as they want, regardless of the type of exercise they choose.</p>\n\n<p>Exercise will not correct scoliosis, but it's not important that mild scoliosis be corrected as it is neither painful or harmful.</p>\n" }, { "answer_id": 14317, "author": "Džuris", "author_id": 11942, "author_profile": "https://health.stackexchange.com/users/11942", "pm_score": 1, "selected": false, "text": "<p>Of course, there are exercises that place no stress on the spine and couldn't worsen your scoliosis. Leg extensions using machine, preacher curls, pec flys are some examples of exercises that doesn't involve the spine at all. </p>\n\n<p>Other exercises like shoulder press, deadlifts, squats put pressure and stresses on the spine and might be more risky with certain back conditions. If doctors advise against gym, these might be the exercises that you are supposed to avoid.</p>\n\n<p>I am not sure about the scientific consensus but it is believed (by both doctors and laymen) that scoliosis may lead to uneven pressures that can lead to disc protrusions and some other trauma easier than normally. So you should (as any person) take extreme care and control your back (and whole body) not only during exercise, but also when carrying weights, preparing for exercise and putting weights down after the exercise. This might be the other reason why doctors advise you against visiting the gym.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14279", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11767/" ]

[ { "answer_id": 15961, "author": "paparazzo", "author_id": 6848, "author_profile": "https://health.stackexchange.com/users/6848", "pm_score": -1, "selected": false, "text": "<p>A gram of fat is 9 calories so with a straight up calculation is 111 grams. <a href=\"http://healthyeating.sfgate.com/gram-protein-carbohydrates-contains-many-kilocalories-5978.html\" rel=\"nofollow noreferrer\">calories in fat</a> <a href=\"https://en.wikipedia.org/wiki/Food_energy\" rel=\"nofollow noreferrer\">wiki</a></p>\n\n<p>Body fat is not pure fat and is about <a href=\"https://www.healthline.com/nutrition/calories-in-a-pound-of-fat\" rel=\"nofollow noreferrer\">3500 calories per pound.</a> Or about 7.7 calories per grams. So 1000 calories is about 130 grams of body fat.</p>\n" }, { "answer_id": 15978, "author": "Chris Rogers", "author_id": 7951, "author_profile": "https://health.stackexchange.com/users/7951", "pm_score": 2, "selected": true, "text": "<blockquote>\n <p>[I]s weight gain a one variable function of calorie intake minus calorie consumption?</p>\n</blockquote>\n\n<p>Yes. It stands to reason because why else is the <a href=\"https://www.nhs.uk/chq/pages/1126.aspx?categoryid=51\" rel=\"nofollow noreferrer\">recommended daily calorie intake</a> always talked about in nutritional information labels? Note, however, that as stipulated in the NHS link,</p>\n\n<blockquote>\n <p>These values can vary depending on age, metabolism and levels of physical activity, among other things.</p>\n</blockquote>\n\n<p>Calories not 'burnt' by the body's metabolism is stored as fat.</p>\n\n<blockquote>\n <p>[H]ow many grams one would gain for excessive 1000 calories?</p>\n</blockquote>\n\n<p>There are no definitive answers to this question as again, it seems to work out differently from person to person due to the components of <a href=\"https://academic.oup.com/ajcn/article/95/4/989/4576902\" rel=\"nofollow noreferrer\">intake and expenditure</a>.</p>\n\n<p><a href=\"https://www.healthline.com/nutrition/calories-in-a-pound-of-fat\" rel=\"nofollow noreferrer\">A link provided by @paparazzo</a> states that with fat working out to be about 3500 calories per pound,</p>\n\n<blockquote>\n <p>Some of the studies state that body fat tissue contains only 72% fat. Different types of body fat may also contain varying amounts of fat.</p>\n \n <p>BOTTOM LINE:A pound of body fat may contain anywhere between 3,436 and 3,752 calories, roughly estimated.</p>\n</blockquote>\n\n<h2>The bottom line on this question</h2>\n\n<p>Calories not 'burnt' by the body's metabolism is stored as fat. If you are overweight you need to reduce your calorie intake <strong>and/or</strong> increase your exercise levels.</p>\n\n<p>If you are underweight it is not straight forward as you need to have your weight gain managed.</p>\n\n<p><a href=\"https://www.nhs.uk/chq/Pages/2302.aspx\" rel=\"nofollow noreferrer\">There are many possible medical reasons for being underweight</a>. Speak to your doctor because before trying to put on weight, you need to know that it is safe to do so. </p>\n" } ]

[ "https://health.stackexchange.com/questions/14287", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11558/" ]

[ { "answer_id": 14308, "author": "D Bagnall", "author_id": 11940, "author_profile": "https://health.stackexchange.com/users/11940", "pm_score": 3, "selected": false, "text": "<p>So let's assume you're speaking of a large bone, like the arm (humerus, radius or ulna) or leg (femur, tibia or fibula), but not the skull, spine or pelvis.</p>\n\n<p>A good rule of thumb: the larger the bone, the more serious it is.</p>\n\n<p>A second rule: if the skin is broken (the bone is sticking out), it is serious.</p>\n\n<p>So, if you suspect a hand or foot fracture with no blood, you can take the person to an urgent care center or ER.</p>\n\n<p>If you suspect a leg or arm fracture, best to call EMTs.</p>\n\n<p>If you see blood, or the person is unconscious, call the EMTs.</p>\n" }, { "answer_id": 14311, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 5, "selected": false, "text": "<h2>You as an untrained bystander can do little to nothing.</h2>\n\n<p>Professionally trained paramedics could (as an example) pull the leg and thus remove tension between two bone membranes (<em><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826636/\" rel=\"noreferrer\">periostei</a></em>) and in a best case scenario alleviate all pain. The bone itself has hardly any nerve endings, it is only the periosteum that causes pain. This only works in a few cases. Other options include administration of pain killers. </p>\n\n<p>A few “guidelines” what to do when:</p>\n\n<ol>\n<li>If the patient is in pain, call an ambulance.</li>\n<li>If the patient can not walk/stand up, call an ambulance.</li>\n<li>If the fracture is open (ruptured skin / blood), call an ambulance.</li>\n<li>If the patient was or still is unconscious, call an ambulance, check for vital functions (breathing, airways).</li>\n<li>If the patient wants an ambulance, call the ambulance.</li>\n</ol>\n\n<p>Bottom line: To be on the safe side, call an ambulance.</p>\n\n<hr>\n\n<h2>What <em>can</em> you do?</h2>\n\n<p>During my very first first-help training, my trainer said something that stuck with me: “We humans have two fundamental fears: To die, and to die alone”. While it is sometimes impossible to save someone’s life, we can always, always be with them and comfort them. \nSo, never leave a patient alone unless there is absolute need, and if so, communicate clearly that you will return very shortly and e.g. just need to grab an AED.</p>\n\n<p>Secondly, being in pain is not very enjoyable, and having a large crowd of bystanders assemble around the patient doesn’t make it a bit better. Try to give them the decency of privacy. If you have already called the ambulance, get a few people to spread out, watch out for the ambulance and guide them to the patient. Hush the other ones away or give them tasks like looking for AEDs in nearby public buildings.</p>\n\n<p>Thirdly, lying immobilised, the patient gets cold quite quickly. Make sure to keep them warm. Jackets, <s>a camp fire</s>, or a <a href=\"https://az768999.vo.msecnd.net/images/products/38/lampa66964_635848435088676854/lampa66964_large_0.jpg\" rel=\"noreferrer\">rescue blanket</a> are always a good idea, even on mild summer days. (Pro Tip: A rescue blanket makes it quite clear to the ambulance drivers where and who the patient is, and it also protects the patient from the watchful eyes of bystanders. Such blankets are usually a part of every first-aid set in public buildings).</p>\n\n<p>Lastly, as a patient you are very dependent on the people around you. Because patients are usually sitting and leaning against a wall or lying on the ground (to prevent meaningful damage if they should collapse), their field of vision is very limited. Pain also distracts, so they are not highly aware of their surroundings. \nThis is why one must explain every action one takes to them, especially if it includes coming very near or touching the patient.</p>\n\n<h2>TL;DR</h2>\n\n<p>Here’s what you could do (order and items on the list depend on every case, don’t take this as a standard rule). Reiterating from above, always tell the patient what you’re doing.</p>\n\n<ol>\n<li>Check vital functions</li>\n<li>Call ambulance</li>\n<li>Check vital functions again</li>\n<li>Direct someone to get a first-aid set from a nearby public building. </li>\n<li>Send a few people as “beacons” for an ambulance, have them look out for it and guide its way upon arrival at the scene.</li>\n<li>If there’s still a large crowd, send a few people looking for AEDs¹</li>\n<li>Ensure warmth of patient.</li>\n<li>Distract the patient until arrival of ambulance. </li>\n</ol>\n\n<hr>\n\n<p>¹: It’s not likely that you will need a defibrillator, and I wouldn’t send for one as a standard procedure. However, it is always easier to send people looking for <em>something</em> than just hushing them away.</p>\n" }, { "answer_id": 14322, "author": "See Jian Shin", "author_id": 11897, "author_profile": "https://health.stackexchange.com/users/11897", "pm_score": 2, "selected": false, "text": "<p>If you are untrained on this subject matter, the best practise is to do nothing about the fracture.* Even most certified first aiders are not trained to handle broken bones. </p>\n\n<p>*By nothing I don't literally mean nothing. I would assume that you have already called for ambulance. If he is in a dangerous location you can try to move him, but you will have move the area of the broken bone as little as possible. If he is unconscious and not breathing proceed to CPR, even if his rib cage is fractured. If he is in an awkward position you can try supporting him with things around you.(for example he could be lying on his side and supporting himself with his arms. Slide a bag for him to lie on.) If he is bleeding seriously carry out first aid. General idea is keep him alive until help arrives, other things can wait.</p>\n" }, { "answer_id": 14323, "author": "Dennis", "author_id": 11949, "author_profile": "https://health.stackexchange.com/users/11949", "pm_score": 1, "selected": false, "text": "<p>From personal experience I can definitely attest that a person with a broken arm can indeed (under reasonable circumstances) hobble to a car and be driven to the hospital (not sure which department, presumably first aid initially).</p>\n\n<p>In my case I was the child with the broken arm and my mom drove met to the hospital.</p>\n\n<p>This way (even with safe driving) I was in the hospital slightly faster then in any other scenario, and we did not put unnecessary pressure on the medical system.</p>\n\n<p>Note that I was not in significant pain, and no blood/bone was coming out (just an arm at an odd angle).</p>\n" }, { "answer_id": 14324, "author": "Graham", "author_id": 11952, "author_profile": "https://health.stackexchange.com/users/11952", "pm_score": 2, "selected": false, "text": "<p>If both legs are OK and there is no way they could have a spinal injury, you may well find it is quicker to get them to hospital in your car. Drive very slowly over bumps and around corners, do not accelerate fast and leave plenty of stopping distance for slow braking. This would be my preferred option for a minor injury to an arm, hand, shoulder or foot.</p>\n\n<p>In any other situation, call an ambulance and follow the phone operator's instructions to the letter. Do <strong><em>NOT</em></strong> try to be clever or show initiative about treating the casualty - you could easily make things worse! That said, be very clear about the situation and telling the operator exactly what happened and any change to the casualty's condition. For example, moving a casualty or removing a bike helmet could increase the damage from a spinal injury, so normally this is a job for the experts - but if the casualty has stopped breathing then the first priority is CPR, because they're guaranteed to die if you don't.</p>\n\n<p>TBH though, your questions suggest you're asking in the wrong place - not the wrong forum, but just generally by asking on the net. You won't learn anything useful here. Get yourself to a properly-run first aid course, learn what to do from people who actually know, and do some hands-on practise so that you can actually do it yourself.</p>\n" }, { "answer_id": 14326, "author": "user149408", "author_id": 11954, "author_profile": "https://health.stackexchange.com/users/11954", "pm_score": 2, "selected": false, "text": "<p><strong>It all depends on the bone that is (or might be) broken, and on the overall condition of the patient.</strong></p>\n\n<ul>\n<li>Call an ambulance for a fractured skull, vertebra or hip.</li>\n<li>Call an ambulance for open fractures (bone piercing through the skin).</li>\n<li>Call an ambulance if the patient is/has been unconscious or under shock.</li>\n<li>Call an ambulance if you are not sure whether you need one.</li>\n<li>Call an ambulance if the patient requests it.</li>\n</ul>\n\n<p>Do not move the patient any more than necessary. Especially, <strong>if you suspect a spinal injury (broken vertebra), absolutely avoid moving the patient unless strictly necessary to save their life</strong>. If you are unsure, call 911 (North America), 112 (Europe) or the local equivalent; they will instruct you what to do.</p>\n\n<p>Secure the accident site if necessary, stay with the patient. Give first aid for any additional conditions (if any), comfort them, make sure they remain conscious, get a blanket to keep them warm if necessary, help them look after their belongings, direct the ambulance to the patient.</p>\n\n<p>It may be OK to take the patient to a hospital on your own if all of the following are true:</p>\n\n<ul>\n<li>The broken bone is just a limb and not under stress while sitting (arm, shoulder, collarbone, foot, possibly tibia or fibula)</li>\n<li>No other complications are present</li>\n<li>The patient can move without additional pain</li>\n<li>The patient agrees</li>\n</ul>\n\n<p>Get the patient to the nearest hospital (urgent care should be sufficient for cases that don’t require an ambulance) or suitable physician. If necessary, they will refer the patient to wherever adequate care can be given. Ski areas often have a specialized doctor in most villages, or even a sports clinic; the same may be true for other areas where outdoor sports are common.</p>\n\n<p>From my own experience, most with ski accidents:</p>\n\n<ul>\n<li>Once a skier asked me to help her up because she couldn’t get up on her own. That turned out to be a bad decision, as it turned a partial femur head fracture into a full one. Lesson learned: if the patient cannot or will not get up on their own, tell them to stay put and get help.</li>\n<li>Another time I came to a site where someone had a knee injured. Her husband had already attempted to splint her knee with her ski poles and attempted to get her up. Same mistake as above, we ended up getting help.</li>\n<li>Yet another time, someone fell on her wrist. She was still OK to ski carefully and I accompanied her to the doctor, who then determined a radius fractured near the wrist.</li>\n</ul>\n\n<p>I know of several skiers who skied downhill with leg or vertebra fractures which were not discovered until they got to the doctor’s. Certainly not recommended if you suspect that kind of injury.</p>\n\n<p><strong>Last but not least: if you feel you might need this kind of knowledge, consider taking a first aid course.</strong></p>\n" } ]

[ "https://health.stackexchange.com/questions/14306", "https://health.stackexchange.com", "https://health.stackexchange.com/users/9186/" ]

[ { "answer_id": 14308, "author": "D Bagnall", "author_id": 11940, "author_profile": "https://health.stackexchange.com/users/11940", "pm_score": 3, "selected": false, "text": "<p>So let's assume you're speaking of a large bone, like the arm (humerus, radius or ulna) or leg (femur, tibia or fibula), but not the skull, spine or pelvis.</p>\n\n<p>A good rule of thumb: the larger the bone, the more serious it is.</p>\n\n<p>A second rule: if the skin is broken (the bone is sticking out), it is serious.</p>\n\n<p>So, if you suspect a hand or foot fracture with no blood, you can take the person to an urgent care center or ER.</p>\n\n<p>If you suspect a leg or arm fracture, best to call EMTs.</p>\n\n<p>If you see blood, or the person is unconscious, call the EMTs.</p>\n" }, { "answer_id": 14311, "author": "Narusan", "author_id": 8212, "author_profile": "https://health.stackexchange.com/users/8212", "pm_score": 5, "selected": false, "text": "<h2>You as an untrained bystander can do little to nothing.</h2>\n\n<p>Professionally trained paramedics could (as an example) pull the leg and thus remove tension between two bone membranes (<em><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826636/\" rel=\"noreferrer\">periostei</a></em>) and in a best case scenario alleviate all pain. The bone itself has hardly any nerve endings, it is only the periosteum that causes pain. This only works in a few cases. Other options include administration of pain killers. </p>\n\n<p>A few “guidelines” what to do when:</p>\n\n<ol>\n<li>If the patient is in pain, call an ambulance.</li>\n<li>If the patient can not walk/stand up, call an ambulance.</li>\n<li>If the fracture is open (ruptured skin / blood), call an ambulance.</li>\n<li>If the patient was or still is unconscious, call an ambulance, check for vital functions (breathing, airways).</li>\n<li>If the patient wants an ambulance, call the ambulance.</li>\n</ol>\n\n<p>Bottom line: To be on the safe side, call an ambulance.</p>\n\n<hr>\n\n<h2>What <em>can</em> you do?</h2>\n\n<p>During my very first first-help training, my trainer said something that stuck with me: “We humans have two fundamental fears: To die, and to die alone”. While it is sometimes impossible to save someone’s life, we can always, always be with them and comfort them. \nSo, never leave a patient alone unless there is absolute need, and if so, communicate clearly that you will return very shortly and e.g. just need to grab an AED.</p>\n\n<p>Secondly, being in pain is not very enjoyable, and having a large crowd of bystanders assemble around the patient doesn’t make it a bit better. Try to give them the decency of privacy. If you have already called the ambulance, get a few people to spread out, watch out for the ambulance and guide them to the patient. Hush the other ones away or give them tasks like looking for AEDs in nearby public buildings.</p>\n\n<p>Thirdly, lying immobilised, the patient gets cold quite quickly. Make sure to keep them warm. Jackets, <s>a camp fire</s>, or a <a href=\"https://az768999.vo.msecnd.net/images/products/38/lampa66964_635848435088676854/lampa66964_large_0.jpg\" rel=\"noreferrer\">rescue blanket</a> are always a good idea, even on mild summer days. (Pro Tip: A rescue blanket makes it quite clear to the ambulance drivers where and who the patient is, and it also protects the patient from the watchful eyes of bystanders. Such blankets are usually a part of every first-aid set in public buildings).</p>\n\n<p>Lastly, as a patient you are very dependent on the people around you. Because patients are usually sitting and leaning against a wall or lying on the ground (to prevent meaningful damage if they should collapse), their field of vision is very limited. Pain also distracts, so they are not highly aware of their surroundings. \nThis is why one must explain every action one takes to them, especially if it includes coming very near or touching the patient.</p>\n\n<h2>TL;DR</h2>\n\n<p>Here’s what you could do (order and items on the list depend on every case, don’t take this as a standard rule). Reiterating from above, always tell the patient what you’re doing.</p>\n\n<ol>\n<li>Check vital functions</li>\n<li>Call ambulance</li>\n<li>Check vital functions again</li>\n<li>Direct someone to get a first-aid set from a nearby public building. </li>\n<li>Send a few people as “beacons” for an ambulance, have them look out for it and guide its way upon arrival at the scene.</li>\n<li>If there’s still a large crowd, send a few people looking for AEDs¹</li>\n<li>Ensure warmth of patient.</li>\n<li>Distract the patient until arrival of ambulance. </li>\n</ol>\n\n<hr>\n\n<p>¹: It’s not likely that you will need a defibrillator, and I wouldn’t send for one as a standard procedure. However, it is always easier to send people looking for <em>something</em> than just hushing them away.</p>\n" }, { "answer_id": 14322, "author": "See Jian Shin", "author_id": 11897, "author_profile": "https://health.stackexchange.com/users/11897", "pm_score": 2, "selected": false, "text": "<p>If you are untrained on this subject matter, the best practise is to do nothing about the fracture.* Even most certified first aiders are not trained to handle broken bones. </p>\n\n<p>*By nothing I don't literally mean nothing. I would assume that you have already called for ambulance. If he is in a dangerous location you can try to move him, but you will have move the area of the broken bone as little as possible. If he is unconscious and not breathing proceed to CPR, even if his rib cage is fractured. If he is in an awkward position you can try supporting him with things around you.(for example he could be lying on his side and supporting himself with his arms. Slide a bag for him to lie on.) If he is bleeding seriously carry out first aid. General idea is keep him alive until help arrives, other things can wait.</p>\n" }, { "answer_id": 14323, "author": "Dennis", "author_id": 11949, "author_profile": "https://health.stackexchange.com/users/11949", "pm_score": 1, "selected": false, "text": "<p>From personal experience I can definitely attest that a person with a broken arm can indeed (under reasonable circumstances) hobble to a car and be driven to the hospital (not sure which department, presumably first aid initially).</p>\n\n<p>In my case I was the child with the broken arm and my mom drove met to the hospital.</p>\n\n<p>This way (even with safe driving) I was in the hospital slightly faster then in any other scenario, and we did not put unnecessary pressure on the medical system.</p>\n\n<p>Note that I was not in significant pain, and no blood/bone was coming out (just an arm at an odd angle).</p>\n" }, { "answer_id": 14324, "author": "Graham", "author_id": 11952, "author_profile": "https://health.stackexchange.com/users/11952", "pm_score": 2, "selected": false, "text": "<p>If both legs are OK and there is no way they could have a spinal injury, you may well find it is quicker to get them to hospital in your car. Drive very slowly over bumps and around corners, do not accelerate fast and leave plenty of stopping distance for slow braking. This would be my preferred option for a minor injury to an arm, hand, shoulder or foot.</p>\n\n<p>In any other situation, call an ambulance and follow the phone operator's instructions to the letter. Do <strong><em>NOT</em></strong> try to be clever or show initiative about treating the casualty - you could easily make things worse! That said, be very clear about the situation and telling the operator exactly what happened and any change to the casualty's condition. For example, moving a casualty or removing a bike helmet could increase the damage from a spinal injury, so normally this is a job for the experts - but if the casualty has stopped breathing then the first priority is CPR, because they're guaranteed to die if you don't.</p>\n\n<p>TBH though, your questions suggest you're asking in the wrong place - not the wrong forum, but just generally by asking on the net. You won't learn anything useful here. Get yourself to a properly-run first aid course, learn what to do from people who actually know, and do some hands-on practise so that you can actually do it yourself.</p>\n" }, { "answer_id": 14326, "author": "user149408", "author_id": 11954, "author_profile": "https://health.stackexchange.com/users/11954", "pm_score": 2, "selected": false, "text": "<p><strong>It all depends on the bone that is (or might be) broken, and on the overall condition of the patient.</strong></p>\n\n<ul>\n<li>Call an ambulance for a fractured skull, vertebra or hip.</li>\n<li>Call an ambulance for open fractures (bone piercing through the skin).</li>\n<li>Call an ambulance if the patient is/has been unconscious or under shock.</li>\n<li>Call an ambulance if you are not sure whether you need one.</li>\n<li>Call an ambulance if the patient requests it.</li>\n</ul>\n\n<p>Do not move the patient any more than necessary. Especially, <strong>if you suspect a spinal injury (broken vertebra), absolutely avoid moving the patient unless strictly necessary to save their life</strong>. If you are unsure, call 911 (North America), 112 (Europe) or the local equivalent; they will instruct you what to do.</p>\n\n<p>Secure the accident site if necessary, stay with the patient. Give first aid for any additional conditions (if any), comfort them, make sure they remain conscious, get a blanket to keep them warm if necessary, help them look after their belongings, direct the ambulance to the patient.</p>\n\n<p>It may be OK to take the patient to a hospital on your own if all of the following are true:</p>\n\n<ul>\n<li>The broken bone is just a limb and not under stress while sitting (arm, shoulder, collarbone, foot, possibly tibia or fibula)</li>\n<li>No other complications are present</li>\n<li>The patient can move without additional pain</li>\n<li>The patient agrees</li>\n</ul>\n\n<p>Get the patient to the nearest hospital (urgent care should be sufficient for cases that don’t require an ambulance) or suitable physician. If necessary, they will refer the patient to wherever adequate care can be given. Ski areas often have a specialized doctor in most villages, or even a sports clinic; the same may be true for other areas where outdoor sports are common.</p>\n\n<p>From my own experience, most with ski accidents:</p>\n\n<ul>\n<li>Once a skier asked me to help her up because she couldn’t get up on her own. That turned out to be a bad decision, as it turned a partial femur head fracture into a full one. Lesson learned: if the patient cannot or will not get up on their own, tell them to stay put and get help.</li>\n<li>Another time I came to a site where someone had a knee injured. Her husband had already attempted to splint her knee with her ski poles and attempted to get her up. Same mistake as above, we ended up getting help.</li>\n<li>Yet another time, someone fell on her wrist. She was still OK to ski carefully and I accompanied her to the doctor, who then determined a radius fractured near the wrist.</li>\n</ul>\n\n<p>I know of several skiers who skied downhill with leg or vertebra fractures which were not discovered until they got to the doctor’s. Certainly not recommended if you suspect that kind of injury.</p>\n\n<p><strong>Last but not least: if you feel you might need this kind of knowledge, consider taking a first aid course.</strong></p>\n" } ]

