Estrace is used for treating conditions due to menopause (eg, hot flashes; vaginal itching, burning, or dryness), treating vulval or vaginal atrophy, and preventing osteoporosis (brittle bones).
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Category: Woman's Health
Estrace is used for treating conditions due to menopause (eg, hot flashes; vaginal itching, burning, or dryness), treating vulval or vaginal atrophy, and preventing osteoporosis (brittle bones).
Active Ingredient: Estradiol
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Toadstool necrosis and healthful timing 3/21/07 Hi GrahamT, <Hello, Daniel.> I am sorry for the misspellings and other errors in the previous e-mail. <I understand the constraints on your time, and thank you for your consideration. I will do my best to reciprocate.> I have a question about my toadstool that I have in my 135 gallon Reef tank. I bought it about 3 weeks ago at a LFS. It fully extends during the day with all polyps out. <Excellent.> But at the base of the coral it seems to be deteriorating or going necrotic. <Ahh. I see.> I have read through the website and found some helpful ideas. My question is when I cut the head of the coral off and toss the stem out have I already infected the rest of the tank even though I have no other leathers? <Hmm, *I* can't answer that directly. I am not sure about the pathogen, if any. I will tell you that this is usually a chain-reaction on the cellular level, where contact is a requisite 90% of the time; meaning that if you cut off the affected part well into the "good" tissue, you can curb its spread.> Where does this infection usually come from miss handling in transit? <It can start from a physical trauma, or injury. Sometimes, it seems as though the specimen has had it with its location and oozes away.> Will coral dipping help to control the infection? <Doubtful. It *may* have done something useful previous to this condition, but probably not. I would say that the possible benefits don't outweigh the risk of extra stress at this point.> The tank parameters are: Salinity: 1.025 Nitrate: 0 ppm Nitrite: 0 ppm Ammonia: 0ppm Calcium: 450 ppm Temperature: 81 degrees F <All good. > The inhabitants are: 160 pounds of live Caribbean rock 120 pounds of live aragonite sand Fairy Wrasse 2" Carpenter Wrasse 2" Blue bar Pseudochromis 2" Blue Devil Damsel 1" South Seas Devil 1" 2x Blood Shrimp 2" Assortment of snails and hermits. Equipment is: 2x Mags 9.5 2x Aqua clear 701's power heads Dual 400W Double ended 14k MH SeaClone 150 protein skimmer <Do you like this skimmer?> Water changes are done once a week at 10% Here is a pic of it the first day I brought it home. http://i101.photobucket.com/albums/m46/blackhemi35003/DSCF0443.jpg <Looks normal there. I think that all in all, you've got the right idea. I want to thank you again for taking the time to repost your query, and for taking the initiative to help your charge(s) by researching. (It makes me feel. well, vindicated) Daniel Carrel
Sick Cabbage Leather With Fungus at Base? 7/5/05 Dear Crew, <Sorry for the lateness of this reply. misplaced> Thanks for taking the time to answer my question. I have searched the FAQ's over and over but cannot find the answer I am looking for, so here I am. Here goes: I have a sick looking batch of cabbage leather. They don't appear very well today. Found this fungus area with some dark brown on it about 5 days ago. I think this may have started when I upgraded the lights from 83watts Power Compact Fluorescent to 143watts PC. The coral is in the top third of the tank near the lights. <Mmm, I might (have) moved this colony lower. > It was doing great with the new lights and it's polyp extension was incredible. Sorry I don't have a pic of it with the new lights and happy. Here's a pic 3 months ago with 83wattsPC: <Very nice> You can see the base where the leather is shedding as it grows. <Yes, natural> Here is a pic today, with 143watts PC: <Yikes, a bit "burnt"> The piece on the far right is on a separate stalk from the other; which is all one bunch. Close-up of the tissue damage: <Unfortunately pic didn't come through> Could this be caused by the new lights? <Yes. but this is likely only a co-factor. something like other livestock incompatibility is likely at play here.> Is there anything I can do to save it? <At this juncture, mainly time going by. addition of Lugol's, other iodine/ide might help, be worthwhile> How about a soft toothbrush scrubbing in a bowl of tank water and then move down on the bottom? <Mmm, I would not do this> All other corals and fish are beautiful and smiling. The nearest coral is a frogspawn whose head is 6" - 7" away. Thanks, David <A water change, adding some activated carbon in your filter flow path would be good as well. Bob Fenner>