[ "https://health.stackexchange.com/questions/14328", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11955/" ]

[ { "answer_id": 14353, "author": "BillDOe", "author_id": 2833, "author_profile": "https://health.stackexchange.com/users/2833", "pm_score": 3, "selected": true, "text": "<p>It's been my understanding that a buildup of lactic acid (aka lactate) eventually causes the muscles to stop being able to process glucose. <a href=\"https://www.scientificamerican.com/article/why-does-lactic-acid-buil/\" rel=\"nofollow noreferrer\">This article</a> from Scientific American describes the processes the muscles use to convert to an anaerobic process as muscle performance outpaces oxygen supplies. The pertinent passage:<br><blockquote>A side effect of high lactate levels is an increase in the acidity of the muscle cells, along with disruptions of other metabolites. The same metabolic pathways that permit the breakdown of glucose to energy perform poorly in this acidic environment.</blockquote></p>\n" }, { "answer_id": 14366, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 3, "selected": false, "text": "<p>If the runner can't drink then dehydration will be the first thing that takes him out. Water is the one essential thing he's going to lose rapidly through sweat, urine and respiration, and as he loses it he's going to lose electrolytes along with it. </p>\n\n<p>The end result will be disabling muscle cramps, weakness, and exhaustion. If he somehow continues on despite these things, cardiac arrhythmias may follow due to electrolyte imbalances.</p>\n\n<p><a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1318513/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1318513/</a></p>\n" }, { "answer_id": 20775, "author": "wisdom_seeker", "author_id": 17314, "author_profile": "https://health.stackexchange.com/users/17314", "pm_score": -1, "selected": false, "text": "<p>Here's an unglamorous answer to the top level question. </p>\n\n<p>I have asthma, and even when I'm very motivated (hourly bus nearing a bus stop, FedEx truck about to do last pick-up), in cold weather I literally run out of breath. It may take me a few blocks, depending on how cold, or if my lungs are already irritated (say an infection), but the bronchi squeeze tighter. It is a sharp diffuse pain, and I just can't breathe in enough to continue. </p>\n\n<p>Your hero doesn't have asthma and is well-conditioned, but if they have to run beyond their cardiovascular limit, I assume something like that would still happen. And of course there's running out of water and electrolytes (since hard breathing, sweat makes you lose both, even when you're well-conditioned) and both are necessary for cellular function. </p>\n" } ]

[ "https://health.stackexchange.com/questions/14352", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11013/" ]

[ { "answer_id": 14356, "author": "Don_S", "author_id": 7166, "author_profile": "https://health.stackexchange.com/users/7166", "pm_score": 6, "selected": true, "text": "<p>Drug molecules, even when stored safely inside a tablet\\capsule, inside a closed container, upon a high shelf (hopefully), are still exposed to the environment, and are thus exposed to all of the chemical processes and reactions that go about all around us (to name just a few - oxidation, hydrolysis, isomerization, polymerization, and more). Depending on the type of drug molecule and its functional groups, the molecule may undergo all kinds of chemical processes that may change its structure and\\or properties.</p>\n\n<p>Therefore, drugs (and foodstuffs, as mentioned in the comment above) degrade and decompose over time, and are thus given an expiration date to indicate that after a certain amount of time, the drug's manufacturer strongly recommends to avoid using the product.</p>\n\n<p>An important remark should follow: the expiration date refers to <strong>the entire pharmaceutical product</strong>, i.e. the formulation, and not just the active ingredient. It is absolutely possible that the active ingredient will remain stable for a long time, but some inactive ingredient (excipient) in the tablet\\capsule\\syrup will have undergone some decomposition that may render the product ineffective, or even worse, toxic.</p>\n\n<p>A quick Google search for \"drug decomposition\" or \"drug degradation\" yields many useful results for further reading. To name just a few:</p>\n\n<p><a href=\"http://www.pharmaceutical-journal.com/learning/learning-article/understanding-the-chemical-basis-of-drug-stability-and-degradation/11029512.article\" rel=\"noreferrer\">Understanding the chemical basis of drug stability and degradation</a></p>\n\n<p><a href=\"https://www.slideshare.net/ms_optimisstic/drug-degradation\" rel=\"noreferrer\">Drug degradation</a> (Slideshare presentation)</p>\n\n<p><a href=\"https://www.slideshare.net/saharishkhaliq/pharmaceutical-degradation\" rel=\"noreferrer\">Pharmaceutical degradation</a> (Slideshare presentation)</p>\n\n<p>And here's a non-scientific article addressing the issue from another angle: <a href=\"https://www.npr.org/sections/health-shots/2017/07/18/537257884/that-drug-expiration-date-may-be-more-myth-than-fact\" rel=\"noreferrer\">That Drug Expiration Date May Be More Myth Than Fact</a> (might be an interesting read for you as well)</p>\n" }, { "answer_id": 14364, "author": "H. Idden", "author_id": 11994, "author_profile": "https://health.stackexchange.com/users/11994", "pm_score": 3, "selected": false, "text": "<p>Beside <a href=\"https://health.stackexchange.com/a/14356/11994\">Don_S's</a> very detailed answer I want to point out a few other things:\nAt least in my country, drugs are not only synthetic chemical drugs. Drugs can also be biological or contain other non synthetic chemical substances.\nExamples are:</p>\n\n<ul>\n<li><a href=\"https://en.wikipedia.org/wiki/Filipendula_ulmaria#Herbal_and_pharmacological\" rel=\"nofollow noreferrer\">Early versions of what is now known as \"Aspirin\" was gained from the plant Meadowsweet.</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Smallpox_vaccine\" rel=\"nofollow noreferrer\">Some preventive antivirus drugs contain weak forms of the real virus</a></li>\n<li><a href=\"https://en.wikipedia.org/wiki/Emulsion#Health_care\" rel=\"nofollow noreferrer\">Some of the drugs are or contain a mixture of oils and fats.</a> <a href=\"https://en.wikipedia.org/wiki/Emulsion#Instability\" rel=\"nofollow noreferrer\">They can go bad the same as for example butter after some time.</a> Some of them have such a short life time that they are directly produced on demand in the drug store and will expire after few days or weeks.</li>\n</ul>\n\n<p>It is hard to produce under such steril conditions and packaging that it is ensured that it will not get polluted for decades.</p>\n\n<p>Another reason might be that the storage life was tested/is known for a limited amount of time and cannot be guaranteed for a longer timespan.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14355", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11558/" ]

[ { "answer_id": 14432, "author": "Shadow Wizard Chasing Stars", "author_id": 45, "author_profile": "https://health.stackexchange.com/users/45", "pm_score": 3, "selected": false, "text": "<p>Yes, anal sex is the most risky method of sex with the highest possible chances for HIV infection.</p>\n\n<p>This is clearly said in the official <a href=\"https://www.cdc.gov/hiv/risk/analsex.html\" rel=\"noreferrer\">Centers for Disease Control and Prevention website</a>:</p>\n\n<blockquote>\n <p>Anal sex is the riskiest sexual behavior for getting and transmitting HIV for men and women.</p>\n</blockquote>\n\n<p>As for the reason, it's neither the penis nor the anus directly. They separate the reasoning for the receptive partner (<em>bottom</em>) and insertive partner (<em>top</em>):</p>\n\n<ul>\n<li><blockquote>\n <p>The bottom’s risk of getting HIV is very high because the lining of the rectum is thin and may allow HIV to enter the body during anal sex.</p>\n</blockquote></li>\n<li><blockquote>\n <p>HIV may enter the top partner’s body through the opening at the tip of the penis (or urethra) or through small cuts, scratches, or open sores on the penis.</p>\n</blockquote></li>\n</ul>\n\n<p>Do note, that article and all above quotes refer to anal sex when the receptive partner can be either male or female. (As it's common belief that gay anal sex is more risky, which is not true.)</p>\n" }, { "answer_id": 15554, "author": "Watercleave", "author_id": 13137, "author_profile": "https://health.stackexchange.com/users/13137", "pm_score": 2, "selected": false, "text": "<p><strong>Major Edit:</strong> Corrected extremely incorrect stats</p>\n\n<p>The vagina, being \"designed\" (evolutionary speaking) for intercourse, has a lining which is reasonably good at fending off pathogens, particularly viruses like HIV. If there are no breaks in this lining (such as from rough sex), the risk of contracting HIV from a single sexual encounter with someone with a high viral load (ie. Lots of virus in their blood, and thus lots to pass on in their other bodily fluids) isn't as high as one might expect. That clearly isn't low enough to condone risky behaviour, but it's enough to affect the spread of the disease, especially because, like many STDs, HIV is more often spread through one-time sexual encounters (mainly casual sex and prostitution) than within a committed relationship.</p>\n\n<p>In contrast, the rectum (the anus is just the opening; the rectum is the actual part of the gut inside) is not \"designed\" for intercourse, and has very poor defenses against pathogens. The risk of the receptive partner in anal sex contracting HIV from a penetrating partner with a high viral load is an order of magnitude higher than from vaginally intercourse</p>\n\n<p>Finally, because of the lack of natural lubrication in the rectum and anal orifice, anal sex is much more likely to result in (minor) damage to the penetrating partner's penis, which increases the risk of the penetrating partner contracting HIV.</p>\n\n<p>In short:</p>\n\n<ul>\n<li><p>The rectum <strong>does not contain substantially more HIV particles than the vagina</strong>; but</p></li>\n<li><p>The rectum is <strong>more vulnerable to infection</strong> by the HI virus, and</p></li>\n<li><p>Anal sex is more likely to be \"rough\" on the penetrating partner's penis, making the penis <strong>more vulnerable to infection by the virus</strong> as well.</p></li>\n</ul>\n\n<p>Thus, anal sex (regardless of the sex/gender of the participants) has a <strong>much higher risk of HIV transmission to the receptive partner</strong>, and a less elevated but still <strong>increased risk of transmission to the penetrating partner</strong>.</p>\n\n<p>This may be part of the reason that HIV was once much more common in the homosexual population. The main reason, though, is that homosexuals and heterosexuals (by definition) don't often have sexual contact with each other, and bisexuality was quite rare in the era when HIV first emerged.</p>\n\n<p>Most likely, a gay man happened to contract the virus relatively early in its spread (ie. Before it was widespread), purely by chance, and it just took a while for it to \"cross the gap\" into the heterosexual population. </p>\n\n<p><strong>Source:</strong></p>\n\n<p>Patel, P., Borkowf, C., Brooks, J., Lasry, A., Lansky, A. and Mermin, J. (2014). Estimating per-act HIV transmission risk. AIDS, 28(10), pp.1509-1519.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14421", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 14432, "author": "Shadow Wizard Chasing Stars", "author_id": 45, "author_profile": "https://health.stackexchange.com/users/45", "pm_score": 3, "selected": false, "text": "<p>Yes, anal sex is the most risky method of sex with the highest possible chances for HIV infection.</p>\n\n<p>This is clearly said in the official <a href=\"https://www.cdc.gov/hiv/risk/analsex.html\" rel=\"noreferrer\">Centers for Disease Control and Prevention website</a>:</p>\n\n<blockquote>\n <p>Anal sex is the riskiest sexual behavior for getting and transmitting HIV for men and women.</p>\n</blockquote>\n\n<p>As for the reason, it's neither the penis nor the anus directly. They separate the reasoning for the receptive partner (<em>bottom</em>) and insertive partner (<em>top</em>):</p>\n\n<ul>\n<li><blockquote>\n <p>The bottom’s risk of getting HIV is very high because the lining of the rectum is thin and may allow HIV to enter the body during anal sex.</p>\n</blockquote></li>\n<li><blockquote>\n <p>HIV may enter the top partner’s body through the opening at the tip of the penis (or urethra) or through small cuts, scratches, or open sores on the penis.</p>\n</blockquote></li>\n</ul>\n\n<p>Do note, that article and all above quotes refer to anal sex when the receptive partner can be either male or female. (As it's common belief that gay anal sex is more risky, which is not true.)</p>\n" }, { "answer_id": 15554, "author": "Watercleave", "author_id": 13137, "author_profile": "https://health.stackexchange.com/users/13137", "pm_score": 2, "selected": false, "text": "<p><strong>Major Edit:</strong> Corrected extremely incorrect stats</p>\n\n<p>The vagina, being \"designed\" (evolutionary speaking) for intercourse, has a lining which is reasonably good at fending off pathogens, particularly viruses like HIV. If there are no breaks in this lining (such as from rough sex), the risk of contracting HIV from a single sexual encounter with someone with a high viral load (ie. Lots of virus in their blood, and thus lots to pass on in their other bodily fluids) isn't as high as one might expect. That clearly isn't low enough to condone risky behaviour, but it's enough to affect the spread of the disease, especially because, like many STDs, HIV is more often spread through one-time sexual encounters (mainly casual sex and prostitution) than within a committed relationship.</p>\n\n<p>In contrast, the rectum (the anus is just the opening; the rectum is the actual part of the gut inside) is not \"designed\" for intercourse, and has very poor defenses against pathogens. The risk of the receptive partner in anal sex contracting HIV from a penetrating partner with a high viral load is an order of magnitude higher than from vaginally intercourse</p>\n\n<p>Finally, because of the lack of natural lubrication in the rectum and anal orifice, anal sex is much more likely to result in (minor) damage to the penetrating partner's penis, which increases the risk of the penetrating partner contracting HIV.</p>\n\n<p>In short:</p>\n\n<ul>\n<li><p>The rectum <strong>does not contain substantially more HIV particles than the vagina</strong>; but</p></li>\n<li><p>The rectum is <strong>more vulnerable to infection</strong> by the HI virus, and</p></li>\n<li><p>Anal sex is more likely to be \"rough\" on the penetrating partner's penis, making the penis <strong>more vulnerable to infection by the virus</strong> as well.</p></li>\n</ul>\n\n<p>Thus, anal sex (regardless of the sex/gender of the participants) has a <strong>much higher risk of HIV transmission to the receptive partner</strong>, and a less elevated but still <strong>increased risk of transmission to the penetrating partner</strong>.</p>\n\n<p>This may be part of the reason that HIV was once much more common in the homosexual population. The main reason, though, is that homosexuals and heterosexuals (by definition) don't often have sexual contact with each other, and bisexuality was quite rare in the era when HIV first emerged.</p>\n\n<p>Most likely, a gay man happened to contract the virus relatively early in its spread (ie. Before it was widespread), purely by chance, and it just took a while for it to \"cross the gap\" into the heterosexual population. </p>\n\n<p><strong>Source:</strong></p>\n\n<p>Patel, P., Borkowf, C., Brooks, J., Lasry, A., Lansky, A. and Mermin, J. (2014). Estimating per-act HIV transmission risk. AIDS, 28(10), pp.1509-1519.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14450", "https://health.stackexchange.com", "https://health.stackexchange.com/users/-1/" ]