Green Finger problem (?) Hey Gang, how you doin'? well I hope. <very fine with thanks> I finally got some clear pics. of a green finger coral in hopes that someone might be able to diagnose the base of this beauty, I don't have any experience on what the appropriate course of action should be. <a very common problem with "colored" leather corals. They are very sensitive to handling. Please avoid touching them with a bare hand at all times. Handle only the base or tissue with gloved hands otherwise> Its been in my tank for three days, and the base looks worse by the day. <it is highly infectious although looks mild here so far> It looked nice at the store (a little frayed at the base) though I probably shouldn't have purchased, but, I reckon hind sight don't apply here. Thanks for the Your friend in Denver, Scott <simple solution here. Have a VERY sharp razor blade or scalpel ready. A needle with clean nylon thread (or fishing line) ready and waiting to stitch too. A piece of small rock or rubble as well. Move 3/4-1" above the highest necrotic area of the base of the stalk. Cut clean and fast through the animal. You must wear gloves and keep the procedure down to a minimum time of handling. After the cut, look at the exposed trunk and be sure that you cleared the soft and necrotic area. if so, run a stitch or two through the base (no more than an inch from the bottom) and tie it off to a piece of rock. Return it to the exact same place it was in the tank and do not touch it for weeks. Maintain strong water flow and very aggressive skimming in the tank. Small daily doses of iodine may be therapeutic for the tank too (not extra iodine. just your weekly dose broken down to daily). Best regards, Anthony>
Re: Green Finger problem (?) Thanks for the info, it will be easier for me to perform this, "MASH 4077" style surgery, out of the water. Will these be ok? <yep. it all takes mere seconds> Just one clean cut, eh. <correct> Is the corals tissue tough to cut thru, like muscle? or, will it be like a hot knife thru butter? <rather in between. the tissue is quite soft but infused with calcareous spicules> (just paged my head nurse to the emergency room, stat!) Wish me luck, we're goin'. Thanks, Scott <Banzai! Or is it bonsai? Both I suppose. Best of luck! Anthony>
Leather Coral infection Anthony, Working late nights again I see. <yes. back from a trip and feeling guilty at having left our friend Steve high and dry solely with e-mail duty <smile>> Thanks for the advice. I will try cutting in place and supplementing with iodine as you recommended. <excellent. it really is a simple and safe maneuver> Running some AC for a few days after the cut would probably be helpful too? <absolutely. although there is a minor concern of light shock to improved water clarity (yellowing agents) if carbon has not been used for a while (4+ weeks. a bad habit)> Just curious, but do you have a guess as to what caused this damage, (bad water quality, fish/crab nibbling. )? <so many things it could be. although water quality and aggression from another coral (even if not touching. called allelopathy. Commonly from hostile LPS corals like Galaxy, Hammers, bubbles and the like)> Also, thanks for the plug on your book. <no. thank you for tolerating the shameless nature of it <wink>> When my wife and I were looking to buy a good coral book, your book and Borneman's was recommended. We went with the one with the pretty pics. We're suckers for nice color reef photos. -) <understood and agreed. as I am too <G>> But you can never have too many books, and now that we've satisfied our pics Jones, we'll be looking to get your book as well. Thanks! <thank you. best regards, Anthony>
Leather Coral infection WWM Crew, How's everyone doing? <very well. thank you, with hope that you are the same> I have a question regarding my leather toadstool coral. A few days ago, I found a damaged area at the bottom edge of his crown. At first it looked like something took a little triangular cut out of it. That cut has grown larger since, and the tissue is very dark around that area. The rest of the coral looks fine, with polyps still fully extending. I've included pics of the top and the infected area on the bottom (sorry about the quality). <the coral is in overall excellent health> I read in Borneman's book that these corals are fast healers and cutting the infected area off, accompanied by a short FW dip would effect a cure. I just wanted a second opinion. < I concur and have written rather extensively about propagating/cutting this species in my book as well (http://www.wetwebmedia.com/bkcorlproprev.htm)> The coral is firmly attached to 2 largish pieces of LR, and removing the whole thing for the "surgery" would be a lot of work. I just wanted to know if I should leave it be and hope for it to get better, or if cutting away the infected area is the best thing to do. Thanks in advance. <cutting would definitely be best and recommended. Wave the polyps down (fully retracted) and go in with a very sharp pair of scissors and cut a notch out of the crown 1/2 to 1 inch beyond the dark necrotic area. With reasonably good current and protein skimming in the tank. you may not have to remove the animal for dipping. Normal daily iodine doses for the tank in general can be therapeutic as well. Best regards, Anthony>
Alcy Torres, MD. Pediatric Neurologist
Alcy Torres’s passion for and dedication to pediatric neurology has taken him halfway around the world.
His journey began in Ecuador, where he graduated summa cum laude from Central University School of Medicine (Universidad Central del Ecuador) in Quito, Ecuador’s capital. Dr. Torres completed residency training in pediatrics and neonatology in Ecuador at Carlos Andrade Marin Hospital and in pediatrics at Miami (Florida) Children’s Hospital. He then pursued a pediatric neurology residency at Boston Children’s Hospital, where he remained on staff as a full-time faculty member for 12 years.
As a member of Boston Medical Center’s Division of Pediatric Neurology and an assistant professor of pediatrics at Boston University School of Medicine, Dr. Torres, who has been named one of Boston’s best pediatric neurologists by Boston magazine, is committed to strengthening BMC’s presence in pediatric neurology and in the Hispanic community.
At BMC, Dr. Torres has undertaken an array of key initiatives to make that commitment a reality, among them creating the hospital’s first open-access clinic for pediatric neurology, which should enable more children with head injuries, concussions and headaches to be seen quickly.
Dr. Torres will establish the city’s first specifically bilingual pediatric neurology clinic at East Boston Neighborhood Health Center, and at clinics serving the Lawrence-Lowell and Fitchburg regions. This should permit giving care and advising families about neurological disorders in either Spanish or English.
“We want to offer bilingual services so that our Spanish-speaking patients can talk with a physician in their native language,” he says.
Dr. Torres continues to work with his international following of patients from South America and plans to expand this aspect of his practice. “Through professional networks, and publishing and lecturing internationally, I want to strengthen BMC’s presence in pediatric neurology throughout the world, spreading the word about our international program and its exceptional services among the people it has been established to care for,” he says.
As an academic teaching hospital, BMC and its physicians embrace the belief that clinical care, teaching and research result in optimal care. Dr. Torres is well known for his work on the diagnosis and treatment of PANDAS syndrome (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections), an uncommon, but important, neurological disorder that involves rapid onset of obsessive-compulsive disorder associated with group A streptococcal infections.
Dr. Torres also has expertise across a full range of neurological conditions including epilepsy, attention deficit hyperactivity disorder (ADHD) and autism.
Assistant Professor of Pediatric Neurology, Boston University School of Medicine, Boston, MA
Central University School of Medicine (Universidad Central del Ecuador), Quito, Ecuador (1990)
Carlos Andrade Marin Hospital, Ecuador (1990-1993)
Miami Children’s Hospital, Miami, FL (1995-1998)
Neurology/Pediatric Neurology Residency:
Children’s Hospital Boston (1998-2000)
Psychiatry and Neurology – Child Neurology
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS)
Hours: M – F, 9 am– 4 pm
Boston Medical Center
8th Floor, Suite 8C
725 Albany Street
Boston, MA 02118
Hours: M – F, 9 am – 4 pm
771 Albany Street
Boston, MA 02118
One out of five children in Europe is affected by overweight or obesity, European children spend only 5% of their school-time in physical activities and less than 10% of them meet the WHO recommendations on physical activity. Research also shows that low levels of physical activity among children can cause bad performance at school and long-term health problems like adult obesity, heart disease and diabetes. These reports are the harshest and most brutal warnings that something has to be done.