[ { "answer_id": 14517, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>No. As asked \"<a href=\"https://en.wikipedia.org/wiki/Toothpaste\" rel=\"nofollow noreferrer\">modern toothpaste</a>\" is very good for you. \"Good\" defined here as: Modern toothpaste is designed to help you keep a happy smile into old age with your natural teeth. It should help to keep your teeth, and everything in your mouth, really, clean, fresh and healthy.</p>\n\n<p>This is the short answer. And that is a bit too simplistic, alas. The longer answer is slightly more complicated and has the following foreword:<br>\nA product that is approved by a nation-wide body of control might indeed be good for most people or at least contain ingredients considered safe or not known to cause general harm. But there are indeed some general bad apples out there on the market. </p>\n\n<p>This is a statement for the general populace and individual results may differ because of allergies, over-reactions or even counter indications on the medical side, taste and preference on the personal side. The nice thing about that is that you still have a <a href=\"https://www.prevention.com/health/health-concerns/the-best-toothpaste-for-your-teeth\" rel=\"nofollow noreferrer\">choice</a> between <a href=\"https://www.test.de/Zahnpasta-im-Test-4607097-tabelle/alleZahnpasten/\" rel=\"nofollow noreferrer\">many products</a> on the <a href=\"https://www.reviews.com/toothpaste/\" rel=\"nofollow noreferrer\">market</a>. </p>\n\n<p>Both 'natural' and lets call them 'industrial' toothpastes come in a staggering variety. Both may contain questionable substances and they all vary on effectiveness. </p>\n\n<p>\"All around the WWW\": it is usually a bad idea to listen to or read what every quack out there has to say about his or her ideas of toxicity. The author of this answer may be a passionate quack! So think for yourself and educate yourself.</p>\n\n<p>The 'right' amount of fluoride will kill you, the right amount of 'natural' substances will kill you also. The <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11359053\" rel=\"nofollow noreferrer\">right amount of fluoride</a> (without scare quotes: the optimal amount of fluoride, coincidently most of the time the amount in toothpastes) <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/16451540\" rel=\"nofollow noreferrer\">will strengthen your teeth</a> and lessen the incidence of tooth decay. Avoiding it completely is a personal choice – and may very well be <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21248357\" rel=\"nofollow noreferrer\">not the best choice</a>.</p>\n\n<p><strong>Your wants:</strong> Things likely to look for in a toothpaste:</p>\n\n<ul>\n<li>fluoride (strengthens teeth, comes in different forms with different profiles, e.g. amin-fluoride, <a href=\"https://www.ewg.org/skindeep/ingredient/724117/STANNOUS_FLUORIDE/\" rel=\"nofollow noreferrer\">stannous fluoride</a>)<br>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29085574\" rel=\"nofollow noreferrer\">The beneficial effects of fluoride on human oral health are well studied. There are numerous studies demonstrating that a small amount of fluoride delivered to the oral cavity decreases the prevalence of dental decay and results in stronger teeth and bones. However, ingestion of fluoride more than the recommended limit leads to toxicity and adverse effects.</a><br>\n _{<strong>Conclusion:</strong>\n The beneficial role of fluoride for the maintenance of good oral health has been known for many decades and strongly evidenced by scientific research. However, it must be emphasized that tooth decay (dental caries) is not caused by fluoride deficiency and fluoride supplementation will never reverse the active or gross carious lesions. Since the level of safety of fluoride is low, products that contain a high level of fluoride should be stored and used according to the recommend-dation and should be monitored by a qualified dental professional especially in children and pregnant women. In children, the swallowing reflex is not very well developed and the fluoride containing dental products are flavored hence increasing the possibility of a child to consume an excessive dose of fluoride. In areas with high fluoride levels in the drinking water, alternative dental products with low fluoride levels should be prescribed and monitored.}</p>\n</blockquote></li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/707061/ZINC_CHLORIDE/\" rel=\"nofollow noreferrer\">zinc chloride</a> (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21762153\" rel=\"nofollow noreferrer\">controls bacterial growth</a>, although: not suitable for children)</li>\n<li>other minerals (e.g. containing calcium, strontium)</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/707002/XYLITOL/\" rel=\"nofollow noreferrer\">xylitol</a> (controls bacterial growth)</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/705994/SODIUM_BICARBONATE/\" rel=\"nofollow noreferrer\">baking soda</a> (helps with lifting plaque)</li>\n<li>plant extracts (mainly, but not just, for flavour: mint, myrrh, anise, salvia, fennel, chamomile, eucalyptus; really a long list…)</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/703046/HYDROXYAPATITE/\" rel=\"nofollow noreferrer\">hydroxyl-apaptite</a> (\"artifical enamel\")</li>\n<li>some enzymes </li>\n</ul>\n\n<p><strong>Your maybes:</strong> Things likely to be included and probably not of concern either way or in a grey zone:</p>\n\n<ul>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/702620/GLYCERIN/\" rel=\"nofollow noreferrer\">glycerin</a> and alcohol</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/717690/CHLORHEXIDINE/\" rel=\"nofollow noreferrer\">chlorhexidine</a> (while great against bacteria and preventing plaque: may stain teeth, causes other problems in your mouth, severly alters taste perception)</li>\n</ul>\n\n<p><strong>Your Unwanted:</strong> Things very likely to avoid:</p>\n\n<ul>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/706110/SODIUM_LAURYL_SULFATE/\" rel=\"nofollow noreferrer\">sodium lauryl sulfate</a> (\"SLS\", <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/2696932\" rel=\"nofollow noreferrer\">foaming</a> irritant) <br>_{(Please excuse the personal advice and anecdotal experience report by the authors of this answer: <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/7825393\" rel=\"nofollow noreferrer\">Does it cause ulcers?</a> – It does for sure!)}</li>\n<li>abrasive materials (use the <a href=\"https://en.wikipedia.org/w/index.php?title=Relative_dentin_abrasivity\" rel=\"nofollow noreferrer\">RDA</a> value of a product as guideline: >100 is too much, aim for &lt;60)</li>\n<li>acids and other sugars or sweeteners than xylitol or stevia (sorbitol, aspartame etc.) _{Note that this doesn't say aspartame e.g. is dangerous, just that there are better options.}</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/706623/TRICLOSAN/\" rel=\"nofollow noreferrer\">triclosan</a> (very <a href=\"https://www.nytimes.com/2016/09/07/well/live/why-your-toothpaste-has-triclosan.html\" rel=\"nofollow noreferrer\">questionable ingredient</a> all around if not strictly prescribed, <em>does help</em> against plaque and gingivitis, but causes a whole lot of problems)</li>\n<li>plastic micro beads (mostly because of the environment, less harmful immediately to the consumer)</li>\n<li>parabenes: steeply raising <a href=\"https://health.howstuffworks.com/skin-care/beauty/skin-and-lifestyle/parabens.htm\" rel=\"nofollow noreferrer\">concerns</a> over their effect as xeno-estrogens, although <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24733628\" rel=\"nofollow noreferrer\">in toothpaste their contribution to unwanted effects seems minimal</a>. </li>\n<li>strange artificial colours (first: because they are completely unnecessary except to make you buy the stuff, second: most beneficial ingredients have their own colour – and if not, what's wrong with white?)</li>\n</ul>\n\n<p>That list is not exhaustive. Questinable materials often found in so-called 'natural toothpaste' <em>is not covered. (and there are lots!)</em> The list above plant extracts above shows: even industrial toothpastes make use of natural components. But those ingredients may include things like green tea extract (generally well tolerated) or tea-tree oil (often not well tolerated and possible allergen). These should be checked especially thoroughly, for allergies, side effects etc. Potential hazards for any ingredient have to be weighed for their beneficial effects and especially the intended use and application considered: do not swallow the pastes! Even the xylitol listed as very beneficial and of very low concern will cause upset stomach and diarrhea when ingested in sufficient quantity.</p>\n\n<p>In general: Look for a toothpaste that meets these criteria, <em>and</em> your tastes and preferences. Try them out. If you tolerate the ingredients: Then go to your dentist and ask him about his opinion about your preferred choice(s).</p>\n\n<hr>\n\n<p>Things listed here <em>and</em> things not listed here but contained in a toothpaste may require you to <a href=\"https://health.stackexchange.com/q/13712/11231\">check yourself</a>:</p>\n\n<ul>\n<li>but don't just google it, and stop there on the first hit, go for <a href=\"https://health.meta.stackexchange.com/q/783/11231\">quality references</a></li>\n<li>check it on wikipedia </li>\n<li>check it on a consumer rights webpage (example <a href=\"https://ec.europa.eu/health/home_en\" rel=\"nofollow noreferrer\">HealthEU</a>)</li>\n<li>check it on drugs.com</li>\n<li>check it on pubchem</li>\n<li>check it on the <a href=\"https://www.ewg.org/skindeep/\" rel=\"nofollow noreferrer\">skindeep database</a></li>\n</ul>\n" }, { "answer_id": 14534, "author": "HerbalResearcher", "author_id": 7983, "author_profile": "https://health.stackexchange.com/users/7983", "pm_score": -1, "selected": false, "text": "<p>Hi I'll try to cover most topics in the subject and link sources efficiently and straight to the points. Including detox studies.</p>\n\n<p>Modern toothpaste is madness for alot of reasons and the main one is that they keep using fluoride(not even it's natural form by the way,which is calcium fluoride and you very well could do without it)</p>\n\n<p>(Main sources from the points below,unless I mentioned a different source comes from this website,which is a database of more than 500 studies about fluoride various health effects(organised by different health issues). <a href=\"http://fluoridealert.org/issues/health/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/issues/health/</a>\n------Check out brain effect , acute toxicity(dosage) ,etc);</p>\n\n<ul>\n<li>1 It's a proved toxic substance and neurotoxin ,and is in several foods,beverages,and in alot of places in the United States it's in water.\n---High fluoride residues in several foods containing pesticides residues,most quantity is in wheat and oats,corn, and meat fed from those same substances.\nSources and content; \nGeneral idea of fluoride content in foods; from studies of content/residues analysis(pesticide link page is broken)\nFluoride in food 1996 – 2013 Part 1;  <a href=\"http://poisonfluoride.com/pfpc/html/f-_in_food.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/f-_in_food.html</a><br>\n---Part 2 <a href=\"http://poisonfluoride.com/pfpc/html/f-_in_food__pt__2.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/f-_in_food__pt__2.html</a>\n---Fluoride in a few processed drinks such as coca cola <a href=\"http://fluoridealert.org/content/processed-drinks/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/content/processed-drinks/</a>\n---Fluoride in drugs <a href=\"http://poisonfluoride.com/pfpc/html/index_drugs.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/index_drugs.html</a>\n---One analysis of a particular himalayan salt brand <a href=\"http://poisonfluoride.com/pfpc/html/analysis.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/analysis.html</a>`</li>\n</ul>\n\n<p>EPA itself (but 2004,so it probably is reduced and some subtances banned,still looking for most recent) <a href=\"http://www.fluoridealert.org/wp-content/pesticides/f.source.food.inerts.htm\" rel=\"nofollow noreferrer\">http://www.fluoridealert.org/wp-content/pesticides/f.source.food.inerts.htm</a></p>\n\n<p>Vitamin D and aluminum absorption. And interraction of phosphate or phosphorique acid,iron ,zinc, and aluminium with fluoride.\n <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1336426/pdf/cmaj00262-0018c.pdf\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1336426/pdf/cmaj00262-0018c.pdf</a></p>\n\n<ul>\n<li>2 All the harmfull effects far outweigth any benefits, which are\nactually very small and most often not very different that from\npeople that don't use fluoride. Also no true meaningfull statistical correlationof cavities prevention or reduction from fluorated area compared to those that aren't. Cavities are caused by health and nutrition habits,enamel health,sugars and bacterias causing acidification and decay, poor dental hygiene substance choices, acids. If you take fluoride or not has little to no effect,except clogging the faulty area.\nstatistical value in whole cities or country are almost the same % . </li>\n</ul>\n\n<p>3 Substances are absorbed through skin and sublingual, but how fluoride % or quantity I did not find enough studies yet. Still compiling studies about how much in ingested from mouth/enamel</p>\n\n<p>3.1 But this study,although in my opinion not the best(since it has a few flaws in it's clarity),is still good to prove the point even more since it has enamel absorption as well as sublingual, because sublingual is alredy proven to increase absorption of many drugs/substances . I will find more,but this one is interresting because in the application theres no open enamel/cavity area. <a href=\"http://iopscience.iop.org/article/10.1088/1742-6596/884/1/012054/pdf\" rel=\"nofollow noreferrer\">http://iopscience.iop.org/article/10.1088/1742-6596/884/1/012054/pdf</a></p>\n\n<p>\" SDF that is applied in the buccal or sublingual mucosa will be rapidly\nabsorbed into the reticulated vein located beneath the oral mucosa and then carried through the\ninternal jugular and braciocephalic veins until it flows into the systemic circulation and is excreted\nthrough the urine [15]\"</p>\n\n<ul>\n<li><p>4 Is supposed to be used topically to be \"effective\", but they still add it in water,weird huh(several MCG/L by the way ,sometimes even MG/L). - 4 In their own words it's supposed to be used topically to be \"effective\", but they still add it in water claiming it's beneficial for teeths,weird huh(several mcg or mg/l by the way). Source; <a href=\"http://fluoridealert.org/articles/50-reasons/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/articles/50-reasons/</a> and alot more studies in there.</p>\n\n<ul>\n<li><p>4.1 Even dentist agree that acids destroy enamel and causes increase risk\nof cavity,yet tap water(and some toothpaste) contain alot of acidic\ncomponents, including(depending on area) alot of places in the United States and some parts in Canada; they are Fluorosilicic Acid/Hydrofluorosilicic Acid/silicofluoride/silicofluoric acid.\nThat seems very counter producting doesnt it and it also leaches city pipes either plastic or metal.\nThe other form added to both sources is Sodium Fluoride.</p></li>\n<li><p>4.2 Then one might say it's for bone health, again benefits outweigth the\nrisk and there is much more healthy substances for bone\nhealth/strength than ingesting such a strong poison(not mentioning\nother heavy metals and other toxins in tap water treated by water\nfactories. One should never drink that, or at minimum have it\nfiltered with 0.0001 micron absolute reverse osmosis,ideally which\nhas a activated carbon filter(block) lower than 5 or 1 micron. Also plastic\nwater bottles leach different bisphenols and phtalates,it's best to use ceramic or glass(and keep it cold in a cooler with bigger frozen bottles).</p></li>\n<li><p>5 It is definetely not a essential nutrient. <a href=\"http://fluoridealert.org/studies/essential-nutrient/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/studies/essential-nutrient/</a></p></li>\n<li><p>6 It's (sometime) efficacity comes from clogging enamel/cavities/or sensitive nerve,but is more absorbed in the cases of open pathway causing toxicity. Cavities are healable naturally with good health habits(avoiding eroding) and bioactive supplementation and/or foods that will repair the tooth,combined with substances that inhibit cavity causing bacterias.<br>\n6.1 And will over time cause fluorosis from teeth or bone exposure ,it's among one of the least harmfull effect.</p></li>\n</ul></li>\n</ul>\n\n<p>-7 Other substances increase absorption of toxins from the skin/buccal.\n <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283952/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283952/</a>\n\"It has been reported that anionic surfactants like sodium lauryl sulfate can penetrate and interact with the skin, producing large alterations in the barrier properties.[30] An additional mechanism for the penetration enhancement by SLS involves the hydrophobic interaction of the SLS alkyl chain with the skin structure which leaves the end sulfate group of the surfactant exposed, creating additional sites in the membrane. This results in the development of repulsive forces that separate the protein matrix, uncoil the filaments, and expose more water binding sites, hence increasing the hydration level of skin.[12] \"</p>\n\n<p>7.1 From same study ; \"Anionic materials tend to permeate relatively poorly through stratum corneum upon short-time exposure but permeation increases with application time.[2] The alkyl sulfates can penetrate and destroy the integrity of the stratum corneum within hours of application.[18] \"</p>\n\n<p>7.2 --- So the long term repeated exposure in that sens ,and shampoo/soaps ,are worse,but oral absorption is very effective as well.\n--- Will find more studies, but it's very convincing.</p>\n\n<p>8 -And there is so much more available studies to be looked at , so anyone saying fluoride should be used and telling others to take it and that theres no risk,are either very uninformed,biased and naive,to stay polite. Even if all forms of buccal absorption can(depending on fluoride content quantity) be small in one day(although small is relative to what dentist and \"health agencies\" call small ), on the medium,and especially on the long term it's not small at all,especially considering the acute toxicity dose of fluoride, and the fact that from skin/buccal absorption,alot of it goes straight through the blood or the brain.</p>\n\n<p>9 *** Heres 2 studies about fluoride detox that show Tamarind Indicus food but mostly extract of seeds and pulp big potential for detox,including bones fluoride removal(second study).\n9.1 Resumed study <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11840184\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/11840184</a> \nFull study <a href=\"https://www.nature.com/articles/1601287\" rel=\"nofollow noreferrer\">https://www.nature.com/articles/1601287</a> </p>\n\n<p>9.2 Full study dogs and fluoride <a href=\"http://societyforfluorideresearch.org/wp-content/uploads/2016/07/Dog-and-fluorosis.pdf\" rel=\"nofollow noreferrer\">http://societyforfluorideresearch.org/wp-content/uploads/2016/07/Dog-and-fluorosis.pdf</a></p>\n\n<p>9.3 The studies contradict themself in some nutrients absorption, but it can show fluoride interraction with those nutrients,especially magnesium. And can be due to various nutritional aspects of the test subjects, such as food and tap water anti-nutrients.</p>\n\n<p>There is other substances that help in detox(more than just fluoride) but I don't have all the references, so I can't name them just yet,but they fairly easy to find.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14472", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12025/" ]