ALCIS: “Action Learning for Children in School”
The ALCIS project (Action Learning for Children in School ) came to life to tackle these key issues by striving to combine action and learning: children are truly at the core of the programme, teachers will guide them throughout the learning process and fitness instructors will support them for the action part. The main objective is to encourage children, their families and friends to be more active, more often… because it is not only fun but an investment for life.
ALCIS, an old appellation for Athens, is one of the most powerful goddesses – mostly known as the goddess of physical prowess and strength. She is a fitting symbol for the project that wants children to reflect about different lifestyle choices in relation to physical activity, stress management and overall well-being with the aim for a long-term impact.
We will cover five EU Member States (Ireland, Italy, Lithuania, Netherlands and United Kingdom) and a total of 50 schools. Nearly 5,000 children will participate in at least four non-competitive group exercise classes. The project will start during the European Week of Sport with a first class group exercise adapted to children between 8 and 12 years old. In the following four weeks children will devote some weekly time to the implementation of the programme, which will end with a final fun group exercise – involving children’s families and friends – at the beginning of November 2015.
The ALCIS project started in May 2015 and will run for 12 months. It is funded with the support of the Erasmus+ Sport Programme of the European Union and it will contribute to the European Week of Sport focus day aimed at education, sport and young people on Tuesday 8 th September 2015. EuropeActive is the leader partner and cooperates with other six not-for-profit associations across Europe in order to develop, implement and ensure the success of the project. These are: eurMind (Belgium), Ireland Active (Ireland), The Wellness Foundation (Italy), The Lithuanian Health and Fitness Association (Lithuania), Fit!vak (Netherlands) and Ukactive (United Kingdom).
EuropeActive formerly known as The European Health & Fitness Association (EHFA), with its origins in 1996 as a not-for-profit organisation, remains as the unique voice for the European health & fitness sector to all of the main EU Institutions. Its mission is to turn back the tide of inactivity and ensure that MORE PEOPLE become MORE ACTIVE as a result of a functional synergy between all of the sector’s actors.
EuropeActive has, among its membership, more than 10,000 facilities, 19 national trade associations, sector leading suppliers, education providers and individuals.
If you’ve been reading our blog (and we hope you have!) you know the numerous benefits that sport and physical activity provide: happiness, more energy, better health, less anxiety …and on and on… what’s not to love! But what we did not stress enough is why it’s so important to start young!
Let’s look at the scary numbers first:
Childhood obesity is no joke – and it’s on the rise in Europe, where according to the WHO, one in three 11 year olds is overweight or obese. Furthermore, European children are 50% less physically active by age 15 than they were at age nine. As computer games, television and mobile devices take up more and more leisure time, physical inactivity is hurting Europe’s children. That’s the reality.
On the other hand, an increasing number of studies are coming out demonstrating the value of incorporating more physical activity into the lives of children. Active kids have been shown to perform better at school and develop more confidence. As we’ve already mentioned. physical activity also helps boost brain power and creativity – these are excellent added benefits for students of all ages. Finally, kids who embrace an active lifestyle are more likely to carry those good habits into adulthood – and that’s a good thing.
This is why encouraging physical activity in the educational environment is so important, and why the European Week of Sport has this setting as one of its Focus Day themes.
There are many ways to encourage kids to #BeActive, but it’s also important to support schools, educators and other decision makers in creating a culture that values more physical activity in the school setting – from nursery to university level.
We’ve shared some tips on our website, but they are just the tip of the iceberg. Have you heard of any innovative programs to get kids active? What do you do to encourage your children to fight inactivity? We would love to hear your thoughts.
Let’s work together to help Europe’s children and youth #BeActive!Share this on
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Abcessed tooth twinge nouns?
Anybody know any good remedies (besides going to the dentist. for obvious reason because it's sunday & there aren't any dental offices open)? Chew on ice, or use Ora Jell, it's cheep and if truth be told works. only drink a large amount of alcohol to hold you over until tomorrow.
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Alfalfa and Joint Pain Relief?
I just wanted to share something near the bloggers My husband is 56 and I am 53 we both suffer from Arthritis and will not go on prescription drugs. So we tried two vitamin supplements called Alfalfa which is a innate anti-inflammatory and does much more for the body.
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Muscle fatigue is a normal byproduct of exercise but can also indicate an injury. Knowing how to tell if you are experiencing simple muscle fatigue or an injury can mean the difference between muscle growth and an ankle brace.Other People Are Reading
Muscle fatigue is the phenomenon of pain or weakness in a muscle after a round of exercise. While exercising, your muscles develop microscopic tears that must be repaired in order for the muscle to grow in strength and size. One good thing about muscle fatigue is that it is fairly predictable and recognizable; its duration also provides a good basic indicator of when it is safe for you to work the sore muscle again.Common Causes
The most common cause of muscle fatigue is exercise; it usually indicates that your workout was able to challenge your muscles adequately to require rest. For fatigue following exercise, proper nutrition and rest are recommended, and you can take an over-the-counter painkiller if your muscles are especially sore.
Another cause of fatigued or weakened muscles is an injury. Mild injuries do not feature sharp, recognizable pains. Often an injury shows as dull pain in a generalized area, similar to exercise-induced muscle fatigue. If you exercised a muscle group longer than three days ago and are still experiencing discomfort and lack of strength, have a health care professional check you out for an injury.Chronic Muscle Fatigue
In addition to exercise and injury, there are a host of chronic medical conditions that affect muscles or motor control, leading to muscle fatigue or weakness. The most common medical conditions that can cause muscle fatigue are colds and influenza; contracting a bug forces your body to put most of its resources into fighting the bacteria or virus, leaving little energy for muscular strength or endurance. Thyroid disease (whether it is an overactive or under-active thyroid) is also a very common cause of muscle fatigue and general lack of strength or energy.
Lifetime chronic illnesses like fibromyalgia, Lou Gehrig's disease and cerebral palsy all limit muscular function, either by affecting the muscle tissue or the motor cortex. These forms of muscle fatigue tend to be elusive and hard to treat, and are often diagnosed early on in life.Misconceptions
Muscle fatigue is not necessarily a bad thing. If you monitor it carefully, fatigue helps you identify your personal limits of exercise and make the most of your rest time. On the other hand, injuries can oftentimes be disguised as simple fatigue, leading to overwork of muscle and perhaps a more severe injury.Benefits of Fatigue
Muscle fatigue is indicative of a good workout. Challenging your muscles is the only way to add muscle mass and improve your physique, so fatigue should be a welcome sign in your workouts and recovery. Also, muscle fatigue provides fairly reliable "pain map" of your body that lets you know which muscles are still recovering and which are safe to work again.
In the name of modern life style people tend to ignore the facts which they should be taken care of. Usually they don't wake up until the side effects descends on them. The fast paced life style is creating dangerous disorders on their health and they begin to feel it only above the age of 40. The junk filled life style has even increased its pace and those who are in their 30s begin to feel it.
There is a old saying that, "we are what we eat". It even holds good today. If you are consuming high calorie foods and not doing enough exercise, it will tell on your health sooner than later. You need to be more careful when you are approaching the age of 40. Diabetes, respiratory infection, high blood pressure, high cholesterol, cardiovascular diseases, cancer and osteoporosis are some main problems, people in this age group confront with. The food habits and unhealthy lifestyle are the main contributors.
The most important period in life is between forty and fifty. It is in this period one ha to bear more responsibilities in their profession as well as family. They have to travel often, attend multiple meetings, manage a team and meet targets or deadlines. Their children will be in their teens and need more care towards their education. The teens need varies from materialistic to emotional. On the other side they have to cope with financial stress. To plan for the imminent arrival of the retirement period and the rising expenses put enormous stress on them.
When nearing 60 the responsibilities will reduce. But the damage done to the health in their busy 40s may be difficult to reverse. Given their busy schedules, these people have little time for any exercise. The stress and strain filled life style, long working hours and unhealthy eating habits complicate matters.