[ { "answer_id": 14517, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>No. As asked \"<a href=\"https://en.wikipedia.org/wiki/Toothpaste\" rel=\"nofollow noreferrer\">modern toothpaste</a>\" is very good for you. \"Good\" defined here as: Modern toothpaste is designed to help you keep a happy smile into old age with your natural teeth. It should help to keep your teeth, and everything in your mouth, really, clean, fresh and healthy.</p>\n\n<p>This is the short answer. And that is a bit too simplistic, alas. The longer answer is slightly more complicated and has the following foreword:<br>\nA product that is approved by a nation-wide body of control might indeed be good for most people or at least contain ingredients considered safe or not known to cause general harm. But there are indeed some general bad apples out there on the market. </p>\n\n<p>This is a statement for the general populace and individual results may differ because of allergies, over-reactions or even counter indications on the medical side, taste and preference on the personal side. The nice thing about that is that you still have a <a href=\"https://www.prevention.com/health/health-concerns/the-best-toothpaste-for-your-teeth\" rel=\"nofollow noreferrer\">choice</a> between <a href=\"https://www.test.de/Zahnpasta-im-Test-4607097-tabelle/alleZahnpasten/\" rel=\"nofollow noreferrer\">many products</a> on the <a href=\"https://www.reviews.com/toothpaste/\" rel=\"nofollow noreferrer\">market</a>. </p>\n\n<p>Both 'natural' and lets call them 'industrial' toothpastes come in a staggering variety. Both may contain questionable substances and they all vary on effectiveness. </p>\n\n<p>\"All around the WWW\": it is usually a bad idea to listen to or read what every quack out there has to say about his or her ideas of toxicity. The author of this answer may be a passionate quack! So think for yourself and educate yourself.</p>\n\n<p>The 'right' amount of fluoride will kill you, the right amount of 'natural' substances will kill you also. The <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11359053\" rel=\"nofollow noreferrer\">right amount of fluoride</a> (without scare quotes: the optimal amount of fluoride, coincidently most of the time the amount in toothpastes) <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/16451540\" rel=\"nofollow noreferrer\">will strengthen your teeth</a> and lessen the incidence of tooth decay. Avoiding it completely is a personal choice – and may very well be <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21248357\" rel=\"nofollow noreferrer\">not the best choice</a>.</p>\n\n<p><strong>Your wants:</strong> Things likely to look for in a toothpaste:</p>\n\n<ul>\n<li>fluoride (strengthens teeth, comes in different forms with different profiles, e.g. amin-fluoride, <a href=\"https://www.ewg.org/skindeep/ingredient/724117/STANNOUS_FLUORIDE/\" rel=\"nofollow noreferrer\">stannous fluoride</a>)<br>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29085574\" rel=\"nofollow noreferrer\">The beneficial effects of fluoride on human oral health are well studied. There are numerous studies demonstrating that a small amount of fluoride delivered to the oral cavity decreases the prevalence of dental decay and results in stronger teeth and bones. However, ingestion of fluoride more than the recommended limit leads to toxicity and adverse effects.</a><br>\n _{<strong>Conclusion:</strong>\n The beneficial role of fluoride for the maintenance of good oral health has been known for many decades and strongly evidenced by scientific research. However, it must be emphasized that tooth decay (dental caries) is not caused by fluoride deficiency and fluoride supplementation will never reverse the active or gross carious lesions. Since the level of safety of fluoride is low, products that contain a high level of fluoride should be stored and used according to the recommend-dation and should be monitored by a qualified dental professional especially in children and pregnant women. In children, the swallowing reflex is not very well developed and the fluoride containing dental products are flavored hence increasing the possibility of a child to consume an excessive dose of fluoride. In areas with high fluoride levels in the drinking water, alternative dental products with low fluoride levels should be prescribed and monitored.}</p>\n</blockquote></li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/707061/ZINC_CHLORIDE/\" rel=\"nofollow noreferrer\">zinc chloride</a> (<a href=\"https://www.ncbi.nlm.nih.gov/pubmed/21762153\" rel=\"nofollow noreferrer\">controls bacterial growth</a>, although: not suitable for children)</li>\n<li>other minerals (e.g. containing calcium, strontium)</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/707002/XYLITOL/\" rel=\"nofollow noreferrer\">xylitol</a> (controls bacterial growth)</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/705994/SODIUM_BICARBONATE/\" rel=\"nofollow noreferrer\">baking soda</a> (helps with lifting plaque)</li>\n<li>plant extracts (mainly, but not just, for flavour: mint, myrrh, anise, salvia, fennel, chamomile, eucalyptus; really a long list…)</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/703046/HYDROXYAPATITE/\" rel=\"nofollow noreferrer\">hydroxyl-apaptite</a> (\"artifical enamel\")</li>\n<li>some enzymes </li>\n</ul>\n\n<p><strong>Your maybes:</strong> Things likely to be included and probably not of concern either way or in a grey zone:</p>\n\n<ul>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/702620/GLYCERIN/\" rel=\"nofollow noreferrer\">glycerin</a> and alcohol</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/717690/CHLORHEXIDINE/\" rel=\"nofollow noreferrer\">chlorhexidine</a> (while great against bacteria and preventing plaque: may stain teeth, causes other problems in your mouth, severly alters taste perception)</li>\n</ul>\n\n<p><strong>Your Unwanted:</strong> Things very likely to avoid:</p>\n\n<ul>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/706110/SODIUM_LAURYL_SULFATE/\" rel=\"nofollow noreferrer\">sodium lauryl sulfate</a> (\"SLS\", <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/2696932\" rel=\"nofollow noreferrer\">foaming</a> irritant) <br>_{(Please excuse the personal advice and anecdotal experience report by the authors of this answer: <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/7825393\" rel=\"nofollow noreferrer\">Does it cause ulcers?</a> – It does for sure!)}</li>\n<li>abrasive materials (use the <a href=\"https://en.wikipedia.org/w/index.php?title=Relative_dentin_abrasivity\" rel=\"nofollow noreferrer\">RDA</a> value of a product as guideline: >100 is too much, aim for &lt;60)</li>\n<li>acids and other sugars or sweeteners than xylitol or stevia (sorbitol, aspartame etc.) _{Note that this doesn't say aspartame e.g. is dangerous, just that there are better options.}</li>\n<li><a href=\"https://www.ewg.org/skindeep/ingredient/706623/TRICLOSAN/\" rel=\"nofollow noreferrer\">triclosan</a> (very <a href=\"https://www.nytimes.com/2016/09/07/well/live/why-your-toothpaste-has-triclosan.html\" rel=\"nofollow noreferrer\">questionable ingredient</a> all around if not strictly prescribed, <em>does help</em> against plaque and gingivitis, but causes a whole lot of problems)</li>\n<li>plastic micro beads (mostly because of the environment, less harmful immediately to the consumer)</li>\n<li>parabenes: steeply raising <a href=\"https://health.howstuffworks.com/skin-care/beauty/skin-and-lifestyle/parabens.htm\" rel=\"nofollow noreferrer\">concerns</a> over their effect as xeno-estrogens, although <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24733628\" rel=\"nofollow noreferrer\">in toothpaste their contribution to unwanted effects seems minimal</a>. </li>\n<li>strange artificial colours (first: because they are completely unnecessary except to make you buy the stuff, second: most beneficial ingredients have their own colour – and if not, what's wrong with white?)</li>\n</ul>\n\n<p>That list is not exhaustive. Questinable materials often found in so-called 'natural toothpaste' <em>is not covered. (and there are lots!)</em> The list above plant extracts above shows: even industrial toothpastes make use of natural components. But those ingredients may include things like green tea extract (generally well tolerated) or tea-tree oil (often not well tolerated and possible allergen). These should be checked especially thoroughly, for allergies, side effects etc. Potential hazards for any ingredient have to be weighed for their beneficial effects and especially the intended use and application considered: do not swallow the pastes! Even the xylitol listed as very beneficial and of very low concern will cause upset stomach and diarrhea when ingested in sufficient quantity.</p>\n\n<p>In general: Look for a toothpaste that meets these criteria, <em>and</em> your tastes and preferences. Try them out. If you tolerate the ingredients: Then go to your dentist and ask him about his opinion about your preferred choice(s).</p>\n\n<hr>\n\n<p>Things listed here <em>and</em> things not listed here but contained in a toothpaste may require you to <a href=\"https://health.stackexchange.com/q/13712/11231\">check yourself</a>:</p>\n\n<ul>\n<li>but don't just google it, and stop there on the first hit, go for <a href=\"https://health.meta.stackexchange.com/q/783/11231\">quality references</a></li>\n<li>check it on wikipedia </li>\n<li>check it on a consumer rights webpage (example <a href=\"https://ec.europa.eu/health/home_en\" rel=\"nofollow noreferrer\">HealthEU</a>)</li>\n<li>check it on drugs.com</li>\n<li>check it on pubchem</li>\n<li>check it on the <a href=\"https://www.ewg.org/skindeep/\" rel=\"nofollow noreferrer\">skindeep database</a></li>\n</ul>\n" }, { "answer_id": 14534, "author": "HerbalResearcher", "author_id": 7983, "author_profile": "https://health.stackexchange.com/users/7983", "pm_score": -1, "selected": false, "text": "<p>Hi I'll try to cover most topics in the subject and link sources efficiently and straight to the points. Including detox studies.</p>\n\n<p>Modern toothpaste is madness for alot of reasons and the main one is that they keep using fluoride(not even it's natural form by the way,which is calcium fluoride and you very well could do without it)</p>\n\n<p>(Main sources from the points below,unless I mentioned a different source comes from this website,which is a database of more than 500 studies about fluoride various health effects(organised by different health issues). <a href=\"http://fluoridealert.org/issues/health/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/issues/health/</a>\n------Check out brain effect , acute toxicity(dosage) ,etc);</p>\n\n<ul>\n<li>1 It's a proved toxic substance and neurotoxin ,and is in several foods,beverages,and in alot of places in the United States it's in water.\n---High fluoride residues in several foods containing pesticides residues,most quantity is in wheat and oats,corn, and meat fed from those same substances.\nSources and content; \nGeneral idea of fluoride content in foods; from studies of content/residues analysis(pesticide link page is broken)\nFluoride in food 1996 – 2013 Part 1;  <a href=\"http://poisonfluoride.com/pfpc/html/f-_in_food.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/f-_in_food.html</a><br>\n---Part 2 <a href=\"http://poisonfluoride.com/pfpc/html/f-_in_food__pt__2.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/f-_in_food__pt__2.html</a>\n---Fluoride in a few processed drinks such as coca cola <a href=\"http://fluoridealert.org/content/processed-drinks/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/content/processed-drinks/</a>\n---Fluoride in drugs <a href=\"http://poisonfluoride.com/pfpc/html/index_drugs.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/index_drugs.html</a>\n---One analysis of a particular himalayan salt brand <a href=\"http://poisonfluoride.com/pfpc/html/analysis.html\" rel=\"nofollow noreferrer\">http://poisonfluoride.com/pfpc/html/analysis.html</a>`</li>\n</ul>\n\n<p>EPA itself (but 2004,so it probably is reduced and some subtances banned,still looking for most recent) <a href=\"http://www.fluoridealert.org/wp-content/pesticides/f.source.food.inerts.htm\" rel=\"nofollow noreferrer\">http://www.fluoridealert.org/wp-content/pesticides/f.source.food.inerts.htm</a></p>\n\n<p>Vitamin D and aluminum absorption. And interraction of phosphate or phosphorique acid,iron ,zinc, and aluminium with fluoride.\n <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1336426/pdf/cmaj00262-0018c.pdf\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1336426/pdf/cmaj00262-0018c.pdf</a></p>\n\n<ul>\n<li>2 All the harmfull effects far outweigth any benefits, which are\nactually very small and most often not very different that from\npeople that don't use fluoride. Also no true meaningfull statistical correlationof cavities prevention or reduction from fluorated area compared to those that aren't. Cavities are caused by health and nutrition habits,enamel health,sugars and bacterias causing acidification and decay, poor dental hygiene substance choices, acids. If you take fluoride or not has little to no effect,except clogging the faulty area.\nstatistical value in whole cities or country are almost the same % . </li>\n</ul>\n\n<p>3 Substances are absorbed through skin and sublingual, but how fluoride % or quantity I did not find enough studies yet. Still compiling studies about how much in ingested from mouth/enamel</p>\n\n<p>3.1 But this study,although in my opinion not the best(since it has a few flaws in it's clarity),is still good to prove the point even more since it has enamel absorption as well as sublingual, because sublingual is alredy proven to increase absorption of many drugs/substances . I will find more,but this one is interresting because in the application theres no open enamel/cavity area. <a href=\"http://iopscience.iop.org/article/10.1088/1742-6596/884/1/012054/pdf\" rel=\"nofollow noreferrer\">http://iopscience.iop.org/article/10.1088/1742-6596/884/1/012054/pdf</a></p>\n\n<p>\" SDF that is applied in the buccal or sublingual mucosa will be rapidly\nabsorbed into the reticulated vein located beneath the oral mucosa and then carried through the\ninternal jugular and braciocephalic veins until it flows into the systemic circulation and is excreted\nthrough the urine [15]\"</p>\n\n<ul>\n<li><p>4 Is supposed to be used topically to be \"effective\", but they still add it in water,weird huh(several MCG/L by the way ,sometimes even MG/L). - 4 In their own words it's supposed to be used topically to be \"effective\", but they still add it in water claiming it's beneficial for teeths,weird huh(several mcg or mg/l by the way). Source; <a href=\"http://fluoridealert.org/articles/50-reasons/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/articles/50-reasons/</a> and alot more studies in there.</p>\n\n<ul>\n<li><p>4.1 Even dentist agree that acids destroy enamel and causes increase risk\nof cavity,yet tap water(and some toothpaste) contain alot of acidic\ncomponents, including(depending on area) alot of places in the United States and some parts in Canada; they are Fluorosilicic Acid/Hydrofluorosilicic Acid/silicofluoride/silicofluoric acid.\nThat seems very counter producting doesnt it and it also leaches city pipes either plastic or metal.\nThe other form added to both sources is Sodium Fluoride.</p></li>\n<li><p>4.2 Then one might say it's for bone health, again benefits outweigth the\nrisk and there is much more healthy substances for bone\nhealth/strength than ingesting such a strong poison(not mentioning\nother heavy metals and other toxins in tap water treated by water\nfactories. One should never drink that, or at minimum have it\nfiltered with 0.0001 micron absolute reverse osmosis,ideally which\nhas a activated carbon filter(block) lower than 5 or 1 micron. Also plastic\nwater bottles leach different bisphenols and phtalates,it's best to use ceramic or glass(and keep it cold in a cooler with bigger frozen bottles).</p></li>\n<li><p>5 It is definetely not a essential nutrient. <a href=\"http://fluoridealert.org/studies/essential-nutrient/\" rel=\"nofollow noreferrer\">http://fluoridealert.org/studies/essential-nutrient/</a></p></li>\n<li><p>6 It's (sometime) efficacity comes from clogging enamel/cavities/or sensitive nerve,but is more absorbed in the cases of open pathway causing toxicity. Cavities are healable naturally with good health habits(avoiding eroding) and bioactive supplementation and/or foods that will repair the tooth,combined with substances that inhibit cavity causing bacterias.<br>\n6.1 And will over time cause fluorosis from teeth or bone exposure ,it's among one of the least harmfull effect.</p></li>\n</ul></li>\n</ul>\n\n<p>-7 Other substances increase absorption of toxins from the skin/buccal.\n <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283952/\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3283952/</a>\n\"It has been reported that anionic surfactants like sodium lauryl sulfate can penetrate and interact with the skin, producing large alterations in the barrier properties.[30] An additional mechanism for the penetration enhancement by SLS involves the hydrophobic interaction of the SLS alkyl chain with the skin structure which leaves the end sulfate group of the surfactant exposed, creating additional sites in the membrane. This results in the development of repulsive forces that separate the protein matrix, uncoil the filaments, and expose more water binding sites, hence increasing the hydration level of skin.[12] \"</p>\n\n<p>7.1 From same study ; \"Anionic materials tend to permeate relatively poorly through stratum corneum upon short-time exposure but permeation increases with application time.[2] The alkyl sulfates can penetrate and destroy the integrity of the stratum corneum within hours of application.[18] \"</p>\n\n<p>7.2 --- So the long term repeated exposure in that sens ,and shampoo/soaps ,are worse,but oral absorption is very effective as well.\n--- Will find more studies, but it's very convincing.</p>\n\n<p>8 -And there is so much more available studies to be looked at , so anyone saying fluoride should be used and telling others to take it and that theres no risk,are either very uninformed,biased and naive,to stay polite. Even if all forms of buccal absorption can(depending on fluoride content quantity) be small in one day(although small is relative to what dentist and \"health agencies\" call small ), on the medium,and especially on the long term it's not small at all,especially considering the acute toxicity dose of fluoride, and the fact that from skin/buccal absorption,alot of it goes straight through the blood or the brain.</p>\n\n<p>9 *** Heres 2 studies about fluoride detox that show Tamarind Indicus food but mostly extract of seeds and pulp big potential for detox,including bones fluoride removal(second study).\n9.1 Resumed study <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11840184\" rel=\"nofollow noreferrer\">https://www.ncbi.nlm.nih.gov/pubmed/11840184</a> \nFull study <a href=\"https://www.nature.com/articles/1601287\" rel=\"nofollow noreferrer\">https://www.nature.com/articles/1601287</a> </p>\n\n<p>9.2 Full study dogs and fluoride <a href=\"http://societyforfluorideresearch.org/wp-content/uploads/2016/07/Dog-and-fluorosis.pdf\" rel=\"nofollow noreferrer\">http://societyforfluorideresearch.org/wp-content/uploads/2016/07/Dog-and-fluorosis.pdf</a></p>\n\n<p>9.3 The studies contradict themself in some nutrients absorption, but it can show fluoride interraction with those nutrients,especially magnesium. And can be due to various nutritional aspects of the test subjects, such as food and tap water anti-nutrients.</p>\n\n<p>There is other substances that help in detox(more than just fluoride) but I don't have all the references, so I can't name them just yet,but they fairly easy to find.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14531", "https://health.stackexchange.com", "https://health.stackexchange.com/users/402/" ]

[ { "answer_id": 14602, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 2, "selected": false, "text": "<p>Stockholm Syndrome does exist. It has an exceptionally high face validity. It does have this attribute due to many case reports available in the non-medical newspapers. You see a pattern, you have a desire to name it.</p>\n\n<p>The trick of taxonomy is trying to explain this behaviour pattern, many psychological theories stand at the ready: </p>\n\n<p><a href=\"http://journals.sagepub.com/doi/abs/10.1080/00048670701261178\" rel=\"nofollow noreferrer\">Traumatic Entrapment, Appeasement and Complex Post-Traumatic Stress Disorder: Evolutionary Perspectives of Hostage Reactions, Domestic Abuse and the Stockholm Syndrome:</a></p>\n\n<blockquote>\n <p>Evolutionary theory and cross-species comparisons are explored to shed new insights into behavioural responses to traumatic entrapment, examining their relationships to the Stockholm syndrome (a specific response to traumatic entrapment) and complex post-traumatic stress disorder (PTSD). […]\n The neurobiological basis of defensive behaviours underlying PTSD is explored with reference to the triune brain model. Victims of protracted traumatic entrapment under certain circumstances may display the Stockholm syndrome, which involves paradoxically positive relationships with their oppressors that may persist beyond release. Similar responses are observed in many mammalian species, especially primates. Ethological concepts including dominance hierarchies, reverted escape, de-escalation and conditional reconciliation appear relevant and are illustrated. These phenomena are commonly encountered in victims of severe abuse and understanding these concepts may assist clinical management. Appeasement is the mammalian defence most relevant to the survival challenge presented by traumatic entrapment and appears to be the foundation of complex PTSD. Evolutionary perspectives have considerable potential to bridge and integrate neurobiology and the social sciences with respect to traumatic stress responses.</p>\n</blockquote>\n\n<p>To properly diagnose a new \"syndrome\" you need to measure \"symptoms\", and <a href=\"https://www.ncbi.nlm.nih.gov/pubmed/3415129\" rel=\"nofollow noreferrer\">make comparisons</a> to enable a differential diagnosis. One such scale applying the concept of \"Stockholm Syndrome\" to dating complications is presented here:</p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/8555117\" rel=\"nofollow noreferrer\"><strong>A scale for identifying \"Stockholm syndrome\" reactions in young dating women: factor structure, reliability, and validity:</strong></a></p>\n</blockquote>\n\n<p>But the whole process is hampered by the rarity in which subjects are scientifically examined compared to the media coverage if such a case is presumed to be present. That concept is now apparently highly attractive for lay persons to explain counter intuitive behaviour up to a point that Stockholm Syndrome now almost replaced the previously assumed intuitive behavioural response of intense hatred. That is the weakness expressed by different researchers in the question. Psychological and psychiatric symptoms, disorders and syndromes are highly influenced or even dependent on culture. (cf. DSM and homosexuality). At the moment the process of clearly defining Stockholm syndrome as a distinct category that is really sharply defined against alternatives and related concepts is not finished:</p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/18028254\" rel=\"nofollow noreferrer\"><strong>‘Stockholm syndrome’: psychiatric diagnosis or urban myth?</strong></a>\n The existing literature on the subject of ‘Stockholm syndrome’ is sparse; the majority of the literature is based on case reports with little reference to how ‘Stockholm syndrome’ was diagnosed and what, if any, is its significance in terms of management of victims. ‘Stockholm syndrome’ is rarely mentioned in peer-reviewed academic research.[…]<br>\n In summary, a systematic literature review has identified large gaps in research into ‘Stockholm syndrome’. Existing literature does very little to support its existence yet case studies demonstrate a possible pattern in the behaviour and experiences of people labelled with it. We found similarities between widely reported cases studies into hostage ⁄ kidnap victims that could be used as the basis for diagnostic criteria. We also suggest that labelling the hostage victim with a psychiatric syndrome makes their story more readable and more likely to boost media circulation. The mystery of the origins of psychiatric illness holds society with fascination; psychiatry does not deal in absolute values and definitions, it is easy for the media to have free reign with medical terms, such as ‘Stockholm syndrome’ that have, as yet not received comprehensive assessment and validating criteria.</p>\n</blockquote>\n" }, { "answer_id": 18246, "author": "Keith Henson", "author_id": 15336, "author_profile": "https://health.stackexchange.com/users/15336", "pm_score": 1, "selected": false, "text": "<p>Stockholm Syndrome certainly does exist. It is a manifestation of capture-bonding, an evolutionary psychology[1] term for the evolved psychological mechanism[2] behind Stockholm syndrome. John Tooby (then a graduate student at Harvard University) originated the concept and its ramifications in the early 1980s, though he did not publish.[3] The term is fairly widely used on the Web and has begun to show up in books. [4]</p>\n\n<p>In the view of evolutionary psychology, \"the mind is a set of information-processing machines that were designed by natural selection to solve adaptive problems faced by our hunter-gatherer ancestors.\" [5]</p>\n\n<p>One of the \"adaptive problems faced by our hunter-gatherer ancestors,\" particularly our female ancestors, was being abducted by another band. Life in the human \"environment of evolutionary adaptiveness\" (EEA) is thought by researchers such as Azar Gat to be similar to that of the few remaining hunter-gatherer societies. \"Deadly violence is also regularly activated in competition over women. . . . Abduction of women, rape, . . . are widespread direct causes of reproductive conflict . . .\" [6] I.e., being captured [7] and having their dependent children killed might have been fairly common. [8] Women who resisted capture in such situations risked being killed. [9]</p>\n\n<p>Azar Gat argues that war and abductions (capture) were typical of human prehistory. [10] When selection is intense and persistent, adaptive traits (such as capture-bonding) become universal to the population or species.</p>\n\n<p>Capture-bonding as an evolutionary psychology mechanism can be used to understand historical events from the Rape of the Sabine Women to the hundreds of accounts of Europeans (mostly women) who were captured and assimilated into Native American tribes. Cynthia Ann Parker (1836 capture) is both an example of the mechanism working and it failing to work when she was captured again much later in life. Evolutionary psychology reasoning would lead you to expect that capture-bonding would be more effective at a younger age when there was more reproductive potential at risk. She did very well evolutionary terms because her son Quanah Parker had 25 children. Mary Jemison (1750 capture) was a very famous case. The last one (1851 capture) may have been Olive Oatman.</p>\n\n<p>Partial activation of the capture-bonding psychological trait may lie behind Battered-wife syndrome, military basic training, fraternity hazing, and sex practices such as sadism/masochism or bondage/discipline. [11]</p>\n\n<p>References</p>\n\n<ol>\n<li><p>\"My contention, simply put, is that the evolutionary approach is the only approach in the social and behavioral sciences that deals with why, in an ultimate sense, people behave as they do. As such, it often unmasks the universal hypocrisies of our species, peering behind self-serving notions about our moral and social values to reveal the darker side of human nature. (Silverman 2003) Confessions of a Closet Sociobiologist: Darwinian Movement in Psychology <a href=\"http://www.epjournal.net/filestore/ep0119.pdf\" rel=\"nofollow noreferrer\">http://www.epjournal.net/filestore/ep0119.pdf</a></p></li>\n<li><p>Consider the mysterious behavior of Elizabeth Smart in Salt Lake City in 2003 or that of Patty Hearst when she was abducted in 1974. In both cases, the victims bonded to their captors and resisted leaving them. The evolutionary origin of this psychological trait, known as the Stockholm syndrome (or more descriptively as capture-bonding) almost certainly comes from millions of years of evolutionary selection where our ancestors-usually our female ancestors-were being violently captured from one tribe by another. Those who had the psychological traits (ultimately gene-based mechanisms) that led them to socially reorient after a few days (i.e., bond) to their captors often survived to pass on the trait. Those who continued to resist, because they didn't have this trait, often became breakfast. Evolutionary Psychology, Memes and the Origin of War, Mankind Quarterly, Volume XLVI Number 4, Summer 2006.</p></li>\n<li><p>source: Leda Cosmides</p></li>\n<li><p>From Princess to Prisoner By Linda C. Mcjunckins <a href=\"http://books.google.com/books?id=f8lS3RMhv7oC&amp;pg=PA211&amp;dq=capture+bonding&amp;sig=XT21yLbFDdm\" rel=\"nofollow noreferrer\">http://books.google.com/books?id=f8lS3RMhv7oC&amp;pg=PA211&amp;dq=capture+bonding&amp;sig=XT21yLbFDdm</a></p></li>\n<li><p>Evolutionary Psychology: A Primer - Leda Cosmides &amp; John Tooby\nPublished in Anthropological Quarterly, 73.2 (2000), 74-88. </p></li>\n<li><p>THE HUMAN MOTIVATIONAL COMPLEX: EVOLUTIONARY THEORY AND THE CAUSES OF HUNTER-GATHERER FIGHTING Azar Gat Part II: Proximate, Subordinate, and Derivative Causes\"</p></li>\n<li><p>\"The percentage of females in the lowland villages who have been abducted is significantly higher: 17% compared to 11.7% in the highland villages.\" (Napoleon Chagnon quoted at Sexual Polarization in Warrior Cultures)</p></li>\n<li><p>\"Elena Valero, a Brazilian woman, was kidnapped by Yanomamo warriors when she was eleven years old . . . . But none were so horrifying as the second [raid]: ‘They killed so many.’ . . . The man then took the baby by his feet and bashed him against the rocks . . . .\" (Hrdy quoted in Sexual Polarization in Warrior Cultures)</p></li>\n<li><p>\"The Shaur and Achuar Jivaros, once deadly enemies . . . . A significant goal of these wars was geared toward the annihilation of the enemy tribe, including women and children. . . . . There were, however, many instances where the women and children were taken as prisoners . . . . A woman who fights, or a woman who refuses to accompany the victorious war-party to their homes and serve a new master, exposes herself to the risk of suffering the same fate as her men-folk.\" (Up de Graff also in Sexual Polarization in Warrior Cultures)</p></li>\n<li><p>Published in Anthropological Quarterly, 73.2 (2000), 74-88. THE HUMAN MOTIVATIONAL COMPLEX: EVOLUTIONARY THEORY AND THE CAUSES OF HUNTER-GATHERER FIGHTING Azar Gat Part II: Proximate, Subordinate, and Derivative Causes\"</p></li>\n<li><p>Being captured by neighboring tribes was a relatively common event for women in human history if anything like the recent history of the few remaining primitive tribes. In some of those tribes (Yanomamo, for instance) practically everyone in the tribe is descended from a captive within the last three generations. Perhaps as high as one in ten of females were abducted and incorporated into the tribe that captured them. Once you understand the evolutionary origin of this trait and its critical nature in genetic survival and reproduction in the ancestral human environment, related mysterious human psychological traits fall into place. Battered-wife syndrome is an example of activating the capture-bonding psychological mechanism, as are military basic training, fraternity bonding by hazing, and sex practices such as sadism/masochism or bondage/discipline. Evolutionary Psychology, Memes and the Origin of War, H. Keith Henson, Mankind Quarterly, Volume XLVI Number 4, Summer 2006.</p></li>\n</ol>\n" } ]