Good and healthy eating habits
As in most families both the parents are working, they find little or no time to cook in the house. They rely heavily on ready to cook food and junk food. These high calorie foods not only affect the health of the parents but also the next generations in their house. Moreover today's job or profession is highly demanding which makes them working for long hours, leaving little time to look after their house and children. This automatically push them to the easiest choice of ready-to-eat junk foods. These foods consists of high calories and has artificial coloring and preservatives. So there is no wonder why these foods are serious health hazards over a period of time. Using readymade foods deprives one of essential vitamins and minerals which are rich in our traditional foods. Vegetables and fruits find no place in their menu.
Frequent consumption of junk foods with irregular intake of meals may contribute to many health problems such as acidity. gastroenteritis, obesity, high cholesterol and high blood pressure. Due to these factors people in this age group complain of fatigue. Those above 40 have no other option but to modify their dietary intake and lifestyle to optimize their health and avoid old age ailments. Take more foods like whole grains and legumes, fruits and vegetables. Lean meat is preferred most and take more protein rich foods. Avoid oily food or reduce to the minimum level. Avoiding bad habits altogether is advisable. Reduce alcohol consumption slowly and quit smoking.
Dietary supplements or nutritional supplements is a must in this world of hectic lifestyle. Remember it is not a choice, but it is a must. Because home-cooking contributes only a little to our daily food and today's fruits and vegetables are contaminated and lack proper nutritional values. So regarding nutrition, there is a huge gap between what we need and what we get. This deprives our inner organs the essential nutrition they need to function normally. As a result they get more aged than our physical age.
Take micronutrient fortified foods. Have a health drink rich in vitamins and minerals. Include more fibrous foods with zero sugar and cholesterol. Plan your daily intake so that your food is balanced with essential nutrients. This helps to get the daily quota of nutrients. A balanced diet helps to improve the immunity level and keep one healthier.
The dietary supplements help to provide nourishment but are not a full substitute to a regular balanced diet. The second most important thing is doing regular exercise. Walking is the best and the easiest form of physical activity. Go for a thirty minute brisk walking, at least four to five days in a week. Regular exercise helps to burn excess calories and avoids becoming obesity. It helps to maintain good health. Take regular health check-ups for sugar level, cholesterol and blood pressure. Change your eating habits. Take more vegetables and fruits and give importance to home cooking. Do regular exercise. The simple thing is, the intake of calories should match the spent calories. Making the necessary adjustments in our routine life will keep away the life style disorders.
Author Information: Detect the mysterious symptoms early and take precautions to avoid irreparable damage to your health.
Studies show that an estimated 85% of people who have Crohn's disease are extremely deficient in certain nutrients. Additionally, some medications given for Crohn's Disease further deplete the bodies already scarce source of nutrients. Needless to say this can worsen the problem
Ablene was formulated to replenish the exact nutrients that Crohn's tends to deplete. Although Ablene is not intended to treat or cure any disease, this supplement can be extremely important for anyone who is experiencing Crohn's.How Does Ablene Work?
Everyday many people may not even know they have Crohn's Disease. It affects your gastrointestinal tract which causes a variety of factors to look for. Some early warning signs are diarrhea, abdominal cramping, severe weight loss, decreased appetite, low-grade fever, and /or rectal bleeding.
After seeing your doctor and being diagnosed with Crohn's Disease, you will need to monitor these three important factors to help with recovery:
Proper Nutrition - Nutrition and supplementation are of tremendous importance for those who have this disease. Ablene is a unique blend specifically formulated to replenish these deficiencies.
Reducing Inflammation - Ablene contains ingredients that inhibit enzymes which activate inflammatory substances.
Controlling Food Allergies - Eliminating foods that cause allergies have been shown to be very helpful. Foods that may cause a reaction include chocolate, dairy products, yeast, cereal grains, fats and artificial sweeteners.
Studies show that nearly 9 out of every 10 people who have Crohn's are nutrient-deficient; this is why Ablene may be so beneficial.Who Can Benefit By Using Ablene?