[ "https://health.stackexchange.com/questions/14572", "https://health.stackexchange.com", "https://health.stackexchange.com/users/3481/" ]

[ { "answer_id": 14601, "author": "LаngLаngС", "author_id": 11231, "author_profile": "https://health.stackexchange.com/users/11231", "pm_score": 3, "selected": false, "text": "<p>One problem with this approach of seeking knowledge is the theoretical nature of the question itself:</p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/24191417\" rel=\"noreferrer\">Unprotected fellatio, which has been practiced by all civilizations since mists of time, is now becoming a cause of concern due to the AIDS epidemic. Most of the sexually transmitted infectious diseases are concerned by fellatio and only few medical studies deal with this topic. This paper is therefore a non exhaustive review of risks brought upon by unprotected fellatio. <strong>It is almost impossible to assess the exact risk for a given infection because of the complexity of sexual intercourse, which is rarely exclusively oro-genital.</strong></a></p>\n</blockquote>\n\n<p>Therefore: if the following quotes contain numbers, please read them as illustrative and explaining, not as an apology or absolution.<br>\nTwo such articles that nevertheless do put a number on it in the way you are looking for are:</p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/22515139\" rel=\"noreferrer\"><strong>Assessing the risk of HIV infection after an isolated exposure incident:</strong></a>\n The higher the plasma viral load of an HIV-infected person, the greater the risk that their blood, sperm and vaginal secretions are infectious. The risk of infection from splashes onto non-intact skin or a mucous membrane is virtually non-existent if the exposed area is washed within 15 minutes. There is almost no risk of HIV transmission from nasal secretions, saliva, urine and vomit, unless they contain visible blood. The risk associated with sexual exposure to HIV varies enormously, depending on the type of sexual activity: almost non-existent for insertive fellatio; estimated at 1.5% for passive (receptive) anal intercourse with ejaculation inside the rectum. The risk of HIV transmission following injury from a sharp object contaminated with blood has been estimated at about 0.3%.</p>\n \n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/12441814\" rel=\"noreferrer\"><strong>Risk of HIV infection attributable to oral sex among men who have sex with men and in the population of men who have sex with men.</strong></a>\n We examined HIV infection and estimated the population-attributable risk percentage (PAR%) for HIV associated fellatio among men who have sex with other men (MSM). Among 239 MSM who practised exclusively fellatio in the past 6 months, 50% had three partners, 98% unprotected; and 28% had an HIV-positive partner; no HIV was detected. PAR%, based on the number of fellatio partners, ranges from 0.10% for one partner to 0.31% for three partners. The risk of HIV attributable to fellatio is extremely low.</p>\n</blockquote>\n\n<p>But these numbers might be quite misleading. These are statistical statements! They are <em>calculated</em> for the whole population and <strong><em>do not correspond to what a single individual will do or receive (that is \"get\").</em></strong></p>\n\n<p>Instead of finding a number to put the mind at ease a more comprehensive risk reduction strategy might be a much better choice:</p>\n\n<blockquote>\n <p><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/11773877\" rel=\"noreferrer\"><strong>Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use:</strong></a><br>\n <strong>Background:</strong>\n Sexual acquisition of HIV is influenced by choice of partner, sex act, and condom use. However, current risk-reduction strategies focus mainly on condom use.<br>\n <strong>Goal:</strong> To estimate the contribution of choice of partner, sex act, and condom use on the per-act relative and absolute risks for HIV infection.<br>\n <strong>Study Design:</strong> Per-act relative risk for HIV infection was <strong>calculated</strong> with use of estimates of HIV prevalence, risk of condom failure, HIV test accuracy, and per-act risk of HIV transmission for different sex acts. Absolute risks were calculated on the basis of these relative risk estimates.<br>\n <strong>Results:</strong> Choosing a partner who tested negative instead of an untested partner reduced the relative risk of HIV infection 47-fold; using condoms, 20-fold; and choosing insertive fellatio rather than insertive anal sex, 13-fold. Choosing one risk-reduction behavior substantially reduces absolute risk of HIV infection for heterosexuals but not for men who have sex with men.<br>\n <strong>Conclusion:</strong> Clarifying the magnitude of risk associated with different choices may help people make effective and sustainable changes in behavior.</p>\n</blockquote>\n\n<p>Even a small risk is still a risk and in case of nuclear power plants these numbers are big enough to demand that these plants be abolished. </p>\n\n<p>To put that into absolute numbers:</p>\n\n<blockquote>\n <p><a href=\"http://journals.lww.com/aidsonline/Abstract/2014/06190/Estimating_per_act_HIV_transmission_risk__a.14.aspx\" rel=\"noreferrer\"><strong>Estimating per-act HIV transmission risk: a systematic review</strong></a><br>\n Sexual exposure risks ranged from low for oral sex to 138 infections per 10 000 exposures. </p>\n</blockquote>\n\n<p>Further if we are talking risk assessment in the field asked in the question, let us not forget that HIV may be the only concern expressed here, but it is by far not the only illness that should be of concern! Some examples of the \"let's not forget\" category are:</p>\n\n<blockquote>\n <p><a href=\"http://sti.bmj.com/content/74/1/6.short\" rel=\"noreferrer\"><strong>Oral sex and the transmission of viral STIs:</strong></a><br> \n To review the literature on the role of oral sex in the transmission of viral sexually transmitted infections (STIs). <br>\n <strong>Conclusions:</strong> Oral sex is a common sexual practice among both heterosexual and homosexual couples. The evidence suggests that HIV transmission can take place through oro-genital sex from penis to mouth and vagina to mouth. Case reports describe apparent transmission from mouth to penis although this appears less likely. The risk of oro-genital transmission of HIV is substantially less than from vaginal and anal intercourse. Receptive oro-genital sex carries a small risk of human papillomavirus infection and possibly hepatitis C, while insertive oro-genital contact is an important risk factor for acquisition of HSV 1. Oro-anal transmission can occur with hepatitis A and B. The transmission of other viruses may occur but is unproved. <strong>The relative importance of oral sex as a route for the transmission of viruses is likely to increase as other, higher risk sexual practices are avoided for fear of acquiring HIV infection.</strong></p>\n</blockquote>\n\n<p>Please re-read the last line in bold a few times, to get a feeling of how to better interpret the numbers given above.</p>\n" }, { "answer_id": 31318, "author": "user237650", "author_id": 8593, "author_profile": "https://health.stackexchange.com/users/8593", "pm_score": 2, "selected": false, "text": "<p>I would just like to add to @LangLangC's answer that the rarity of transmission of HIV from insertive fellatio can be due to the presence of inhibitory substances in saliva and also due it's hypotonicity.</p>\n<blockquote>\n<p>In saliva, inhibition of HIV may be partly due to several inhibitors of viruses that are present in the saliva. For example, absence of nonspecific inhibitors in the saliva of a few patients with the acquired immunodeficiency syndrome correlates with the presence of infectious HIV in their saliva. Free secretory antibody is also present in saliva but may not be effective due to it's low concentrations. However, considering the limited in vitro inhibition of HIV by salivary inhibitors (2- to 5-fold) but the almost complete absence of infectious HIV in saliva, even after shedding of infected blood, additional mechanisms may inhibit infectious HIV shed orally. Since most of the infectious virus that is shed orally during the asymptomatic phase of infection is in, or produced by, infected leukocytes, and since the CD4-negative mucosal epithelial cells resist infection by cell-free HIV, we hypothesized that salivas (that have only one seventh the toxicity of normal interstitial fluids) may disrupt these crucial-infected cells and render them incapable of supporting virus multiplication and cell-to-cell transmission of HIV. Experimental support for this hypothesis is presented.</p>\n</blockquote>\n<p>.....[Ref 1]</p>\n<p><strong>References:</strong></p>\n<ol>\n<li><p>Baron, S., Poast, J., &amp; Cloyd, M. W. (1999). Why is HIV rarely transmitted by oral secretions? Saliva can disrupt orally shed, infected leukocytes. Archives of internal medicine, 159(3), 303–310. <a href=\"https://doi.org/10.1001/archinte.159.3.303\" rel=\"nofollow noreferrer\">https://doi.org/10.1001/archinte.159.3.303</a></p>\n</li>\n<li><p>Shugars, D. C., Sweet, S. P., Malamud, D., Kazmi, S. H., Page-Shafer, K., &amp; Challacombe, S. J. (2002). Saliva and inhibition of HIV-1 infection: molecular mechanisms. Oral diseases, 8 Suppl 2, 169–175. <a href=\"https://doi.org/10.1034/j.1601-0825.8.s2.7.x\" rel=\"nofollow noreferrer\">https://doi.org/10.1034/j.1601-0825.8.s2.7.x</a></p>\n</li>\n</ol>\n" } ]

[ "https://health.stackexchange.com/questions/14598", "https://health.stackexchange.com", "https://health.stackexchange.com/users/3481/" ]

[ { "answer_id": 24281, "author": "Thomas", "author_id": 19070, "author_profile": "https://health.stackexchange.com/users/19070", "pm_score": 0, "selected": false, "text": "<p>Generally, in intensive care medicine there are variants of catecholamines (the general class epinephrine belongs to) that can be applied to increase heart output. However, there are various drawbacks to this therapy, including putting increased strain on an already strained muscle and the effect of e. g. epinephrine on all the other organs of the body.</p>\n<p>For side effects of epinephrine and catecholamines in general see e. g. here: <a href=\"https://www.researchgate.net/figure/Adverse-and-beneficial-effects-of-catecholamines_tbl1_316052992\" rel=\"nofollow noreferrer\">https://www.researchgate.net/figure/Adverse-and-beneficial-effects-of-catecholamines_tbl1_316052992</a></p>\n<blockquote>Is it that the patient's blood flow is also increased when using epinephrine, making blood loss more significant?</blockquote>\nMore blood volume output per time can increase bleeding (if it the heart is sufficiently able to increase volume output from increased activation). That said, flow and pressure are two different things to consider - peripherally epinephrine casues vasoconstriction and may decrease blood flow. Still, that very same vasoconstriction may in turn increase blood pressure and wash away previously formed blood clots, which is why epinephrine (or increasing blood pressure) may result in increased bleeding.\n<p>Generally speaking treatment of heart failure (the insufficiency of the heart to pump blood) has a variety of approaches depending on the cause and stage of heart failure.</p>\n<p>For maintenance, generally the heart's work is reduced by trying to decrease peripheral resistance to pumping and/or decreasing volume to be pumped e. g. by increasing extraction of water in the kidney.</p>\n" }, { "answer_id": 24534, "author": "Pantomath", "author_id": 20293, "author_profile": "https://health.stackexchange.com/users/20293", "pm_score": 2, "selected": false, "text": "<p>Aadrenaline will generally quickly worsen heart failure because</p>\n<ol>\n<li>it massively increases peripheral vascular resistance and thus after-load on the heart.</li>\n<li>It significantly increases myocardial oxygen demand and in heart failure due to ischaemic heart disease this can quickly lead to myocardial infarction.</li>\n</ol>\n<blockquote>\n<p>Do the effects of epinephrine not last long enough</p>\n</blockquote>\n<p>The effects of epinephrine are indeed short but so are most ionotropic drugs - this is irrelevant however since if it were to be used in surgery it would be given via continuous infusion or repeated iv bolus doses.</p>\n<blockquote>\n<p>... or have potentially harmful effects in larger quantities?</p>\n</blockquote>\n<p>It has potentially harmful effects even in small quantities in heart failure.</p>\n<blockquote>\n<p>Is it that the patient's blood flow is also increased when using epinephrine, making blood loss more significant?</p>\n</blockquote>\n<p>No.</p>\n<p>The exact opposite. A major function of epinephrine in the body is to minimize blood loss in the case of trauma by inducing profound peripheral vasoconstriction. This is why for example it is often used topically to treat acute epistaxis (nose bleeds). So while it does under normal circumstances increase cardiac output it would be incorrect to say it &quot;increases blood flow&quot;.</p>\n<p>Although epinephrine does have important uses in surgery (to treat for example low blood pressure in the setting of bradycardia) there are generally more effective alternative drugs when it comes to heart failure (dobutamine for example).</p>\n<p>The blocking of adrenaline is in fact a cornerstone in the treatment of heart failure which is why beta-blockers (i.e beta-adrenergic receptor blockers) are usually prescribed to patients with heart failure.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14760", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12407/" ]

[ { "answer_id": 14823, "author": "Ravindranath Swarna", "author_id": 12454, "author_profile": "https://health.stackexchange.com/users/12454", "pm_score": 1, "selected": false, "text": "<p>Anal Stenosis, I think, is commonly seen in newborns or infants.\nThis needs treatment by itself. </p>\n\n<p>A adult person having \"Anal Stenosis\", if he/she is passing stools normally, then he can, as well go for Colonoscopy.</p>\n\n<p>Colo-Rectal surgeons do surgeries, like complications Crohn's disease or Ulcerative Colitis or Megacolon, resection of Colon cancer etc.</p>\n\n<p>Colonoscopy/Endoscopy is a different speciality where the physicians get training in looking, excising small polyps, taking biopsies etc. They are not trained in surgery. If the lesion is beyond the scope of Gastro-Enterologist, then it has to be dealt with by a surgeon. Colo-rectal surgeries, some of them can be done endoscopically, in an operation theatre, just in case, if anything goes wrong, they should be ready for Laparatomy (opening of the abdomen)</p>\n" }, { "answer_id": 14839, "author": "Ravindranath Swarna", "author_id": 12454, "author_profile": "https://health.stackexchange.com/users/12454", "pm_score": 0, "selected": false, "text": "<p>I am sorry to hear that. \nHemorrhoidal surgery does not go as deep as anal sphincter. Somebody must have cut his anal sphincter and tried to repair which might have resulted in Anal Stenosis.</p>\n\n<p>Once you have ulcers etc at the anus, you need colonoscopy to rule out any Crohn’s disease or ulcerative colitis. </p>\n\n<p>If there is no other pathology, manual anal dilatation can be attempted under anesthesia in several installments </p>\n\n<p>I do not know if your father forms lot of scar when he gets a scar.\nThat could be a problem. Some steroids may have to be used during the healing process after the procedure. </p>\n\n<p>Other option is Colostomy and give some rest to the anus.\nDuring that time, Anal stenosis can be dealt with.\nOnce anal stenosis is satisfactorily corrected, then colostomy can be closed. This is my opinion </p>\n" } ]

[ "https://health.stackexchange.com/questions/14811", "https://health.stackexchange.com", "https://health.stackexchange.com/users/1456/" ]

[ { "answer_id": 14841, "author": "WP Shala", "author_id": 12469, "author_profile": "https://health.stackexchange.com/users/12469", "pm_score": -1, "selected": false, "text": "<p>This may not be the answer you are looking for if you are only interested in a (Western) scientific explanation, but I would suggest reading about the practical life science of Ayurveda, which determines 3 'doshas' or body types, based on an elemental world view. </p>\n\n<p>You may find the detailed explanation from Ayurveda (take an online dosha quiz for quick results, and then read more deeply) a more practical and actionable set of information than Western medicine would provide on this particular question.</p>\n\n<p>Woo-woo / new age disclaimer. I am not into either of those realms particularly. However, I mention that because lots of people have a hard time distinguishing Vedic Science and actual Yoga from all the hippy hocus pocus being peddled around, especially in America :)</p>\n" }, { "answer_id": 15808, "author": "Kenneth Kho", "author_id": 13142, "author_profile": "https://health.stackexchange.com/users/13142", "pm_score": -1, "selected": false, "text": "<p>This question should be migrated to Physics SE. since this is mainly about thermodynamics and has nothing to do with health. This is fairly simple, it depends on your metabolism. We call it Basal Metabolic Rate (BMR). Before your question was edited by Carey, you said that your palms are mostly sweaty and having a hard time sweating while working out. Muscle mass play a key role to your metabolism no doubt. You will also feel \"warmer\" when your blood vessels near the surface of the skin. In addition, during cold climate your blood vessels will constrict to conserve heat and vice versa.</p>\n" }, { "answer_id": 15820, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": true, "text": "<p>For a constant basal metabolic rate, then those with relatively smaller body surface areas will feel warmer than those with high body surface area. This is because with a higher BSA the body has to shut down more of the surface blood flow to conserve heat and thereby ensure a constant core body temperature.</p>\n\n<blockquote>\n <p>In addition, larger animals usually have a smaller surface area relative to their body mass and, therefore, are comparatively inefficient at radiating their body heat off into the surrounding environment. The relationship between surface area and volume of objects was described in the 1630's by Galileo. ¹</p>\n</blockquote>\n\n<p>But on top of this men have more muscle mass which generates more heat and this needs to be lost by increasing blood flow to the skin. So, this explains why women are so cold.</p>\n\n<blockquote>\n <p>A 1998 study found that women's average hand temperature hovers around 87.2 °F, while men's averages 90 °F ²</p>\n</blockquote>\n\n<ol>\n<li><a href=\"https://www2.palomar.edu/anthro/adapt/adapt_2.htm\" rel=\"nofollow noreferrer\">https://www2.palomar.edu/anthro/adapt/adapt_2.htm</a></li>\n<li><a href=\"http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2978875-9/fulltext\" rel=\"nofollow noreferrer\">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2978875-9/fulltext</a></li>\n</ol>\n" } ]

[ "https://health.stackexchange.com/questions/14828", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12460/" ]

[ { "answer_id": 14866, "author": "Carey Gregory", "author_id": 805, "author_profile": "https://health.stackexchange.com/users/805", "pm_score": 3, "selected": false, "text": "<p>Many drugs come in more than one form -- or formulation, I should say. For example, it's common for a drug to come in an oral formulation and an injectable formulation: same chemical, different formulation with different usages. There are many <a href=\"https://en.wikipedia.org/wiki/Dosage_form\" rel=\"noreferrer\">dosage forms</a>. </p>\n\n<p>Do they work differently? Yes and no. Typically, the drug is going to exert the same general effects regardless of delivery method, but those effects are going to occur more rapidly if given intravenously than orally, for example.</p>\n\n<p>A good example is <a href=\"https://www.drugs.com/search.php?searchterm=minoxidil\" rel=\"noreferrer\">menoxidil</a>. </p>\n\n<blockquote>\n <p>Minoxidil is a vasodilator that relaxes (widens) blood vessels and\n improves blood flow.</p>\n</blockquote>\n\n<p>This effect gives minoxidil two very different uses: the first is as a pill that reduces high blood pressure, and the second is as a topical ointment that can regrow hair on the scalp. The mechanism of action is the same for both purposes (increasing blood flow), but the effect is very different given the formulation. A pill affects the body as a whole and so reduces blood pressure, but the topical ointment affects only a small area of scalp so encourages hair growth in that area without having an effect on blood pressure. </p>\n\n<p>Similar examples abound. </p>\n" }, { "answer_id": 14874, "author": "BillDOe", "author_id": 2833, "author_profile": "https://health.stackexchange.com/users/2833", "pm_score": 2, "selected": false, "text": "<p>In addition to Carey's excellent answer, many drugs also exhibit polymorphism, the ability to form different crystal structures (think coal, graphite, and diamond, which are all different crystal structures of carbon), solvates, and hydrates (H₂O added). Each polymorph will almost certainly have different chemical properties such as solubility, melting and boiling points, etc. <a href=\"https://www.acs.org/content/acs/en/pressroom/cutting-edge-chemistry/crystallization-and-polymorphism.html\" rel=\"nofollow noreferrer\">This article</a> from American Chemical Society describes the problems synthesizing a drug called axitinib, as it can form sixty-six different polymorphs. It also describes a drug, raltegravir that Merck is exploring the different properties of with those different forms. Also, <a href=\"https://en.wikipedia.org/wiki/Polymorphism_(materials_science)\" rel=\"nofollow noreferrer\">this article</a> from Wikipedia (please note here I am referencing Wikipedia for chemical, not medical, information) describes some excellent issues with polymorphs of Zantac, among others.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14862", "https://health.stackexchange.com", "https://health.stackexchange.com/users/11558/" ]

[ { "answer_id": 14926, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 3, "selected": true, "text": "<p>You can see that 100 g of uncooked quinoa has about 3 times as much of everything (calories, carbs, fats and proteins) as 100 g of cooked quionoa, so you can assume that the difference is due to water absorption.</p>\n\n<p>A small amount of carbs, fats and proteins can be lost in the cooking water.</p>\n\n<p>A significant amount of vitamins can be destroyed by cooking and a lot of minerals can be lost in the cooking water (<a href=\"http://nutritiondata.self.com/topics/processing\" rel=\"nofollow noreferrer\">NutritionData</a>).</p>\n" }, { "answer_id": 15080, "author": "Nate", "author_id": 12678, "author_profile": "https://health.stackexchange.com/users/12678", "pm_score": 1, "selected": false, "text": "<p>This is entirely due to the fact that when you cook quinoa, it absorbs lots of water and weighs more.</p>\n\n<p>If you start with 100g of uncooked quinoa, and cook it, that same amount will now weigh about 300g.</p>\n\n<p>Therefore, it takes 300g of cooked quinoa to have the same nutrients as 100g of uncooked quinoa. On paper, this looks like it has 1/3 the nutrients, but in reality it's the same number of grains of quinoa, they're just much plumper now that they've absorbed water.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14916", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12531/" ]

[ { "answer_id": 14926, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 3, "selected": true, "text": "<p>You can see that 100 g of uncooked quinoa has about 3 times as much of everything (calories, carbs, fats and proteins) as 100 g of cooked quionoa, so you can assume that the difference is due to water absorption.</p>\n\n<p>A small amount of carbs, fats and proteins can be lost in the cooking water.</p>\n\n<p>A significant amount of vitamins can be destroyed by cooking and a lot of minerals can be lost in the cooking water (<a href=\"http://nutritiondata.self.com/topics/processing\" rel=\"nofollow noreferrer\">NutritionData</a>).</p>\n" }, { "answer_id": 15080, "author": "Nate", "author_id": 12678, "author_profile": "https://health.stackexchange.com/users/12678", "pm_score": 1, "selected": false, "text": "<p>This is entirely due to the fact that when you cook quinoa, it absorbs lots of water and weighs more.</p>\n\n<p>If you start with 100g of uncooked quinoa, and cook it, that same amount will now weigh about 300g.</p>\n\n<p>Therefore, it takes 300g of cooked quinoa to have the same nutrients as 100g of uncooked quinoa. On paper, this looks like it has 1/3 the nutrients, but in reality it's the same number of grains of quinoa, they're just much plumper now that they've absorbed water.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14932", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12538/" ]

[ { "answer_id": 15002, "author": "Philipp", "author_id": 156, "author_profile": "https://health.stackexchange.com/users/156", "pm_score": 2, "selected": false, "text": "<p>Why? Evolution.</p>\n\n<p>It's not just that spoiled food starts to show symptoms, we were naturally selected for aeons to detect these symptoms.</p>\n\n<p>Telling the difference between food and poison is one of the most important survival skills for any higher organism. Any hairless monkeys which couldn't tell the difference and ate spoiled food died and didn't pass on their genes. Those who were able to tell the difference survived and passed on their genes to us.</p>\n\n<p>This is how humans have evolved the ability to smell if food is good or bad. When microbes do their work, they produce poisonous chemicals. Human olfactory senses evolved to detect these chemicals and respond to them with a strong aversion. This is why bad food \"stinks\". Similarly we evolved an instinct to notice certain colors or textures which hint at spoilage and find them distasteful.</p>\n\n<p>So if it looks spoiled, smells spoiled or tastes spoiled, follow your instincts and don't eat it.</p>\n\n<p>But remember that your natural senses to detect spoiled food are not perfect. In an early phase of spoilage, the signs might not be there yet, but the food is already bad. There are certain kinds of spoilage you can not detect instinctively at all. You can only protect yourself from them <a href=\"https://cooking.stackexchange.com/questions/34670/how-do-i-know-if-food-left-at-room-temperature-is-still-safe-to-eat/34671#34671\">by following common food safety rules</a>. There are also some kinds of foods which appear spoiled but are actually safe to eat (like blue cheese. Throw it away when you see mold on it which is <em>not</em> blue).</p>\n" }, { "answer_id": 15680, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 1, "selected": false, "text": "<p>It's clear from episodes of food poisoning everywhere that the appearance of food is not a good indication as to how healthy it is to eat. And that's why we have fairly clear rules on how many times to defrost something, or reheat something, before we eat them.</p>\n\n<p>If food which has been properly cooked is left to rot, then we are mainly talking about penicillin like molds growing on them. Are they actually harmful to us? Perhaps not unless you're allergic to penicillin. But mycotoxins which can cause serious injury don't usually reach a dangerous level until the food is quite rotten at which case you're not likely to want to eat it anyway.</p>\n\n<p>So, well cooked food is likely to be okay to eat until it is rotten. But it may well taste increasingly nasty and nastier.</p>\n\n<p><a href=\"https://www.healthline.com/nutrition/is-moldy-food-dangerous#section6\" rel=\"nofollow noreferrer\">https://www.healthline.com/nutrition/is-moldy-food-dangerous#section6</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/14954", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12564/" ]

[ { "answer_id": 19324, "author": "Jan", "author_id": 3002, "author_profile": "https://health.stackexchange.com/users/3002", "pm_score": 1, "selected": false, "text": "<p><strong>SODIUM REQUIREMENTS DEPEND ON THE SWEATING RATE</strong></p>\n\n<p>Adequate intake for sodium for <em>moderately active adults</em> can range from <strong>460 to 1,500 mg/day,</strong> depending on whom you ask (<a href=\"http://www.nutritionaustralia.org/national/frequently-asked-questions/salt-and-hypertension\" rel=\"nofollow noreferrer\">Nutrition Australia</a>, <a href=\"https://www.nal.usda.gov/sites/default/files/fnic_uploads/449-464.pdf\" rel=\"nofollow noreferrer\">USDA</a>). You can meet these intakes without adding salt to foods, especially if you eat foods that are already salted, for example, <a href=\"https://ndb.nal.usda.gov/ndb/foods/show/18076?fgcd=&amp;manu=&amp;format=&amp;count=&amp;max=25&amp;offset=&amp;sort=default&amp;order=asc&amp;qlookup=bread%20whole&amp;ds=SR&amp;qt=standard&amp;qp=&amp;qa=&amp;qn=&amp;q=&amp;ing=\" rel=\"nofollow noreferrer\">100 g of bread can contain more than 500 mg of sodium</a>. Foods that are not pre-salted, usually contain less than 100 mg of sodium per serving.</p>\n\n<p>According to <a href=\"https://www.nal.usda.gov/sites/default/files/fnic_uploads/449-464.pdf\" rel=\"nofollow noreferrer\">USDA, p.460</a>:</p>\n\n<blockquote>\n <p>the sodium AI [adequate intake] has been set at <strong>1.5 g/day.</strong> Sodium\n intake at this level would be adequate to cover losses from sweating\n among those who are moderately active.</p>\n</blockquote>\n\n<p>but</p>\n\n<blockquote>\n <p>...the AI of 1.5 g/day does not apply to individuals who lose large\n volumes of sodium in sweat, such as competitive athletes and workers\n exposed to extreme heat stress....sweat losses during exercise in the\n heat may easily exceed 1 L/hour with a sodium concentration of greater\n than 0.8 to 1.15 g/L.</p>\n</blockquote>\n\n<p>When sweating a lot, you may need <strong>more than 5 grams</strong> of sodium per day. <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2267797/\" rel=\"nofollow noreferrer\">Sweat rate and sodium loss during work in the heat (PubMed, 2008)</a>:</p>\n\n<blockquote>\n <p>People working in moderately hot conditions for 10 hours on\n average will lose between 4.8 and 6 g of sodium (Na) equivalent to\n 12–15 g of salt (NaCl) depending on acclimatisation.</p>\n</blockquote>\n\n<p><strong>CURRENTLY RECOMMENDED SODIUM INTAKE TO PREVENT HEART DISEASE</strong></p>\n\n<p>The <a href=\"https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/how-much-sodium-should-i-eat-per-day\" rel=\"nofollow noreferrer\">American Heart Association</a> recommends no more than 2,300 mg of sodium a day and moving toward an ideal limit of no more than 1,500 mg per day for most adults.</p>\n\n<p><strong>EVIDENCE THAT LOW-SODIUM DIET MAY BE HARMFUL</strong></p>\n\n<p>It is good to be aware that not only high-sodium, but also low-sodium diet may be harmful for the heart.</p>\n\n<p><a href=\"https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30467-6/fulltext\" rel=\"nofollow noreferrer\">Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies (Lancet, 2016)</a>:</p>\n\n<blockquote>\n <p>In summary, our results show <strong>an association between low sodium\n intake (vs moderate intake) and increased risk of clinical outcomes</strong>\n in those individuals with and without hypertension, whereas high\n sodium intake (greater than 6 g/day) was associated with an increased\n risk in individuals with hypertension. Our findings suggest that\n sodium reduction should be confined to only those individuals with\n hypertension and high sodium intake.</p>\n</blockquote>\n\n<p>One recent study has found a similar relationship between salt intake and chronic kidney disease.</p>\n\n<p><a href=\"https://www.kidney-international.org/article/S0085-2538(18)30002-4/fulltext\" rel=\"nofollow noreferrer\">U-shaped dietary sodium–associated incidence of chronic kidney disease cautions against salt overrestriction in hypertension (Kidney-international.org, 2018)</a>:</p>\n\n<blockquote>\n <p>In this population study salt intake is not associated with\n development of chronic kidney disease (CKD) in individuals with normal\n blood pressure, whereas <strong>in hypertensive individuals both low and\n high salt intakes are associated with increased incidence of CKD,</strong>\n similar to U-shaped associations between salt intake and mortality\n found in previous studies. The results contribute to the skepticism,\n which has questioned the present public health policy to reduce salt\n intake below 5.8 g.</p>\n</blockquote>\n" }, { "answer_id": 19335, "author": "xiota", "author_id": 14759, "author_profile": "https://health.stackexchange.com/users/14759", "pm_score": 2, "selected": false, "text": "<p>Assuming you are <em>healthy</em>, you will likely naturally regulate your sodium intake to appropriate levels. (Sodium is highly regulated by the <a href=\"https://en.wikipedia.org/wiki/Renin%E2%80%93angiotensin_system\" rel=\"nofollow noreferrer\">renin-angiotensin-aldosterone system</a>.) Too low and too high are both possible, and I would <em>not</em> attempt to manipulate sodium intake without without measuring or calculating current intake first.</p>\n\n<p>If you are thirsty, you are either not getting enough water or eating too much salt. If you are craving salty foods, you're either drinking too much or not eating enough salt. Excessively high or low salt intake over long periods of time alters RAAS activity (otherwise serum sodium levels would be affected), so changes should be made gradually. <strong>Before making significant changes to your diet, you should consult your physician.</strong></p>\n\n<hr>\n\n<p>Decreasing salt intake had been recommended to decrease blood pressure. In \"Why Should I Limit Sodium?\" (<a href=\"https://www.heart.org/-/media/data-import/downloadables/pe-abh-why-should-i-limit-sodium-ucm_300625.pdf\" rel=\"nofollow noreferrer\">pdf</a>), The American Heart Association states:</p>\n\n<blockquote>\n <p>Having less sodium in your diet may help you lower or avoid high blood pressure. People with high blood pressure are more likely to develop heart disease or have a stroke.</p>\n</blockquote>\n\n<p>However, note that blood pressure is a proxy indicator with many causes that may have nothing to do with your overall health or how long you live. It is also possible for blood pressure to be too low (<a href=\"https://en.wikipedia.org/wiki/Shock_(circulatory)\" rel=\"nofollow noreferrer\">shock</a>). <strong>No blood pressure = No life.</strong></p>\n\n<p>Many studies have not collected data on extremely low-levels of sodium intake, so no conclusion can be drawn from those studies about the safety of low sodium intake. More recently, data has been collected showing that very low levels are associated with increased mortality. These outcomes are reasonable because <a href=\"https://en.wikipedia.org/wiki/Na%2B/K%2B-ATPase\" rel=\"nofollow noreferrer\">Na/K-ATPase</a> <em>requires</em> sodium to function. Some well known poisons (<a href=\"https://en.wikipedia.org/wiki/Digitalis\" rel=\"nofollow noreferrer\">digitalis</a>, <a href=\"https://en.wikipedia.org/wiki/Ouabain\" rel=\"nofollow noreferrer\">ouabain</a>) work by disabling the sodium-potassium pump. <strong>No salt = No life.</strong></p>\n\n<p>Here is a graph from BMJ: <a href=\"https://www.bmj.com/content/364/bmj.l772\" rel=\"nofollow noreferrer\">Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study</a>.</p>\n\n<p><a href=\"https://i.stack.imgur.com/kjjOz.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/kjjOzm.jpg\" alt=\"all-cause mortality\"></a></p>\n\n<p>And a similar graph from NEJM: <a href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa1311889\" rel=\"nofollow noreferrer\">Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events</a>.</p>\n\n<p><a href=\"https://i.stack.imgur.com/k6993.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/k6993m.jpg\" alt=\"another graph\"></a></p>\n\n<p>Of interest:</p>\n\n<ul>\n<li>JAMA: <a href=\"https://jamanetwork.com/journals/jama/fullarticle/899663\" rel=\"nofollow noreferrer\">Fatal and Nonfatal Outcomes, Incidence of Hypertension, and Blood Pressure Changes in Relation to Urinary Sodium Excretion</a></li>\n<li>NEJM: <a href=\"https://www.nejm.org/doi/full/10.1056/NEJMoa1311889\" rel=\"nofollow noreferrer\">Urinary Sodium and Potassium Excretion, Mortality, and Cardiovascular Events</a></li>\n<li>BMJ: <a href=\"https://www.bmj.com/content/364/bmj.l772\" rel=\"nofollow noreferrer\">Joint association of urinary sodium and potassium excretion with cardiovascular events and mortality: prospective cohort study</a></li>\n<li><a href=\"https://www.ncbi.nlm.nih.gov/pubmed/29727609\" rel=\"nofollow noreferrer\">Conflicting Evidence on Health Effects Associated with Salt Reduction Calls for a Redesign of the Salt Dietary Guidelines.</a></li>\n<li>Clinical Science: <a href=\"http://www.clinsci.org/content/114/3/221\" rel=\"nofollow noreferrer\">Normal-sodium diet compared with low-sodium diet in compensated congestive heart failure: is sodium an old enemy or a new friend?</a></li>\n<li>AJH: <a href=\"https://academic.oup.com/ajh/article/27/9/1129/2730186\" rel=\"nofollow noreferrer\">Compared With Usual Sodium Intake, Low- and Excessive-Sodium Diets Are Associated With Increased Mortality: A Meta-Analysis</a></li>\n</ul>\n" } ]

[ "https://health.stackexchange.com/questions/14961", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12571/" ]

[ { "answer_id": 14989, "author": "Glorfindel", "author_id": 7205, "author_profile": "https://health.stackexchange.com/users/7205", "pm_score": 2, "selected": false, "text": "<p>According to <a href=\"https://en.wikipedia.org/wiki/Health_effects_of_chocolate\" rel=\"nofollow noreferrer\">Wikipedia</a>, the answer is no:</p>\n\n<blockquote>\n <p>Although considerable research has been conducted to evaluate the potential health benefits of consuming chocolate, there are insufficient studies to confirm any effect and no medical or regulatory authority has approved any health claim.</p>\n</blockquote>\n\n<p>While dark chocolate (i.e. chocolate rich in cocoa) is generally considered to be healthier than other forms of chocolate, it does not have any provable benefits over eating a varied, well-balanced diet (of which dark chocolate may be a part).</p>\n" }, { "answer_id": 18727, "author": "Don_S", "author_id": 7166, "author_profile": "https://health.stackexchange.com/users/7166", "pm_score": 2, "selected": false, "text": "<p>For all such questions, no matter what is the foodstuff in question, the answer cannot be yes or no, good or bad. </p>\n\n<p>The way towards the answer (which will probably never be definite) is more complex and requires integration of several factors: what does this food contain, how much do you eat of that food, what does your diet generally consist of (to understand what you are getting from your food and what might be missing), how does your body process what you eat, and probably other factors.</p>\n\n<p>A frequently quoted adage in that context is \"<a href=\"https://en.wikipedia.org/wiki/The_dose_makes_the_poison\" rel=\"nofollow noreferrer\">the dose makes the poison</a>\", i.e. too much of ANYTHING can be bad for you, and the amount where it is not harmful and perhaps even beneficial should be sought and determined before a foodstuff can be considered \"good for health\". </p>\n\n<p>Some of the factors I listed above you can determine (and control) directly and some others you cannot:</p>\n\n<ol>\n<li><strong>What does this food contain</strong> - for dark chocolate, you can check it out <a href=\"https://ndb.nal.usda.gov/ndb/foods/show/19904?n1=%7BQv%3D1%2C%20Q333969%3D1%2C%20Q333970%3D1%7D&amp;fgcd=&amp;man=&amp;lfacet=&amp;count=&amp;max=&amp;sort=&amp;qlookup=&amp;offset=&amp;format=Full&amp;new=&amp;measureby=&amp;Qv=1&amp;ds=&amp;qt=&amp;qp=&amp;qa=&amp;qn=&amp;q=&amp;ing=\" rel=\"nofollow noreferrer\">here</a>. The United States Department of Agriculture website hosts a <a href=\"https://ndb.nal.usda.gov/ndb/search/list\" rel=\"nofollow noreferrer\">National Nutrient Database</a>, in which you can search for many types of foodstuffs and see what they contain for different mass/volume units.</li>\n<li><strong>How much do you eat of that food</strong> - well, that entirely depends on you. We already know that the dose makes the poison. In most cases it should be safe to <a href=\"https://www.google.com/search?q=start%20low%20and%20go%20slow&amp;rlz=1C1GCEA_enIL809IL809&amp;oq=start%20low%20and%20go%20slow&amp;aqs=chrome.0.0l6.2991j0j7&amp;sourceid=chrome&amp;ie=UTF-8\" rel=\"nofollow noreferrer\">start low and go slow</a> (an approach borrowed from medicinal treatment for the elderly). Follow your body's reactions to try and understand if the amounts you eat are good for you.</li>\n<li><strong>What does your diet generally consist of</strong> - this is also under your control, although many people do not eat as healthy as they would like. This is important when you want to know if you are regularly getting all the essential nutrients you need from your diet, and what you can add to your nutritional intake from the foodtuff in question (see item 1 above). \n<br>For example, dark chocolate contains ample amounts (relatively, of course) of Potassium (715 mg/100 g of dark chocolate with 70-85% cacao solids) and Phosphorus (308 mg/100 g of dark chocolate with 70-85% cacao solids). This may be good for you if you are not getting these minerals from other sources.</li>\n</ol>\n\n<p>However, bear in mind that when you eat 100 grams of dark chocolate you get the \"full package\", which also contains 23.99 gr total sugars and 42.63 gr total lipids. This should also be taken into account.</p>\n\n<p><strong>Important note:</strong> for adjusting your diet to your needs and health, it is best to speak to a professional dietitian.</p>\n\n<ol start=\"4\">\n<li><strong>How does your body process what you eat</strong> - this is something you usually do not know until you actually try new foods, and you have no control over it. But of course, if you are allergic to some foods or if they have bad effects on you (indigestion, heartburn etc.) they would not be beneficial for you and you should probably avoid them.</li>\n</ol>\n\n<p>I believe my answer demonstrates why there is no black and white, good or bad in this kind of questions. The best approach is to be aware of what the food you eat actually contains and consult with healthcare professionals as necessary.</p>\n" } ]

[ "https://health.stackexchange.com/questions/14987", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8466/" ]

[ { "answer_id": 15026, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 2, "selected": false, "text": "<p>When reading radiographs in human health, the x-rays are read as though facing the patient. So, when you have a PA chest x-ray ( or dorsoventral view for a dog ) the x-rays enter the posterior surface, exit the anterior surface to hit the imaging surface. This used to be x-ray film. So, the right side of the chest appears on the right of the film, and the left side on the left. But the sides are switched so you actually read the films as though looking from the anterior side of the patient i.e. facing the patient.</p>\n\n<p>When taking an AP film, the patient is positioned so that the posterior surface is now closest to the film, and the patient's left is on the left of the film. And that's the way the film is read, from the front.</p>\n\n<p>I've noticed some DV images of animals are not switched so that the R is on the left but apparently most are. But I'm guessing that vets also read DV and VD images of the thorax as though facing the ventral surface.</p>\n\n<p>BTW, when taking horizontal or transverse CT slices through the human thorax, the view shown is that from caudal to cranial, i.e. looking upwards to the head.</p>\n\n<p><a href=\"https://www.radiologymasterclass.co.uk/tutorials/chest/chest_quality/chest_xray_quality_projection\" rel=\"nofollow noreferrer\">https://www.radiologymasterclass.co.uk/tutorials/chest/chest_quality/chest_xray_quality_projection</a></p>\n\n<p>And here's an <a href=\"https://www.bcftechnology.com/veterinary-learning/small-animal-learning/head/skull-dorsoventral-canine-x-ray-positioning-guide/\" rel=\"nofollow noreferrer\">example of a canine head using the DorsoVentral positioning</a></p>\n\n<p><a href=\"https://i.stack.imgur.com/lJ4uS.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/lJ4uS.png\" alt=\"doggie head positioning\"></a></p>\n\n<p><a href=\"https://i.stack.imgur.com/7SlwG.png\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/7SlwG.png\" alt=\"DV canine head\"></a></p>\n\n<p>and you can see that the image is not reversed which I presume is because this is the normal way to read these type of images.</p>\n\n<p>TL;DR - it's a convention used to reduce cognitive loading on radiologists.</p>\n" }, { "answer_id": 15213, "author": "bengy", "author_id": 12856, "author_profile": "https://health.stackexchange.com/users/12856", "pm_score": 0, "selected": false, "text": "<p>Think about it as a mirror. If I a-ray all the teeth for example. That means I mirror the mouth to the sheet. Now when I read the paper I need to invert the paper and look at it. The right side was ascribed on the right side and the left on the left of the paper. Once inverted the sides take a flip. I am gonna see the right side on the left and the left on the right. The key is to think about it as mirroring the picture and then you gotta switch it to view the picture.</p>\n" } ]