People of all ages suffering from Crohn's Disease can benefit from Exomine. Whether you are newly diagnosed or have been suffering for awhile with Crohn's Disease or Leaky Gut Syndrome. Ablene can help.Ablene Customer Testimonial
Ablene users have reported some impressive improvements with their Crohn's Disease problems. Below is a letter from an Ablene user who is experiencing similar benefits:
Please keep in mind that although you do not need a prescription to buy our product, the customer below was told by his doctor that Ablene contained ingredients that may be vital to his health :
"After reading about your product on the web, I asked my doctor if it was ok to take Ablene with my medications. He said this product may actually be a vital part of my health during the recovery process, so I decided to order fours bottles. After taking this product I started feeling a lot better. I seemed to feel very groggy and sick, but after taking Ablene, those feelings went away. My doctor agrees with my that this product added some benefits to my recovery."
Order now and discover what others have found in their battle against Crohn's Disease and Leaky Gut Syndrome. The only thing you have to lose is daily problems associated with your illness!Buy Ablene Online
So if you're tired of feeling run down and the other problms you suffer from your Crohn's Disease there's only one question. Aren't you ready to do something about it right now? If you are then Ablene can help you with this and you can get started now by ordering online below. Don't hesitate, get to feeling better physically right now!
by John H. Furlong N.D.Synthesis and Function
L-Carnitine is synthesized in mammalian liver, kidney and brain tissue with lysine, methionine and vitamin C among the required substrates and co-factors. The main body stores are in skeletal and cardiac muscle. Acetyl-L-Carnitine is one of the esters of carnitine and is found along with free plasma carnitine and other acyl esters of varying chain length.1
This mechanism can explain the improved cholinergic neurotransmission and enhanced intracellular energetics observed in ALC research.4, 5 Studies in humans and guinea pigs have shown that supplemental choline is able to decrease the urinary excretion of carnitine while resulting in increased muscle carnitine stores, giving further evidence of this enzymatic linkage.6HIV, CFS and Immunomodulation
HIV infection presents numerous problems related to the carnitines. Human and animal studies show an increased urinary excretion of carnitine when pivampicillin is administered. Animal studies indicate that pivampicillin interferes with myocardial carnitine metabolism subsequent to pivalocarnitine formation in the heart, leading to increased excretion. AZT can result in muscle carnitine depletion, contributing to the lipid accumulation and mitochondrial dysfunction characteristic of this myopathy. Malabsorption may decrease carnitine availability at the cellular level, while HIV-related renal dysfunction may increase excretion of the compound. Thus it is postulated that a subgroup of HIV-infected individuals are burdened with secondary carnitine deficiencies.7-9
Peripheral blood monocytes in AIDS patients are low in intracellular carnitine. Serum levels may be high, low or normal and is therefore unreliable as an indicator of carnitine metabolism.10,11 Peripheral blood monocytes from HIV-infected individuals were cultured with the mitogen PHA and ALC for 48 hours. PHA-induced proliferation was significantly improved and a dimunition of TNF-a released by the cultured monocytes was also observed to be significant. As TNF-a has a key role in HIV-mediated apoptotic cell destruction, decreased levels of this cytokine may have protective effects on CD4+ cell populations.12
Research has examined the effects of ALC in various dementias, cognitive defects and age-related disorders. These observations represent the clearest understanding and application of ALC in clinical practice. It has been established that ALC traverses the blood-brain barrier efficiently, with CSF concentrations increasing significantly via both an I.V. and oral route in patients with severe dementia.18 There are multiple mechanisms of action responsible for ALC-induced CNS changes: enhanced cholinergic neurotransmission, neuronotrophic effects (via binding of cortisol and increased nerve growth factor production in the hippocampus),muscarinic receptor changes as well as decreased free radical generation and lipofuscin deposits in animal models.18,19Depression/Cortisol Levels Diabetes/Neurological Symptoms