[ "https://health.stackexchange.com/questions/15004", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12602/" ]

[ { "answer_id": 15021, "author": "anongoodnurse", "author_id": 169, "author_profile": "https://health.stackexchange.com/users/169", "pm_score": 2, "selected": false, "text": "<p>Sure, it could be an allergy to vicryl, but if it wasn't itchy, it probably wasn't. You probably saw some granulation tissue, normal in healing, expecially visible if you're poking around in an incompletely healed incision.</p>\n\n<p>If you want to know if you're allergic to Vicryl, simply ask your doctor to place one stitch somewhere on your body where your skin is soft and relatively thin, like the inside of your forearm or the small of your back. If you start to itch and the area swells up, you're allergic.</p>\n\n<p><a href=\"https://journals.lww.com/dermatitis/Citation/2014/11000/A_Technique_for_Identifying_Vicryl_Suture.8.aspx\" rel=\"nofollow noreferrer\">A Technique for Identifying Vicryl Suture Hypersensitivity</a></p>\n" }, { "answer_id": 15133, "author": "RudyB", "author_id": 12770, "author_profile": "https://health.stackexchange.com/users/12770", "pm_score": 1, "selected": false, "text": "<p>Vicryl takes many weeks to hydrolyze and absorb (56-70 days per Ethicon data), and in the process it can generate a foreign body reaction from the body. The body does one of two things for foreign bodies: 1) pushes them out or 2) walls them off.</p>\n\n<p>Inflammation and foreign body reaction are not allergic responses. Please go back to your surgeon and ask for a professional opinion. After all, your surgeon's fee for the procedure covers routine follow-up visits and wound healing issues are definitely in that category.</p>\n" } ]

[ "https://health.stackexchange.com/questions/15019", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12616/" ]

[ { "answer_id": 15043, "author": "JMP", "author_id": 97, "author_profile": "https://health.stackexchange.com/users/97", "pm_score": 4, "selected": true, "text": "<p>In the American system of Dentistry, there are three levels:</p>\n\n<blockquote>\n <ul>\n <li>Dentist</li>\n <li>Orthodontist</li>\n <li>Board Certified Orthodontist</li>\n </ul>\n</blockquote>\n\n<p>This is visually demonstrated by the ABO <a href=\"https://www.americanboardortho.com/general-public/what-is-a-board-certified-orthodontist/\" rel=\"noreferrer\">here</a>.</p>\n\n<p>Dentists have passed sufficient tests to qualify for <a href=\"http://www.ada.org/en\" rel=\"noreferrer\">ADA</a> membership. This is about 160,000 members in the USA.</p>\n\n<p>Orthodontists have passed sufficient tests to qualify for <a href=\"https://www.aaoinfo.org/1/about\" rel=\"noreferrer\">AAO</a> membership, which includes about 19,000 members.</p>\n\n<p>Once you have passed these tests, you can voluntarily study and take exams offered by the <a href=\"https://www.americanboardortho.com\" rel=\"noreferrer\">ABO</a>, which need renewing every 10 years.</p>\n\n<p>The ABO is recognized by both the ADA and AAO (in fact it is their <em>only</em> recognized orthodontic board). About 150 members became Board Certified, or renewed, in <a href=\"https://www.americanboardortho.com/media/5190/abo-announces-newly-certified-or-recertified-orthodontists-september-2017-examination.pdf\" rel=\"noreferrer\">September 2017</a>.</p>\n\n<p>Just for reference, they have a Facebook page:</p>\n\n<ul>\n<li><a href=\"https://www.facebook.com/pg/American-Board-of-Orthodontics-409192062500370/about/?ref=page_internal\" rel=\"noreferrer\">Facebook</a></li>\n</ul>\n\n<p>and provide a list of questions to ask your potential orthodontist:</p>\n\n<ul>\n<li><a href=\"https://www.americanboardortho.com/general-public/how-to-choose-an-orthodontist/what-to-ask-before-you-choose/\" rel=\"noreferrer\">Questions</a></li>\n</ul>\n" }, { "answer_id": 16464, "author": "user13904", "author_id": 13904, "author_profile": "https://health.stackexchange.com/users/13904", "pm_score": 0, "selected": false, "text": "<p>AAO: is just an association that almost all ortho's belong to by default. ABO: is a board certification status that indicates that the doctor has gone through the optional process to become a diplomate of the ABO. Most ABO certified doc's are going to be very good. Doc's that are not ABO certified are by no means inferior, they have just not gone through the process yet. You cannot really use AAO/ABO as an accurate way to decide if a doctor is better than another doctor.</p>\n" } ]

[ "https://health.stackexchange.com/questions/15040", "https://health.stackexchange.com", "https://health.stackexchange.com/users/5304/" ]

[ { "answer_id": 15075, "author": "Nate", "author_id": 12678, "author_profile": "https://health.stackexchange.com/users/12678", "pm_score": -1, "selected": false, "text": "<p>There are no studies looking at iodine concentrations of that specific soup broth that I could find. But <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696276/\" rel=\"nofollow noreferrer\">this study</a>, published in Nutrition Journal 2 years ago, looks at iodine intake in various Japanese dietary groups.</p>\n\n<p>In one type of diet, participants consumed more than 1 bowl of miso soup and 2 servings of seaweed a day, and their daily iodine intake was about 650 micrograms, right in the middle of the recommended range of 150-1100 micrograms a day.</p>\n\n<p>So you should be just fine eating plenty of miso soup and/or seaweed.</p>\n" }, { "answer_id": 15411, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 1, "selected": false, "text": "<p>This study from Australia <a href=\"https://www.mja.com.au/journal/2010/193/7/iodine-toxicity-soy-milk-and-seaweed-ingestion-associated-serious-thyroid\" rel=\"nofollow noreferrer\">https://www.mja.com.au/journal/2010/193/7/iodine-toxicity-soy-milk-and-seaweed-ingestion-associated-serious-thyroid</a> indicates that iodine toxicity has been documented in people consuming soy milk made with kombu and illustrates the dangers of importing a foreign diet or manufactured food substance.</p>\n\n<blockquote>\n <p>We report a series of cases of thyroid dysfunction in adults associated with ingestion of a brand of soy milk manufactured with kombu (seaweed), and a case of hypothyroidism in a neonate whose mother had been drinking this milk. We also report two cases of neonatal hypothyroidism linked to maternal ingestion of seaweed made into soup. These products were found to contain high levels of iodine. Despite increasing awareness of iodine deficiency, the potential for iodine toxicity, particularly from sources such as seaweed, is less well recognised.</p>\n</blockquote>\n" } ]

[ "https://health.stackexchange.com/questions/15060", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12563/" ]

[ { "answer_id": 15062, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 4, "selected": false, "text": "<p>Influenza deaths are not specifically tracked in those over the age of 18 but they can be estimated from death certificates.</p>\n\n<blockquote>\n <p>CDC estimates that from 2010-2011 to 2013-2014, influenza-associated deaths in the United States ranged from a low of 12,000 (during 2011-2012) to a high of 56,000 (during 2012-2013). Death certificate data and weekly influenza virus surveillance information was used to estimate how many flu-related deaths occurred among people whose underlying cause of death on their death certificate included respiratory or circulatory causes.</p>\n</blockquote>\n\n<p>So deaths from influenza are often from a secondary bacterial pneumonia or excessive immune response (cytokine storm) to the flu infection. Some young people can die <a href=\"https://www.nbcnews.com/health/health-news/here-s-how-flu-virus-kills-some-people-so-quickly-n839936\" rel=\"noreferrer\">within hours</a> of the flu infection from the latter reason. </p>\n\n<p>And if we just look at <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359836/table/Tab3/\" rel=\"noreferrer\">hospitalization rates</a> we can see that for the age range 18-49, the rate of 41/100,000 is under half that of the average but twice higher than age range 5-17 years. </p>\n\n<p>And 50 million deaths from the 1918 pandemic makes your statement that \"flu is an irritant\" completely erroneous.</p>\n\n<p>Interestingly a <a href=\"http://www.thelancet.com/pdfs/journals/lanpub/PIIS2468-2667(17)30004-X.pdf\" rel=\"noreferrer\">new paradigm</a> for managing seasonal flu has been suggested. The issue is that the people who most need the vaccination (elderly, sick, very young) are those that benefit the least from vaccination due to an impaired immune response to the vaccine, and it may be more effective to vaccinate the older young who respond well to vaccination:</p>\n\n<blockquote>\n <p>Furthermore, influenza\n epidemiology is unfortunately characterised by\n dissociation between populations most likely to\n have severe disease (infants and elderly people), and\n populations most likely to benefit from vaccination\n (older children and adolescents—ie, those aged\n 2–16 years).3\n Older children and adolescents seem to\n be important for the early propagation of influenza\n in populations, and the efficacy of influenza vaccines\n is greater in these populations than in elderly people,\n but they are generally not prioritised for immunisation\n because of their lower risk of morbidity and mortality\n from this infection.3\n This paradoxical state of affairs\n has led some researchers to suggest that the best way\n to minimise the burden of seasonal influenza would\n be to focus immunisation programmes on children,\n adolescents, and young adults, with benefit accrued by\n elderly people and infants as a result of herd immunity.3</p>\n</blockquote>\n\n<p>And ...</p>\n\n<blockquote>\n <p>analysis highlights\n the importance of herd effects for decision makers:\n a rapidly implemented LAIV programme focused on\n children aged 2–16 years is actually more effective\n at preventing disease in elderly people than a more\n slowly implemented programme that includes both\n LAIV and direct immunisation of elderly people\n themselves. This finding is because a rapid, early focus\n on young individuals, in whom the vaccine is more\n effective, stops the influenza epidemic in its tracks. </p>\n</blockquote>\n" }, { "answer_id": 15065, "author": "StrConDexWisIntCha", "author_id": 12655, "author_profile": "https://health.stackexchange.com/users/12655", "pm_score": 7, "selected": true, "text": "<p>In general, the benefit of flu shots is to the general population. Taking the cited value of 40%-60% from the CDC, we can say that it might be a coin toss for you <em>personally</em> to be protected from influenza by the shot. However, if many thousands of people take the flu shot, even if it only works on 40% of them, it helps protect the remaining population from the spread of the virus (AKA herd immunity). This is especially important to those within the population who cannot access the shot or cannot receive it due to a preexisting medical condition. As Graham Chiu's answer points out, influenza is no joke, especially for vulnerable members of the population (such as the elderly or people with certain medical conditions).</p>\n\n<p>With regards to mercury in the flu shot, the specific additive is called \"Thimerosal\". Firstly: <a href=\"https://www.cdc.gov/flu/protect/vaccine/thimerosal.htm\" rel=\"noreferrer\">not all flu shots contain Thimerosal</a>. If you feel strongly about it, ask your pharmacist for a vaccine that doesn't contain Thimerosal. The additive is a <a href=\"https://www.cdc.gov/vaccinesafety/concerns/thimerosal/faqs.html\" rel=\"noreferrer\">preservative</a> to prevent bacteria or fungi from growing in multi-dose vials containing the influenza vaccine. For explanations as to why you don't need to worry about Thimerosal, see the <a href=\"https://health.stackexchange.com/a/15070/12655\">other</a> great <a href=\"https://health.stackexchange.com/a/15074/12655\">answers</a> below.</p>\n\n<p>Some further information to put your mind at ease. In their <a href=\"https://www.scientificamerican.com/article/straight-talk-about-vaccination/\" rel=\"noreferrer\">article</a> in Scientific American, Matthew F. Daly and Jason M. Glanz (a pediatrician and epidemiologist respectively at Kaiser Permanente's Institute for Health Research in Denver) have this to say about the safety of vaccines:</p>\n\n<blockquote>\n <p>Because vaccines are given to huge numbers of people, including healthy infants, they are held to a much higher safety standard than medications used for people who are already sick.</p>\n</blockquote>\n\n<p>From the same article:</p>\n\n<blockquote>\n <p>The key facts [you] need to know, though, are that vaccines prevent potentially fatal diseases, that vaccines have a high degree of safety, and that their safety is constantly evaluated and reevaluated in a system operating independently from the pharmaceutical companies that make vaccines.</p>\n</blockquote>\n\n<p>As a final note: in that article shared by the OP there are several scientifically unsound arguments and factual errors. I'm not going through the effort of refuting them all here. It is however worth pointing out that the presence of Thimerosal in vaccines is not a secret, and is well known among the scientific and medical community. In a <strong>brief</strong> search of medical literature in the medical science database <em><a href=\"https://www.ncbi.nlm.nih.gov/\" rel=\"noreferrer\">PubMed.gov</a></em> (free to the public, by the way) with the search terms \"influenza vaccine safety\" I could find no results making any claims about adverse side effects due to Thimerosal. In a database containing literally millions of independent, peer-reviewed medical scientific publications, you will be hard pressed to find any supporting the claims made in the aforementioned article shared by the OP.</p>\n\n<p>In fact, this <a href=\"http://dx.doi.org/10.1080/21645515.2017.1423153\" rel=\"noreferrer\">review article</a> (where researchers summarize the results of 190 other sources on vaccine safety) had this to say on the topic of vaccine safety [paraphrased by me]:</p>\n\n<blockquote>\n <ul>\n <li>Influenza causes substantial death, suffering and socioeconomic impact worldwide.</li>\n <li>Vaccination is the best defense against influenza.</li>\n <li>Influenza vaccines are \"very safe\".</li>\n <li>The only known side effects of influenza vaccines are temporary nasal congestion (runny nose) and sometimes allergic reactions.</li>\n <li>Allergic reactions appear in less than 1 out of every 1,000,000 doses.</li>\n <li>Children with asthma under the age of 2 are particularly susceptible to the side effects of the influenza vaccine and more study is required to ensure it's safety for this particular high-risk group.</li>\n </ul>\n</blockquote>\n\n<p>In other words, infants who have problems breathing might be more significantly affected by allergic reactions or congestion. That's all they have to say about flu vaccine side effects (regardless of whether they contain Thimerosal). Finally, a direct quote from the conclusion:</p>\n\n<blockquote>\n <p>Vaccines have to meet higher safety standards, since they are administered to healthy people, mainly healthy children. The monitoring of annual influenza vaccine safety, which is particular [sic] important on account of the annual changes in the viral antigen composition of the vaccine, constitutes a critical component of the influenza vaccination program. Indeed, not only does this strategy ensure the safety of vaccines, it can also maintain public trust in the national vaccination program.</p>\n</blockquote>\n" }, { "answer_id": 15070, "author": "Konrad Rudolph", "author_id": 3120, "author_profile": "https://health.stackexchange.com/users/3120", "pm_score": 5, "selected": false, "text": "<p>Tackling your points in turn, in inverted order:</p>\n\n<blockquote>\n <p>flu is an irritant but nowhere near deadly</p>\n</blockquote>\n\n<p>You are probably confusing the flu (influenza) with the common cold, <a href=\"https://www.cdc.gov/flu/about/qa/coldflu.htm\" rel=\"noreferrer\">which is colloquially often called “the flu”</a>, or <a href=\"https://en.wikipedia.org/wiki/Gastroenteritis\" rel=\"noreferrer\">gastroenteritis</a> (colloquially called “stomach flu”). Unfortunately these are actually very different diseases. The common cold is indeed largely harmless. By contrast, influenza (and potentially also gastroenteritis) is a serious, and potentially deadly, disease. Its symptoms vary but <a href=\"https://www.nhs.uk/conditions/flu/\" rel=\"noreferrer\">it usually leads to high fever, strong pain, diarrhoea and difficulty sleeping</a>. In a word, you’ll feel rotten for the better part of a week.</p>\n\n<p>In addition, the mortality may not <em>seem</em> very high but (even ignoring that it caused the <a href=\"https://en.wikipedia.org/wiki/1918_flu_pandemic\" rel=\"noreferrer\">deadliest epidemic</a> in human history) <a href=\"https://www.cdc.gov/nchs/fastats/flu.htm\" rel=\"noreferrer\"><strong>each year thousands of people die from it in the US alone</strong></a>. In fact, the numbers vary greatly with each season, from about 3,000 to almost 50,000.</p>\n\n<p>As a healthy 40-year-old you are less likely to <em>die</em> from the flu but you could still get very seriously ill. Furthermore, by getting vaccinated, you contribute to <a href=\"https://en.wikipedia.org/wiki/Herd_immunity\" rel=\"noreferrer\">herd immunity</a>. This prevents the flu’s spread and protects other, less healthy people, from dying from the flu.</p>\n\n<blockquote>\n <p>[40%–60% risk reduction] is not considered highly effective for a vaccine.</p>\n</blockquote>\n\n<p>Even a 40% risk reduction is very effective. It’s maybe not considered “highly effective” <em>compared to other vaccines</em> because vaccines, in general, are extremely effective. But compared to other remedies, vaccines are one of the most effective treatment methods.</p>\n\n<p>Rather than thinking of 40%–60% as a coin toss, think of it this way: amongst the vaccinated population, the <a href=\"https://en.wikipedia.org/wiki/Incidence_%28epidemiology%29\" rel=\"noreferrer\">incidence</a> is more than halved (due to the compounding effect of reduced risk of infection in the population). This is impressive.</p>\n\n<blockquote>\n <p>[The flu vaccine contains] mercury that is harmful to the body, according to Natural News.</p>\n</blockquote>\n\n<p>This is intentionally deceptive: <a href=\"https://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html\" rel=\"noreferrer\">flu vaccines do not contain elementary mercury</a> (and never have)! <em>Some</em> flu vaccines contain <a href=\"https://en.wikipedia.org/wiki/Thiomersal\" rel=\"noreferrer\">thiomersal</a> (or “thimerosal”), which in turn contains <em>ethylmercury</em>. Despite its name, this is a different compound, and does not have the same chemical properties as elementary mercury.¹ Contrary to what <em>Natural News</em> claims, thiomersal in vaccines is safe: it has never been found to produce a negative effect in humans.²</p>\n\n<p>Beware of your news sources: <a href=\"https://en.wikipedia.org/wiki/Natural_News\" rel=\"noreferrer\"><em>Natural News</em> is a scam website</a> that lies to sell ineffective, unregulated, and potentially harmful supplements. When researching health topics, always cross-reference your information with respectable sources such as the WHO, the NHS or the CDC. You don’t need to <em>exclusively</em> rely on them but they accurately portray the scientific consensus and, unlike sites like <em>Natural News</em>, they have no financial interest in lying to the public, since they do not make profit off it. Furthermore, they are funded independently by different governments.</p>\n\n<hr>\n\n<p>_{¹ This is a very important point, so it bears explaining: Consider table salt. Table salt is the chemical compound sodium chloride. Both sodium and chloride, in isolation, are highly toxic. But when combined chemically, as in table salt, they form a harmless compound that is safe for normal consumption. The same is true for the relationship between mercury and ethylmercury.}</p>\n\n<p>_{² As everywhere, <em>the dose makes the poison</em>. Thiomersal in high concentrations is toxic, just like table salt. Toxicity is often measured in <a href=\"https://en.wikipedia.org/wiki/Median_lethal_dose\" rel=\"noreferrer\">LD₅₀</a>. Salt has an LD₅₀ of <a href=\"http://whs.rocklinusd.org/documents/Science/Lethal_Dose_Table.pdf\" rel=\"noreferrer\">12357 mg/kg</a> in humans, which means that <a href=\"http://www.traditionaloven.com/culinary-arts/cooking/table-salt/convert-kilogram-kg-to-table-spoon-tbsp.html\" rel=\"noreferrer\">approx. 58 tablespoons</a> are problematic for an 80 kg man. Thiomersal has an LD₅₀ of <a href=\"https://en.wikipedia.org/wiki/Thiomersal\" rel=\"noreferrer\">75 mg/kg</a> (in rats), which means that you’d need to vaccinate that 80 kg man <a href=\"https://www.cdc.gov/mmwr/volumes/66/rr/rr6602a1.htm\" rel=\"noreferrer\">over 100,000 times</a>, at once, for a similar effect!}</p>\n" }, { "answer_id": 15074, "author": "ymbirtt", "author_id": 12670, "author_profile": "https://health.stackexchange.com/users/12670", "pm_score": 4, "selected": false, "text": "<p>Other answers have explained why being vaccinated is generally a good idea, and I fully support the ones that do. That said, the article you've linked to does indeed present some very scary points, and I fully understand why reading something like that would give you some doubts about your own safety, so I'd like to directly tackle the key point raised by it.</p>\n\n<p>I have no medical qualifications whatsoever, so just like you I'm reading the information that's available as a lay person.</p>\n\n<blockquote>\n <p>Mercury is toxic at any dose when injected into the body, even in micrograms.</p>\n</blockquote>\n\n<p>Injecting a syringe full of mercury into your body is definitely a <a href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2740532/\" rel=\"noreferrer\">bad idea</a>. The article is mostly worried about Thimerosal, which is used as a preservative. The US National Toxicology Department has tested this ingredient in response to fears, and you can see the results <a href=\"https://ntp.niehs.nih.gov/ntp/htdocs/chem_background/exsumpdf/thimerosal_508.pdf\" rel=\"noreferrer\">here</a>. It tells us the following:</p>\n\n<blockquote>\n <p>In this study, the LD50 of thimerosal in rats was 98 mg/kg</p>\n</blockquote>\n\n<p>The LD50 being 98mg/kg means that, to have a 50% chance of killing a rat that weighs one kilogram, you'll need to inject 98mg of Thimerosal. Looking at <a href=\"http://web.jhu.edu/animalcare/procedures/rat.html\" rel=\"noreferrer\">this</a>, 400g for a rat's weight seems like a reasonable estimate, so it'll take about 40mg of Thimerosal to have a 50% chance of killing a pet rat. Heading back to your article:</p>\n\n<blockquote>\n <p>As you can see from this snapshot, the package insert readily admits that each vaccine dose “contains 50 mcg thimerosal (&lt;25 mcg mercury).”</p>\n</blockquote>\n\n<p>Yep, it absolutely does. Converting the units, 50mcg=0.05mg. If we want to kill that rat from Thimerosal poisoning, we'd need to inject it with 800 of these flu shots. I'm going to re-state this in big text just in case you're only skimming:</p>\n\n<p><strong>To stand a decent chance of killing a pet rat from mercury poisoning, you'd need to inject it with 800 of the flu vaccines discussed in that article, all at the same time</strong></p>\n\n<p>You're probably a lot bigger than your average lab rat, so we're talking tens of thousands of flu shots before the mercury inside it starts getting dangerous.</p>\n\n<p>The article also discusses formaldehyde, and if you're interested you can do your own research into the toxicity of that and see how many flu shots you'd need to be in danger of death from formaldahyde poisoning.</p>\n\n<p>It's a real shame that the articles trying to tell you vaccines are dangerous are so exciting to read, whilst articles describing actual scientific research are so dry and boring. You can see why ideas like this gain so much traction - it's terribly exciting to read! Unfortunately, it just doesn't stand up to any serious scrutiny.</p>\n" }, { "answer_id": 15082, "author": "Alexander", "author_id": 12697, "author_profile": "https://health.stackexchange.com/users/12697", "pm_score": 4, "selected": false, "text": "<blockquote>\n <p>Influenza vaccines do not have satisfactory effective rates of preventing flu. Flu vaccination reduces the risk of flu illness by between 40% and 60%</p>\n</blockquote>\n\n<p>Vaccines aren't meant to stop diseases by making 100% invulnerable individuals. Of course we want the highest possible efficacy, but the primary benefit is the large impact they have on a collective level, by limiting the spread of a disease, so that it snuffs itself off.</p>\n\n<p>It's all about reducing the <a href=\"https://en.wikipedia.org/wiki/Basic_reproduction_number\" rel=\"noreferrer\">basic reproduction number (<em>R</em>₀)</a>, the number of cases of the disease that are caused by infection from one case of the desease. There are 3 ranges this number can fall into</p>\n\n<ul>\n<li>1 &lt; <em>R</em>₀ Each person, on average, infects more than 1 person before recovering. Disease spreads as more people get infected than people are recovering.</li>\n<li><em>R</em>₀ = 1 Each person, on average, infects exactly 1 other person before recovering. The disease spread plateaus (i.e. the number of infected remains the same.), as the number of people getting infected exactly matches the number of people recovering.</li>\n<li>0 ≤ <em>R</em>₀ &lt; 1 Each person, on average, infects less than 1 person before recovering. The disease gets snuffed out over time, as people recover faster than people are getting infected.</li>\n</ul>\n\n<p>The exponential math that models disease spread applies in many areas, such as in nuclear chain reactions, where the <a href=\"https://en.wikipedia.org/wiki/Nuclear_chain_reaction#Effective_neutron_multiplication_factor\" rel=\"noreferrer\">effective neutron multiplication factor</a> is the average number of neutrons from one fission that cause another fission. Just as <a href=\"https://en.wikipedia.org/wiki/Control_rod\" rel=\"noreferrer\">control rods</a> are used in nuclear reactors to maintain the <em>k</em> around 1 (a stable, non-growning, non-dying rate of reaction), vaccines can be used to bring <em>R</em>₀ below 1, so that deceases snuff themselves out.</p>\n\n<p>Herd immunity is a proportional to the product of vaccine efficacy, and the vaccination rate. Here's a simplified visualization of herd immunity, which I think presumes 100% vaccine efficacy. We can compensate for lower vaccine efficacy by increasing the vaccination rate.</p>\n\n<p><a href=\"https://i.imgur.com/J7LANQ4.gif\" rel=\"noreferrer\"><img src=\"https://i.imgur.com/J7LANQ4.gif\" alt=\"Herd immunity simulation\"></a></p>\n\n<p>Not using a vaccine because it's \"only\" 40% - 60% effective is counterproductive: that's <strong><em>exactly</em></strong> when we need a high vaccination rate, <strong><em>the most!</em></strong></p>\n" }, { "answer_id": 15127, "author": "cbeleites unhappy with SX", "author_id": 11479, "author_profile": "https://health.stackexchange.com/users/11479", "pm_score": 2, "selected": false, "text": "<p>A few more points, in addition to the good answers you already have and just addressing:</p>\n\n<blockquote>\n <p>Does it make sense for a healthy male in his early 40s to take the influenza vaccine [...]?</p>\n</blockquote>\n\n<p><strong>Short answer</strong>: healthy 40-year-old male already excludes a number of high risk/priority groups, but not all of them (e.g. if you help taking care of 90- year-old grandma, maybe you don't want to risk <em>her</em> health). </p>\n\n<hr>\n\n<p><strong>long answer</strong></p>\n\n<ul>\n<li><p>Several answers above have already discussed the topic of herd immunity. The difficulty here with the flu is that it changes so rapidly that we cannot really get there (which is also the reason for the low efficacy of the flu shot and the need to develop and distribute new shots every flu season).</p></li>\n<li><p>In general, whether it makes sense to try approaching herd immunity, i.e. to recommend vaccination for everyone also depends on circumstances. </p>\n\n<ul>\n<li>E.g. in Germany we have no yellow fever, so vaccination is only recommended for people travelling to regions that have. </li>\n</ul></li>\n<li><p>Now for the flu, at least with current vaccine development technology, we cannot reach true herd immunity (it changes too fast). However, if we can reduce the number of infections by half, and slow down the spread of the infection, that can make a vital difference for the health system: there are only so many patients that can be taken care of at a given time. If you can keep the number of patients below what the capabilities are, that's much better for everyone compared to situations where patients can only be put to beds in the hallway of the hospital and half of the staff is ill as well.<br>\nFrom a macroscopic perspective, you can then ask what strategy is better: e.g. vaccination campaign or building more hospitals. </p></li>\n<li><p>There's also an intermediate concept between full herd immunity and no vaccination: vaccinate only certain groups of people. These will typically be </p>\n\n<ul>\n<li>persons more susceptible to the disesase (likely to contract and/or higher risk of (severe) complications)</li>\n<li>persons that may be in the position to infect many other and/or many susceptible people (for the flu: public office, teachers, health care workers)</li>\n<li>health care workers: you need them particularly when there's an outbreak of disease </li>\n</ul>\n\n<p>For the <strong>flu</strong>, these <strong>high risk/priority groups</strong> are:</p>\n\n<ul>\n<li>Kids 6 months - 4 years (CDC)</li>\n<li>People over 50 (CDC) or 60 (RKI)</li>\n<li>People with certain chronic diseases (CDC and RKI)</li>\n<li>Residents of retirement or nursing homes in general (CDC and RKI) </li>\n<li>Pregnant women (CDC and RKI) </li>\n<li>Caretakers and household contacts for high risk persons (CDC and RKI)</li>\n<li>Persons with increased professional risk (health care workers, CDC and RKI), workers in public offices, teachers etc. (RKI)</li>\n<li>Persons working with birds (this is in order to avoid double infection with human and avian influenza, RKI)</li>\n<li>American Indians/Alaska Natives (CDC)\n(Lists from the documents linked below)</li>\n</ul></li>\n<li><p><a href=\"https://www.cdc.gov/flu/protect/whoshouldvax.htm\" rel=\"nofollow noreferrer\">CDC decided that it is worth trying to get as many people vaccinated against flu as possible</a>, whereas the <a href=\"https://www.rki.de/EN/Content/infections/Vaccination/recommandations/34_2017_engl.pdf?__blob=publicationFile\" rel=\"nofollow noreferrer\">RKI [German equivalent of CDC] has a certain groups policy</a><br>\nNote that this does not necessary mean a controversy between experts, but this may be caused by regional differences.</p></li>\n<li><p>Just to be complete: there are also counter-indications, but \"healthy\" pretty much excludes them.</p>\n\n<p>-</p></li>\n</ul>\n" } ]

[ "https://health.stackexchange.com/questions/15061", "https://health.stackexchange.com", "https://health.stackexchange.com/users/8973/" ]

[ { "answer_id": 15144, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 1, "selected": false, "text": "<p>If the person has a valid out of hospital DNR order, then that person should not be resuscitated if they experience a cardio respiratory arrest. In that case the person clearly is not healthy.</p>\n\n<p>The DNR order has to be reviewed every 90 days by the person's doctor. And in the event of an arrest can be overridden by a relative or physician where the person is unable to object.</p>\n\n<p><a href=\"https://www.health.ny.gov/professionals/ems/policy/99-10.htm\" rel=\"nofollow noreferrer\">https://www.health.ny.gov/professionals/ems/policy/99-10.htm</a></p>\n" }, { "answer_id": 15146, "author": "Nate", "author_id": 12678, "author_profile": "https://health.stackexchange.com/users/12678", "pm_score": 4, "selected": true, "text": "<p><a href=\"https://www.health.ny.gov/professionals/ems/policy/10-05.htm\" rel=\"noreferrer\">The MOLST (Medical Orders for Life-Sustaining Treatment) form</a> is an update to the non-hospital DNR, which as you saw in a previous answer has very stringent (and frankly unrealistic) requirements.</p>\n\n<p>The MOLST is printed on bright pink paper, and EMS providers are trained to look for it upon entering a house. In addition, patients are able to wear a metal bracelet stating \"DNR\" if they have a valid MOLST or non-hospital DNR form that states the patient is DNR, and EMS services are trained to treat this bracelet the same as the form itself.</p>\n\n<p>The MOLST does need to be signed by a physician, but any signed MOLST is considered valid unless there is a more recent form or there is other evidence to suggest that the wishes of the patient have changed. This eliminates the 90-day renewal requirement of the non-hospital DNR.</p>\n\n<p>The one limitation I could find is that a MOLST is not valid for psychiatric patients or patients with developmental disabilities.</p>\n\n<p>Many healthy people have DNR forms. In fact, whether or not you want a DNR is a part of an advance directive <a href=\"http://www.caringinfo.org/files/public/ad/New_York.pdf\" rel=\"noreferrer\">(here's the form for New York)</a>, which every person is encouraged to have, regardless of health status. <a href=\"http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/\" rel=\"noreferrer\">Here is an interesting essay</a> that provides anecdotal evidence about doctors with no health problems of their own choosing to have a DNR order in place. A doctor is likely to ask you questions about your advance directive in order to make sure that you are not depressed or suicidal (which would invalidate the MOLST), but there are many good reasons for not wanting aggressive care. A good doctor will respect your decisions about the medical care you want to receive.</p>\n" }, { "answer_id": 15247, "author": "faustus", "author_id": 12881, "author_profile": "https://health.stackexchange.com/users/12881", "pm_score": 2, "selected": false, "text": "<blockquote>\n <p>If an otherwise healthy person has a do not resuscitate order and has a heart attack and the ambulance comes, will they just let him die like that? Or is do not resuscitate only applicable to terminally ill people?</p>\n</blockquote>\n\n<p>This is a very interesting question. And as a non-American, I am quite shocked by the answer.</p>\n\n<p>To begin with, what you are essentially asking is does an express refusal override implied consent? Morally, yes: the whole point about autonomy is that people have the right to make bad decisions about their life.</p>\n\n<p>The matter is complicated because such a directive has to be explicitly known by the person. So let's simplify things: suppose you have a \"Do Not Resuscitate\" tattoo on your chest. This is unambiguously stating your express refusal to be resuscitated, like so:</p>\n\n<p><a href=\"https://i.stack.imgur.com/cp9VS.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/cp9VS.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>The following case study from Miami, FL was reported in NEJM just a few months ago:</p>\n\n<p><a href=\"http://www.nejm.org/doi/full/10.1056/NEJMc1713344\" rel=\"nofollow noreferrer\">http://www.nejm.org/doi/full/10.1056/NEJMc1713344</a></p>\n\n<blockquote>\n <p><strong>An Unconscious Patient with a DNR Tattoo</strong></p>\n \n <p><strong>We present the case of a person whose presumed code-status preference\n led him to tattoo “Do Not Resuscitate” on his chest. Paramedics\n brought an unconscious 70-year-old man with a history of chronic\n obstructive pulmonary disease, diabetes mellitus, and atrial\n fibrillation to the emergency department</strong>, where he was found to have\n an elevated blood alcohol level. The staff of the medical intensive\n care unit evaluated him several hours later when hypotension and an\n anion-gap metabolic acidosis with a pH of 6.81 developed. His anterior\n chest had a tattoo that read “Do Not Resuscitate,” accompanied by his\n presumed signature (Figure 1).</p>\n</blockquote>\n\n<p>A good case how to make your express refusal known, right? Nope, not quite:</p>\n\n<blockquote>\n <p><strong>We initially decided not to honor the tattoo, invoking the principle\n of not choosing an irreversible path when faced with uncertainty.</strong> This\n decision left us conflicted owing to the patient’s extraordinary\n effort to make his presumed advance directive known; therefore, an\n ethics consultation was requested.</p>\n</blockquote>\n\n<p>Regarding your question about New York state, can such a directive still be ignored? Yes, it would seem so. Though granted, there is a recent update to the matter:</p>\n\n<blockquote>\n <p>Cuomo on Nov. 29 signed the legislation that will add “attending nurse\n practitioner” to the list of health care providers that patients and\n families can tap to create various directives related to end-of-life\n decisions.</p>\n</blockquote>\n\n<p><a href=\"https://libn.com/2017/11/30/state-lets-nps-sign-off-on-do-not-resuscitate/\" rel=\"nofollow noreferrer\">https://libn.com/2017/11/30/state-lets-nps-sign-off-on-do-not-resuscitate/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/15141", "https://health.stackexchange.com", "https://health.stackexchange.com/users/447/" ]

[ { "answer_id": 15144, "author": "Graham Chiu", "author_id": 3414, "author_profile": "https://health.stackexchange.com/users/3414", "pm_score": 1, "selected": false, "text": "<p>If the person has a valid out of hospital DNR order, then that person should not be resuscitated if they experience a cardio respiratory arrest. In that case the person clearly is not healthy.</p>\n\n<p>The DNR order has to be reviewed every 90 days by the person's doctor. And in the event of an arrest can be overridden by a relative or physician where the person is unable to object.</p>\n\n<p><a href=\"https://www.health.ny.gov/professionals/ems/policy/99-10.htm\" rel=\"nofollow noreferrer\">https://www.health.ny.gov/professionals/ems/policy/99-10.htm</a></p>\n" }, { "answer_id": 15146, "author": "Nate", "author_id": 12678, "author_profile": "https://health.stackexchange.com/users/12678", "pm_score": 4, "selected": true, "text": "<p><a href=\"https://www.health.ny.gov/professionals/ems/policy/10-05.htm\" rel=\"noreferrer\">The MOLST (Medical Orders for Life-Sustaining Treatment) form</a> is an update to the non-hospital DNR, which as you saw in a previous answer has very stringent (and frankly unrealistic) requirements.</p>\n\n<p>The MOLST is printed on bright pink paper, and EMS providers are trained to look for it upon entering a house. In addition, patients are able to wear a metal bracelet stating \"DNR\" if they have a valid MOLST or non-hospital DNR form that states the patient is DNR, and EMS services are trained to treat this bracelet the same as the form itself.</p>\n\n<p>The MOLST does need to be signed by a physician, but any signed MOLST is considered valid unless there is a more recent form or there is other evidence to suggest that the wishes of the patient have changed. This eliminates the 90-day renewal requirement of the non-hospital DNR.</p>\n\n<p>The one limitation I could find is that a MOLST is not valid for psychiatric patients or patients with developmental disabilities.</p>\n\n<p>Many healthy people have DNR forms. In fact, whether or not you want a DNR is a part of an advance directive <a href=\"http://www.caringinfo.org/files/public/ad/New_York.pdf\" rel=\"noreferrer\">(here's the form for New York)</a>, which every person is encouraged to have, regardless of health status. <a href=\"http://www.zocalopublicsquare.org/2011/11/30/how-doctors-die/ideas/nexus/\" rel=\"noreferrer\">Here is an interesting essay</a> that provides anecdotal evidence about doctors with no health problems of their own choosing to have a DNR order in place. A doctor is likely to ask you questions about your advance directive in order to make sure that you are not depressed or suicidal (which would invalidate the MOLST), but there are many good reasons for not wanting aggressive care. A good doctor will respect your decisions about the medical care you want to receive.</p>\n" }, { "answer_id": 15247, "author": "faustus", "author_id": 12881, "author_profile": "https://health.stackexchange.com/users/12881", "pm_score": 2, "selected": false, "text": "<blockquote>\n <p>If an otherwise healthy person has a do not resuscitate order and has a heart attack and the ambulance comes, will they just let him die like that? Or is do not resuscitate only applicable to terminally ill people?</p>\n</blockquote>\n\n<p>This is a very interesting question. And as a non-American, I am quite shocked by the answer.</p>\n\n<p>To begin with, what you are essentially asking is does an express refusal override implied consent? Morally, yes: the whole point about autonomy is that people have the right to make bad decisions about their life.</p>\n\n<p>The matter is complicated because such a directive has to be explicitly known by the person. So let's simplify things: suppose you have a \"Do Not Resuscitate\" tattoo on your chest. This is unambiguously stating your express refusal to be resuscitated, like so:</p>\n\n<p><a href=\"https://i.stack.imgur.com/cp9VS.jpg\" rel=\"nofollow noreferrer\"><img src=\"https://i.stack.imgur.com/cp9VS.jpg\" alt=\"enter image description here\"></a></p>\n\n<p>The following case study from Miami, FL was reported in NEJM just a few months ago:</p>\n\n<p><a href=\"http://www.nejm.org/doi/full/10.1056/NEJMc1713344\" rel=\"nofollow noreferrer\">http://www.nejm.org/doi/full/10.1056/NEJMc1713344</a></p>\n\n<blockquote>\n <p><strong>An Unconscious Patient with a DNR Tattoo</strong></p>\n \n <p><strong>We present the case of a person whose presumed code-status preference\n led him to tattoo “Do Not Resuscitate” on his chest. Paramedics\n brought an unconscious 70-year-old man with a history of chronic\n obstructive pulmonary disease, diabetes mellitus, and atrial\n fibrillation to the emergency department</strong>, where he was found to have\n an elevated blood alcohol level. The staff of the medical intensive\n care unit evaluated him several hours later when hypotension and an\n anion-gap metabolic acidosis with a pH of 6.81 developed. His anterior\n chest had a tattoo that read “Do Not Resuscitate,” accompanied by his\n presumed signature (Figure 1).</p>\n</blockquote>\n\n<p>A good case how to make your express refusal known, right? Nope, not quite:</p>\n\n<blockquote>\n <p><strong>We initially decided not to honor the tattoo, invoking the principle\n of not choosing an irreversible path when faced with uncertainty.</strong> This\n decision left us conflicted owing to the patient’s extraordinary\n effort to make his presumed advance directive known; therefore, an\n ethics consultation was requested.</p>\n</blockquote>\n\n<p>Regarding your question about New York state, can such a directive still be ignored? Yes, it would seem so. Though granted, there is a recent update to the matter:</p>\n\n<blockquote>\n <p>Cuomo on Nov. 29 signed the legislation that will add “attending nurse\n practitioner” to the list of health care providers that patients and\n families can tap to create various directives related to end-of-life\n decisions.</p>\n</blockquote>\n\n<p><a href=\"https://libn.com/2017/11/30/state-lets-nps-sign-off-on-do-not-resuscitate/\" rel=\"nofollow noreferrer\">https://libn.com/2017/11/30/state-lets-nps-sign-off-on-do-not-resuscitate/</a></p>\n" } ]

[ "https://health.stackexchange.com/questions/15154", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12678/" ]

[ { "answer_id": 15174, "author": "mehmet", "author_id": 12828, "author_profile": "https://health.stackexchange.com/users/12828", "pm_score": 0, "selected": false, "text": "<p>Based on data of the <a href=\"https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html\" rel=\"nofollow noreferrer\">Center for Disease Control and Prevention</a>, the number of annual human fatalities due to rabies is less than 5 in the entire US. Thus, that put the chances to much less than 1% for a family of 5 over 10 years. So, I conclude it does not seem to be worth having the pre-exposure vaccination in abundance of caution. </p>\n" }, { "answer_id": 15175, "author": "Community", "author_id": -1, "author_profile": "https://health.stackexchange.com/users/-1", "pm_score": 2, "selected": false, "text": "<p>I asked a couple of medical doctors about this and they said a rabies vaccine was not necessary. The rabies vaccine is indicated for people at high risk of exposure to the rabies virus such as researchers working with rabies, veterinarians, and animal control personnel. </p>\n\n<p>They do however recommend staying current with tetanus vaccines as an outdoor cat could possibly pick up some of the bacteria that causes tetanus in their claws and possibly transmit it to a person if they scratch them.</p>\n" } ]

[ "https://health.stackexchange.com/questions/15173", "https://health.stackexchange.com", "https://health.stackexchange.com/users/12828/" ]