Peripheral neuropathy associated with diabetes mellitus (DM) is extremely common, approaching over 28% of some populations.27 Various mechanisms of neuronal damage have been postulated, including polyol pathway generation of sorbitol and free radical damage. Reduced nerve conduction velocities occur in DM and have led to experimental models assessing this function in rats. Animals given ALC after experimental diabetes induction have improved nerve conduction velocities.28,29 Correction of abnormal enteric peptides associated with autonomic neuropathies was also observed in animal models. 30
Human studies also show beneficial effects of ALC in neuropathies. Intramuscular administration of the compound given to 63 patients with painful neuropathy for 15 days showed significant improvement in motility and subjective measures.31 A small double-blind study in humans again using the I.M. route of administration, showed highly significant improvement in painful neuropathies. Again the anti-oxidant function of ALC was believed to be a likely mechanism of action.32Aging and Repair of Neuronal Tissue
The changes which occur in CNS tissue of aged laboratory animals as well as tissue samples from humans have both structural and metabolic components. One of these changes is the reduced surface contact area found in dendritic networks. The capacity for recovery and expansion of the dendritic network does, however, remain present in older individuals.33 ALC was administered orally to rats over a 6-22 month period after which brain synaptic tissue was evaluated for size and number of junctions. The expected decline in synaptic contact area was partially reversed in the treatment groups.34
Human studies confirm the impact ALC can have on neurological function. Bonavita observed significant improvements in aged subjects participating in a 40-day, double-blind trial with oral ALC, 3 g/day. The first changes tended to relate to spatial recognition, judgment and depression; second-phase changes centered on short and long-term memory, self-care, and sociability. Intravenous administration of ALC elicited increased visual evoked potential amplitude among both healthy volunteers and patients with various dementias. The changes persisted over a 50-90 minute period, showing the rapid clearing of the substance by renal tubular mechanisms. 35
Clinical applications of the neuro-regenerative effects of ALC were investigated in an experimental model of post-ischemic cerebral injury. In a simulation of the cerebral ischemia present after cardiac arrest, ALC was administered intravenously to canines. Their recovery was assessed via neurologic deficit scores and neurochemical markers. The ALC group fared significantly better than controls in post-ischemic recovery parameters. 37Cardiovascular Effects
Cerebral and peripheral circulation are apparently affected differently by administration of ALC. Ten patients with recent cerebral vascular accidents were given ALC intravenously which resulted in acute enhancement of cerebral blood flow to areas of ischemia via sensitive SPEC tomography assessments.40 In evaluation of patients with peripheral arterial occlusive disease, two studies show that the effect of carnitine esters on improved walking distance was due to metabolic vs. hemodynamic changes and that L-Propionylcarnitine was clearly superior to L-Carnitine in this effect. These studies demonstrate the ability of carnitine esters to positively influence tissue energetics which may prove beneficial in a chronic administration model.41,42Acetyl-L-Carnitine and Ethanol
A number of interesting reports on the relationship between hepatic detoxification of ethanol and carnitines have been produced. It is observed that pretreatment of both rats and chickens with carnitines resulted in a prolonged half-life of ethanol in the blood.43,44 Additionally, a protective effect on prenatal ethanol damage to thalamic and cortical regions in rats was observed with administration of ALC.47 Two studies by Cha and Sachan with isolated rat hepatocytes harvested after pretreatment with ALC elucidate the mechanism of these interesting effects. An inhibition of alcohol dehydrogenase was present and significantly increased when the nicotinamide adenine dinucleotide:ALC ratio was low. It was also shown that L-Carnitine itself was much less effective at producing this inhibition.47,48 As a final addition to these findings of great therapeutic interest, oral administration of ALC was shown to improve the cognitive impairments of 55 chronic alcoholics.48Adverse Effects/Interactions
In addition to the minor adverse reactions to ALC from the above human trials, a cautionary note may be extrapolated from rat studies whereby an intracerebral injection of ALC induced epileptic phenomena.51 Another researcher found however, no changes in cell excitability and no epileptic discharges in ALC- treated rats exposed to high-frequency stimulation.19 From the clinical and experimental research, it seems prudent to:
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The statements contained in this article have not been evaluated or approved by the U.S. Food & Drug Administration (FDA).